Hirdes John P, Frijters Dinnus H, Teare Gary F
Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada.
J Am Geriatr Soc. 2003 Jan;51(1):96-100. doi: 10.1034/j.1601-5215.2002.51017.x.
To develop a scale predicting mortality and other adverse outcomes associated with frailty.
Observational study based on Minimum Data Set (MDS) 2.0 and mortality data.
Ontario chronic hospitals.
All chronic hospital patients (N = 28,495) assessed with the MDS 2.0 after mandatory implementation in July 1996 followed until May 1999.
MDS 2.0 assessments done as part of normal practice mainly by registered nurses or multidisciplinary teams in a chronic hospital. Mortality data are available from the accompanying discharge tracking form.
The MDS-Changes in Health, End-stage disease and Symptoms and Signs (CHESS) score is a composite measure addressing changes in health, end-stage disease, and symptoms and signs of medical problems. It is a strong predictor of mortality (P <.0001) independent of the effects of age, sex, activities of daily living impairment, cognition, and do-not-resuscitate orders. It is also strongly associated with physician activity, complex medical procedures, and pain (P <.001 for each dependent variable).
The CHESS score provides a useful new MDS-based test to predict mortality and to measure instability in health as a clinical outcome.
制定一个预测与衰弱相关的死亡率及其他不良结局的量表。
基于最小数据集（MDS）2.0和死亡率数据的观察性研究。
安大略省慢性病医院。
1996年7月强制实施后使用MDS 2.0进行评估的所有慢性病医院患者（N = 28495），随访至1999年5月。
MDS 2.0评估主要由慢性病医院的注册护士或多学科团队作为常规操作的一部分进行。死亡率数据可从随附的出院追踪表中获得。
MDS-健康、终末期疾病及症状体征变化（CHESS）评分是一项综合指标，涉及健康变化、终末期疾病以及医疗问题的症状和体征。它是死亡率的有力预测指标（P <.0001），独立于年龄、性别、日常生活活动障碍、认知及不进行心肺复苏医嘱的影响。它还与医生活动、复杂医疗程序及疼痛密切相关（每个因变量的P <.001）。
CHESS评分提供了一种基于MDS的有用新测试，可预测死亡率并衡量作为临床结局的健康不稳定性。
