Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study

MPI_AGE Investigators

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. METHODS: This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. RESULTS: Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79-6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70-20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. CONCLUSIONS: In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

Original languageEnglish
Pages (from-to)1643-1649
Number of pages7
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Volume74
Issue number10
DOIs
Publication statusPublished - Sep 15 2019

Fingerprint

Multicenter Studies
Institutionalization
Mortality
Home Care Services
Odds Ratio
Longitudinal Studies
Geriatric Assessment
Pressure Ulcer
Patient Admission
Public Hospitals
Nutritional Status
Comorbidity
Cohort Studies
Retrospective Studies

Keywords

  • Aged
  • Cohort study
  • Hospital
  • Multidimensional Prognostic Index
  • Prognosis

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

@article{255551736492436d840fa81549938d02,
title = "Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study",
abstract = "BACKGROUND: Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. METHODS: This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. RESULTS: Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8{\%}) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95{\%} CI: 1.79-6.17; p < .001) and severe risk (OR = 10.72, 95{\%} CI: 5.70-20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. CONCLUSIONS: In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.",
keywords = "Aged, Cohort study, Hospital, Multidimensional Prognostic Index, Prognosis",
author = "{MPI_AGE Investigators} and Alberto Pilotto and Nicola Veronese and Julia Daragjati and Cruz-Jentoft, {Alfonso J.} and Polidori, {Maria Cristina} and Francesco Mattace-Raso and Marc Paccalin and Eva Topinkova and Giacomo Siri and Antonio Greco and Mangoni, {Arduino A.} and Stefania Maggi and Luigi Ferrucci",
year = "2019",
month = "9",
day = "15",
doi = "10.1093/gerona/gly239",
language = "English",
volume = "74",
pages = "1643--1649",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons

T2 - A Prospective, Multicenter, International Study

AU - MPI_AGE Investigators

AU - Pilotto, Alberto

AU - Veronese, Nicola

AU - Daragjati, Julia

AU - Cruz-Jentoft, Alfonso J.

AU - Polidori, Maria Cristina

AU - Mattace-Raso, Francesco

AU - Paccalin, Marc

AU - Topinkova, Eva

AU - Siri, Giacomo

AU - Greco, Antonio

AU - Mangoni, Arduino A.

AU - Maggi, Stefania

AU - Ferrucci, Luigi

PY - 2019/9/15

Y1 - 2019/9/15

N2 - BACKGROUND: Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. METHODS: This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. RESULTS: Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79-6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70-20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. CONCLUSIONS: In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

AB - BACKGROUND: Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. METHODS: This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. RESULTS: Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79-6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70-20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. CONCLUSIONS: In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

KW - Aged

KW - Cohort study

KW - Hospital

KW - Multidimensional Prognostic Index

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85072316874&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072316874&partnerID=8YFLogxK

U2 - 10.1093/gerona/gly239

DO - 10.1093/gerona/gly239

M3 - Article

C2 - 30329033

AN - SCOPUS:85072316874

VL - 74

SP - 1643

EP - 1649

JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

IS - 10

ER -