Abstract
The multidimensional prognostic index (MPI) is a sensitive and specific prognosis estimation tool that accurately predicts all-cause mortality in frail older patients. It has been validated to assess the risk of 1-month to 2-year mortality in frail older patients during hospitalization and after hospital discharge. However, whether the MPI is a valid prognostic tool for follow-up periods of different lengths remains to be validated. To this end, we followed up 80 hospitalized patients (female=37, male 43) at least 75 years of age (mean age=82.6±4.4, range=75-94 years) to assess the 3-month all-cause mortality (mean follow-up=61.0 ± 31.7 months [range 4-90 days]). Accordingly, patients were subdivided into low (MPI-1, score 0-0.33), moderate (MPI-2, score 0.34-0.66) and high (MPI-3, score 0.67-1) mortality risk classes. Moreover, baseline biochemical, inflammatory and metabolic parameters, as well as anamnestic and clinical characteristics, were obtained. Although the MPI-3 score was significantly associated with 3-month all-cause mortality in univariate analysis (HR=5.79, 95%CI=1.77-18.92, p=0.004), a multivariate model indicated that only low albumin (HR=0.33, 95%CI=0.16-0.68, p=0.003) and high IL6 (HR=1.01, 95%CI=1.00-1.02, p=0.010) levels were significantly associated with 3-month all-cause mortality. In conclusion, we suggest that measurement of IL6 as well as albumin, rather than the MPI score, may help in providing tailored therapeutic interventions to decrease short term mortality in older hospitalized individuals.
Highlights
The multidimensional prognostic index (MPI) is a sensitive and specific prognosis estimation tool that accurately predicts all-cause mortality in frail older patients
Six patients were excluded because they were younger than 75 years, and 11 patients were excluded because the Comprehensive Geriatric Assessment (CGA) was not completed
The best multivariable Cox regression model indicated that the 3-month all cause-mortality was significantly and independently associated with high IL6 levels (HR=1.01, 95%CI=1.00–1.02, p=0.010) and low albumin levels (HR=0.33, 95%CI=0.16–0.68, p=0.003)
Summary
The multidimensional prognostic index (MPI) is a sensitive and specific prognosis estimation tool that accurately predicts all-cause mortality in frail older patients. It has been validated to assess the risk of 1month to 2-year mortality in frail older patients during hospitalization and after hospital discharge. Whether the MPI is a valid prognostic tool for follow-up periods of different lengths remains to be validated To this end, we followed up 80 hospitalized patients (female=37, male 43) at least 75 years of age (mean age=82.6±4.4, range=75–94 years) to assess the 3-month all-cause mortality (mean follow-up=61.0 ±31.7 months [range 4–90 days]). The multidimensional prognostic index (MPI), a validated and accurate algorithm for assessing the risk of 1-month to 2year mortality, is used to assess frail older patients after hospital discharge [5,6,7,8]. We performed a hypothesis-generating short follow-up to investigate 3-month total mortality after discharge in a group of very old inpatients hospitalized for acute and severe medical events
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
