Universität zu Köln

Pickert, Lena, Meyer, Anna M., Becker, Ingrid ORCID: 0000-0001-5829-3553, Heess, Annika, Noetzel, Nicolas ORCID: 0000-0002-1826-1001, Brinkkoetter, Paul, Pilotto, Alberto, Benzing, Thomas and Polidori, Maria C. (2021). Role of a multidimensional prognosis in-hospital monitoring for older patients with prolonged stay. Int. J. Clin. Pract., 75 (5). HOBOKEN: WILEY. ISSN 1742-1241

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Abstract

Objectives: The Multidimensional Prognostic Index (MPI) is a prognostic tool-amongst others-validated for mortality, length of hospital stay (LHS) and rehospitalisation risk assessment. Like the Comprehensive Geriatric Assessment (CGA), the MPI is usually obtained at hospital admission and discharge, not during the hospital stay. The aim of the present study was to address the role of an additional CGA-based MPI measurement during hospitalisation as an indicator of real-time in-hospital changes. Study design and main outcome measures: Two-hundred consecutive multimorbid patients (128 M, 72 F, median age 75 (78-82)) admitted to an internal medicine ward of a German metropolitan university hospital prospectively underwent a CGA and a prognosis calculation using the MPI on admission and discharge. Seven to 10 days later, an intermediate assessment (IA) was performed for patients needing a longer stay. Results: The median LHS was 10 (6-19) days. As expected, patients who received an IA had poorer prognosis as measured by higher MPI values (P = .037) and a worse functional status at admission than patients who had a shorter stay (P = .025). In case of prolonged hospitalisation, significant changes in the MPI were detected between admission and IA, both in terms of improvement and deterioration (P < .001). Different overtime courses were observed during prolonged hospitalisation according to the severity of prognosis (P < .001). Conclusion: A CGA-based MPI evaluation during hospitalisation can be used as an objective instrument to detect changes in multidimensional health course. Prompt identification of the latter may enable quick tailored interventions to ensure overall better outcomes at and after discharge.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pickert, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Anna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Heess, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Noetzel, Nicolas UNSPECIFIED orcid.org/0000-0002-1826-1001 UNSPECIFIED Brinkkoetter, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, Maria C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-585404
DOI:	10.1111/ijcp.13989
Journal or Publication Title:	Int. J. Clin. Pract.
Volume:	75
Number:	5
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1742-1241
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Medicine, General & Internal; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58540