Clinical research studyA Prognostic Model for 1-Year Mortality in Older Adults after Hospital Discharge
Section snippets
Participants
The data used in these analyses were collected on individuals enrolled in a prospective cohort study comparing costs and outcomes of care by hospitalist and non-hospitalist physicians. It was conducted on an academic general medicine service at the University of Chicago Hospitals in Chicago, Ill from July 1, 1997 through June 30, 2001. The study included 14,661 patients admitted to the general medicine service either directly or transferred from nonmedical services or intensive care. Details of
Study Populations
Characteristics of the derivation and validation cohorts are listed in Table 1. The mean (SD) age of the patients in the derivation cohort was 78 (8.3) years. Sixty-three percent were female, 81% were African American, and 15% were discharged to a nursing home or skilled nursing facility. Thirty-five percent had a length of stay of at least 5 days in the hospital before discharge. During 1-year of follow-up, 722 patients (26%) died.
The mean (SD) age of the patients in the validation cohort was
Discussion
We have created a relatively simple prognostic index for older adults discharged from a general medicine service that stratifies patients at risk for 1-year mortality using information readily available from standard administrative data. Because many Medicare beneficiaries are hospitalized at least once in the year before death,22 the hospital admission becomes an important window of opportunity for recognizing persons at risk for further decline and mortality. As medical records are becoming
Acknowledgments
Supported by the University of Chicago Hospitals, Chicago, Illinois; the Charles E. Culpeper Foundation, New York, New York; the National Institute of Aging, Bethesda, Maryland; the Robert Wood Johnson Foundation, Princeton, New Jersey; the Hulda B. and Maurice L. Rothschild Foundation, Chicago, Illinois; the Academic and Managed Care Forum, Hartford, Connecticut; and the John A. Hartford Foundation/American Federation for Aging Research, New York, New York.
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