ePrognosis - Fischer 1 Year CARING Index

Fischer 1 Year CARING Index

Risk Calculator

1. How old is your patient?

2. Does your patient have a primary diagnosis of cancer?

Yes No

3. How many times has your patient been admitted to the hospital for a chronic illness in the last year?

4. Is your patient resident in a nursing home?

Yes No

5. Has your patient been admitted to the ICU with multi-organ failure during this hospitalization?

Yes No

Yes No

Total Points: 0

The index was developed in 435 patients admitted to the medical service of a US Department of Veterans Affairs hospital in 1999 (mean age 63 years, 2% female, 69% white, 26% 1-y mortality).
The index was internally validated in 438 patients from the same sample.
This index was externally validated in 427 patients from a university hospital in 2005 (mean age 54, 50% female).
Discrimination: This risk calculator sorts patients who died from patients who lived correctly 82% of the time (c-statistic). An error rate of 26% was reported in the validation cohort. No c-statistic was reported for the external validation.
Citation: Fischer SM, Wendolyn SG, Sauaia A, Sung-Joon M, Kutner JS, and Kramer A. A practical tool to identify patients who may benefit from a palliative approach: The CARING criteria. J Pain Sym Man. 2006;31(4):285-292.
Additional Validation Study: Youngwerth J, Fischer S, Min S-J, Kutner J. Who would benefit from a palliative care consult in the hospital? CARING about prognosis (CAP) (313-C). J Pain Symptom Manage. 2011;41(1)192-3.

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The information provided on ePrognosis is designed to complement, not replace, the relationship between a patient and his/her own medical providers. ePrognosis was created with the support of the Division of Geriatrics at the University of California San Francisco. However, its content is strictly the work of its authors and has no affiliation with any organization or institution. This web site does not accept advertisements. If you reproduce the material on the website please cite appropriately. For feedback and questions regarding the site please email Sei Lee, MD (sei.lee@ucsf.edu), Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu).