• Pamela S Harris, Tapati Stalam, Kevin A Ache, Joan E Harrold, Teresa Craig, Joan Teno, Eugenia Smither, Meredith Dougherty, and David Casarett.
• 1 Kansas City Hospice and Palliative Care , Kansas City, Missouri.
• J Palliat Med. 2014 Aug 1;17(8):894-8.

ObjectiveTo determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months.DesignElectronic health record-based retrospective cohort study.SettingPatients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness).ParticipantsHospice patients.Main Outcome MeasuresMortality at 6 months following hospice admission.ResultsAmong 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%.ConclusionsHospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.

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