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
