Predicting the risk of functional decline in older patients admitted to the hospital: a comparison of three screening instruments

Braes, Tom; Flamaing, Johan; Sterckx, Wendy; Lipkens, Piet; Sabbé, Marc; Rooij, Sophia E. de; Schuurmans, Marieke J.; Moons, Philip; Milisen, Koen

doi:10.1093/ageing/afp097

Cited by 55 publications

(45 citation statements)

References 17 publications

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“…These rates were higher than those detected in other studies handling geriatric clinic patients of similar ages 9,12,13,15,30 . As a matter of fact, only 29% of the PPs included remained alive and maintained their basal functional status for ADL; a similar rate to that obtained in the Sanfeliu study, which included patients aged !90 years 14 .…”

Section: Discussioncontrasting

confidence: 74%

Functional Decline Over 1-year Follow-up in a Multicenter Cohort of Polypathological Patients: A New Approach to Functional Prognostication

Bernabéu-Wittel¹,

Ollero-Baturone²,

Ruiz-Cantero³

et al. 2012

International Journal of Gerontology

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s u m m a r yBackground: Little is known about the fitness of the available tools in predicting functional decline of polypathological patients (PPs). Our objective was to assess accuracy of the Triage Risk Screening Tool (TRST), the Variable Indicative of Placement risk (VIP) and to develop a specific functional prognostic index adjusted to this population in a multicenter cohort of hospital-based PP. Methods: Prospective 12-month follow-up study of PPs from 36 hospitals. Functional decline was defined as loss of !20 points on Barthel's index (BI). Accuracy of TRST/VIP was assessed by calibration/ discrimination tests. Development of the new score was performed by dividing into a derivation cohort (constructing the index by logistic regression), and a validation cohort (in which calibration/discrimination of the index were tested). Results: Nine hundred and fifty-eight patients from the 1632 included survived during follow-up. Basal/ 12-month BI was 85/70, respectively. Mean fall in BI score was 11.7 AE 24 points [353 (36.8%) fell by !20 points]. The activities for daily living that declined most frequently were toilet use, grooming, dressing and bathing. TRST/VIP fitted well but their discrimination power was poor (area under the curve ¼ 0.49 and 0.46, respectively). A simplified PROFUNCTION index was derived containing seven items (!85 years, neurological condition, osteoarticular disease, IIIeIV functional class of dyspnea, !4 polypathology categories, basal BI < 60, and social problems). Functional decline risk ranged from 21% to 24% in the lowest risk group (0 items) to 38e46% in the highest (4e7 items). Calibration as well as discrimination power (area under the curve ¼ 0.56e0.59) of this simplified index were good. Conclusion: We developed and validated a new functional prognostic index specifically focused on these patients with better discrimination power than other tools available.

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Section: Discussioncontrasting

confidence: 74%

Functional Decline Over 1-year Follow-up in a Multicenter Cohort of Polypathological Patients: A New Approach to Functional Prognostication

Bernabéu-Wittel¹,

Ollero-Baturone²,

Ruiz-Cantero³

et al. 2012

International Journal of Gerontology

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“…Ces outils exigent peu de temps et sont faciles à administrer (Deschodt et al, 2011); de plus, ils évitent de faire une EG et conviennent aux patients âgés qui ne nécessitent pas d'évaluation exhaustive. Plusieurs outils de dépistage sont utilisés en oncologie, comme le questionnaire G8 (Bellera et al, 2012;Soubeyran et al, 2008), la version flamande de l'outil de dépistage des risques au triage (Triage Risk Screening Tool [fTRST]; Braes et al, 2009;Kenis et al, 2006;Meldon et al, 2003;Moons et al, 2007), l'indice de fragilité Groningern (Groningern Frailty Indicator; Slaets, 2006), le sondage pour les personnes âgées vulnérables (Vulnerable Elders Survey-13 [VES-13]; Mohile et al, 2007), et l'évaluation gériatrique exhaustive abré-gée (Comprehensive Geriatric Assessment; Overcash et al, 2005). Toutefois, la validation adéquate de ces outils quant à leur capacité à établir un pronostic sur le déclin fonctionnel et le taux de survie des patients atteints d'un cancer manque encore.…”

Section: Gériatrieunclassified

Vers une approche multidisciplinaire optimale du traitement du cancer du sein chez les patientes plus âgées

Thavarajah¹,

Menjak²,

Trudeau³

et al. 2015

CONJ

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“…Hospital admission can be a significant cause of functional decline in persons older than 65, and affects anywhere from 30% to 60% or more of inpatients. [25][26][27][28] Functional decline has been reported to occur by day 2 of hospitalization, and has devastating consequences, such as increased mortality, morbidity, duration of stay, long-term care placement, and hospital readmissions. 29,30 Many patients never regain full prehospitalization function.…”

Section: Functional Statusmentioning

confidence: 99%

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Gunn

Fowler

2014

Critical Care Nursing Clinics of North America

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Predicting the risk of functional decline in older patients admitted to the hospital: a comparison of three screening instruments

Cited by 55 publications

References 17 publications

Functional Decline Over 1-year Follow-up in a Multicenter Cohort of Polypathological Patients: A New Approach to Functional Prognostication

Functional Decline Over 1-year Follow-up in a Multicenter Cohort of Polypathological Patients: A New Approach to Functional Prognostication

Vers une approche multidisciplinaire optimale du traitement du cancer du sein chez les patientes plus âgées

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