Predicting functional adverse outcomes in hospitalized older patients: A systematic review of screening tools

Saint-Hubert, Marie de; Stilmant, Didier; Cornette, Pascale; D’Hoore, William; Boland, Benoît; Swine, Christian

doi:10.1007/s12603-010-0086-x

Cited by 75 publications

(59 citation statements)

References 36 publications

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“…We believe that the Norton scale may be an ideal tool for predicting morbidity and mortality in large populations of elderly patients admitted to internal medicine departments since it is easy to learn, easy to use, and not time consuming. Most importantly, however, contrary to other emergency department screening tools that predict mortality in the elderly, such as the Identification of Seniors at Risk (ISAR) or Blaylock Risk Assessment Screening Score (BRASS) [17], the Norton scale is already being used successfully and therefore implementation should be simple and not require exhaustive medical staff tutorials.…”

Section: Discussionmentioning

confidence: 99%

Norton Scale, Hospitalization Length, Complications, and Mortality in Elderly Patients Admitted to Internal Medicine Departments

et al. 2013

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Background: The Norton scale is used for assessing pressure ulcer risk. The association between admission Norton scale scores (ANSS), hospitalization length, complications, and mortality in elderly patients admitted to internal medicine departments has never been studied. Objective: To determine if ANSS are associated with hospitalization length, complications, in-hospital mortality, and 1-year mortality in elderly patients admitted to an internal medicine department. Methods: Medical charts of consecutive elderly (≥65 years) patients admitted to a single internal medicine department between January and March 2009 were studied for ANSS, demographics, comorbidities, hospitalization length, complications during hospitalization, in-hospital mortality, and 1-year mortality. Complications during hospitalization included acute coronary syndrome, major arrhythmias, major bleeding, stroke, systemic infections, organ failure, thromboembolism, etc. ANSS ≤14 were considered low. Results: The final cohort included 259 elderly patients: 54.4% were women, the mean age was 81.6 years, and the mean hospitalization length was 3.7 days. Overall, 7.3% of the patients had complications other than pressure ulcers, 3.9% died during hospitalization, and 28.6% died within 1 year. The mean ANSS was 15.4, and 37.8% of the patients had low ANSS. Patients with low ANSS had longer hospitalization (4.7 vs. 2.9 days; p = 0.002), a higher incidence of complications during hospitalization (odds ratio: 3.9; p = 0.006), and higher rates of in-hospital mortality (odds ratio: 7.0; p = 0.007) relative to patients with high ANSS. Regression analysis showed that ANSS were independently negatively associated with hospitalization length, complications during hospitalization, and in-hospital mortality (p < 0.0001, p = 0.003, and p = 0.018, respectively) regardless of age, gender, comorbidities, and pressure ulcer appearance. Rates of 1-year mortality were similar in patients with low and high ANSS. Conclusions: The Norton scale may be used for predicting hospitalization length, complications during hospitalization other than pressure ulcers, and in-hospital mortality in elderly patients admitted to an internal medicine department.

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Section: Discussionmentioning

confidence: 99%

Norton Scale, Hospitalization Length, Complications, and Mortality in Elderly Patients Admitted to Internal Medicine Departments

et al. 2013

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“…7 Several studies have been published on instruments assessing functional change during hospitalization, whereas little is known about multidimensional and more comprehensive tools' ability to track variation in the overall patient's health condition. 8,9 The Multidimensional Prognostic Index (MPI) is a validated index based on six commonly used geriatric assessment scales exploring cognitive, functional, nutritional, and clinical status, as well as on information about drugs taken and patient's social support. 10 Its long-term predictive value has been established in the overall hospitalized population 11 as well as in older subjects hospitalized for specific clinical conditions.…”

mentioning

confidence: 99%

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Volpato

Daragjati

Simonato

et al. 2016

Rejuvenation Research

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on behalf of the MPI-TriVeneto Study Group * AbstractWe investigated and describe change in the Multidimensional Prognostic Index (MPI) score between admission and discharge in 960 older patients admitted to 20 geriatric units for an acute disease or a relapse of a chronic disease. The MPI was calculated at admission and at discharge. Subjects were divided into three groups of MPI score, low risk (MPI-1 value £0.33), moderate risk (MPI-2 value 0.34-0.66), and severe risk of mortality (MPI-3 value ‡0.67), on the basis of previously established cutoffs. Variation of MPI values over length of hospital stay (LOS) was analyzed with a multivariable longitudinal linear model for repeated measurements. At admission, 23.5% subjects had an MPI-1 score, 33.3% had an MPI-2 score, and 43.0% had an MPI-3 score. Overall, for almost 60% of the patients, MPI score at hospital discharge was different compared with the score at admission, although the difference was not statistically significant (-0.003; p = 0.708). Patients with high and intermediate MPI scores at admission had a decrease of MPI score at discharge (delta-MPI -0.026, p < 0.001, and delta-MPI -0.066, p = 0.569, respectively), whereas patients in the MPI-low group, experienced a significant increase in MPI score (delta-MPI 0.041, p < 0.001). The evolution of MPI score as a function of LOS had a curvilinear shape because it significantly decreased for patients with short hospitalization (1-6 days) and tended to increase for those with longer LOS. The MPI, a well-established prognostic tool, is sensitive to change of patient's health status and might be used to objectively track and monitor the clinical evolution of acutely ill geriatric patients admitted to the hospital.

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“…Se han propuesto recomendaciones para mejorar las investigaciones que desarrollan escalas de predicción para DF (48). Inicialmente se requiere determinar el objetivo buscado con su aplicación, por ejemplo, intervenir sobre FR o evaluar el riesgo de ser institucionalizado posterior al alta, porque no siempre estos dos factores implican el desarrollo de desenlaces similares (24,27).…”

Section: Factores De Riesgo De La Declinación Funcionalunclassified

Revisión sistemática de literatura. Declinación funcional en ancianos hospitalizados

Ocampo

2016

Rev. Médica Risaralda

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Los ancianos requieren con frecuencia admisión hospitalaria, durante la cual se generan riesgos para desarrollar eventos adversos, que en ocasiones no se relacionan con las características del anciano ni la enfermedad aguda, sino con tratamientos médicos, el ambiente y las rutinas de cuidado hospitalario. Los ancianos con enfermedad aguda son un grupo heterogéneo y vulnerable debido a múltiples compromisos en las esferas biopsicosociales como disminución de la reserva funcional, comorbilidad, polifarmacia, alteraciones cognoscitivas, compromiso funcional y alteraciones en las esferas social y familiar. Estas características ubican al anciano en riesgo para desarrollar durante la hospitalización declinación funcional, por lo cual se debe realizar identificación oportuna de los factores de riesgo con el objetivo de prevenir y manejar esta condición mediante un equipo interdisciplinario.La implementación de modelos de atención que prevengan y mejoren el compromiso funcional deber ser una prioridad para las instituciones y personal de salud que atienden ancianos. Estos modelos incluyen revisión del manejo farmacológico, rehabilitación interdisciplinaria temprana, programas de ejercicio y diseño del egreso geriátrico planeado.

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Predicting functional adverse outcomes in hospitalized older patients: A systematic review of screening tools

Cited by 75 publications

References 36 publications

Norton Scale, Hospitalization Length, Complications, and Mortality in Elderly Patients Admitted to Internal Medicine Departments

Norton Scale, Hospitalization Length, Complications, and Mortality in Elderly Patients Admitted to Internal Medicine Departments

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Revisión sistemática de literatura. Declinación funcional en ancianos hospitalizados

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