The Surprise Question in Older Hospitalized Patients: To Use or Not to Use?

Identifying patients in the palliative phase is challenging but important, as timely and proactive palliative care can improve quality of life.1 One way of determining whether a patient is in the palliative phase is via the Surprise Question, a widely recommended single-item tool (Would I be surprised if this patient died in the next 12 months?). However, there is a distinct lack of studies into the performance of the Surprise Question in older hospitalized patients. Currently, relatively few frail older patients have the opportunity to discuss their end-of-life care with their physician, even though most would appreciate such a conversation.