Derivation and validation of a mortality-risk index from a cohort of frail elderly patients hospitalised in medical wards via emergencies: the SAFES study.

Details

Serval ID
serval:BIB_047B5637ED4C
Type
Article: article from journal or magazin.
Collection
Publications
Title
Derivation and validation of a mortality-risk index from a cohort of frail elderly patients hospitalised in medical wards via emergencies: the SAFES study.
Journal
European Journal of Epidemiology
Author(s)
Dramé M., Novella J.L., Lang P.O., Somme D., Jovenin N., Lanièce I., Couturier P., Heitz D., Gauvain J.B., Voisin T., De Wazières B., Gonthier R., Ankri J., Jeandel C., Saint-Jean O., Blanchard F., Jolly D.
ISSN
1573-7284 (Electronic)
ISSN-L
0393-2990
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
23
Number
12
Pages
783-791
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies Publication Status: ppublish
Abstract
To identify predictive factors for 2-year mortality in frail elderly patients after acute hospitalisation, and from these to derive and validate a Mortality Risk Index (MRI). A prospective cohort of elderly patients was set up in nine teaching hospitals. This cohort was randomly split up into a derivation cohort (DC) of 870 subjects and a validation cohort (VC) of 436 subjects. Data obtained from a Comprehensive Geriatric Assessment were used in a Cox model to predict 2-year mortality and to identify risk groups for mortality. A ROC analysis was performed to explore the validity of the MRI. Five factors were identified and weighted using hazard ratios to construct the MRI: age 85 or over (1 point), dependence for the ADL (1 point), delirium (2 points), malnutrition risk (2 points), and co-morbidity level (2 points for medium level, 3 points for high level). Three risk groups were identified according to the MRI. Mortality rates increased significantly across risk groups in both cohorts. In the DC, mortality rates were: 20.8% in the low-risk group, 49.6% in the medium-risk group, and 62.1% in the high-risk group. In the VC, mortality rates were respectively 21.7, 48.5, and 65.4%. The area under the ROC curve for overall score was statistically the same in the DC (0.72) as in the VC (0.71). The proposed MRI appears as a simple and easy-to-use tool developed from relevant geriatric variables. Its accuracy is good and the validation procedure gives a good stability of results.
Keywords
Aged, Aged, 80 and over, Cohort Studies, Emergency Service, Hospital, Female, Frail Elderly/statistics & numerical data, France/epidemiology, Geriatric Assessment/methods, Hospitals, Teaching, Humans, Interviews as Topic, Male, Mortality, Prognosis, Proportional Hazards Models, ROC Curve, Risk Assessment/methods, Severity of Illness Index
Pubmed
Web of science
Create date
15/04/2015 8:34
Last modification date
20/08/2019 12:26
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