CRISTAL TEST- PREDICTING ELDRLY DTH WITHIN A MONTH

Table 3

Proposed components of the Criteria for Screening and Triaging to Appropriate aLternative care tool to identify end-of-life status before hospital admission

□	Age ≥6542638586 AND
□	Being admitted via emergency this hospitalisation96 (associated with 25% mortality within 1 year)
□	OR Meets 2 or more of the following deterioration criteria on admission 30 32 98
□	1. Decreased LOC: Glasgow Coma Score change >2 or AVPU=P or U
□	2. Systolic blood pressure <90 hg="" mm="" td="">
□	3. Respiratory rate <5 or="">30
□	4. Pulse rate <40 or="">140
□	5. Need for oxygen therapy or known oxygen saturation <90 class="xref-bibr" id="xref-ref-33-3" span="" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-size: 1.2rem; font-weight: bolder; line-height: 1.4em; vertical-align: 0.6rem;">33

□6. Hypoglycaemia: BGL99 □7. Repeat or prolonged seizures99 □8. Low urinary output (<15 class="xref-bibr" h="" id="xref-ref-100-1" kg="" ml="" or="" span="" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-size: 1.2rem; font-weight: bolder; line-height: 1.4em; vertical-align: 0.6rem;">100 □OR MEW or SEWS score >4 46 79 ANDOTHER RISK FACTORS /PREDICTORS OF SHORT-MEDIUM-TERM DEATH □Personal history of active disease (at least one of): 18 25 42 46 63 101 102  □ Advanced malignancy  □ Chronic kidney disease  □ Chronic heart failure  □ Chronic obstructive pulmonary disease  □ New cerebrovascular disease  □ Myocardial infarction  □ Moderate/severe liver disease □Evidence of cognitive impairment (eg, long term mental disorders, dementia, behavioural alterations or disability from stroke) 25 42 63 73 83 □Previous hospitalisation in past year10 □Repeat ICU admission at previous hospitalisation95 (associated with a fourfold increase in mortality) □Evidence of frailty: 2 or more of these: 42 46 63 85 89 98  □ Unintentional or unexplained weight loss (10 lbs in past year)18 83 85  □ Self-reported exhaustion (felt that everything was an effort or felt could not get going at least 3 days in the past week)85  □ Weakness (low grip strength for writing or handling small objects, difficulty or inability to lift heavy objects >=4.5Kg)63  □ Slow walking speed (walks 4.5 m in >7 s)  □ Inability for physical activity or new inability to stand46 98 □Nursing home resident/in supported accommodation33 46 □Proteinuria on a spot urine sample: positive marker for chronic kidney disease & predictor of mortality: >30 mg albumin/g creatinine56 103 □Abnormal ECG (Atrial fibrillation, tachycardia, any other abnormal rhythm or ≥5 ectopics/min, Changes to Q or ST waves18 42 97

• ICU, intensive care unit; MEW, modified early warning.