Morganti Wanda, Seminerio Emanuele, Veronese Nicola, Custureri Romina, Massone Carolina, Fielding Peter, Corti Maria Chiara, Maggi Stefania, Ferrucci Luigi, Pilotto Alberto
Research, Development and Scientific Coordination Unit, National Reference & High Specialization Hospital, E.O. Galliera Hospitals, Genoa, Italy.
Geriatrics Unit, Department of Medicine and Geriatrics, E.O. Galliera Hospital, Genoa, Italy.
Aging Clin Exp Res. 2025 Jun 9;37(1):184. doi: 10.1007/s40520-025-03098-1.
The Multidimensional Evaluation of Elderly Person Form (SVaMA) is the official Comprehensive Geriatric Assessment (CGA) tool in most Italian regions for assessing medical, social, and functional needs of community-dwelling older people and developing an integrated care plan to meet them. The Multidimensional Prognostic Index (MPI) is a validated CGA-based tool for predicting mortality, other negative health outcomes and assessing multidimensional frailty. SVaMA's wide diffusion in clinical practice prompted the development of an MPI version based on its data (MPI-SVaMA).
Assessing the usefulness in predicting mortality of a new digital version of the MPI-SVaMA (MPI-SVaMA Digit) through a simpler model.
In this retrospective cohort study, 12.020 community-dwelling older people (≥ 65 years) who underwent the SVaMA in Veneto, Italy were included. One-month and one-year mortality rates were retrieved from Registry Offices. The MPI-SVaMA Digit was obtained by assigning a risk category to each domain assessed in the SVaMA. Accuracy and precision were assessed using Area Under the Curve (AUC) and concordance index (C-index). The association between MPI-SVaMA Digit and mortality was evaluated through Cox regression analysis.
The MPI-SVaMA Digit showed good accuracy and precision in predicting 1-month (AUC = 0.78; 95%CI 0.75-0.81, C-index = 0.78 95%CI 9.75-0.81) and 1-year mortality (AUC = 0.77; 95%CI 0.76-0.78, C-index = 0.72 95%CI 0.71-0.74). People at moderate and severe risk of multidimensional frailty showed, respectively a 4-fold and 12-fold increased mortality risk than the group at mild risk.
The new MPI-SVaMA Digit is an accurate prognostic tool for short- and long-term mortality useful to address clinical and organizational demands in community-dwelling older people.
老年人多维评估表（SVaMA）是意大利大多数地区用于评估社区居住老年人的医疗、社会和功能需求并制定综合护理计划以满足这些需求的官方综合老年评估（CGA）工具。多维预后指数（MPI）是一种经过验证的基于CGA的工具，用于预测死亡率、其他负面健康结果以及评估多维衰弱状况。SVaMA在临床实践中的广泛应用促使基于其数据开发了一个MPI版本（MPI-SVaMA）。
通过一个更简单的模型评估MPI-SVaMA的新数字版本（MPI-SVaMA Digit）在预测死亡率方面的实用性。
在这项回顾性队列研究中，纳入了意大利威尼托地区12020名接受SVaMA评估的社区居住老年人（≥65岁）。从户籍办公室获取了1个月和1年的死亡率。MPI-SVaMA Digit是通过为SVaMA中评估的每个领域分配一个风险类别而获得的。使用曲线下面积（AUC）和一致性指数（C-index）评估准确性和精确性。通过Cox回归分析评估MPI-SVaMA Digit与死亡率之间的关联。
MPI-SVaMA Digit在预测1个月（AUC = 0.78；95%CI 0.75 - 0.81，C-index = 0.78 95%CI 9.75 - 0.81）和1年死亡率（AUC = 0.77；95%CI 0.76 - 0.78，C-index = 0.72 95%CI 0.71 - 0.74）方面显示出良好的准确性和精确性。多维衰弱处于中度和重度风险的人群，其死亡风险分别比轻度风险组增加了4倍和12倍。
新的MPI-SVaMA Digit是一种准确的短期和长期死亡率预后工具，有助于满足社区居住老年人的临床和组织需求。
