1. Development and validation of a prognostic index for 6- and 12-month mortality in hospitalized older adults.
- Author
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Gallego González, Eva, Ortiz Alonso, Francisco Javier, Vidán Astiz, Maria Teresa, Soria Felix, Selene, García Cárdenas, Verónica, Omonte Guzmán, John, Abizanda, Pedro, Valadés Malagón, Maria Isabel, Oreja Sevilla, Silvia, and Serra Rexach, José Antonio
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GERIATRIC assessment , *PRESSURE ulcers , *CALIBRATION , *DISCRIMINANT analysis , *EXPERIMENTAL design , *GRIP strength , *HEART failure , *LENGTH of stay in hospitals , *LONGITUDINAL method , *RESEARCH methodology , *MULTIVARIATE analysis , *PROBABILITY theory , *PROGNOSIS , *SEX distribution , *SURVIVAL analysis (Biometry) , *TUMORS , *BODY mass index , *DISCHARGE planning , *RECEIVER operating characteristic curves , *RESEARCH methodology evaluation , *DATA analysis software , *DESCRIPTIVE statistics , *HOSPITAL mortality , *OLD age - Abstract
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 < 0.001) for each tertile in both scores. 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. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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