Development of a multivariable model to predict vulnerability in older American patients hospitalised with cardiovascular disease

BMJ Open
Susan P BellVanderbilt Inpatient Cohort Study

Abstract

To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. Prospective observational cohort study of 445 individuals aged ≥ 65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decompensated heart failure. Participants completed an inperson interview during hospitalisation, which included vulnerable functional status using the Vulnerable Elders Survey (VES-13), sociodemographic, healthcare utilisation practices and clinical patient-specific measures. A multivariable proportional odds logistic regression model examined associations between VES-13 and prior healthcare utilisation, as well as other coincident medical and psychosocial risk factors for poor outcomes in cardiovascular disease. Vulnerability was highly prevalent (54%) and associated with a higher number of clinic visits, emergency room visits and hospitalisations (all p<0.001). A multivariable analysis demonstrating a 1-point increase in VES-13 (vulnerability) was independently associated with being female (OR 1.55, p=0.030), diagnosis of heart failure (OR 3.11, p<0.001), prior hospitalisations (OR 1.30, p<0.001), low social support (OR 1.42, p=0.007) and d...Continue Reading

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Citations

Sep 12, 2019·Ciência & saúde coletiva·Juliana Fernandes CabralCleber Nascimento do Carmo
Dec 12, 2019·Revista brasileira de enfermagem·Keylla Talitha Fernandes BarbosaMaria das Graças Melo Fernandes
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