Multidimensional Prognostic Index Predicts Mortality and Length of Stay During Hospitalization in the Older Patients: A Multicenter Prospective Study

Volpato, Stefano; Bazzano, Salvatore; Fontana, Andrea; Ferrucci, Luigi

doi:10.1093/gerona/glu167

Cited by 76 publications

(62 citation statements)

References 32 publications

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“…MPI has been consistently related to short 17 and longterm mortality risk after hospital discharge in patients with a broad spectrum of specific diseases, including, but not limited to, pneumonia, 12 dementia, 13 congestive heart failure, 14 and kidney failure. 15 The results of the present work extend those of previous studies of this group, providing new insight into the potential clinical application of MPI assessment.…”

Section: Volpato Et Almentioning

confidence: 99%

“…10 Its long-term predictive value has been established in the overall hospitalized population 11 as well as in older subjects hospitalized for specific clinical conditions. [12][13][14][15][16] Recently, we have demonstrated the validity of MPI in predicting in-hospital mortality and length of hospital stay (LOS) among patients with multiple types of diseases and causes of hospitalization, 17 but no data are available on change in MPI score over hospital stay and on its sensitivity to patient's clinical modification over time.…”

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confidence: 99%

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Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Volpato

Daragjati

Simonato

et al. 2016

Rejuvenation Research

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on behalf of the MPI-TriVeneto Study Group * AbstractWe investigated and describe change in the Multidimensional Prognostic Index (MPI) score between admission and discharge in 960 older patients admitted to 20 geriatric units for an acute disease or a relapse of a chronic disease. The MPI was calculated at admission and at discharge. Subjects were divided into three groups of MPI score, low risk (MPI-1 value £0.33), moderate risk (MPI-2 value 0.34-0.66), and severe risk of mortality (MPI-3 value ‡0.67), on the basis of previously established cutoffs. Variation of MPI values over length of hospital stay (LOS) was analyzed with a multivariable longitudinal linear model for repeated measurements. At admission, 23.5% subjects had an MPI-1 score, 33.3% had an MPI-2 score, and 43.0% had an MPI-3 score. Overall, for almost 60% of the patients, MPI score at hospital discharge was different compared with the score at admission, although the difference was not statistically significant (-0.003; p = 0.708). Patients with high and intermediate MPI scores at admission had a decrease of MPI score at discharge (delta-MPI -0.026, p < 0.001, and delta-MPI -0.066, p = 0.569, respectively), whereas patients in the MPI-low group, experienced a significant increase in MPI score (delta-MPI 0.041, p < 0.001). The evolution of MPI score as a function of LOS had a curvilinear shape because it significantly decreased for patients with short hospitalization (1-6 days) and tended to increase for those with longer LOS. The MPI, a well-established prognostic tool, is sensitive to change of patient's health status and might be used to objectively track and monitor the clinical evolution of acutely ill geriatric patients admitted to the hospital.

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Section: Volpato Et Almentioning

confidence: 99%

mentioning

confidence: 99%

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Volpato

Daragjati

Simonato

et al. 2016

Rejuvenation Research

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“…In a previous study on MPI (Volpato et al, 2014), the in-hospital mortality rates by MPI risk level were largely consistent (Low-risk 1.1%, Moderate-risk 4.3%, Severe-risk 9.6%). The slight difference <0.0001 CIRS* (Q1-Q3) 5 (4-6) 6 (4-7) <0.0001 Drugs* (Q1-Q3) 7 (5-9) 7 (5-9) 0.27 Hospital stay (days)* (Q1-Q3) 7 (5-11) 9 (6-14) <0.0001 MPI score on admission* (Q1-Q3) 0.62 ( between the overall in-hospital mortality rates in the two studies (5.8% vs 7.4%) is most likely due to the smaller percentage of patients with severe-risk MPI scores in the earlier study (42.6% vs 58.9% in our sample), even though the two sample populations were of similar age.…”

Section: Discussionmentioning

confidence: 57%

“…The prognostic value of MPI scores has been confirmed in different acute and chronic disease scenarios (Giantin, Valentini, & Iasevoli, 2013;Pilotto et al, 2007Pilotto et al, , 2009aPilotto et al, , 2009bVolpato, Bazzano, Fontana, Ferrucci, & Pilotto, 2014). The MPI is generally used as part of the clinical work-up for assessing a patient on admission.…”

Section: Introductionmentioning

confidence: 98%

Short- and longer-term predictive capacity of the Multidimensional Prognostic Index: The timing of the assessment is of no consequence

Luca

Perissinotto

Fabris

et al. 2015

Archives of Gerontology and Geriatrics

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“…With increasing age, due to reduced function of organs and underlying diseases, the complications after open heart surgery would be more in the elderly than in other age groups. One of the most common complications after cardiac surgery, especially in the elderly, is depression (4); the rate of depression in the elderly after open heart surgery is estimated between 17.5% and 28.7% (5).…”

Section: Introductionmentioning

confidence: 99%

Depression, Functionality and Adaptability of Elderly Patients After Open Heart Surgery Off- or On-Pump

Asgari

Bahramnezhad

Mehrdad

et al. 2015

Jundishapur J Chronic Dis Care

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Background:Open heart surgery is performed by two methods of off or on cardiopulmonary bypass. Both methods may affect the rate of depression, level of functionality and adaptation of the elderly undergoing the operations. Objectives: The current study aimed to assess depression, level of functionality and adaptability in elderly patients undergoing open heart surgery with off or on pump in the in open heart surgery intensive care unit of Imam Khomeini and Shariati Hospitals, Tehran University of Medical Sciences. Patients and Methods:This cross-sectional study was conducted from 23 September 2013 to 22 March 2014. The samples were 160 elderly patients who were selected by convenience sampling method and divided into two groups of on-and off-pump coronary artery bypass graft. The rate of depression and level of functionality of the patients were assessed before and six weeks after surgery by Geriatric Depression Scale (GDS) and Medical Outcome Study SF 12 (MOS SF-12) questionnaires respectively, in a self-reporting approach. The rate of patient's adaptability was also evaluated six weeks after the surgery by Ways of Coping Questionnaire (WOCQ). Results: In on-and off-pump groups, there were statistically significant differences in terms of depression rate and level of functionality before and six weeks after the surgery, respectively, as (P = 0.001) and (P = 0.0001). The t-test results also showed that the patients' adapt ability in the on-pump group with the mean ± SD of 111.1 ± 56.17 was significantly different from that of the off-pump group with the average changes of 70.88 ± 91.15 (P = 0.0001). Conclusions: It is recommended to further support the patients undergoing on-pump open heart surgery, and some programs will be designed to reduce the level of their depression and increase their adaptability and functionality levels.

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Multidimensional Prognostic Index Predicts Mortality and Length of Stay During Hospitalization in the Older Patients: A Multicenter Prospective Study

Abstract: In older acute care inpatients, MPI score assessed at hospital admission is an independent predictor of in-hospital mortality and the length of hospital stay.

Cited by 76 publications

References 32 publications

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Short- and longer-term predictive capacity of the Multidimensional Prognostic Index: The timing of the assessment is of no consequence

Depression, Functionality and Adaptability of Elderly Patients After Open Heart Surgery Off- or On-Pump

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