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American Journal of Hospice and Palliative Medicine®
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Prediction of Patient Survival by Healthcare Professionals in a Specialist Palliative Care Inpatient Unit: A Prospective Study

Feargal Twomey, MB, MRCPI

Marymount Hospice, St Patrick's Hospital, Wellington Road, Cork, Ireland, uatuama1{at}ireland.com

Norma O'Leary, MB, MRCPI

Marymount Hospice, St Patrick's Hospital, Wellington Road, Cork, Ireland

Tony O'Brien, MB, FRCPI

Marymount Hospice, St Patrick's Hospital, Wellington Road, Cork, Ireland

Accurate prognostication is an enormous challenge for professionals caring for patients with advanced disease. Few studies have compared the prognostic accuracy of different professional groups within a hospice setting. The aim of this study was to compare the ability of 5 professional groups to estimate the survival of patients admitted to a specialist palliative care unit. No group accurately predicted the length of patient survival more than 50% of the time. Nursing and junior medical staff were most accurate while care assistants were least accurate. When in error, senior clinical staff tended to under-estimate survival. Independent mobility on admission was the only variable predictive of length of survival. Thus, professional groups differ in their prognostic accuracy. An awareness of a group's propensity to over- or under-estimate prognosis should be incorporated into future work on prognostication models.

Key Words: prognostication • palliative care • hospice • survival prediction • multidisciplinary • performance status

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 2, 139-145 (2008)
DOI: 10.1177/1049909107312594
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