title: [Reliability of the PROFUND index to predict 4-year mortality in polypathological patients].
abstract: OBJECTIVE
  To determine the usefullness of the PROFUND index to assess the risk of global death after 4 years in polypathological patients.
  
  
  METHODS
  Multicenter prospective cohort (Internal Medicine and Geriatrics) study. Polypathological patients admitted between March 1st and June 30th 2011 were included. For each patient, data concerning age, sex, living at home or in a nursing residence, polypathology categories, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs, hemoglobin and creatinine values were gathered, and the PROFUND index was calculated. The follow-up lasted 4 years.
  
  
  RESULTS
  We included 441 patients, 324 from Internal Medicine and 117 from Geriatrics, with a mean age of 80.9 (8.7) years. Of them, 245 (55.6%) were women. Heart (62.7%), neurological (41.4%) and respiratory (37.3%) diseases were the most frequent. Geriatrics inpatients were older and more dependants and presented greater cognitive deterioration. After 4 years, 335 (76%) patients died. Mortality was associated with age, dyspnoea, Barthel index<60, delirium, advanced neoplasia and≥4 admissions in the last year. The area under the curve of the PROFUND index was 0.748, 95% CI 0.689-0.806, P<.001 in Internal Medicine and 0.517, 95% CI 0.369-0.666, P=.818 in Geriatrics patients, respectively.
  
  
  CONCLUSIONS
  The PROFUND index is a reliable tool for predicting long-term global mortality in polypathological patients from Internal Medicine but not from Geriatrics departments.
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España. Electronic address: jdiez@aragon.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España; Grupo de investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Del Corral Beamonte
authors.affiliation: Servicio de Geriatría, Hospital San Juan de Dios, Zaragoza, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ramos Ibáñez
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Lambán Aranda
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
authors.forename: Carla
authors.initials: C
authors.lastname: Toyas Miazza
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Rodero Roldán
authors.affiliation: Servicio de Geriatría, Hospital San Juan de Dios, Zaragoza, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Ortiz Domingo
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
authors.forename: Eulalia
authors.initials: E
authors.lastname: Munilla López
authors.affiliation: Grupo de investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España; Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
authors.forename: Begoña
authors.initials: B
authors.lastname: de Escalante Yangüela
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005853:Geriatrics; D006760:Hospitalization; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D009026:Mortality; D000076322:Multimorbidity; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
keywords: Mortalidad; Mortality; Paciente pluripatológico; Polypathological patient; Prognostic index; Índice pronóstico