Validation of the profund index to predict early post-hospital discharge mortality.
QJM. 2019 Jul 11;:
Authors: Martín-Escalante MD, Quirós-López R, Martos-Pérez F, Olalla-Sierra J, Rivas-Ruiz F, Aguilar-García JA, Jiménez-Puente A, García-Alegría J
BACKGROUND: The Profund Index is a prognostic scale for polypathological patients at 12 months.The objective of the study was to validate the PROFUND index as a predictor of one-year mortality in a current cohort of polypathological patients and analyse its prognostic usefulness in the short term (1 and 3 months) after discharge from Internal Medicine.
DESIGN: We conducted a prospective observational study and all polypathological patients discharged from an Internal Medicine Department between 01 March 2016 and 28 February 2017 were enrolled.
METHODS: The variables recorded for each patient were age, sex, diseases and diagnostic categories defining patients as polypathological patients, PROFUND index at discharge, number of hospital admissions, length of stay, vital status at one year, and date and place of death if applicable. Follow-up lasted one year from the time of enrolment.
RESULTS: 610 polypathological patients were enrolled. Mortality was 41% and the patients who died were older, their length of stay was longer, and their PROFUND index was higher compared with those who survived. The discrimination of the PROFUND index for predicting mortality was good, with a C-statistic of 0.718 (95% confidence interval [CI]: 0.67- 0.76). In addition, a subgroup of patients with early mortality after discharge was identified, with a C-statistic of 0.74 (95% CI: 0.67-0.80) at 30 days and 0.73 (95% CI: 0.68-0.78) at 90 days.
CONCLUSIONS: The PROFUND index is a valid tool for predicting early and one-year mortality in polypathological patients after discharge from Internal Medicine.
PMID: 31297526 [PubMed - as supplied by publisher]