Development and validation of a prognostic index for 6- and 12-month mortality in hospitalized older adults
| Autor: | José Antonio Serra Rexach, John Omonte Guzmán, Pedro Abizanda, Selene Soria Felix, Francisco Javier Ortiz Alonso, Verónica García Cárdenas, María Teresa Vidán Astiz, Eva Gallego González, Silvia Oreja Sevilla, Maria Isabel Valadés Malagón |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Risk Gerontology Aging medicine.medical_specialty Health (social science) Frail Elderly 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Grip strength 0302 clinical medicine Risk Factors Internal medicine medicine Dependent Ambulation Health Status Indicators Humans 030212 general & internal medicine Mortality Geriatric Assessment Male gender Survival analysis Aged Aged 80 and over Estimation Receiver operating characteristic business.industry After discharge Prognosis medicine.disease Survival Analysis Patient Discharge Hospitalization Logistic Models ROC Curve Heart failure Multivariate Analysis Female Geriatrics and Gerontology business |
| Zdroj: | Archives of Gerontology and Geriatrics. 73:269-278 |
| ISSN: | 0167-4943 |
| DOI: | 10.1016/j.archger.2017.07.008 |
| Popis: | Background/aim Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non–disease–specific tool to predict individual mortality risk after hospital discharge in older adults. Methods Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later. Determinants of mortality were obtained. Using multivariable analysis, beta coeffcicients were calculated to build 2 scores able to predict mortality at 6 and 12 months after discharge. The scores were tested on a sample comprising 75% of the patients, who were randomly selected; they were validated using the remaining 25%. Discrimination was assessed using ROC curves. Scores were calculated for each patient and divided into tertiles. Survival analysis was performed. Results Determinants of mortality at 6 months were dependent ambulation at baseline, full dependence at discharge, length of stay, pluripatology, pressure ulcers, low grip strength, malignacy, and male gender. At 12 months the determinants were: dependent amblation at baseline, full dependence at discharge, pluripatology, low BMI, low grip strength, heart failure, malignacy, and male gender. Discrimination and calibration were excellent. Survival analysis demonstrated different survival trajectories (p Conclusions Our incices provide accurate prognostic information in elderly patients after discharge. They can be calculated easily, quickly and do not require technical or laboratory support, thus endorsing their value in dalily clinical practice. |
| Databáze: | OpenAIRE |
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