Screening of older community-dwelling people at risk for death and hospitalization: The Assistenza Socio-Sanitaria in Italia project

Giampiero Mazzaglia, Lorenzo Roti, Giacomo Corsini, Angela Colombini, Gavino MacIocco, Niccolò Marchionni, Eva Buiatti, Luigi Ferrucci, Mauro Di Bari

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To develop and validate mortality and hospitalization prognostic tools based upon information readily available to primary care physicians (PCPs). DESIGN: Population-based cohort study. Baseline predictors were patient demographics, a seven-item questionnaire on functional status and general health, use of five or more drugs, and previous hospitalization. SETTING: Community-based study. PARTICIPANTS: Prognostic indexes were developed in 2,470 subjects and validated in 2,926 subjects, all community-dwelling, aged 65 and older, and randomly sampled from the rosters of 98 PCPs in Florence, Italy. MEASUREMENTS: Fifteen-month mortality and hospitalization. RESULTS: Two scores were derived from logistic regression models and used to stratify participants into four groups. With Model 1, based upon the seven-item questionnaire, mortality rate ranged from 0.8% in the lowest-risk group (0-1 point) to 9.4% in the highest risk group (≥3 points), and hospitalization rate ranged from 12.4% to 29.3%; area under the receiver operating characteristic curves (AUC) was 0.75 and 0.60, respectively. With Model 2, considering also drug use and previous hospitalization, mortality and hospitalization rates ranged from 0.3% to 8.2% and from 8.1% to 29.7%, for the lowest-risk to the highest-risk group; the AUC increased significantly only for hospitalization (0.67). CONCLUSION: Prediction of death and hospitalization in older community-dwelling people can be easily obtained with two indexes using information promptly available to PCPs. These tools might be useful for guiding clinical care and targeting interventions to reduce the need for hospital care in older persons.

Original languageEnglish (US)
Pages (from-to)1955-1960
Number of pages6
JournalJournal of the American Geriatrics Society
Volume55
Issue number12
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Independent Living
Hospitalization
Primary Care Physicians
Mortality
Area Under Curve
Logistic Models
ROC Curve
Pharmaceutical Preparations
Italy
Health Status
Cohort Studies
Demography

Keywords

  • Elderly
  • Hospitalization
  • Mortality
  • Screening

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Screening of older community-dwelling people at risk for death and hospitalization : The Assistenza Socio-Sanitaria in Italia project. / Mazzaglia, Giampiero; Roti, Lorenzo; Corsini, Giacomo; Colombini, Angela; MacIocco, Gavino; Marchionni, Niccolò; Buiatti, Eva; Ferrucci, Luigi; Bari, Mauro Di.

In: Journal of the American Geriatrics Society, Vol. 55, No. 12, 12.2007, p. 1955-1960.

Research output: Contribution to journalArticle

Mazzaglia, G, Roti, L, Corsini, G, Colombini, A, MacIocco, G, Marchionni, N, Buiatti, E, Ferrucci, L & Bari, MD 2007, 'Screening of older community-dwelling people at risk for death and hospitalization: The Assistenza Socio-Sanitaria in Italia project', Journal of the American Geriatrics Society, vol. 55, no. 12, pp. 1955-1960. https://doi.org/10.1111/j.1532-5415.2007.01446.x
Mazzaglia, Giampiero ; Roti, Lorenzo ; Corsini, Giacomo ; Colombini, Angela ; MacIocco, Gavino ; Marchionni, Niccolò ; Buiatti, Eva ; Ferrucci, Luigi ; Bari, Mauro Di. / Screening of older community-dwelling people at risk for death and hospitalization : The Assistenza Socio-Sanitaria in Italia project. In: Journal of the American Geriatrics Society. 2007 ; Vol. 55, No. 12. pp. 1955-1960.
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abstract = "OBJECTIVES: To develop and validate mortality and hospitalization prognostic tools based upon information readily available to primary care physicians (PCPs). DESIGN: Population-based cohort study. Baseline predictors were patient demographics, a seven-item questionnaire on functional status and general health, use of five or more drugs, and previous hospitalization. SETTING: Community-based study. PARTICIPANTS: Prognostic indexes were developed in 2,470 subjects and validated in 2,926 subjects, all community-dwelling, aged 65 and older, and randomly sampled from the rosters of 98 PCPs in Florence, Italy. MEASUREMENTS: Fifteen-month mortality and hospitalization. RESULTS: Two scores were derived from logistic regression models and used to stratify participants into four groups. With Model 1, based upon the seven-item questionnaire, mortality rate ranged from 0.8{\%} in the lowest-risk group (0-1 point) to 9.4{\%} in the highest risk group (≥3 points), and hospitalization rate ranged from 12.4{\%} to 29.3{\%}; area under the receiver operating characteristic curves (AUC) was 0.75 and 0.60, respectively. With Model 2, considering also drug use and previous hospitalization, mortality and hospitalization rates ranged from 0.3{\%} to 8.2{\%} and from 8.1{\%} to 29.7{\%}, for the lowest-risk to the highest-risk group; the AUC increased significantly only for hospitalization (0.67). CONCLUSION: Prediction of death and hospitalization in older community-dwelling people can be easily obtained with two indexes using information promptly available to PCPs. These tools might be useful for guiding clinical care and targeting interventions to reduce the need for hospital care in older persons.",
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AU - Colombini, Angela

AU - MacIocco, Gavino

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