Geriatrics index of comorbidity was the most accurate predictor of death in geriatric hospital among six comorbidity scores.
OBJECTIVE
To compare the abilities of six validated comorbidity indices (Charlson index, cumulative illness rating scale [CIRS], index of coexistent diseases, Kaplan scale, geriatrics index of comorbidity [GIC], and chronic disease score) to predict adverse hospitalization outcomes (death during hospitalization, length of stay, and institutionalization).


METHODS
Prospective cohort of 444 elderly inpatients (mean age 85.3) was randomly selected from Geneva geriatric hospital.


RESULTS
In univariate analyses, GIC was the best predictor for all outcomes. The risk of death was 30 times higher and the risk of prolonged hospitalization and being institutionalized was eight to nine times higher in patients with scores of class 3 or 4. In adjusted logistic regression models, GIC remained the best predictor of death during hospitalization. Higher GIC scores accounted for 25% of the variance of this outcome, with mortality rates differing by a factor of four between the highest and the lowest scores. CIRS was a strong predictor of a prolonged hospital stay and institutionalization, accounting for 10% of the variance of these outcomes.


CONCLUSIONS
GIC was the most accurate predictor of death during hospitalization. CIRS could be used to select elderly patients at admission as an indicator of improvement at discharge.
Rehabilitation and Geriatrics Department, Geneva University, chemin du Pont-Bochet, Thônex, Switzerland. dina.zekry@hcuge.ch
Dina
D
Zekry
Bernardo Hermont
BH
Loures Valle
Claudia
C
Lardi
Christoph
C
Graf
Jean-Pierre
JP
Michel
Gabriel
G
Gold
Karl-Heinz
KH
Krause
François R
FR
Herrmann
D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D005853:Geriatrics / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D012720:Severity of Illness Index; D013557:Switzerland