Predictors of mortality shortly after entering a long-term care facility.
Age Ageing
; 53(5)2024 05 01.
Article
in En
| MEDLINE
| ID: mdl-38773946
ABSTRACT
OBJECTIVE:
Moving into a long-term care facility (LTCF) requires substantial personal, societal and financial investment. Identifying those at high risk of short-term mortality after LTCF entry can help with care planning and risk factor management. This study aimed to (i) examine individual-, facility-, medication-, system- and healthcare-related predictors for 90-day mortality at entry into an LTCF and (ii) create risk profiles for this outcome.DESIGN:
Retrospective cohort study using data from the Registry of Senior Australians.SUBJECTS:
Individuals aged ≥ 65 years old with first-time permanent entry into an LTCF in three Australian states between 01 January 2013 and 31 December 2016.METHODS:
A prediction model for 90-day mortality was developed using Cox regression with the purposeful variable selection approach. Individual-, medication-, system- and healthcare-related factors known at entry into an LTCF were examined as predictors. Harrell's C-index assessed the predictive ability of our risk models.RESULTS:
116,192 individuals who entered 1,967 facilities, of which 9.4% (N = 10,910) died within 90 days, were studied. We identified 51 predictors of mortality, five of which were effect modifiers. The strongest predictors included activities of daily living category (hazard ratio [HR] = 5.41, 95% confidence interval [CI] = 4.99-5.88 for high vs low), high level of complex health conditions (HR = 1.67, 95% CI = 1.58-1.77 for high vs low), several medication classes and male sex (HR = 1.59, 95% CI = 1.53-1.65). The model out-of-sample Harrell's C-index was 0.773.CONCLUSIONS:
Our mortality prediction model, which includes several strongly associated factors, can moderately well identify individuals at high risk of mortality upon LTCF entry.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Long-Term Care
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
Oceania
Language:
En
Year:
2024
Type:
Article