title: Intraindividual change in SF-36 in ambulatory clinic primary care patients predicted mortality and hospitalizations.
abstract: OBJECTIVE
  We sought to determine whether change in SF-36 scores over time is associated with the risk of adverse outcomes.
  
  
  METHODS
  7,702 participants in the Ambulatory Care Quality Improvement Project who completed a baseline and 1-year SF-36. Using logistic regression methods we estimated the 1-year risk of hospitalization and death based on previous 1-year changes in the physical (PCS) and mental (MCS) component summary scores.
  
  
  RESULTS
  After adjusting for baseline PCS scores, age, VA hospital site, distance to VA, and comorbidity, a >10-point decrease in PCS score was associated with an increased risk of death (OR 2.3, 95% CI 1.6-3.4) and hospitalization (OR 1.8, 1.4-2.2). An increased risk was also seen with a >10-point decrease in the MCS (OR for death, 1.6, 1.1-2.3; OR for hospitalization 1.5, 1.2-1.8).
  
  
  CONCLUSIONS
  Change in SF-36 PCS and MCS scores is associated with mortality and hospitalizations, and provides important prognostic information over baseline scores alone.
authors.affiliation: Health Services Research and Development (152), Center of Excellence, VA Puget Sound Health Care System, 1600 South Columbian Way, Seattle, WA 98108-1597, USA. vfan@u.washington.edu
authors.forename: Vincent S
authors.initials: VS
authors.lastname: Fan
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.forename: Mary B
authors.initials: MB
authors.lastname: McDonell
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods; D014481:United States / Q000453:epidemiology