Pauline Boeckxstaens1, Bert Vaes2, Gijs Van Pottelbergh2, An De Sutter3, Delphine Legrand4, Wim Adriaensen4, Catharina Matheï4, Olivia Dalleur5, Jan Degryse2. 1. Department of Family Medicine and Primary Health Care, Ghent University (UG), UZ Gent 3K3 De Pintelaan, 185 9000 Ghent, Belgium. Electronic address: Pauline.boeckxstaens@ugent.be. 2. Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium; Department of Public and Primary HealthCare, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 35 blok d, box 7001, B-3000, Leuven, Belgium. 3. Department of Family Medicine and Primary Health Care, Ghent University (UG), UZ Gent 3K3 De Pintelaan, 185 9000 Ghent, Belgium. 4. Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium. 5. Pharmacy Department, Cliniques Universitaires Saint-Luc; Louvain Drug Research Institute (LDRI), Université Catholique de Louvain, Avenue E. Mounier 73, B-1200, Brussels, Belgium.
Abstract
OBJECTIVES: To assess and compare the ability of two measures of multimorbidity and a simple disease count (DC) to predict health outcomes in a population of patients aged ≥80 years. STUDY DESIGN AND SETTING: A prospective, observational, and population-based cohort study including 567 individuals [3.0 years (standard deviation ± 0.25) follow-up]. RESULTS: Of the patients, 37.6% were reported with five or more diseases. Multimorbidity was measured by means of a modified Charlson comorbidity index [mCCI; median score, 5 (range, 4-15)], Cumulative Illness Rating Scale [CIRS; median score, 4 (range, 1-11)], and a simple DC of 22 selected chronic conditions [median score, 4 (range, 0-13)]. All measures were independently related to mortality [adjusted hazard ratio (HR) mCCI, 2.5 (confidence interval {CI}: 1.5, 4.1); CIRS, 2.1 (CI: 1.4, 3.2); DC, 2.1 (CI: 1.4, 3.2)] and hospitalization [adjusted HR DC, 2.3 (CI: 1.7, 3.1); mCCI, 2.1 (CI: 1.5, 3.0), CIRS, 1.9 (CI: 1.5, 2.6)] but not to functional decline. Areas under the curve for mortality and hospitalization were all below 0.70. Net reclassification improvements did not indicate that any one measure provided a significant benefit over the others. CONCLUSION: In this population, the mCCI, CIRS, and unweighted DC predicted mortality and hospitalization but not functional decline. There is no clear advantage of using one measure over another.
OBJECTIVES: To assess and compare the ability of two measures of multimorbidity and a simple disease count (DC) to predict health outcomes in a population of patients aged ≥80 years. STUDY DESIGN AND SETTING: A prospective, observational, and population-based cohort study including 567 individuals [3.0 years (standard deviation ± 0.25) follow-up]. RESULTS: Of the patients, 37.6% were reported with five or more diseases. Multimorbidity was measured by means of a modified Charlson comorbidity index [mCCI; median score, 5 (range, 4-15)], Cumulative Illness Rating Scale [CIRS; median score, 4 (range, 1-11)], and a simple DC of 22 selected chronic conditions [median score, 4 (range, 0-13)]. All measures were independently related to mortality [adjusted hazard ratio (HR) mCCI, 2.5 (confidence interval {CI}: 1.5, 4.1); CIRS, 2.1 (CI: 1.4, 3.2); DC, 2.1 (CI: 1.4, 3.2)] and hospitalization [adjusted HR DC, 2.3 (CI: 1.7, 3.1); mCCI, 2.1 (CI: 1.5, 3.0), CIRS, 1.9 (CI: 1.5, 2.6)] but not to functional decline. Areas under the curve for mortality and hospitalization were all below 0.70. Net reclassification improvements did not indicate that any one measure provided a significant benefit over the others. CONCLUSION: In this population, the mCCI, CIRS, and unweighted DC predicted mortality and hospitalization but not functional decline. There is no clear advantage of using one measure over another.
Authors: Pauline Boeckxstaens; Bert Vaes; An De Sutter; Isabelle Aujoulat; Gijs van Pottelbergh; Catharina Matheï; Jean-Marie Degryse Journal: Ann Fam Med Date: 2016-07 Impact factor: 5.166
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