You Only Die Once9 Apr 2023

Hospital and Specialist in One Year

Prognostication is a complicated process. Physicians rely on many pieces of data to provide prognostic information and time frames for patients. Knowing the disease state, stage and how this will change over time as the disease advances is important for pts and families to know. Disease occurrence and progression many times is no ones fault and we need to resist to look for a place to place blame. It is not about giving up but about patients making choices and having the ability and time to share thoughts with their Health Care Surrogate. Understanding the outcomes of offered procedures is crucial information for patients to have so they can consider what life and function might look like over time. Patients should have time to consider this information and accurate prognostication can provide this time. One basic method that is not necessarily disease specific is the rules of threes. More than 3 hospital admissions in a year for the same organ system. More than 3 episodes of serious infections requiring a hospital admission. More than 3 specialists that a patient needs to see yearly because of serious medical issues. There are many disease specific prognostic data points but these are some broad areas that provide evidence of disease progression.

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