Prognostic significance of the Karnofsky Performance Status score in patients with acute myocardial infarction: Comparison with the left ventricular ejection fraction and the exercise treadmill test performance

Brezinski, Damian A.; Stone, PH; Muller, J. E.; Tofler, G.; Davis, Vicki G.; Parker, Cora; Hartley, L. Howard; Braunwald, Eugene

doi:10.1016/0002-8703(91)90141-4

Cited by 42 publications

(23 citation statements)

References 15 publications

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“…The purpose of this study was to test the hypothesis that one example of integrative functioning, physical function, is useful as a measure of prognosis and case mix in elders hospitalized with acute medical illness. Although this hypothesis is supported by previous work demonstrating a relation between functional status and mortality, [1][2][3][4][5][6][7][8][9][10] measures of physical function have seldom been used to adjust for prognosis and case mix.…”

mentioning

confidence: 89%

Measuring Prognosis and Case Mix in Hospitalized Elders: The Importance of Functional Status

et al. 1997

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OBJECTIVE : Although physical function is believed to be an important predictor of outcomes in older people, it has seldom been used to adjust for prognosis or case mix in evaluating mortality rates or resource use. The goal of this study was to determine whether patients' activity of daily living (ADL) function on admission provided information useful in adjusting for prognosis and case mix after accounting for routine physiologic measures and comorbid diagnoses. SETTING : The general medical service of a teaching hospital.PARTICIPANTS : Medical inpatients ( n ‫؍‬ 823) over age 70 (mean age 80.7, 68% women). hysical function is believed to be an important predictor of hospital outcomes in older people, yet it has not been used extensively to adjust for prognosis or case mix in evaluating mortality rates or resource use. Most methods of adjusting for prognosis or case mix consider either measures of internal physiologic function, such as laboratory values and vital signs, or principal and comorbid diagnoses. However, measures of integrative functioning, such as physical, emotional, and cognitive functioning, may also be useful for prognostic and case-mix adjustment. The purpose of this study was to test the hypothesis that one example of integrative functioning, physical function, is useful as a measure of prognosis and case mix in elders hospitalized with acute medical illness. Although this hypothesis is supported by previous work demonstrating a relation between functional status and mortality, 1-10 measures of physical function have seldom been used to adjust for prognosis and case mix. MEASUREMENTS

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confidence: 89%

Measuring Prognosis and Case Mix in Hospitalized Elders: The Importance of Functional Status

et al. 1997

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“…Despite the increasing body of evidence showing that functional status occupies an important role in health outcomes [53][54][55][56][57][58][59] and that it is a better predictor of mortality than disease- [60][61][62] prior research has often overlooked the role of functional status on hospital readmissions. Of the 26 distinct readmission models examined in a 2011 systematic review, only eight models considered functional status as a predictor variable, and only two studies ultimately included overall health and functional status, activities of daily living dependence, and mobility in their final models.…”

Section: Discussionmentioning

confidence: 99%

Functional Status Outperforms Comorbidities in Predicting Acute Care Readmissions in Medically Complex Patients

Shih

Gerrard²,

Goldstein

et al. 2015

J GEN INTERN MED

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OBJECTIVE:To examine functional status versus medical comorbidities as predictors of acute care readmissions in medically complex patients. DESIGN: Retrospective database study. SETTING: U.S. inpatient rehabilitation facilities. PARTICIPANTS: Subjects included 120,957 patients in the Uniform Data System for Medical Rehabilitation admitted to inpatient rehabilitation facilities under the medically complex impairment group code between 2002 and 2011. INTERVENTIONS: A Basic Model based on gender and functional status was developed using logistic regression to predict the odds of 3-, 7-, and 30-day readmission from inpatient rehabilitation facilities to acute care hospitals. Functional status was measured by the FIM ® motor score. The Basic Model was compared to six other predictive models-three Basic Plus Models that added a comorbidity measure to the Basic Model and three GenderComorbidity Models that included only gender and a comorbidity measure. The three comorbidity measures used were the Elixhauser index, Deyo-Charlson index, and Medicare comorbidity tier system. The c-statistic was the primary measure of model performance. MAIN OUTCOME MEASURES: We investigated 3-, 7-, and 30-day readmission to acute care hospitals from inpatient rehabilitation facilities. RESULTS: Basic Model c-statistics predicting 3-, 7-, and 30-day readmissions were 0.69, 0.64, and 0.65, respectively. The best-performing Basic Plus Model (Basic+Elixhauser) c-statistics were only 0.02 better than the Basic Model, and the best-performing GenderComorbidity Model (Gender+Elixhauser) c-statistics were more than 0.07 worse than the Basic Model. CONCLUSIONS:Readmission models based on functional status consistently outperform models based on medical comorbidities. There is opportunity to improve current national readmission risk models to more accurately predict readmissions by incorporating functional data.

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“…It is widely used with cancer patients on whom the validity and reliability has been based. One study (Brezinsky et al 1991) used the questionnaire with MI patients but not to differentiate between intervention or response to treatment.…”

Section: ~ Measurements Of Psycho-social Parametersmentioning

confidence: 99%

Effects of Rehabilitation in Patients with Cardiac Disease

Taylor¹

1996

Physiotherapy

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Prognostic significance of the Karnofsky Performance Status score in patients with acute myocardial infarction: Comparison with the left ventricular ejection fraction and the exercise treadmill test performance

Cited by 42 publications

References 15 publications

Measuring Prognosis and Case Mix in Hospitalized Elders: The Importance of Functional Status

Measuring Prognosis and Case Mix in Hospitalized Elders: The Importance of Functional Status

Functional Status Outperforms Comorbidities in Predicting Acute Care Readmissions in Medically Complex Patients

Effects of Rehabilitation in Patients with Cardiac Disease

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