Functional Decline Over 1-year Follow-up in a Multicenter Cohort of Polypathological Patients: A New Approach to Functional Prognostication
| Autor: | Lourdes Moreno-Gaviño, José Murcia-Zaragoza, Alberto Ruiz-Cantero, Máximo Bernabeu-Wittel, Bosco Barón-Franco, C. Ramos-Cantos, Antonio Alemán, Aurelio Fuertes, Manuel Ollero-Baturone |
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| Rok vydání: | 2012 |
| Předmět: |
education.field_of_study
medicine.medical_specialty Activities of daily living multimorbidity Bathing business.industry Population 1 year follow up frailty lcsh:Geriatrics polypathology Logistic regression Triage functional prognostication Surgery lcsh:RC952-954.6 Internal medicine functional decline Cohort Medicine Geriatrics and Gerontology Functional decline education business |
| Zdroj: | International Journal of Gerontology, Vol 6, Iss 2, Pp 68-74 (2012) |
| ISSN: | 1873-9598 |
| DOI: | 10.1016/j.ijge.2011.09.038 |
| Popis: | Background: Little is known about the fitness of the available tools in predicting functional decline of polypathological patients (PPs). Our objective was to assess accuracy of the Triage Risk Screening Tool (TRST), the Variable Indicative of Placement risk (VIP) and to develop a specific functional prognostic index adjusted to this population in a multicenter cohort of hospital-based PP. Methods: Prospective 12-month follow-up study of PPs from 36 hospitals. Functional decline was defined as loss of ≥20 points on Barthel’s index (BI). Accuracy of TRST/VIP was assessed by calibration/discrimination tests. Development of the new score was performed by dividing into a derivation cohort (constructing the index by logistic regression), and a validation cohort (in which calibration/discrimination of the index were tested). Results: Nine hundred and fifty-eight patients from the 1632 included survived during follow-up. Basal/12-month BI was 85/70, respectively. Mean fall in BI score was 11.7±24 points [353 (36.8%) fell by ≥20 points]. The activities for daily living that declined most frequently were toilet use, grooming, dressing and bathing. TRST/VIP fitted well but their discrimination power was poor (area under the curve=0.49 and 0.46, respectively). A simplified PROFUNCTION index was derived containing seven items (≥85 years, neurological condition, osteoarticular disease, III–IV functional class of dyspnea, ≥4 polypathology categories, basal BI |
| Databáze: | OpenAIRE |
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