A. Pilotto et al. 25. Maki KC, Dicklin MR, Baum SJ. Statins and diabetes. Cardiol Clin 2015; 33: 233–43. 26. Szadkowska I, Stanczyk A, Aronow WS et al. Statin therapy in the elderly: a review. Arch Gerontol Geriatr 2010; 50: 114–8. 27. Williams B. The changing face of hypertension treatment: treatment strategies from the 2007 ESH/ESC hypertension guidelines. J Hypertens Suppl 2009; 27: S19–26. 28. Munther P, DeSalvo KB, Wildman RP, Raggi P, He J, Whelton PK. Trends in prevalence, awareness, treatment and control of cardiovascular disease risk factors among noninstitutionalized patients with a history of myocardial infarction and stroke. Am J Epidemiol 2006; 163: 913–20.
Age and Ageing 2016; 45: 90–96 doi: 10.1093/ageing/afv167
29. Farshad F, Mariedl MF, Gooarz D et al. National, regional and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 2011; 377: 578–86. 30. Ostchega Y, Dillon CF, Hugher JP et al. Trends in hypertension prevalence, awareness, treatment and control in older US adults: data from the National Health and Nutrition Examination surveys 1988 to 2004. J Am Geriatr Soc 2007; 55: 1056–65. Received 26 August 2014; accepted in revised form 7 August 2015
© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: [email protected]
The Multidimensional Prognostic Index predicts in-hospital length of stay in older patients: a multicentre prospective study ALBERTO PILOTTO1,2, DANIELE SANCARLO2, FABIO PELLEGRINI3, FRANCO RENGO4, NICCOLÒ MARCHIONNI5, STEFANO VOLPATO6, LUIGI FERRUCCI7, ON BEHALF OF THE FIRI-SIGG STUDY GROUP* 1
Department of OrthoGeriatrics, Rehabilitation and Stabilization, E.O. Galliera Hospital, Genova 16128, Italy Gerontology-Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 3 Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 4 Geriatric Department, Università Federico II, Napoli, Italy 5 Geriatric Department, Università di Firenze, Florence, Italy 6 Geriatrics Unit, University of Ferrara, Ferrara, Italy 7 National Institute on Aging, Baltimore, MD, USA 2
Address correspondence to: A. Pilotto. Tel: (+39) 01056384319. Email: [email protected]
Abstract Background: prediction of length of stay (LOS) may be useful to optimise care plans to reduce the negative outcomes related to hospitalisation. Objective: to evaluate whether the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), may predict LOS in hospitalised older patients. Design: prospective multicentre cohort study. Setting: twenty Geriatrics Units. Participants: patients aged 65 and older consecutively admitted to Geriatrics Units. Measurement: at admission, the CGA-based MPI was calculated by using a validated algorithm that included information on basal and instrumental activities of daily living, cognitive status, nutritional status, the risk of pressures sores, co-morbidity, number of drugs and co-habitation status. According to validated cut-offs, subjects were divided into three groups of risk, i.e. MPI-1 low risk (value ≤0.33), MPI-2 moderate risk (value 0.34–0.66) and MPI-3 severe risk of mortality (value ≥0.67).
*
Fondazione Italiana per la Ricerca sull’Invecchiamento and Gerontology and Geriatrics Italian Society (Supplementary data, Appendix, available in Age and Ageing online).
90
MPI predicts length of stay in older patients Results: two thousand and thirty-three patients were included; 1,159 were women (57.0%). Age- and sex-adjusted mean LOS in patients divided according to the MPI grade was MPI-1 = 10.1 (95% CI 8.6–11.8), MPI-2 = 12.47 (95% CI 10.7–14.68) and MPI-3 = 13.41 (95% CI 11.5–15.7) days (P for trend 10 days). Such analyses were restricted to patients who survived during the hospitalisation only. A P value of
Age and Ageing 2016; 45: 90–96 doi: 10.1093/ageing/afv167
29. Farshad F, Mariedl MF, Gooarz D et al. National, regional and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 2011; 377: 578–86. 30. Ostchega Y, Dillon CF, Hugher JP et al. Trends in hypertension prevalence, awareness, treatment and control in older US adults: data from the National Health and Nutrition Examination surveys 1988 to 2004. J Am Geriatr Soc 2007; 55: 1056–65. Received 26 August 2014; accepted in revised form 7 August 2015
© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: [email protected]
The Multidimensional Prognostic Index predicts in-hospital length of stay in older patients: a multicentre prospective study ALBERTO PILOTTO1,2, DANIELE SANCARLO2, FABIO PELLEGRINI3, FRANCO RENGO4, NICCOLÒ MARCHIONNI5, STEFANO VOLPATO6, LUIGI FERRUCCI7, ON BEHALF OF THE FIRI-SIGG STUDY GROUP* 1
Department of OrthoGeriatrics, Rehabilitation and Stabilization, E.O. Galliera Hospital, Genova 16128, Italy Gerontology-Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 3 Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 4 Geriatric Department, Università Federico II, Napoli, Italy 5 Geriatric Department, Università di Firenze, Florence, Italy 6 Geriatrics Unit, University of Ferrara, Ferrara, Italy 7 National Institute on Aging, Baltimore, MD, USA 2
Address correspondence to: A. Pilotto. Tel: (+39) 01056384319. Email: [email protected]
Abstract Background: prediction of length of stay (LOS) may be useful to optimise care plans to reduce the negative outcomes related to hospitalisation. Objective: to evaluate whether the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), may predict LOS in hospitalised older patients. Design: prospective multicentre cohort study. Setting: twenty Geriatrics Units. Participants: patients aged 65 and older consecutively admitted to Geriatrics Units. Measurement: at admission, the CGA-based MPI was calculated by using a validated algorithm that included information on basal and instrumental activities of daily living, cognitive status, nutritional status, the risk of pressures sores, co-morbidity, number of drugs and co-habitation status. According to validated cut-offs, subjects were divided into three groups of risk, i.e. MPI-1 low risk (value ≤0.33), MPI-2 moderate risk (value 0.34–0.66) and MPI-3 severe risk of mortality (value ≥0.67).
*
Fondazione Italiana per la Ricerca sull’Invecchiamento and Gerontology and Geriatrics Italian Society (Supplementary data, Appendix, available in Age and Ageing online).
90
MPI predicts length of stay in older patients Results: two thousand and thirty-three patients were included; 1,159 were women (57.0%). Age- and sex-adjusted mean LOS in patients divided according to the MPI grade was MPI-1 = 10.1 (95% CI 8.6–11.8), MPI-2 = 12.47 (95% CI 10.7–14.68) and MPI-3 = 13.41 (95% CI 11.5–15.7) days (P for trend 10 days). Such analyses were restricted to patients who survived during the hospitalisation only. A P value of
