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A Multidimensional Risk Score to Predict All-Cause Hospitalization in Community-Dwelling Older Individuals With
Rosanne J H C G Beijers1, Bram van den Borst1, Anne B Newman2
1NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Background:
Both respiratory and nonrespiratory hospitalizations are common and costly events in older individuals with obstructive lung disease. Prevention of any hospitalization in these individuals is essential. We aimed to construct a prediction model for all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease.
Methods:
We studied 268 community-dwelling individuals with obstructive lung disease (defined as FEV1/FVC
Results:
There were 225 individuals with 1 or more hospitalizations and 43 individuals free from hospitalization during the follow-up. Heart and vascular disease (H), objectively measured lower extremity dysfunction (O), systemic inflammation (S), dyspnea (P), impaired renal function (I), and tobacco exposure (T) were independent predictors for all-cause hospitalization (ALL). These factors were combined into the HOSPITALL score (0-23 points), with an area under the curve in ROC analysis of 0.70 (P < .001). The hazard ratio for all-cause hospitalization per 1-point increase in the HOSPITALL score was 1.15 (95% confidence interval, 1.11-1.19, P = .001). Increasing HOSPITALL score was further associated with shorter time to first admission, increased admission rate, and more respiratory admissions.
Conclusion:
The HOSPITALL score is a multidimensional score to predict all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease that may aid in patient counseling and prevention to reduce burden and health care costs.
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