Pilotto, Alberto, Veronese, Nicola, Daragjati, Julia, Cruz-Jentoft, Alfonso J., Polidori, Maria Cristina, Mattace-Raso, Francesco, Paccalin, Marc, Topinkova, Eva, Siri, Giacomo ORCID: 0000-0001-8006-0668, Greco, Antonio, Mangoni, Arduino A., Maggi, Stefania, Ferrucci, Luigi, Musacchio, Clarissa, Custureri, Romina, Simonato, Matteo, Durando, Mario, Miret-Corchado, Carmen, Montero-Errasquin, Beatriz, Meyer, Anna, Hoffmann, Dirk, Schulz, Ralf-Joachim, Tap, Lisanne, Egberts, Angelique, Bureau, Marie-Laure, Brunet, Thomas, Liuu, Evelyne, Michalkova, Helena ORCID: 0000-0002-4774-0861, Madlova, Pavla, Sancarlo, Daniele, D'Onofrio, Grazia and Ruxton, Kimberley (2019). Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study. J. Gerontol. Ser. A-Biol. Sci. Med. Sci., 74 (10). S. 1643 - 1650. CARY: OXFORD UNIV PRESS INC. ISSN 1758-535X

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Abstract

Background: Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods: This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results: Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79-6.17; p <.001) and severe risk (OR = 10.72, 95% CI: 5.70-20.18, p <.0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions: In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Pilotto, AlbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Veronese, NicolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Daragjati, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cruz-Jentoft, Alfonso J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Polidori, Maria CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mattace-Raso, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paccalin, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Topinkova, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siri, GiacomoUNSPECIFIEDorcid.org/0000-0001-8006-0668UNSPECIFIED
Greco, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mangoni, Arduino A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maggi, StefaniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferrucci, LuigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Musacchio, ClarissaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Custureri, RominaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Simonato, MatteoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Durando, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miret-Corchado, CarmenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montero-Errasquin, BeatrizUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulz, Ralf-JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tap, LisanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Egberts, AngeliqueUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bureau, Marie-LaureUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brunet, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liuu, EvelyneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michalkova, HelenaUNSPECIFIEDorcid.org/0000-0002-4774-0861UNSPECIFIED
Madlova, PavlaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sancarlo, DanieleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Onofrio, GraziaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruxton, KimberleyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-132160
DOI: 10.1093/gerona/gly239
Journal or Publication Title: J. Gerontol. Ser. A-Biol. Sci. Med. Sci.
Volume: 74
Number: 10
Page Range: S. 1643 - 1650
Date: 2019
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1758-535X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COMPREHENSIVE GERIATRIC ASSESSMENT; ONE-YEAR MORTALITY; TERM MORTALITY; VALIDATION; GUIDELINES; DEATH; SCOREMultiple languages
Geriatrics & Gerontology; GerontologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13216

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