Abstract
The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI) for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA) and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH). The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1%) and 340 SNUBH patients (30.7%) died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital.
Highlights
The global population is aging and the proportion of older adults is increasing in South Korea [1]
Variables for the geriatric prognosis index (GPI) were selected in an a priori fashion to facilitate adaptation for a widespread Geriatric assessment (GA) with generally accepted domains and to prevent over-fitting in the study dataset; these variables included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status, which are associated with prognosis
The GPI score was positively associated with age in both the development (B = 0.14, 95% confidence intervals (CIs) 0.12–0.16, R2 = 0.43) and validation (B = 0.07, 95% CI 0.07–0.08, R2 = 0.28) cohorts in the linear regression analysis
Summary
We aimed to develop a multidimensional geriatric prognosis index (GPI) for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. We aimed to develop a practical and generally accepted multidimensional geriatric prognosis index (GPI) based on GA to predict long-term mortality in Korean communitydwelling elderly and validate the GPI in a separate hospital-based population
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