Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Switzerland.
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
Maturitas. 2018 Apr;110:57-61. doi: 10.1016/j.maturitas.2018.01.018. Epub 2018 Jan 31.
The 6-item Brief Geriatric Assessment (BGA) is a screening tool to identify frail inpatients who are at risk of adverse health events. Its predictive value for in-hospital mortality has not been examined yet.
This study examined whether the BGA is able to predict in-hospital mortality in older patients.
A total of 1082 participants were included in this observational prospective cohort study. At their admission to the medical wards of Angers University Hospital (France), all inpatients aged ≥65 years were screened with the BGA. Its 6 items are: age ≥85 years, male gender, polypharmacy (i.e., ≥5 drugs per day), non-use of home-help services, history of falls in the previous 6 months, and temporal disorientation (i.e., inability to give the month and/or year). Three levels (low, intermediate and high) of risk of adverse health events had previously been identified, based on different combinations of BGA items. Patients were separated into 2 groups using the occurrence of in-hospital death. The length of stay was calculated as the number of days in hospital using the hospital registry. The use of psychoactive drugs and the reason for admission were used as covariates.
Older inpatients who died were more frequently admitted for an acute organ failure (P < 0.001). Cox regression models showed that a priori intermediate risk (HR = 1.89, P < .001) and high risk (HR = 2.34, P < .001) risk levels predicted in-hospital mortality. Kaplan-Meier survival curves confirmed that inpatients at high risk (P = .047) and those at intermediate risk (P = .013) died earlier than patients at low risk.
Combinations of items on the BGA successfully predicted the risk of in-hospital mortality in this sample of older inpatients.
6 项简明老年评估（BGA）是一种筛选工具，用于识别有发生不良健康事件风险的虚弱住院患者。其对住院患者死亡率的预测价值尚未得到检验。
本研究旨在检验 BGA 是否能够预测老年患者的住院死亡率。
本观察性前瞻性队列研究共纳入 1082 名参与者。在法国昂热大学医院的内科病房，所有年龄≥65 岁的住院患者均接受 BGA 筛查。其 6 项内容为：年龄≥85 岁、男性、多种药物（即每天≥5 种药物）、不使用家庭帮助服务、过去 6 个月内跌倒史、时间定向障碍（即无法给出月份和/或年份）。此前，根据 BGA 项目的不同组合，确定了 3 个不良健康事件风险水平（低、中、高）。根据住院期间死亡的发生情况，将患者分为 2 组。使用医院登记册计算住院天数作为住院时间。将使用精神活性药物和入院原因作为协变量。
死亡的老年住院患者更常因急性器官衰竭而入院（P<0.001）。Cox 回归模型显示，预先设定的中危（HR=1.89，P<0.001）和高危（HR=2.34，P<0.001）风险水平预测了住院死亡率。Kaplan-Meier 生存曲线证实，高危（P=0.047）和中危（P=0.013）患者的死亡率高于低危患者。
BGA 项目的组合成功预测了该老年住院患者样本的住院死亡率风险。
