Prognosis and prognostic research validating a prognostic model dating set

Posted by / 18-Jun-2017 19:38

Prognosis and prognostic research validating a prognostic model

Methods: prospective cohort study of consecutive patients discharged from hospital or intermediate care to nursing homes from January 2012 to January 2014.

MMRI-R scoring was done prior to discharge and subsequent deaths were ascertained.

The MMRI-R tool is a 10-item score sheet with yes/no options, weighted points for each item and scoring guidance [10].

It uses easily available clinical data, which are a standard part of hospital clinical assessment.

The first eight items are admission to nursing home in the last 3 months, unintentional weight loss, renal failure, chronic heart failure, poor appetite, male sex, dehydration and shortness of breath [10].

Kaplan–Meier curves were plotted with scores stratified by the cutpoint. By the end of follow-up, 99 patients (54.1%) were dead.The Minimum Data Set (MDS) Mortality Risk Index—Revised (MMRI-R), a simplification of the original MDS Mortality Risk Index (MMRI), was designed, and validated in the USA using information from the MDS, a clinical and administrative database designed to monitor quality of care in Medicare and Medicaid registered nursing homes [10, 11].It predicts 6-month mortality in US nursing home residents, and has not been formally validated in the UK [10].A proportion of such patients will be in the last few months of life.National recommendations suggest that people approaching the end of life should have an agreed care plan [4].

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Results: a total of 183 patients were followed up for a median of 230 days. The Hosmer–Lemeshow test showed -values of 0.4406 for 3-month and 0.8904 for 6-month mortality.

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