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[Validation of a prognostic model for polypathological patients (PP) in Primary Health Care: "PROFUND STUDY-AP"].

Abstract：

AIMS:to validate the PROFUND index in PP in Primary Health Care (PHC). DESIGN:two-year prospective multicenter study. LOCATION:three health care centers in Seville Province (Spain). SUBJECTS OF THE ASSESSMENT:PP with signed informed consent. SAMPLE:n=446 (p=20%; α=5%; β=99%); consecutive sampling. MEASUREMENT:Dependent variable: mortality (2 years). INDEPENDENT VARIABLES:socio-demography, clinic, anthropometric, laboratory, pharmacologic prescriptions, functional, cognitive and socio-familiar evaluation and the use of health resources. INFORMATION SOURCE:interview with patients and clinical charts. STATISTICAL ANALYSIS:uni and multivariate analysis according to the variables; Accuracy was assessed in the cohort by risk terciles calibration, and discrimination power, by ROC curves. Finally, accuracy of the index was compared with that of the Charlson index. RESULTS:446 subjects were included (53.8% men); average age was 75.44yr (Confidence interval 95% 74.58-76.31). Average of diagnostic categories was 2.37 (Confidence interval 95% 2.30-2.44). Prevalent categories were: A (64.1%), F (41.7%) and E (33.5%). Mortality within 2 years was 24.1%. Calibration in predicted/observed mortality along the three established risk strata was 16%/16.7% for PP with 0-2 points, 22%/19.5% for PP with 3-6, and 34%/36% for PP with 7 or more points (Hosmer-Lemeshow test with p=0.119). Discrimination power of PHC PROFUND's by area under the curve was (AUC) ROC was 0.622 (Confidence interval 95% 0.556-0.689; p<0.001), and that of Charlson index 0.510 (Confidence interval 95% 0.446 - 0.575; p>0.005). CONCLUSIONS:The PROFUND index is a good indicative tool in the stratification of 2-year mortality risk polypathological patients in PHC.

journal_name

Aten Primaria

journal_title

Atencion primaria

authors

Colombo PB,Nieto Martín MD,Pascual de la Pisa B,José García Lozano M,Angeles Ortiz Camúñez M,Wittel MB

doi

10.1016/S0212-6567(14)70064-2

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

41-8

eissn

0212-6567

issn

1578-1275

pii

S0212-6567(14)70064-2

journal_volume

46 Suppl 3

pub_type

杂志文章,多中心研究

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[Validation of a prognostic model for polypathological patients (PP) in Primary Health Care: "PROFUND STUDY-AP"].