title: External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón.
abstract: The objective of the study was to validate externally and prospectively the PROFUND index to predict survival of polypathological patients after a year. An observational, prospective and multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data concerning age, gender, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs and number of admissions during the previous year were gathered for each patient. The PROFUND index was calculated. The follow-up lasted 1 year. A Cox proportional regression model was calculated, and was used to analyze the association of the variables to mortality and C-statistic. 465 polypathological patients, 333 from internal medicine and 132 from geriatrics, were included. One-year mortality is associated with age [hazard ratio (HR) 1.52 95 % CI 1.04-2.12; p = 0.01], presence of neoplasia [HR 2.68 95 % CI 1.71-4.18; p = 0.0001] and dependence for basic activities of daily living [HR 2.34 95 % CI 1.61-3.40; p = 0.0009]. In predicting mortality, the PROFUND index shows good discrimination in patients from internal medicine (C-statistics 0.725 95 % CI 0.670-0.781), but a poor one in those from geriatrics (0.546 95 % CI 0.448-0.644). The PROFUND index is a reliable tool for predicting mortality in internal medicine PP patients.
authors.affiliation: Internal Medicine Department, Hospital Royo Villanova, Avda San Gregorio no 30, 50015, Saragossa, Spain. jdiez@aragon.es.|Research Group on Comorbidity and Polypathology in Aragón, Aragón Health Sciences Institute, Saragossa, Spain. jdiez@aragon.es.|Department of Medicine, Dermatology and Psychiatry, University of Zaragoza School of Medicine, Saragossa, Spain. jdiez@aragon.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.affiliation: Internal Medicine Department, Hospital de la Defensa, Saragossa, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cabrerizo García
authors.affiliation: Geriatric Department, Hospital Nuestra Señora de Gracia, C/Ramón y Cajal no 60, 50003, Saragossa, Spain. egarciaarilla@salud.aragon.es.
authors.forename: Ernesto
authors.initials: E
authors.lastname: García-Arilla Calvo
authors.affiliation: Research Group on Comorbidity and Polypathology in Aragón, Aragón Health Sciences Institute, Saragossa, Spain.|Internal Medicine Department, Hospital Ernest Lluch, Calatayud, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Jimeno Saínz
authors.affiliation: Internal Medicine Department, Hospital San Jorge, Huesca, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Calvo Beguería
authors.affiliation: Internal Medicine Department, Hospital Royo Villanova, Avda San Gregorio no 30, 50015, Saragossa, Spain.|Department of Medicine, Dermatology and Psychiatry, University of Zaragoza School of Medicine, Saragossa, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Martínez-Álvarez
authors.affiliation: Internal Medicine Department, Hospital Royo Villanova, Avda San Gregorio no 30, 50015, Saragossa, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Bejarano Tello
authors.affiliation: Research Group on Comorbidity and Polypathology in Aragón, Aragón Health Sciences Institute, Saragossa, Spain.|Internal Medicine Department, Hospital Ernest Lluch, Calatayud, Spain.
authors.forename: Aránzazu
authors.initials: A
authors.lastname: Caudevilla Martínez
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D005853:Geriatrics; D006748:Hospital Departments; D006801:Humans; D007388:Internal Medicine; D008297:Male; D009369:Neoplasms / Q000401:mortality; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
keywords: Geriatrics; Internal medicine; Mortality; Multimorbidity; Polypathological patient