Morbidity Measures Predicting Mortality in Inpatients: A Systematic Review

Area of Science:

• Geriatric Medicine
• Clinical Epidemiology
• Health Outcomes Research

Background:

• Morbidity is a significant predictor of mortality.
• Various morbidity measures exist to assess patient health outcomes.
• Accurate prediction of mortality risk is crucial for clinical decision-making.

Purpose of the Study:

• To systematically review and compare the predictive capacity of different morbidity measures for mortality in hospitalized patients.
• To identify the most effective morbidity measures for predicting mortality in internal medicine and geriatric wards.

Main Methods:

• A systematic literature search was performed across four major databases (Medline, Embase, Cochrane, CINAHL) from inception to March 2019.
• Included studies focused on morbidity measures used to predict mortality in inpatients aged 65 years or older.
• 34 articles were included from an initial retrieval of 12,800 articles.

Main Results:

• The Charlson Comorbidity Index (CCI) was frequently reported, with higher scores correlating with increased mortality risk, especially over longer follow-up periods.
• Comparative analyses indicated that the Geriatric Index of Comorbidity outperformed the CCI, Cumulative Illness Rating Scale, Index of Coexistent Disease, and simple disease count in predicting mortality.
• Higher scores on morbidity measures generally correlated with increased mortality risk at extended follow-up intervals.

Conclusions:

• Morbidity measures are valuable tools for predicting mortality risk in hospitalized older adults.
• The Geriatric Index of Comorbidity shows superior performance in predicting mortality and warrants wider clinical adoption.
• Utilizing robust morbidity measures like the Geriatric Index of Comorbidity can enhance clinical decision-making and patient care.