Thursday, September 15, 2005
Review of prognosis in non-cancer diagnoses
May's Age & Aging has a review of predicting prognosis in elderly patients dying of non-malignant diseases. The review is quite comprehensive and well written & has a fantastic pages-long table summarizing all their reviewed articles--quite a handy reference. There are, of course, no big revelations here & one of their conclusions is essentially that the NHPCO guidelines are ineffective in discriminating the 6 month "hospice elibible" people with CHF, COPD, dementia, etc. Part of me thinks we should give up--that asking who in this population is going to die within 6 months is an artificial issue created by the Medicare hospice benefit--and that the "real," "patient-centered" question here is who in this population is appropriate for comprehensive palliative care....
