Universität zu Köln

Rarek, Marcel Pascal, Meyer, Anna Maria, Pickert, Lena, Pilotto, Alberto, Benzing, Thomas, Burst, Volker and Polidori, Maria Cristina . The prognostic signature of health-related quality of life in older patients admitted to the emergency department: a 6-month follow-up study. Aging Clin. Exp. Res.. NEW YORK: SPRINGER. ISSN 1720-8319

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Abstract

Background The management of older and multimorbid patients with complex care requires a personalised and comprehensive approach. The main diagnosis is often registered as the cause of hospitalisation, yet poor health-related quality of life (HRQoL) as well as multimorbidity may represent the underlying cause and markedly influence prognosis. Aims To analyse the association of HRQoL and clinical prognosis over time as assessed by a Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI) in older patients admitted to the emergency department (ED). Methods We used data from the prospective MPI-HOPE (Influence of the MPI on the Hospitalisation of Older Patients admitted to the Emergency department) study. Data from 165 patients (>= 75 years) admitted to the ED of the University Hospital of Cologne, Germany, between Oct 2017 and Jan 2018 were included. Clinical prognosis was calculated by the MPI and HRQoL by the EQ5D-5L. Follow-up interviews assessed HRQoL up to 6 months after discharge. Results Most patients were multimorbid and presented with several geriatric syndromes. At admission, HRQoL was highest in patients with the best clinical prognosis. The MPI showed a negative correlation with the EQ-Index at admission (r(s)(86) = - 0.50, p < 0.0001) and follow-up assessments after 3 and 6 months (r(s)(86) = - 0.55 and r(s)(86) = - 0.47, p < 0.0001). Discussion Our results suggest that patients' self-perceived HRQoL in the ED is related to functional health status and clinical prognosis. Conclusion The MPI as a multidimensional snapshot provides information on clinical health indicators and informs about subjective HRQoL, thereby helping in identifying patients who would benefit from a specific treatment within the frame of a patient-centered, value-based care strategy geriatric treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rarek, Marcel Pascal UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Pickert, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-313691
DOI:	10.1007/s40520-020-01732-8
Journal or Publication Title:	Aging Clin. Exp. Res.
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1720-8319
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPREHENSIVE GERIATRIC ASSESSMENT; ONE-YEAR MORTALITY; CLINICAL-PRACTICE; CARE; OUTCOMES; FRAILTY; ADULTS; INDEX; ASSOCIATION; VALIDATION Multiple languages Geriatrics & Gerontology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31369