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Development and validation of predictive model for long-term hospitalization, readmission, and in-hospital death of patients over 60 years old.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Instituto de Ensino e Pesquisa Albert Einstein Country of Publication: Brazil NLM ID: 101281800 Publication Model: eCollection Cited Medium: Internet ISSN: 2317-6385 (Electronic) Linking ISSN: 16794508 NLM ISO Abbreviation: Einstein (Sao Paulo) Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: São Paulo, SP : Instituto de Ensino e Pesquisa Albert Einstein
    • الموضوع:
      Hospitalization* ; Patient Readmission*; Aged ; Brazil/epidemiology ; Hospital Mortality ; Humans ; Length of Stay ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors
    • نبذة مختصرة :
      Objective: To develop and validate a high-risk predictive model that identifies, at least, one common adverse event in older population: early readmission (up to 30 days after discharge), long hospital stays (10 days or more) or in-hospital deaths.
      Methods: This was a retrospective cohort study including patients aged 60 years or older (n=340) admitted at a 630-beds tertiary hospital, located in the city of São Paulo, Brazil. A predictive model of high-risk indication was developed by analyzing logistical regression models. This model prognostic capacity was assessed by measuring accuracy, sensitivity, specificity, and positive and negative predictive values. Areas under the receiver operating characteristic curve with 95% confidence intervals were also obtained to assess the discriminatory power of the model. Internal validation of the prognostic model was performed in a separate sample (n=168).
      Results: Statistically significant predictors were identified, such as current Barthel Index, number of medications in use, presence of diabetes mellitus, difficulty chewing or swallowing, extensive surgery, and dementia. The study observed discrimination model acceptance in the construction sample 0.77 (95% confidence interval: 0.71-0.83) and good calibration. The characteristics of the validation samples were similar, and the receiver operating characteristic curve area was 0.687 (95% confidence interval: 0.598-0.776). We could assess an older patient's adverse health events during hospitalization after admission.
      Conclusion: A predictive model with acceptable discrimination was obtained, with satisfactory results for early readmission (30 days), long hospital stays (10 days), or in-hospital death.
    • References:
      Md State Med J. 1965 Feb;14:61-5. (PMID: 14258950)
      J Gerontol A Biol Sci Med Sci. 2019 Sep 15;74(10):1643-1649. (PMID: 30329033)
      J Am Med Dir Assoc. 2013 Apr;14(4):287-92. (PMID: 23402948)
      Rev Saude Publica. 2011 Feb;45(1):106-12. (PMID: 21181052)
      Swiss Med Wkly. 2004 Oct 16;134(41-42):606-11. (PMID: 15592954)
      J Gerontol A Biol Sci Med Sci. 2017 Jan;72(1):59-60. (PMID: 27803097)
      Aging Clin Exp Res. 2019 Sep;31(9):1233-1242. (PMID: 30406920)
      BMJ. 2009 Mar 31;338:b604. (PMID: 19336487)
      Stat Methods Med Res. 2016 Aug;25(4):1692-706. (PMID: 23907781)
      BMC Med Inform Decis Mak. 2017 Apr 8;17(1):35. (PMID: 28390405)
      BMJ. 2009 May 28;338:b605. (PMID: 19477892)
      Clinics (Sao Paulo). 2009;64(7):613-8. (PMID: 19606235)
      Am J Geriatr Psychiatry. 2018 Oct;26(10):1015-1033. (PMID: 30076080)
      J Am Geriatr Soc. 1975 Oct;23(10):433-41. (PMID: 1159263)
      J Am Geriatr Soc. 2019 Aug;67(8):1559-1564. (PMID: 31045254)
      Cad Saude Publica. 2007 Oct;23(10):2479-89. (PMID: 17891307)
      J Am Geriatr Soc. 2000 Feb;48(2):164-9. (PMID: 10682945)
      J Gen Intern Med. 2012 Nov;27(11):1467-74. (PMID: 22692634)
      Rev Saude Publica. 2006 Dec;40(6):1049-56. (PMID: 17173162)
      J Am Geriatr Soc. 2018 Apr;66(4):748-754. (PMID: 29473941)
      Popul Health Manag. 2015 Aug;18(4):256-64. (PMID: 25608114)
      BMC Geriatr. 2019 Mar 21;19(1):89. (PMID: 30898161)
      PM R. 2019 May;11(5):522-532. (PMID: 30758920)
      J Gerontol A Biol Sci Med Sci. 2005 Sep;60(9):1180-3. (PMID: 16183960)
      J Am Geriatr Soc. 1988 Aug;36(8):687-92. (PMID: 3403873)
      Epidemiology. 2010 Jan;21(1):128-38. (PMID: 20010215)
    • الموضوع:
      Date Created: 20220622 Date Completed: 20220623 Latest Revision: 20220716
    • الموضوع:
      20240829
    • الرقم المعرف:
      PMC9239538
    • الرقم المعرف:
      10.31744/einstein_journal/2022AO8012
    • الرقم المعرف:
      35730807