Comparison of five indices for prediction of adverse outcomes in hospitalised Mexican older adults: a cohort study

Dent, Elsa and Perez-Zepeda, Mario (2015) Comparison of five indices for prediction of adverse outcomes in hospitalised Mexican older adults: a cohort study. Archives of Gerontology and Geriatrics, 60 1: 89-95. doi:10.1016/j.archger.2014.09.011


Author Dent, Elsa
Perez-Zepeda, Mario
Title Comparison of five indices for prediction of adverse outcomes in hospitalised Mexican older adults: a cohort study
Journal name Archives of Gerontology and Geriatrics   Check publisher's open access policy
ISSN 1872-6976
0167-4943
Publication date 2015-01-01
Sub-type Article (original research)
DOI 10.1016/j.archger.2014.09.011
Open Access Status Not Open Access
Volume 60
Issue 1
Start page 89
End page 95
Total pages 7
Place of publication Shannon, Clare, Ireland
Publisher Elsevier Ireland
Language eng
Formatted abstract
The aim of this prospective study was to investigate the ability of five indices of risk stratification to predict functional decline and prolonged length of stay (LOS) in older Mexicans hospitalized in the acute care setting. A total of 254 patients aged ≥60 years were followed up. Risk indices were constructed from baseline data collected during the first 48 h of ward admission, and included: Frailty Index (FI), Hospital Admission Risk Profile (HARP), Score Hospitalier d’Evaluation du Risque de Perte d’Autonomie (SHERPA), Acute Physiology and Chronic Health Evaluation II (APACHE II) and Charlson's Co-morbidity Index (CCI). Area Under Receiver Operating Characteristic (auROC) curves was used to compare the ability of risk indices to predict adverse outcome, with outcomes of interest being prolonged LOS, and functional decline, the latter defined as ≥10% drop in Barthel Index score across hospitalization. Mean (SD) FI score was 0.31 (0.14). Effective in predicting long LOS were FI, SHERPA and APACHE II; effective in predicting functional decline were SHERPA and HARP. Indices generally showed high specificity values (most were >80%), although all indices lacked adequate sensitivity values for outcome prediction (<80%). Geriatricians could use information from FI, SHERPA, APACHE II, HARP to guide patient management decisions. However, given that all indices lacked accuracy of prediction, results should be interpreted with caution.
Keyword Acute care
Functional decline
Older adults
Risk stratification
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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