title: Comorbidity burden assessment in older people admitted to a Portuguese University Hospital.
abstract: OBJECTIVE
  To determine the most valuable comorbidity index to apply in a clinical context and its prospective association with 1-year mortality and 3-month readmission. The authors also intend to gauge the evolution of older patients' admission profile over 13 years, in the same clinical setting.
  The authors analyzed data from 100 consecutive patients admitted in 2012. The Charlson Comorbidity Index (CCI), the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and the Medication-Based Disease Burden Index (MDBI) were used to evaluate comorbidity. Length of stay, number of diagnoses and of medications, readmission and mortality were assessed. A p value <0.05 was considered significant.
  
  
  RESULTS
  Mean age was 80.6 years, mean length of stay was 8.8 days, and mean number of diagnosis per patient was 7.9. Mean values of score were of 3.6 for the CCI, 11.3 for the CIRS-G and 0.552 for the MDBI. Three-month readmission and 1-year mortality rates related to higher CCI and CIRS-G scores. No association was found between MDBI and the outcomes evaluated. One-year mortality reached 24 % and 3-month readmission was of 43 %. Comparing the two samples, mean age increased in 2.1 years and the number of diagnosis by 2.2. Length of stay decreased 2 days.
  
  
  CONCLUSIONS
  CCI was easier to use but the CIRS-G was better at evaluating comorbidity. MDBI did not seem to be a trustworthy tool. Despite an older population with high comorbidity, length of stay decreased over 13 years. However, readmission was high. Introduction of geriatric care standards is required to improve health outcomes for older patients.
authors.affiliation: Respiratory Medicine Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal, ana.pgrdias@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Dias
authors.forename: Francisca
authors.initials: F
authors.lastname: Teixeira-Lopes
authors.forename: Ana
authors.initials: A
authors.lastname: Miranda
authors.forename: Mariana
authors.initials: M
authors.lastname: Alves
authors.forename: Marco
authors.initials: M
authors.lastname: Narciso
authors.forename: Luis
authors.initials: L
authors.lastname: Mieiro
authors.forename: Teresa
authors.initials: T
authors.lastname: Fonseca
authors.forename: J P
authors.initials: JP
authors.lastname: Gorjão-Clara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies