October 8, 2019

Association of Emergency Clinicians' Assessment of Mortality Risk With Actual 1-Month Mortality Among Older Adults Admitted to the Hospital

In this prospective cohort study including 10,737 older adults who visited the ED, emergency clinicians’ response of no to the question Surprise Question (“Would you be surprised if your patient died in the next one month?”) was used to predict 1 month mortality

In a multivariable model, the odds of death at 1 month were higher in patients for whom clinicians would not be surprised if the patient died compared with patients for whom clinicians answered that they would be surprised if the patient died in the next 1 month (odds ratio, 2.4 [95% CI, 2.2-2.7]; P < .001).

However, the diagnostic test characteristics of the surprise question were poor (sensitivity, 20%; specificity, 93%; positive predictive value, 43%; negative predictive value, 82%)

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Ouchi et al JAMA Netw Open. 2019;2(9)