Journal article
Prediction of unplanned hospital admissions in older community dwellers using the 6-item Brief Geriatric Assessment: Results from REPERAGE, an observational prospective population-based cohort study.
- Beauchet O Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Aging and Chronic Diseases of McGill integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: olivier.beauchet@mcgill.ca.
- Launay CP Geriatric Medicine and Geriatric Rehabilitation Division, Department of Medicine, Lausanne University Hospital, Switzerland.
- Chabot J Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.
- Dejager S MSD, Medical Department, Courbevoie, France.
- Bineau S MSD, Medical Department, Courbevoie, France.
- Galery K Gerontopole des pays de la Loire, Nantes, France.
- Berrut G Gerontopole des pays de la Loire, Nantes, France; Department of Geriatrics, Nantes University Hospital, University of Nantes, Nantes, France.
- 2019-02-25
Published in:
- Maturitas. - 2019
Epidemiology
Frailty
Geriatric assessment
Hospital admission
Primary care
Aged, 80 and over
Female
Geriatric Assessment
Hospitalization
Humans
Independent Living
Male
Odds Ratio
Primary Health Care
Proportional Hazards Models
Prospective Studies
English
BACKGROUND
The 6-item Brief Geriatric Assessment (BGA) provides a priori risk stratification of incident hospital health adverse events, but it has not been used yet to assess the risk of unplanned hospital admission for older patients in primary care. This study aims to examine the association between the a priori risk stratification levels of the 6-item BGA performed by general practitioners (GPs) and incident unplanned hospital admissions in older community patients.
METHODS
Based on an observational prospective cohort design, 668 participants (mean age 84.7 ± 3.9 years; 64.7% female) were recruited by their GPs during an index primary care visit. The 6-item BGA was completed at baseline and provided an a priori risk stratification in three levels (low, moderate, high). Incident unplanned hospital admissions were recorded during a 6-month follow-up.
RESULTS
The incidence of unplanned hospital admissions increased with the risk level of the 6-item BGA stratification, the highest prevalence (35.3%) being reported with the high-risk level (P = 0.001). The risk of unplanned hospital admission at the high-risk level was significant (crude odds ratio (OR) = 5.48, P = 0.001 and fully adjusted OR = 3.71, P = 0.032, crude hazard ratio (HR) = 4.20; P = 0.002 and fully adjusted HR = 2.81; P = 0.035). The Kaplan-Meier's distributions of incident unplanned hospital admissions differed significantly between the three risk levels (P-value = 0.002). Participants with a high-risk level were more frequently admitted to hospital than those at a low-risk level (P = 0.001). Criteria performances of all risk levels were poor, except the specificity of the high-risk level, which was 98.2%.
CONCLUSIONS
The a priori 6-item BGA risk stratification was significantly associated with incident unplanned hospital admissions in primary care older patients. However, except for the specificity of the high-risk level, its criteria performances were poor, suggesting that this tool is unsuitable for screening older patients in primary care settings at risk of unplanned hospital admission.
The 6-item Brief Geriatric Assessment (BGA) provides a priori risk stratification of incident hospital health adverse events, but it has not been used yet to assess the risk of unplanned hospital admission for older patients in primary care. This study aims to examine the association between the a priori risk stratification levels of the 6-item BGA performed by general practitioners (GPs) and incident unplanned hospital admissions in older community patients.
METHODS
Based on an observational prospective cohort design, 668 participants (mean age 84.7 ± 3.9 years; 64.7% female) were recruited by their GPs during an index primary care visit. The 6-item BGA was completed at baseline and provided an a priori risk stratification in three levels (low, moderate, high). Incident unplanned hospital admissions were recorded during a 6-month follow-up.
RESULTS
The incidence of unplanned hospital admissions increased with the risk level of the 6-item BGA stratification, the highest prevalence (35.3%) being reported with the high-risk level (P = 0.001). The risk of unplanned hospital admission at the high-risk level was significant (crude odds ratio (OR) = 5.48, P = 0.001 and fully adjusted OR = 3.71, P = 0.032, crude hazard ratio (HR) = 4.20; P = 0.002 and fully adjusted HR = 2.81; P = 0.035). The Kaplan-Meier's distributions of incident unplanned hospital admissions differed significantly between the three risk levels (P-value = 0.002). Participants with a high-risk level were more frequently admitted to hospital than those at a low-risk level (P = 0.001). Criteria performances of all risk levels were poor, except the specificity of the high-risk level, which was 98.2%.
CONCLUSIONS
The a priori 6-item BGA risk stratification was significantly associated with incident unplanned hospital admissions in primary care older patients. However, except for the specificity of the high-risk level, its criteria performances were poor, suggesting that this tool is unsuitable for screening older patients in primary care settings at risk of unplanned hospital admission.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.maturitas.2019.01.002
- PMID 30797525
- Persistent URL
- https://fredi.hepvs.ch/global/documents/181920
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