Ribeiro Heloísa, Martins Yolanda, Natário Isabel, Tavares Luís Pedro
Serviço de Medicina Interna, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
NOVA MATH & Department of Mathematics, NOVA School of Science and Technology, NOVA University of Lisbon, Lisboa, Portugal.
Am J Med Open. 2024 Jul 30;12:100074. doi: 10.1016/j.ajmo.2024.100074. eCollection 2024 Dec.
To evaluate the connection between the items included in the AVD-DezIs score (a questionnaire about basic and instrumental activities of daily living and other topics related to social and personal life) and in-hospital and 30-day mortality after discharge.
Prospective cohort study of hospitalizations in the Internal Medicine ward from 2014 to 2020, including >18 years old patients with a fully completed AVD-DezIs. To identify in-hospital and 30 days mortality, univariate and multivariate logistic models were applied, including random effects if justified.
A total of 19,771 episodes of hospitalization were included. In the univariate analysis, except for the presence of isolation and financial insufficiency, all the items were predictors of mortality in-hospital or within 30 days after discharge. In multivariate analysis, older age, male sex, longer hospital stay, higher Charlson score, deficiency in all four activities of daily living, deficiency in meal preparation and housekeeping, presence of pain/depression, immobility, and malnutrition are associated with a higher probability of in-hospital death whereas older age, male gender, higher Charlson score, longer length of hospital stay, deficiency in personal hygiene, ambulation, and eating habits, as well as the presence of incontinence and malnutrition, are associated with a higher probability of 30 days after discharge death.
DISCUSSION/CONCLUSION: Except for isolation and financial insufficiency, all items were individually associated with the outcomes. When they are considered in conjunction and taking into account sex, age, comorbidities and length of stay, the predictive ability of in-hospital and 30 days mortality differed.
评估AVD-DezIs评分（一份关于日常生活基本活动和工具性活动以及其他与社会和个人生活相关主题的问卷）所包含的项目与住院期间及出院后30天死亡率之间的关联。
对2014年至2020年内科病房住院患者进行前瞻性队列研究，纳入年龄大于18岁且AVD-DezIs问卷填写完整的患者。为确定住院期间和30天死亡率，应用单变量和多变量逻辑模型，如有必要包括随机效应。
共纳入19771例住院病例。在单变量分析中，除存在隔离和经济困难外，所有项目均为住院期间或出院后30天内死亡率的预测因素。在多变量分析中，年龄较大、男性、住院时间较长、Charlson评分较高、四项日常生活活动均有缺陷、膳食准备和家务管理有缺陷、存在疼痛/抑郁、行动不便和营养不良与住院死亡概率较高相关，而年龄较大、男性、Charlson评分较高、住院时间较长、个人卫生、行走和饮食习惯有缺陷，以及存在失禁和营养不良与出院后30天死亡概率较高相关。
讨论/结论：除隔离和经济困难外，所有项目均与结局单独相关。当综合考虑这些因素并考虑性别、年龄、合并症和住院时间时，住院期间和30天死亡率的预测能力有所不同。
