Evaluation of prognostic indices in elderly hospitalized patients

Aim: Prognosis informs the physician's decision-making process, especially for frail older adults. So far, any non-disease-specific index has proven full evidence for routine use in clinical practice. Here, we aimed at assessing, prospectively, the calibration and discriminating accuracy of validated prognostic indices in a cohort of elderly hospitalized patients. Methods: This was a prospective observational study that enrolled elderly patients (n=100). The patients' assessment included clinical variables, as well as the following five prognostic indices of mortality: (i) Levine index (2007); (ii) Walter index (2001); (iii) CARING (C, primary diagnosis of cancer; A, ≥ 2 admissions to the hospital for a chronic illness within the last year; R, resident in a nursing home; I, intensive care unit admission with multiorgan failure, NG, noncancer hospice guidelines [meeting ≥ 2 of the National Hospice and Palliative Care Organization's guidelines]) criteria of Fischer (2006-2011); (iv) Silver Code of Di Bari (2010); and (v) Burden of Illness Score for Elderly Persons of Inouye (2003). Results: Patients' clinical characteristics: 70% women (age 86.20±0.69years), 30% men (age 85.40±1.07years), Comorbidity Illness rating scale (CIRS) 4.3±0.61 and Barthel Index 28±0.54. Walter and Burden of Illness Score for Elderly Persons scores showed similar prediction rates when compared with the expected validated values (ancova: F=14.00, P