Using mortality risk scores for long-term prognosis of nursing home residents: caution is recommended

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
R L KruseS C Zweig

Abstract

Determining prognosis for nursing home residents is important for care planning, but reliable prediction is difficult. We compared performance of four long-term mortality risk indices for nursing home residents-the Minimum Data Set Mortality Risk Index (MMRI), a recent revision to this index (MMRI-R), and the original and revised Flacker-Kiely models. We conducted a prospective cohort study in one 92-bed facility in Missouri. Participants were 130 residents who received a Minimum Data Set assessment from May through October, 2007. We collected the Minimum Data Set variables needed to calculate the mortality risk scores. We determined 6- and 12-month mortality for included residents. Using each mortality risk score as the sole independent predictor in logistic models predicting mortality, we determined discrimination (c-statistic) and calibration (Hosmer-Lemeshow goodness-of-fit statistic) for each model. In our sample, discrimination was 0.59 for both the MMRI and the MMRI-R. Discrimination of the original Flacker-Kiely model was 0.69 for both 6 months and 1 year and 0.71 and 0.70, respectively, for the revised model. Model calibration was adequate for all models. Performance of four models that predict long-term mortality of n...Continue Reading

References

Nov 1, 1990·Statistics in Medicine·J C Van Houwelingen, S Le Cessie
Jul 1, 1994·Journal of Gerontology·J N MorrisL A Lipsitz
Aug 26, 1998·Journal of the American Geriatrics Society·J M Flacker, D K Kiely
Mar 13, 1999·Annals of Internal Medicine·A C JusticeJ A Berlin
Mar 1, 2000·Statistics in Medicine·D G Altman, P Royston
Jul 27, 2001·Journal of Clinical Epidemiology·E W SteyerbergJ D Habbema
Dec 26, 2001·JAMA : the Journal of the American Medical Association·D R MehrR B D'Agostino
Feb 1, 2003·Journal of the American Geriatrics Society·Jonathan M Flacker, Dan K Kiely
Nov 5, 2003·Intensive Care Medicine·Reidar KvåleHans Flaatten
Nov 8, 2003·Chest·Adrián V HernándezEwout W Steyerberg
Jun 10, 2004·JAMA : the Journal of the American Medical Association·Susan L MitchellBrant E Fries
Jun 4, 2005·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Davina PorockGreg Petroski
Apr 25, 2006·Journal of Pain and Symptom Management·Stacy M FischerAndrew Kramer
Jun 16, 2006·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·J Brandon Wallace, Suzanne S Prevost
Mar 17, 2009·Journal of Nursing Care Quality·Debra Parker OliverDavid Mehr

❮ Previous
Next ❯

Citations

Jan 12, 2012·JAMA : the Journal of the American Medical Association·Lindsey C YourmanAlexander K Smith
Oct 5, 2011·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·James S GoodwinYong-Fang Kuo
Nov 19, 2014·Journal of the American Medical Directors Association·Barbara J Messinger-RapportJohn E Morley
Mar 11, 2015·Journal of the American Geriatrics Society·Yoonyoung ParkKrista F Huybrechts
Feb 14, 2014·Australasian Journal on Ageing·Martin J ConnollyMerryn Gott
Oct 27, 2015·Journal of the American Association of Nurse Practitioners·Susan E MullaneyRobert MacArthur
Feb 6, 2015·Age and Ageing·Claire Patricia HeppenstallMartin J Connolly
Oct 20, 2018·Journal of the American Geriatrics Society·Joshua D NiznikCarolyn T Thorpe
Nov 7, 2019·The Journal of Nursing Research : JNR·SeolHwa Moon, Gwi-Ryung Son Hong
Feb 23, 2019·Systematic Reviews·Danni Collingridge MooreKatherine Froggatt
Jul 22, 2019·Current Diabetes Reports·Scott J PillaElbert S Huang

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of the American Geriatrics Society
Jonathan M Flacker, Dan K Kiely
JAMA : the Journal of the American Medical Association
Susan L MitchellB E Fries
Journal of the American Medical Directors Association
Jenny T van der SteenGerrit van der Wal
© 2021 Meta ULC. All rights reserved