Use of the interRAI CHESS Scale to Predict Mortality among Persons with Neurological Conditions in Three Care Settings

Abstract

BackgroundPersons with certain neurological conditions have higher mortality rates than the population without neurological conditions, but the risk factors for increased mortality within diagnostic groups are less well understood. The interRAI CHESS scale has been shown to be a strong predictor of mortality in the overall population of persons receiving health care in community and institutional settings. This study examines the performance of CHESS as a predictor of mortality among persons with 11 different neurological conditions.MethodsSurvival analyses were done with interRAI assessments linked to mortality data among persons in home care (n = 359,940), complex continuing care hospitals/units (n = 88,721), and nursing homes (n = 185,309) in seven Canadian provinces/territories.ResultsCHESS was a significant predictor of mortality in all 3 care settings for the 11 neurological diagnostic groups considered after adjusting for age and sex. The distribution of CHESS scores varied between diagnostic groups and within diagnostic groups in different care settings.ConclusionsCHESS is a valid predictor of mortality in neurological populations in community and institutional care. It may prove useful for several clinical, administrative, policy-development, evaluation and research purposes. Because it is routinely gathered as part of normal clinical practice in jurisdictions (like Canada) that have implemented interRAI assessment instruments, CHESS can be derived without additional need for data collection.

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes

“…Similar proportions of persons living in PH and RH have notable health instability, whereas LTCH residents have lower levels of health instability. Another study (Hirdes et al 2014) reported similar lower levels of health instability in LTCH compared with persons receiving home care in seven Canadian provinces and territories.…”

Comprehensive clinical assessment of home‐based older persons within New Zealand: an epidemiological profile of a national cross‐section

“…While the information gained is used primarily to inform person‐level decisions around care, opportunities exist to better understand older persons’ health and their health care needs within their own home setting. Internationally, there are numerous activities and population studies using the interRAI, 17–20 but, as yet, relatively little has been published in NZ. Critical to these investigations is an understanding of the interRAI‐HC population and the quality of the recorded data.…”

Minimum Data Set Changes in Health, End‐Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents

“…The Changes in Health, End‐stage disease and Symptoms and Signs (CHESS) scale is a composite measure specifically designed to identify health instability in long‐term care populations using routinely collected data . Since its development in 2003, it has been used, primarily as a risk adjustment tool, to identify people with high health instability who are likely to experience adverse health outcomes, including death …”

“…1 Since its development in 2003, it has been used, primarily as a risk adjustment tool, to identify people with high health instability who are likely to experience adverse health outcomes, including death. [2][3][4][5][6][7][8][9][10] The assessment instrument from which the CHESS scale was derived, the Minimum Data Set (MDS) version 2.0, underwent extensive revision, and version 3.0 was released for use in October 2010. 11 MDS 3.0 does not contain several items from the original MDS-CHESS scale, including change in cognitive status, change in ability to perform activities of daily living (ADLs) self, edema, and leaving 25% of food uneaten.…”