Prognosestellung bei schwer kranken Menschen
Stiel S, Radbruch L (2014)
Publication Type: Journal article
Publication year: 2014
Journal
Original Authors: S. Stiel, L. Radbruch
Book Volume: 15
Pages Range: 109-121
Issue: 03
Journal Issue: 3
Abstract
Prognosis of the remaining life time is challenging and may be ethically problematic in the care of severely ill or dying patients. The question “how much time do I have left?” includes a range of different aspects that might be essential within the context of the patient’s life. Health care professionals need to answer that question as well, as it has a major role in treatment decisions.
Prognosis based on the clinical knowledge of the physician is overly optimistic in 80 % of cases, often overestimating survival times by the factor of five. In the German language area two prognostic instruments have been used in palliative care: the Palliative Prognostic Index (PPI) and the Palliative Prognostic Score (PaP-S). However, it is not clear whether the value of these instruments is for the evaluation of patient groups rather than individual patients.
In clinical practice the use of the “surprise question” is recommended, as it can provide a warning for shorter as well as for longer time frames which patients may have shorter survival times than previously assumed. The physician asks himself “Would I be surprised if this patient dies in the next year/next week/next hours?” If this is answered with “No, I would not be surprised” the probability is high that the patient will die within this time range. The surprise question can also be used for non-cancer diseases where the prognostic scores have not been tested adequately, and it enables the health care professionals to align communication and care planning with the prognosis of the patient.
Involved external institutions
Germany (DE)How to cite
APA:
Stiel, S., & Radbruch, L. (2014). Prognosestellung bei schwer kranken Menschen. Zeitschrift für Palliativmedizin, 15(3), 109-121. https://doi.org/10.1055/s-0034-1370017
MLA:
Stiel, Stephanie, and Lukas Radbruch. "Prognosestellung bei schwer kranken Menschen." Zeitschrift für Palliativmedizin 15.3 (2014): 109-121.
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