{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:46:48Z","timestamp":1789645608364,"version":"4.0.0"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Palliative care is essential in intensive care, improving symptom control, quality of life, and reducing hospital stays without increasing mortality. However, early identification of patients who could benefit remains a major challenge. This study aimed to evaluate the NECesidades PALiativas (NECPAL) tool\u2019s effectiveness in identifying ICU patients in Italy with PC needs. Methods: This prospective observational study was conducted from March 2024 to February 2025. Adult ICU patients (\u226518 years), admitted for at least 24 h and meeting NECPAL eligibility criteria (e.g., cancer, COPD, heart failure, dementia, and frailty), were evaluated using the NECPAL tool. Results: A total of 85 patients were enrolled; 28 (32.9%) were classified as NECPAL-positive and 57 (67.1%) as NECPAL-negative. NECPAL-positive patients had a significantly higher ICU mortality rate (32.1%) compared to NECPAL-negative patients (1.8%) (p &lt; 0.001). The median ICU length of stay was slightly longer for NECPAL-positive patients [11.0 days (IQR: 8.0\u201316.2)] versus NECPAL-negative patients [10.0 days (IQR: 5.0\u201314.0)], though not statistically significant. Multivariable Firth penalized logistic regression confirmed NECPAL positivity as an independent predictor of ICU mortality (OR 19.55; 95% CI: 3.06\u2013124.93; p &lt; 0.001). Conclusions: In this study, NECPAL identified about one-third of ICU patients as having palliative care needs, who also showed a higher mortality risk. Integration with ICU severity scores may improve early recognition of these needs, warranting validation in larger multicenter studies.<\/jats:p>","DOI":"10.3390\/jcm14176244","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T10:55:37Z","timestamp":1756983337000},"page":"6244","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Early Detection of Palliative Care Needs in Critically Ill Patients Using the NECPAL Tool"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5027-5318","authenticated-orcid":false,"given":"Savino","family":"Spadaro","sequence":"first","affiliation":[{"name":"Emergency Department, Azienda Ospedaliera Universitaria di Ferrara, Aldo Moro, 8, 441232 Ferrara, Italy"},{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Azzolina","sequence":"additional","affiliation":[{"name":"Biostatistics and Clinical Trial Methodology Unit, Clinical Research Center DEMeTra, Department of Translational Medicine, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Vuan","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Colasanto","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Manzetto","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Busnardo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Filieri","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Persefoni","family":"Fagogeni","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ganzaroli","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viorel","family":"Gamanji","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Poles","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Complessa Cure Palliative AULSS3 Serenissima, Venezia Mestre, Cappuccina, 129, 30172 Venezia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Spinazzola","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-6121","authenticated-orcid":false,"given":"Carlo Alberto","family":"Volta","sequence":"additional","affiliation":[{"name":"Emergency Department, Azienda Ospedaliera Universitaria di Ferrara, Aldo Moro, 8, 441232 Ferrara, Italy"},{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9739-4082","authenticated-orcid":false,"given":"Gaetano","family":"Scaramuzzo","sequence":"additional","affiliation":[{"name":"Emergency Department, Azienda Ospedaliera Universitaria di Ferrara, Aldo Moro, 8, 441232 Ferrara, Italy"},{"name":"Department of Translational Medicine, University of Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta","family":"Gulmini","sequence":"additional","affiliation":[{"name":"Cure Palliative\/Hospice, Azienda Ospedaliera Universitaria di Ferrara, Cavallotti 347, 44100 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/014107680509801111","article-title":"Palliative Care in Non-Malignant Diseases","volume":"98","author":"Traue","year":"2005","journal-title":"J. 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