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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Prognostication in acutely admitted older patients by nurses and physicians
Bianca M Buurman1, Barbara C van Munster, Johanna C Korevaar
1Department of Internal Medicine, Geriatric section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Journal of General Internal Medicine
|September 5, 2008
Summary
Prognostication for older patients is challenging. Four factors predict 90-day mortality risk in hospitalized older adults, but clinical impression scores do not improve prediction accuracy.
Area of Science:
- Gerontology
- Internal Medicine
- Clinical Epidemiology
Background:
- Prognostication for acutely hospitalized older adults remains underexplored.
- Identifying factors associated with mortality risk is crucial for this demographic.
Purpose of the Study:
- To identify factors predicting 90-day mortality in acutely hospitalized older medical patients.
- To evaluate if clinical impression scores from nurses or physicians enhance mortality prediction.
Main Methods:
- Prospective cohort study of 463 older medical patients (≥65 years).
- Collected baseline characteristics, clinical parameters, and nurse/physician clinical impression scores.
- Registered 90-day mortality post-admission.
Main Results:
- 23.8% of patients died within 90 days.
- Four factors significantly predicted mortality: functional impairment, malignancy, co-morbidities, and high serum urea nitrogen.
- The baseline model achieved an AUC of 0.76; adding clinical impression scores did not significantly improve predictive accuracy.
Conclusions:
- A model with four clinical variables effectively predicts mortality risk in acutely hospitalized older patients.
- Clinical impression scores from nurses or physicians do not enhance the discriminatory ability of this mortality prediction model.
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