LAUSR

Purpose: To examine the ability of existing triggers for intensive care unit (ICU) palliative care consultation to predict 6‐month mortality, and derive new triggers for consultation based on risk factors for 6‐month mortality. Materials and methods: Retrospective cohort study of NY state residents who received intensive care, 2008–2013. We examined sensitivity and specificity of existing triggers for predicting 6‐month mortality and used logistic regression to generate patient subgroups at high‐risk for 6‐month mortality as potential novel triggers for ICU palliative care consultation. Results: Of 1,019,849 patients, 195,847 (19.2%) died within 6 months of admission. Existing triggers were specific but not sensitive for predicting 6‐month mortality, (sensitivity 0.3%–11.1%, specificity 96.5–99.9% for individual triggers). Using logistic regression, patient subgroups with the highest predicted probability of 6‐month mortality were older patients admitted with sepsis (age 70–79 probability 49.7%, [49.5–50.0]) or cancer (non‐metastatic cancer, age 70–79 probability 51.5%, [51.1–51.9]; metastatic cancer, age 70–79 probability 60.3%, [59.9–60.6]). Sensitivity and specificity of novel triggers ranged from 0.05% to 9.2% and 98.6% to 99.9%, respectively. Conclusions: Existing triggers for palliative care consultation are specific, but insensitive for 6‐month mortality. Using a data‐driven approach to derive novel triggers may identify subgroups of patients at high‐risk of 6‐month mortality. HIGHLIGHTSExisting palliative care triggers are specific for 6‐month mortality.Older patients with severe sepsis or cancer are at high risk of 6‐month mortality.These populations may also be appropriate for palliative care consultation.