Drame et al developed an index for predicting 2-year mortality for a frail, elderly adult who has had an emergency admission to a medical ward of a hospital. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospital in France and Switzerland.
Patient selection: frail, elderly adult >= 75 years of age with an emergency admission to a medical ward
Outcome: 2-year mortality
Parameters:
(1) age of the patient in years
(2) activities of daily living (based on Katz index)
(3) delirium
(4) malnutrition risk (based on Mini Nutritional Index short form score)
(5) comorbidity
Parameter |
Finding |
Points |
age of the patient |
< 85 years |
0 |
|
>= 85 years |
1 |
activities of daily living |
independent |
0 |
|
dependent |
1 |
delirium |
absent |
0 |
|
present |
2 |
malnutrition risk |
absent |
0 |
|
present |
2 |
comorbidity |
low |
0 |
|
medium |
2 |
|
high |
3 |
where:
• Comorbidity was based on the Charlson comorbidity score with 0 or 1 low, 2 to 4 medium, and 5 or more high.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the risk of mortality.
Score |
Risk Group |
2-Year Mortality Rate |
0 to 2 |
low |
21% |
3 to 5 |
medium |
50% |
6 to 9 |
high |
65% |
Performance:
• The area under the ROC curve is 0.72.
• The mortality rate for the high risk group looks low.
Specialty: Sports Medicine & Rehabilitation