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Validación predictiva de un método de clasificación funcional en adultos mayores

OBJECTIVE. Evaluate the predictive validity of a functional classification (FC) method for the use of emergency services and hospitalization, mortality, and health care costs among older adults. METHODS. Retrospective cohort study that included 2 168 older adults in a chronic noncommunicable disease...

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Autores principales: García-Arango, Víctor, Osorio-Ciro, Jorge, Aguirre-Acevedo, Daniel, Vanegas-Vargas, Catalina, Clavijo-Usuga, Carmen, Gallo-Villegas, Jaime
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Organización Panamericana de la Salud 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905750/
https://www.ncbi.nlm.nih.gov/pubmed/33643398
http://dx.doi.org/10.26633/RPSP.2021.15
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author García-Arango, Víctor
Osorio-Ciro, Jorge
Aguirre-Acevedo, Daniel
Vanegas-Vargas, Catalina
Clavijo-Usuga, Carmen
Gallo-Villegas, Jaime
author_facet García-Arango, Víctor
Osorio-Ciro, Jorge
Aguirre-Acevedo, Daniel
Vanegas-Vargas, Catalina
Clavijo-Usuga, Carmen
Gallo-Villegas, Jaime
author_sort García-Arango, Víctor
collection PubMed
description OBJECTIVE. Evaluate the predictive validity of a functional classification (FC) method for the use of emergency services and hospitalization, mortality, and health care costs among older adults. METHODS. Retrospective cohort study that included 2 168 older adults in a chronic noncommunicable disease (CNCD) care program in Medellin, Colombia. Patients were stratified according to a FC method based on functional status, presence of risk factors, and control of comorbidity. During one year of follow-up, the predictive validity of the FC method was assessed for the studied outcomes. Discrimination and calibration were measured with the C-statistic and Hosmer-Lemeshow (HL) test, respectively. RESULTS. The average age was 74.6 ± 7.9 years; 40.8% (n = 884) were men and 7.7% (n = 168) died. The risk of death (odds ratio [OR]: 1.767; 3.411; 8.525), hospitalization (OR: 1.397; 2.172; 3.540) and high cost of health care (OR: 1.703; 2.369; 5.073) increased in proportion to a deterioration in functional classification (classes 2B, 3, and 4, respectively). The predictive model for the outcome of death showed good capacity for discrimination (C-statistic = 0.721) and calibration (HL statistic 10.200; P = 0.251). CONCLUSION. There is a dose-response relationship between deterioration in FC and a higher risk of death, hospitalization, and high cost. FC has predictive validity for the mortality rate and could be used to stratify older adults in CNCD care programs with a view to guiding interventions.
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spelling pubmed-79057502021-02-26 Validación predictiva de un método de clasificación funcional en adultos mayores García-Arango, Víctor Osorio-Ciro, Jorge Aguirre-Acevedo, Daniel Vanegas-Vargas, Catalina Clavijo-Usuga, Carmen Gallo-Villegas, Jaime Rev Panam Salud Publica Investigación Original OBJECTIVE. Evaluate the predictive validity of a functional classification (FC) method for the use of emergency services and hospitalization, mortality, and health care costs among older adults. METHODS. Retrospective cohort study that included 2 168 older adults in a chronic noncommunicable disease (CNCD) care program in Medellin, Colombia. Patients were stratified according to a FC method based on functional status, presence of risk factors, and control of comorbidity. During one year of follow-up, the predictive validity of the FC method was assessed for the studied outcomes. Discrimination and calibration were measured with the C-statistic and Hosmer-Lemeshow (HL) test, respectively. RESULTS. The average age was 74.6 ± 7.9 years; 40.8% (n = 884) were men and 7.7% (n = 168) died. The risk of death (odds ratio [OR]: 1.767; 3.411; 8.525), hospitalization (OR: 1.397; 2.172; 3.540) and high cost of health care (OR: 1.703; 2.369; 5.073) increased in proportion to a deterioration in functional classification (classes 2B, 3, and 4, respectively). The predictive model for the outcome of death showed good capacity for discrimination (C-statistic = 0.721) and calibration (HL statistic 10.200; P = 0.251). CONCLUSION. There is a dose-response relationship between deterioration in FC and a higher risk of death, hospitalization, and high cost. FC has predictive validity for the mortality rate and could be used to stratify older adults in CNCD care programs with a view to guiding interventions. Organización Panamericana de la Salud 2021-02-26 /pmc/articles/PMC7905750/ /pubmed/33643398 http://dx.doi.org/10.26633/RPSP.2021.15 Text en https://creativecommons.org/licenses/by-nc-nd/3.0/igo/legalcode Este es un artículo de acceso abierto distribuido bajo los términos de la licencia Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO, que permite su uso, distribución y reproducción en cualquier medio, siempre que el trabajo original se cite de la manera adecuada. No se permiten modificaciones a los artículos ni su uso comercial. Al reproducir un artículo no debe haber ningún indicio de que la OPS o el artículo avalan a una organización o un producto específico. El uso del logo de la OPS no está permitido. Esta leyenda debe conservarse, junto con la URL original del artículo.
spellingShingle Investigación Original
García-Arango, Víctor
Osorio-Ciro, Jorge
Aguirre-Acevedo, Daniel
Vanegas-Vargas, Catalina
Clavijo-Usuga, Carmen
Gallo-Villegas, Jaime
Validación predictiva de un método de clasificación funcional en adultos mayores
title Validación predictiva de un método de clasificación funcional en adultos mayores
title_full Validación predictiva de un método de clasificación funcional en adultos mayores
title_fullStr Validación predictiva de un método de clasificación funcional en adultos mayores
title_full_unstemmed Validación predictiva de un método de clasificación funcional en adultos mayores
title_short Validación predictiva de un método de clasificación funcional en adultos mayores
title_sort validación predictiva de un método de clasificación funcional en adultos mayores
topic Investigación Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905750/
https://www.ncbi.nlm.nih.gov/pubmed/33643398
http://dx.doi.org/10.26633/RPSP.2021.15
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