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07.11.2018 | Originalien

New associations of the Multidimensional Prognostic Index

Zeitschrift:
Zeitschrift für Gerontologie und Geriatrie
Autoren:
Anna Maria Meyer, Ingrid Becker, Giacomo Siri, Paul Thomas Brinkkötter, Thomas Benzing, Alberto Pilotto, MD PhD FRCP M. Cristina Polidori
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00391-018-01471-6) contains supplementary material, which is available to authorized users.
A. Pilotto and M.C. Polidori contributed equally to the manuscript.

Abstract

Background

The multidimensional prognostic index (MPI) is a validated, sensitive, and specific prognosis estimation tool based on a comprehensive geriatric assessment (CGA). The MPI accurately predicts mortality after 1 month and 1 year in older, multimorbid patients with acute disease or relapse of chronic conditions.

Objective

To evaluate whether the MPI predicts indicators of healthcare resources, i.e. grade of care (GC), length of hospital stay (LHS) and destination after hospital discharge in older patients in an acute medical setting.

Material and methods

In this study 135 hospitalized patients aged 70 years and older underwent a CGA evaluation to calculate the MPI on admission and discharge. Accordingly, patients were subdivided in low (MPI‑1, score 0–0.33), moderate (MPI-2, score 0.34–0.66) and high (MPI-3, score 0.67–1) risk of mortality. The GC, LHS and the discharge allocation were also recorded.

Results

The MPI score was significantly related to LHS (p = 0.011) and to GC (p < 0.001). In addition, MPI-3 patients were significantly more often transferred from other hospital settings (p = 0.007) as well as significantly less likely to be discharged home (p = 0.04) than other groups.

Conclusion

The CGA-based MPI values are significantly associated with use of indicators of healthcare resources, including GC, LHS and discharge allocation. These findings suggest that the MPI may be useful for resource planning in the care of older multimorbid patients admitted to hospital.

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