Jesús Díez-Manglano1, Noelia Gómez-Aguirre2, José Velilla-Marco3, María Pilar Lambán Aranda4, Begoña de Escalante Yangüela5, Daniel Fuertes Ruiz4, Alfonso García Aranda3, Carolina Clemente Sarasa4. 1. Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de Investigación en Comorbilidad y Puripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España. Electronic address: jdiez@aragon.es. 2. Servicio de Medicina Interna, Hospital Ernest Lluch, Calatayud, España. 3. Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España. 4. Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España. 5. Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Abstract
BACKGROUND AND OBJECTIVE: To compare the discrimination power of PROFUND and PALIAR indexes for predicting mortality in polypathological patients with advanced non-oncologic chronic disease. MATERIAL AND METHODS: Prospective multicentre cohort study. We included polypathological patients with advanced non-oncologic chronic disease, who were admitted to internal medicine departments between July 1st and December 31th, 2014. Data was collected from each patient on age, sex, categories of polypathology, advanced disease, comorbidity, functional and cognitive assessment, terminal illness symptoms, need for caregiver, hospitalisation in the past three and 12 months and number of drugs. We calculated the PROFUND and PALIAR indexes and conducted a 12-month follow-up. We assessed mortality with the Kaplan-Meier survival curves and the discrimination of indexes with the ROC curves. RESULTS: We included 213 patients with a mean (standard deviation) age of 83.0 (7.0) years, 106 (49.8%) of whom were female. Mortality at six months was 40.4% and at 12 months 50.2%. Deceased patients scored higher scores on the PROFUND [11.2(4.2) vs 8.5(3.9); P<.001] and PALIAR [6.7 (4.6) vs 3.6(3.1); p<0,001] indexes. The discrimination of PALIAR index at six months (under the curve area 0.734 95%CI 0.665-0.803) was higher than of PROFUND, and there was no difference at 12 months. CONCLUSIONS: In polypathological patients with advanced non-oncologic chronic disease, the PALIAR index had better discrimination power than PROFUND index at 66 months and there were no differences at 12 months.
BACKGROUND AND OBJECTIVE: To compare the discrimination power of PROFUND and PALIAR indexes for predicting mortality in polypathological patients with advanced non-oncologic chronic disease. MATERIAL AND METHODS: Prospective multicentre cohort study. We included polypathological patients with advanced non-oncologic chronic disease, who were admitted to internal medicine departments between July 1st and December 31th, 2014. Data was collected from each patient on age, sex, categories of polypathology, advanced disease, comorbidity, functional and cognitive assessment, terminal illness symptoms, need for caregiver, hospitalisation in the past three and 12 months and number of drugs. We calculated the PROFUND and PALIAR indexes and conducted a 12-month follow-up. We assessed mortality with the Kaplan-Meier survival curves and the discrimination of indexes with the ROC curves. RESULTS: We included 213 patients with a mean (standard deviation) age of 83.0 (7.0) years, 106 (49.8%) of whom were female. Mortality at six months was 40.4% and at 12 months 50.2%. Deceased patients scored higher scores on the PROFUND [11.2(4.2) vs 8.5(3.9); P<.001] and PALIAR [6.7 (4.6) vs 3.6(3.1); p<0,001] indexes. The discrimination of PALIAR index at six months (under the curve area 0.734 95%CI 0.665-0.803) was higher than of PROFUND, and there was no difference at 12 months. CONCLUSIONS: In polypathological patients with advanced non-oncologic chronic disease, the PALIAR index had better discrimination power than PROFUND index at 66 months and there were no differences at 12 months.
Authors: Pere Almagro; Ana Ponce; Shakeel Komal; Maria de la Asunción Villaverde; Cristina Castrillo; Gemma Grau; Lluis Simon; Alex de la Sierra Journal: PLoS One Date: 2020-01-28 Impact factor: 3.240