Highlights
- •We have described the prognostic variables in a group of chronic patients.
- •With these variables we have developed a prognostic index: CRONIGAL Index.
- •The CRONIGAL Index includes 7 variables and has turned out to be a good predictor of mortality.
- •The CRONIGAL Index is useful for all chronic patients including polipathological.
Abstract
Objective
We have followed patients admitted to a Polypathology and Advanced Age Unit for two
years in order to identify the variables that best define the mortality prognosis
at medium-term (1–2 years) for chronic and polypathological patients requiring admission at an Internal
Medicine Department.
Methods
This is an observational, prospective study in clinical practice. Polypathological,
chronic or multimorbidity patients were included. The classification of the Spanish
Ministry for Health was used in order to classify patients as chronic or polypathological.
The Charlson Index and Barthel Index were estimated and the Pfeiffer test was administered.
The Spanish PROFUND Index was also used. Logistic regression models and Cox proportional
hazard model were built in order to study the influence of prognostic factors on survival.
Results
A total of 567 patients were included: 333 met polypathological (PPP) criteria and
234 chronic criteria (CC). Mean age was 84.8 + 7.3 years. A total of 469 were followed up, most patients belonged to category E (282),
174 to category A and 118 to category C. The prognosis at one year of our patients
can be estimated with 7 variables: age, neoplasia, delirium, Barthel, Pfeiffer, presence
of atrial fibrillation, and creatinine. The area under the curve is 0.74.
Conclusion
The variables dementia, neoplasia, delirium at admission, Barthel Index under 60,
or deceased spouse have mortality prognosis value at one or two years. An index with
7 variables applicable to chronic and polypathological patients after admission may
serve as tool to better manage complex chronic patients and follow them up.
Keywords
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Article info
Publication history
Published online: October 10, 2016
Accepted:
August 2,
2016
Received in revised form:
August 1,
2016
Received:
May 17,
2016
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
