[Validation of a prognostic model for polypathological patients (PP) in Primary Health Care: "PROFUND STUDY-AP"]

to validate the PROFUND index in PP in Primary Health Care (PHC).

two-year prospective multicenter study.

three health care centers in Seville Province (Spain).

PP with signed informed consent.

n=446 (p=20%; α=5%; β=99%); consecutive sampling.

Dependent variable: mortality (2 years).

socio-demography, clinic, anthropometric, laboratory, pharmacologic prescriptions, functional, cognitive and socio-familiar evaluation and the use of health resources.

interview with patients and clinical charts.

uni and multivariate analysis according to the variables; Accuracy was assessed in the cohort by risk terciles calibration, and discrimination power, by ROC curves. Finally, accuracy of the index was compared with that of the Charlson index.

446 subjects were included (53.8% men); average age was 75.44yr (Confidence interval 95% 74.58-76.31). Average of diagnostic categories was 2.37 (Confidence interval 95% 2.30-2.44). Prevalent categories were: A (64.1%), F (41.7%) and E (33.5%). Mortality within 2 years was 24.1%. Calibration in predicted/observed mortality along the three established risk strata was 16%/16.7% for PP with 0-2 points, 22%/19.5% for PP with 3-6, and 34%/36% for PP with 7 or more points (Hosmer-Lemeshow test with p=0.119). Discrimination power of PHC PROFUND's by area under the curve was (AUC) ROC was 0.622 (Confidence interval 95% 0.556-0.689; p<0.001), and that of Charlson index 0.510 (Confidence interval 95% 0.446 - 0.575; p>0.005).

The PROFUND index is a good indicative tool in the stratification of 2-year mortality risk polypathological patients in PHC.