Díez-Manglano Jesús, Del Corral Beamonte Esther, Ramos Ibáñez Rosa, Lambán Aranda María Pilar, Toyas Miazza Carla, Rodero Roldán María Del Mar, Ortiz Domingo Concepción, Munilla López Eulalia, de Escalante Yangüela Begoña
Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España.
Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España.
Med Clin (Barc). 2016 Sep 16;147(6):238-44. doi: 10.1016/j.medcli.2016.06.003. Epub 2016 Jul 13.
To determine the usefullness of the PROFUND index to assess the risk of global death after 4 years in polypathological patients.
Multicenter prospective cohort (Internal Medicine and Geriatrics) study. Polypathological patients admitted between March 1st and June 30th 2011 were included. For each patient, data concerning age, sex, living at home or in a nursing residence, polypathology categories, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs, hemoglobin and creatinine values were gathered, and the PROFUND index was calculated. The follow-up lasted 4 years.
We included 441 patients, 324 from Internal Medicine and 117 from Geriatrics, with a mean age of 80.9 (8.7) years. Of them, 245 (55.6%) were women. Heart (62.7%), neurological (41.4%) and respiratory (37.3%) diseases were the most frequent. Geriatrics inpatients were older and more dependants and presented greater cognitive deterioration. After 4 years, 335 (76%) patients died. Mortality was associated with age, dyspnoea, Barthel index<60, delirium, advanced neoplasia and≥4 admissions in the last year. The area under the curve of the PROFUND index was 0.748, 95% CI 0.689-0.806, P<.001 in Internal Medicine and 0.517, 95% CI 0.369-0.666, P=.818 in Geriatrics patients, respectively.
The PROFUND index is a reliable tool for predicting long-term global mortality in polypathological patients from Internal Medicine but not from Geriatrics departments.
确定PROFUND指数在评估多病患者4年后全因死亡风险中的作用。
多中心前瞻性队列（内科与老年医学）研究。纳入2011年3月1日至6月30日期间收治的多病患者。收集每位患者的年龄、性别、居家或住养老院情况、多病类别、查尔森指数、巴氏指数和劳顿-布罗迪指数、 Pfeiffer问卷、社会家庭希洪量表、谵妄、用药数量、血红蛋白和肌酐值等数据，并计算PROFUND指数。随访持续4年。
我们纳入了441例患者，其中内科324例，老年医学科117例，平均年龄80.9（8.7）岁。其中，245例（55.6%）为女性。心脏疾病（62.7%）、神经疾病（41.4%）和呼吸疾病（37.3%）最为常见。老年医学科住院患者年龄更大、依赖性更强且认知功能衰退更严重。4年后，335例（76%）患者死亡。死亡率与年龄、呼吸困难、巴氏指数<60、谵妄、晚期肿瘤以及去年≥4次入院有关。在内科患者中，PROFUND指数的曲线下面积为0.748，95%可信区间为0.689 - 0.806，P<0.001；在老年医学科患者中，曲线下面积为0.517，95%可信区间为0.369 - 0.666，P = 0.818。
PROFUND指数是预测内科多病患者长期全因死亡率的可靠工具，但不适用于老年医学科患者。
