Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de Investigación en Comorbilidad y Puripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España.
Servicio de Medicina Interna, Hospital Ernest Lluch, Calatayud, España.
Med Clin (Barc). 2019 Sep 13;153(5):196-201. doi: 10.1016/j.medcli.2019.01.034. Epub 2019 Mar 28.
To compare the discrimination power of PROFUND and PALIAR indexes for predicting mortality in polypathological patients with advanced non-oncologic chronic disease.
Prospective multicentre cohort study. We included polypathological patients with advanced non-oncologic chronic disease, who were admitted to internal medicine departments between July 1st and December 31th, 2014. Data was collected from each patient on age, sex, categories of polypathology, advanced disease, comorbidity, functional and cognitive assessment, terminal illness symptoms, need for caregiver, hospitalisation in the past three and 12 months and number of drugs. We calculated the PROFUND and PALIAR indexes and conducted a 12-month follow-up. We assessed mortality with the Kaplan-Meier survival curves and the discrimination of indexes with the ROC curves.
We included 213 patients with a mean (standard deviation) age of 83.0 (7.0) years, 106 (49.8%) of whom were female. Mortality at six months was 40.4% and at 12 months 50.2%. Deceased patients scored higher scores on the PROFUND [11.2(4.2) vs 8.5(3.9); P<.001] and PALIAR [6.7 (4.6) vs 3.6(3.1); p<0,001] indexes. The discrimination of PALIAR index at six months (under the curve area 0.734 95%CI 0.665-0.803) was higher than of PROFUND, and there was no difference at 12 months.
In polypathological patients with advanced non-oncologic chronic disease, the PALIAR index had better discrimination power than PROFUND index at 66 months and there were no differences at 12 months.
比较 PROFUND 和 PALIAR 指数在预测晚期非肿瘤性慢性疾病合并多种疾病的患者死亡风险方面的能力。
前瞻性多中心队列研究。我们纳入了 2014 年 7 月 1 日至 12 月 31 日期间因晚期非肿瘤性慢性疾病入住内科病房的合并多种疾病的患者。从每位患者收集年龄、性别、多种疾病类别、晚期疾病、合并症、功能和认知评估、终末期疾病症状、是否需要护理人员、过去 3 个月和 12 个月的住院情况以及药物使用数量等数据。我们计算了 PROFUND 和 PALIAR 指数,并进行了 12 个月的随访。使用 Kaplan-Meier 生存曲线评估死亡率,使用 ROC 曲线评估指数的区分能力。
我们纳入了 213 名患者,平均(标准差)年龄为 83.0(7.0)岁,其中 106 名(49.8%)为女性。6 个月时的死亡率为 40.4%,12 个月时的死亡率为 50.2%。死亡患者的 PROFUND [11.2(4.2)比 8.5(3.9);P<.001]和 PALIAR [6.7(4.6)比 3.6(3.1);P<0.001]指数得分更高。PALIAR 指数在 6 个月时的区分能力(曲线下面积 0.734,95%CI 0.665-0.803)高于 PROFUND,12 个月时无差异。
在晚期非肿瘤性慢性疾病合并多种疾病的患者中,PALIAR 指数在 6 个月时的区分能力优于 PROFUND 指数,而在 12 个月时无差异。