Cohort study reveals key predictors of one-year mortality in older multimorbid adults, highlighting a novel risk stratification tool.
Key Points
To develop and internally validate a point-based 1-year mortality prognostic index tailored specifically for older adults with multimorbidity and polypharmacy.
Analyzed data from 805 hospitalized adults aged ≥70 years with multimorbidity (≥3 chronic conditions) and polypharmacy (≥5 medications) from the OPERAM cohort in Bern, Switzerland.
Identified predictors of time to 1-year all-cause mortality using a parametric Weibull regression model with backward stepwise selection.
Internally validated the model and corrected for optimism using bootstrapping techniques, assessing performance via the C statistic and calibration slope.
Over 1 year of follow-up, 158 of 805 participants (20%) died.
Predictors included age, Charlson Comorbidity Index, medication count, BMI, prior hospitalizations, Barthel Index, and nursing home residency, yielding an optimism-corrected C statistic of 0.70 and calibration slope of 0.93.
The point-based score stratified participants into 1-year mortality rates of 7% in the low-risk group, 19% in the moderate-risk group, and 37% in the high-risk group.