Sensitivity of scales as prognostic indicators and palliative needs in elderly patients with non-oncological diseases

Abstract

Palliative care has a multidisciplinary approach that improves the quality of life. Traditionally, palliative care focused on oncology patients; however, it can be applied to in-patients with advanced chronicity, for whom there is a lack of validated instruments to assess and determine palliative care. This study aims to describe the sensitivity of the NECPAL, PROFUND, and Charlson scales for assessing and determining mortality and palliative care in older adults with chronic non-oncologic disease through a narrative review in the BMJ, Elsevier, PubMed, HINARI, and SciELO databases. Original articles, review articles, and clinical trials in Spanish and English published in the last five years were included. The NECPAL tool identifies patients who are candidates for palliative care and measures the prevalence of palliative care needs. The PROFUND index is a multidimensional prognostic score that estimates the risk for one-year mortality in patients with advanced chronicity. As a prognostic tool, it assesses 30-day mortality risk. The Charlson comorbidity index, created to predict one-year mortality risk after hospitalization, is an excellent predictor in hospitalized patients, does not require laboratory tests, and is applicable in various clinical scenarios.