Value of the PROFUND index in comparison with clinical intuition for the prognosis of multipathological hospitalized patients
DOI:
https://doi.org/10.31053/1853.0605.v78.n4.30189Keywords:
multimorbidity, mortality, prognostic, inpatientsAbstract
Introduction: To study in Pluripathological patients (PP) if the PROFUND index, an objective multidimensional prognostic score, is superior to the intuition of the clinician to predict death during the first year of follow-up after hospitalization in a general ward.
Methods: Prospective and observational study. Adult pluripathological patients were included. Variables: PROFUND index, subjective prognosis of death (PSM). Do you think this patient will die in the next 12 months?: “yes” PSM (+) “no” PSM (-). Mortality 12 months after discharge.
Results: 92 patients were analyzed. The average age was 75.3 (± 9.5) years and 51.1% male. 47 patients (51.6%) died. The average PROFUND index was 6.9 (± 4.5) points and the PS was (+) at 46.7%. Within follow-up, 65.9% (29 of 44) and 38.3% (18 of 47) of patients with a PROFUND index> 6 and ≤6 points, respectively, died (p = 0.0021). Of the 43 patients with PS (+) 58.1% died and of the 48 with PS (-) 45.8% (p = 0.1003). From the Cox model, the risk of dying is 2 times higher in patients with a PROFUND index> 6 points (HR: 2,269 95% CI: 1,231-4,184). The AUC to predict 12-month mortality from the PROFUND index and PS were: 0.712 (95% CI: 0.607-0.817) and 0.561 (95% CI: 0.458-0.664) respectively (p 0.0212).
Conclusion: In hospitalized patients with pluripathology, the PROFUND index exceeds the 12-month mortality prognostic capacity of the treating clinician.
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