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Bedside Risk Scoring System for Mortality in Older Adults After Hospitalization

Purpose: To evaluate an elderly patient at the time of hospital discharge for 1 year mortality using the Bedside Risk Score.

Description

The Bedside Risk Score can be used to predict mortality for an older adult 1 year after discharge from the hospital. It uses information available at the time of hospital discharge. This can help identify patients who might benefit from more aggressive therapy and monitoring.


Patients: age >= 70 years of age

 

Parameters:

(1) gender

(2) dependence in activities of daily living (ADL)

(3) comorbid conditions for heart failure and cancer

(4) laboratory findings for serum creatinine and albumin

 

Activities of daily living:

(1) bathing

(2) dressing

(3) using the toilet

(4) transferring from bed to chair

(5) eating

 

Parameter

Finding

Points

gender

female

0

 

male

1

need for assistance with activities of daily living

0

0

 

1 to 4

2

 

all 5

5

heart failure

absent

0

 

present

2

cancer

absent

0

 

solitary cancer

3

 

metastatic

8

serum creatinine

<= 3.0 mg/dL

0

 

> 3.0 mg/dL

2

albumin

> 3.4 g/dL

0

 

3.0 – 3.4 g/dL

1

 

< 3.0 g/dL

2

 

bedside risk score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score, the more severely affected the patient.

 

Risk Score

Percent Dead at 1 Year in Derivation Set (95% CI)

Percent Dead at 1 Year in Validation Set (95% CI)

0 to 1

13% (10-16%)

4% (2-6%)

2 to 3

20% (16-24%)

19% (15-23%)

4 to 6

37% (33-41%)

34% (29-39%)

> 6

68% (63%-73%)

64% (58-70%)

from Table 4, page 2992


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Specialty

Objective

ICD-10