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Background <p>The risk of frailty and mortality in older inpatients and outpatients can be quantified using the validated Multidimensional Prognostic Index (MPI), which is composed of eight different domains. The MPI provides a&#xa0;value between 0&#xa0;and&#xa0;1, allowing classification into three risk groups. The lower the MPI, the lower frailty and the risk for mortality.</p> Objectives <p>Evaluation of the MPI for identifying geriatric high-risk patients and mortality risk over 24&#xa0;months in the special setting of the emergency department (ED).</p> Methods <p>In all, 167 patients aged ≥ 75&#xa0;years admitted to the ED at the University Hospital of Cologne were included in the prospective observational study from 10/2017 to 03/2020. The MPI, geriatric syndromes (GS) and resources (GR) were assessed on admission. Follow-up was conducted by telephone to collect health-related data for up to 24&#xa0;months after initial contact.</p> Results <p>The median age was 80&#xa0;years (interquartile range 78–85); 43.7% were women. Of the 167 patients, 101 (61%) were alive after 24&#xa0;months; a&#xa0;higher MPI score was significantly associated with a&#xa0;higher mortality (<i>p</i> &lt; 0.001). Furthermore, a&#xa0;significantly higher number of GS and a&#xa0;significantly lower number of GR were associated with higher MPI scores (<i>p</i> &lt; 0.001). Patients with higher MPI scores had significantly more in-hospital days at 12&#xa0;(<i>p</i> = 0.043) and 24&#xa0;months (<i>p</i> = 0.018) than patients with lower MPI scores, regardless of age and sex.</p> Conclusion <p>In view of the AWMF-S3 guideline “Comprehensive Geriatric Assessment (CGA) for hospitalised patients”, it could be demonstrated that the CGA-based MPI is suitable for predicting the 2‑year survival of older patients in the ED, which can support structured clinical decision-making.</p>

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Hochaltrige Patient*innen in der Notaufnahme: eine 24-monatige Beobachtungsstudie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月4日

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  • Dominik Rudol,
  • Lena Pickert,
  • Marcel Pascal Rarek,
  • Ingrid Becker,
  • Volker Burst,
  • M. Cristina Polidori,
  • Anna Maria Affeldt

摘要

Background

The risk of frailty and mortality in older inpatients and outpatients can be quantified using the validated Multidimensional Prognostic Index (MPI), which is composed of eight different domains. The MPI provides a value between 0 and 1, allowing classification into three risk groups. The lower the MPI, the lower frailty and the risk for mortality.

Objectives

Evaluation of the MPI for identifying geriatric high-risk patients and mortality risk over 24 months in the special setting of the emergency department (ED).

Methods

In all, 167 patients aged ≥ 75 years admitted to the ED at the University Hospital of Cologne were included in the prospective observational study from 10/2017 to 03/2020. The MPI, geriatric syndromes (GS) and resources (GR) were assessed on admission. Follow-up was conducted by telephone to collect health-related data for up to 24 months after initial contact.

Results

The median age was 80 years (interquartile range 78–85); 43.7% were women. Of the 167 patients, 101 (61%) were alive after 24 months; a higher MPI score was significantly associated with a higher mortality (p < 0.001). Furthermore, a significantly higher number of GS and a significantly lower number of GR were associated with higher MPI scores (p < 0.001). Patients with higher MPI scores had significantly more in-hospital days at 12 (p = 0.043) and 24 months (p = 0.018) than patients with lower MPI scores, regardless of age and sex.

Conclusion

In view of the AWMF-S3 guideline “Comprehensive Geriatric Assessment (CGA) for hospitalised patients”, it could be demonstrated that the CGA-based MPI is suitable for predicting the 2‑year survival of older patients in the ED, which can support structured clinical decision-making.