title: Use of the interRAI CHESS scale to predict mortality among persons with neurological conditions in three care settings.
abstract: BACKGROUND
  Persons with certain neurological conditions have higher mortality rates than the population without neurological conditions, but the risk factors for increased mortality within diagnostic groups are less well understood. The interRAI CHESS scale has been shown to be a strong predictor of mortality in the overall population of persons receiving health care in community and institutional settings. This study examines the performance of CHESS as a predictor of mortality among persons with 11 different neurological conditions.
  
  
  METHODS
  Survival analyses were done with interRAI assessments linked to mortality data among persons in home care (n = 359,940), complex continuing care hospitals/units (n = 88,721), and nursing homes (n = 185,309) in seven Canadian provinces/territories.
  
  
  RESULTS
  CHESS was a significant predictor of mortality in all 3 care settings for the 11 neurological diagnostic groups considered after adjusting for age and sex. The distribution of CHESS scores varied between diagnostic groups and within diagnostic groups in different care settings.
  
  
  CONCLUSIONS
  CHESS is a valid predictor of mortality in neurological populations in community and institutional care. It may prove useful for several clinical, administrative, policy-development, evaluation and research purposes. Because it is routinely gathered as part of normal clinical practice in jurisdictions (like Canada) that have implemented interRAI assessment instruments, CHESS can be derived without additional need for data collection.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: John P
authors.initials: JP
authors.lastname: Hirdes
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Poss
authors.affiliation: Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Mitchell
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Korngut
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Heckman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D003710:Demography; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009422:Nervous System Diseases / Q000401:mortality*; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D016019:Survival Analysis