Rosanne J H C G Beijers1, Bram van den Borst2, Anne B Newman3, Sachin Yende4, Stephen B Kritchevsky5, Patricia A Cassano6, Douglas C Bauer7, Tamara B Harris8, Annemie M W J Schols1. 1. NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands. 2. NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands. Electronic address: b.vdborst@maastrichtuniversity.nl. 3. Department of Epidemiology and Center for Aging and Population Research, University of Pittsburgh, Pittsburgh, PA. 4. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. 5. Department of Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC. 6. Division of Nutritional Sciences, Cornell University, Ithaca, NY; Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, NY. 7. Department of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA. 8. Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD.
Abstract
BACKGROUND: Both respiratory and nonrespiratory hospitalizations are common and costly events in older individuals with obstructive lung disease. Prevention of any hospitalization in these individuals is essential. We aimed to construct a prediction model for all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease. METHODS: We studied 268 community-dwelling individuals with obstructive lung disease (defined as FEV1/FVC<LLN) who participated in the observational Health, Aging, and Body Composition Study and constructed a prediction model for 9-year all-cause hospitalization risk using a weighted linear combination based on beta coefficients. RESULTS: There were 225 individuals with 1 or more hospitalizations and 43 individuals free from hospitalization during the follow-up. Heart and vascular disease (H), objectively measured lower extremity dysfunction (O), systemic inflammation (S), dyspnea (P), impaired renal function (I), and tobacco exposure (T) were independent predictors for all-cause hospitalization (ALL). These factors were combined into the HOSPITALL score (0-23 points), with an area under the curve in ROC analysis of 0.70 (P < .001). The hazard ratio for all-cause hospitalization per 1-point increase in the HOSPITALL score was 1.15 (95% confidence interval, 1.11-1.19, P = .001). Increasing HOSPITALL score was further associated with shorter time to first admission, increased admission rate, and more respiratory admissions. CONCLUSION: The HOSPITALL score is a multidimensional score to predict all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease that may aid in patient counseling and prevention to reduce burden and health care costs.
BACKGROUND: Both respiratory and nonrespiratory hospitalizations are common and costly events in older individuals with obstructive lung disease. Prevention of any hospitalization in these individuals is essential. We aimed to construct a prediction model for all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease. METHODS: We studied 268 community-dwelling individuals with obstructive lung disease (defined as FEV1/FVC<LLN) who participated in the observational Health, Aging, and Body Composition Study and constructed a prediction model for 9-year all-cause hospitalization risk using a weighted linear combination based on beta coefficients. RESULTS: There were 225 individuals with 1 or more hospitalizations and 43 individuals free from hospitalization during the follow-up. Heart and vascular disease (H), objectively measured lower extremity dysfunction (O), systemic inflammation (S), dyspnea (P), impaired renal function (I), and tobacco exposure (T) were independent predictors for all-cause hospitalization (ALL). These factors were combined into the HOSPITALL score (0-23 points), with an area under the curve in ROC analysis of 0.70 (P < .001). The hazard ratio for all-cause hospitalization per 1-point increase in the HOSPITALL score was 1.15 (95% confidence interval, 1.11-1.19, P = .001). Increasing HOSPITALL score was further associated with shorter time to first admission, increased admission rate, and more respiratory admissions. CONCLUSION: The HOSPITALL score is a multidimensional score to predict all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease that may aid in patient counseling and prevention to reduce burden and health care costs.
Authors: Dennis E Niewoehner; Kathryn Rice; Claudia Cote; Daniel Paulson; J Allen D Cooper; Larry Korducki; Cara Cassino; Steven Kesten Journal: Ann Intern Med Date: 2005-09-06 Impact factor: 25.391
Authors: Fabio Pitta; Thierry Troosters; Martijn A Spruit; Vanessa S Probst; Marc Decramer; Rik Gosselink Journal: Am J Respir Crit Care Med Date: 2005-01-21 Impact factor: 21.405
Authors: Samuel Y Ash; Rola Harmouche; Rachel K Putman; James C Ross; Alejandro A Diaz; Gary M Hunninghake; Jorge Onieva Onieva; Fernando J Martinez; Augustine M Choi; David A Lynch; Hiroto Hatabu; Ivan O Rosas; Raul San Jose Estepar; George R Washko Journal: Chest Date: 2017-05-12 Impact factor: 9.410