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Validation of the PROFUND index to predict early post-hospital discharge mortality

M D Martín-Escalante1, R Quirós-López1,2, F Martos-Pérez1

  • 1From the Internal Medicine Department, Hospital Costa del Sol, Marbella, Málaga, Spain.

QJM : Monthly Journal of the Association of Physicians
|July 13, 2019
PubMed

Insights

The PROFUND index (PI) accurately predicts 1-year mortality in polypathological patients. This validated prognostic scale also effectively identifies patients at higher risk of early mortality post-discharge.

Area of Science:

  • Geriatrics
  • Internal Medicine
  • Clinical Prognostics

Background:

  • Polypathological patients represent a growing challenge in internal medicine.
  • The PROFUND index (PI) is a prognostic scale developed to assess 12-month mortality risk.
  • Validation of existing prognostic tools in current patient cohorts is crucial.

Purpose of the Study:

  • To validate the PROFUND index (PI) as a predictor of 1-year mortality in contemporary polypathological patients.
  • To assess the short-term prognostic utility of the PI (1 and 3 months) post-discharge.
  • To evaluate the PI's effectiveness in identifying high-risk patients early.

Main Methods:

  • Prospective observational study design.
  • Enrollment of polypathological patients discharged from Internal Medicine (March 2016 - February 2017).
  • Data collection included demographics, comorbidities, PI score, hospital admissions, length of stay, and vital status at 1 year.

Main Results:

  • The study included 610 polypathological patients with a 41% 1-year mortality rate.
  • Higher PI scores, older age, and longer hospital stays were associated with increased mortality.
  • The PI demonstrated good discrimination for 1-year mortality (C-statistic=0.718) and early mortality at 30 (C=0.74) and 90 days (C=0.73).

Conclusions:

  • The PROFUND index (PI) is a validated and effective tool for predicting both early and 1-year mortality in polypathological patients.
  • The PI aids in risk stratification for patients discharged from Internal Medicine.
  • The findings support the routine use of the PI in clinical practice for this patient population.
Abstract

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