Format

Send to

Choose Destination
J Palliat Med. 2010 Jul;13(7):837-40. doi: 10.1089/jpm.2010.0018.

Prognostic significance of the "surprise" question in cancer patients.

Author information

1
West Virginia University, Morgantown, West Virginia 26506, USA. amoss@hsc.wvu.edu

Abstract

BACKGROUND:

Physicians consistently overestimate survival for patients with cancer. The "surprise" question--"Would I be surprised if this patient died in the next year?"--improves end-of-life care by identifying patients with a poor prognosis. It has not been previously studied in patients with cancer.

OBJECTIVE:

To determine the efficacy of the surprise question in patients with cancer.

DESIGN:

Prospective cohort study.

SETTING:

Academic cancer center.

PATIENTS:

853 consecutive patients with breast, lung, or colon cancer.

MEASUREMENTS:

Surprise question classification and patient status at 12 months, alive or dead, by surprise question response.

RESULTS:

Oncologists classified 826 of 853 prospective patients with cancer (97%) with 131 (16%) classified into the "No" group and 695 (84%) into the "Yes" group. In multivariate analysis, a "No" response identified patients with cancer who had a seven times greater hazard of death in the next year compared to patients in the "Yes" group (HR 7.787, p < 0.001).

LIMITATIONS:

Single center study.

CONCLUSION:

The surprise question is a simple, feasible, and effective tool to identify patients with cancer who have a greatly increased risk of 1-year mortality.

PMID:
20636154
DOI:
10.1089/jpm.2010.0018
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center