Triple threat of mortality among advance cancer patients presenting to an emergency department.

138Background: Early identification of cancer patients with short survival will help address end of life issues and avoid costly interventions. Dyspnea, delirium, and poor performance are known to predict short survival in palliative care. Our goal is to test whether these 3 conditions could predict mortality in the emergency department (ED) setting because a shorter tool would be practical. Methods: We randomly selected 243 English-speaking patients with advanced cancer who presented to the MD Anderson hospital ED and who were judged clinically stable. Patients were assessed for the presence of delirium(Confusion Assessment Method and Memorial DeliriumAssessment Scale), poor performance (Eastern Cooperative Oncology Group score 3 or 4), and dyspnea (MD Anderson Symptom Inventory shortness of breath score > 5). All measures (survival and symptom) were available for 212 patients. Triple threat was defined as the presence of one of more of the 3 conditions: delirium(by either tool), poor performance, or ...