The prognostic signature of health-related quality of life in older patients admitted to the emergency department: a 6-month follow-up study.
Clinical decision-making
Emergency department
Geriatric assessment
Health-related quality of life
Prognosis
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
20
06
2020
accepted:
01
10
2020
pubmed:
3
11
2020
medline:
28
7
2021
entrez:
2
11
2020
Statut:
ppublish
Résumé
The management of older and multimorbid patients with complex care requires a personalised and comprehensive approach. The main diagnosis is often registered as the cause of hospitalisation, yet poor health-related quality of life (HRQoL) as well as multimorbidity may represent the underlying cause and markedly influence prognosis. To analyse the association of HRQoL and clinical prognosis over time as assessed by a Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI) in older patients admitted to the emergency department (ED). We used data from the prospective MPI-HOPE (Influence of the MPI on the Hospitalisation of Older Patients admitted to the Emergency department) study. Data from 165 patients (≥ 75 years) admitted to the ED of the University Hospital of Cologne, Germany, between Oct 2017 and Jan 2018 were included. Clinical prognosis was calculated by the MPI and HRQoL by the EQ5D-5L. Follow-up interviews assessed HRQoL up to 6 months after discharge. Most patients were multimorbid and presented with several geriatric syndromes. At admission, HRQoL was highest in patients with the best clinical prognosis. The MPI showed a negative correlation with the EQ-Index at admission (r Our results suggest that patients' self-perceived HRQoL in the ED is related to functional health status and clinical prognosis. The MPI as a multidimensional snapshot provides information on clinical health indicators and informs about subjective HRQoL, thereby helping in identifying patients who would benefit from a specific treatment within the frame of a patient-centered, value-based care strategy geriatric treatment.
Sections du résumé
BACKGROUND
BACKGROUND
The management of older and multimorbid patients with complex care requires a personalised and comprehensive approach. The main diagnosis is often registered as the cause of hospitalisation, yet poor health-related quality of life (HRQoL) as well as multimorbidity may represent the underlying cause and markedly influence prognosis.
AIMS
OBJECTIVE
To analyse the association of HRQoL and clinical prognosis over time as assessed by a Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI) in older patients admitted to the emergency department (ED).
METHODS
METHODS
We used data from the prospective MPI-HOPE (Influence of the MPI on the Hospitalisation of Older Patients admitted to the Emergency department) study. Data from 165 patients (≥ 75 years) admitted to the ED of the University Hospital of Cologne, Germany, between Oct 2017 and Jan 2018 were included. Clinical prognosis was calculated by the MPI and HRQoL by the EQ5D-5L. Follow-up interviews assessed HRQoL up to 6 months after discharge.
RESULTS
RESULTS
Most patients were multimorbid and presented with several geriatric syndromes. At admission, HRQoL was highest in patients with the best clinical prognosis. The MPI showed a negative correlation with the EQ-Index at admission (r
DISCUSSION
CONCLUSIONS
Our results suggest that patients' self-perceived HRQoL in the ED is related to functional health status and clinical prognosis.
CONCLUSION
CONCLUSIONS
The MPI as a multidimensional snapshot provides information on clinical health indicators and informs about subjective HRQoL, thereby helping in identifying patients who would benefit from a specific treatment within the frame of a patient-centered, value-based care strategy geriatric treatment.
Identifiants
pubmed: 33135133
doi: 10.1007/s40520-020-01732-8
pii: 10.1007/s40520-020-01732-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2203-2211Informations de copyright
© 2020. Springer Nature Switzerland AG.
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