HOSPITAL Score and LACE Index to Predict Mortality in Multimorbid Older Patients.

Aubert, Carole E; Rodondi, Nicolas; Terman, Samuel W; Feller, Martin; Schneider, Claudio; Oberle, Jolanda; Dalleur, Olivia; Knol, Wilma; O'Mahony, Denis; Aujesky, Drahomir; Donzé, Jacques (2022). HOSPITAL Score and LACE Index to Predict Mortality in Multimorbid Older Patients. Drugs & aging, 39(3), pp. 223-234. Adis International 10.1007/s40266-022-00927-0

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BACKGROUND

Estimating life expectancy of older adults informs whether to pursue future investigation and therapy. Several models to predict mortality have been developed but often require data not immediately available during routine clinical care. The HOSPITAL score and the LACE index were previously validated to predict 30-day readmissions but may also help to assess mortality risk. We assessed their performance to predict 1-year and 30-day mortality in hospitalized older multimorbid patients with polypharmacy.

METHODS

We calculated the HOSPITAL score and LACE index in patients from the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly) trial (patients aged ≥ 70 years with multimorbidity and polypharmacy, admitted to hospital across four European countries in 2016-2018). Our primary and secondary outcomes were 1-year and 30-day mortality. We assessed the overall accuracy (scaled Brier score, the lower the better), calibration (predicted/observed proportions), and discrimination (C-statistic) of the models.

RESULTS

Within 1 year, 375/1879 (20.0%) patients had died, including 94 deaths within 30 days. The overall accuracy was good and similar for both models (scaled Brier score 0.01-0.08). The C-statistics were identical for both models (0.69 for 1-year mortality, p = 0.81; 0.66 for 30-day mortality, p = 0.94). Calibration showed well-matching predicted/observed proportions.

CONCLUSION

The HOSPITAL score and LACE index showed similar performance to predict 1-year and 30-day mortality in older multimorbid patients with polypharmacy. Their overall accuracy was good, their discrimination low to moderate, and the calibration good. These simple tools may help predict older multimorbid patients' mortality after hospitalization, which may inform post-hospitalization intensity of care.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Aubert, Carole Elodie, Rodondi, Nicolas, Feller, Martin, Schneider, Claudio, Oberle, Jolanda, Aujesky, Drahomir

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1170-229X

Publisher:

Adis International

Funders:

[4] Swiss National Science Foundation ; [201] Staatssekretariat für Bildung, Forschung und Innovation (SBFI) = Swiss State Secretariat for Education, Research and Innovation (SERI)

Language:

English

Submitter:

Pubmed Import

Date Deposited:

11 Mar 2022 10:12

Last Modified:

02 Mar 2023 23:36

Publisher DOI:

10.1007/s40266-022-00927-0

PubMed ID:

35260994

Additional Information:

Open Access funding provided by University of Bern.

BORIS DOI:

10.48350/167237

URI:

https://boris.unibe.ch/id/eprint/167237

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