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Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study

Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in old...

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Autores principales: Veronese, Nicola, Vianello, Stefano, Danesin, Claudia, Tudor, Florina, Pozzobon, Gianfranco, Pilotto, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232637/
https://www.ncbi.nlm.nih.gov/pubmed/34203781
http://dx.doi.org/10.3390/jcm10122632
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author Veronese, Nicola
Vianello, Stefano
Danesin, Claudia
Tudor, Florina
Pozzobon, Gianfranco
Pilotto, Alberto
author_facet Veronese, Nicola
Vianello, Stefano
Danesin, Claudia
Tudor, Florina
Pozzobon, Gianfranco
Pilotto, Alberto
author_sort Veronese, Nicola
collection PubMed
description Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI-2 0.20–0.34, MPI-3 > 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well.
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spelling pubmed-82326372021-06-26 Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study Veronese, Nicola Vianello, Stefano Danesin, Claudia Tudor, Florina Pozzobon, Gianfranco Pilotto, Alberto J Clin Med Article Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI-2 0.20–0.34, MPI-3 > 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well. MDPI 2021-06-15 /pmc/articles/PMC8232637/ /pubmed/34203781 http://dx.doi.org/10.3390/jcm10122632 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Veronese, Nicola
Vianello, Stefano
Danesin, Claudia
Tudor, Florina
Pozzobon, Gianfranco
Pilotto, Alberto
Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title_full Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title_fullStr Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title_full_unstemmed Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title_short Multidimensional Prognostic Index and Mortality in Intermediate Care Facilities: A Retrospective Study
title_sort multidimensional prognostic index and mortality in intermediate care facilities: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232637/
https://www.ncbi.nlm.nih.gov/pubmed/34203781
http://dx.doi.org/10.3390/jcm10122632
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