Value of the PROFUND index in comparison with clinical intuition for the prognosis of multipathological hospitalized patients

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 observat...

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Autores principales: Moretti, Dino, Buncuga, Martin Gonzalo, Scolari Pasinato, Carlos Mariano, Rossi, Francisco Esteban, Quiñones, Nadia Daniela, Laudanno, Carlos Dario
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
Materias:
multimorbidity
mortality
prognostic
inpatients
multimorbilidad
mortalidad
pronóstico
pacientes hospitalizados
multimorbidade
mortalidade
prognóstico
pacientes internados
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/30189
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
Descripción
Sumario: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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