{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:30:15Z","timestamp":1766068215888,"version":"3.45.0"},"reference-count":52,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Federal Government of Lower Austria","award":["500430025","RTO_025"],"award-info":[{"award-number":["500430025","RTO_025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Early integration of palliative care (PC) improves outcomes for patients with life-limiting diseases (LLDs). This study evaluated the effectiveness of the Palliative Care and Rapid Emergency Screening (P-CaRES) tool\u2014originally developed for emergency settings\u2014in identifying unmet PC needs among patients admitted to internal medicine wards. Methods: In this retrospective study, the P-CaRES tool was applied to medical records of patients with LLDs. Demographic and clinical data were extracted from charts. Logistic regression identified predictors of PC receipt; survival was analyzed using Kaplan\u2013Meier estimates and log-rank tests. Results: Among 2509 patients screened, 631 (23.9%) had at least one LLD. Of these, 451 (71.5%) were identified as having PC needs. However, only 132 (20.9%) received PC services\u2014126 with documented need and 6 without. Advanced cancer (OR = 6.46, p &lt; 0.001), a positive response to the surprise question (OR = 4.88, p = 0.008), and frequent hospitalizations (OR = 2.24, p &lt; 0.001) predicted PC receipt. Median survival declined with increasing disease burden (10 vs. 372 days for patients with \u22653 vs. 1 LLD), unmet PC needs (85 vs. 1383 days), and a \u201cyes\u201d response to the surprise question (79 vs. 1598 days) (all p &lt; 0.001). Conclusions: The P-CaRES tool effectively identified PC needs in patients with LLDs, including those with cancer. Clinical indicators such as frequent hospital admissions, a positive response to the surprise question, and multimorbidity predicted both the need for PC and shorter survival. Nonetheless, substantial gaps existed between identified needs and PC delivery\u2014especially for non-cancer patients. Structured screening and timely referrals may bridge this gap and improve care for seriously ill individuals.<\/jats:p>","DOI":"10.3390\/jcm14124206","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T06:19:28Z","timestamp":1749795568000},"page":"4206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Using the P-CaRES Tool to Identify Palliative Care Needs in Patients with Life-Limiting Diseases: An Analysis of Internal Medicine Admissions"],"prefix":"10.3390","volume":"14","author":[{"given":"Luise","family":"Fidelsberger","sequence":"first","affiliation":[{"name":"Division of Palliative Care, Division of Internal Medicine 2, University Hospital Krems, 3500 Krems, Austria"},{"name":"Karl Landsteiner University of Health Sciences, 3500 Krems, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Health Economics, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-7079","authenticated-orcid":false,"given":"Gudrun","family":"Kreye","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Division of Internal Medicine 2, University Hospital Krems, 3500 Krems, Austria"},{"name":"Karl Landsteiner University of Health Sciences, 3500 Krems, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Meran","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 2, Hospital of St. John of God, 1020 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-5028","authenticated-orcid":false,"given":"Rudolf","family":"Likar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medicine, Klinikum Klagenfurt am W\u00f6rthersee, 9020 Klagenfurt, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0929-8988","authenticated-orcid":false,"given":"Raphael","family":"van Tulder","sequence":"additional","affiliation":[{"name":"Karl Landsteiner University of Health Sciences, 3500 Krems, Austria"},{"name":"Division of Internal Medicine 1, University Hospital Krems, 3500 Krems, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haro","family":"Stettner","sequence":"additional","affiliation":[{"name":"Institute for Statistics, Alpen-Adria University Klagenfurt, 9020 Klagenfurt, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva Katharina","family":"Masel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Clinical Division of Palliative Medicine, Medical University Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-2412","authenticated-orcid":false,"given":"Josef","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Division of Internal Medicine 2, University Hospital Krems, 3500 Krems, Austria"},{"name":"Karl Landsteiner University of Health Sciences, 3500 Krems, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-3037","authenticated-orcid":false,"given":"Nguyen-Son","family":"Le","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Division of Internal Medicine 2, University Hospital Krems, 3500 Krems, Austria"},{"name":"Karl Landsteiner University of Health Sciences, 3500 Krems, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Maresova, P., Javanmardi, E., Barakovic, S., Barakovic Husic, J., Tomsone, S., Krejcar, O., and Kuca, K. 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Synth."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T12:58:47Z","timestamp":1763470727000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,13]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14124206"],"URL":"https:\/\/doi.org\/10.3390\/jcm14124206","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,6,13]]}}}