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External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón

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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.

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Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was approved by the Ethics Committee for Clinical Research of Aragon. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Internal Medicine Department, Hospital Royo Villanova, Avda San Gregorio no 30, 50015, Saragossa, Spain

    Jesús Díez-Manglano, Rosa M. Martínez-Álvarez & Esperanza Bejarano Tello

  2. Research Group on Comorbidity and Polypathology in Aragón, Aragón Health Sciences Institute, Saragossa, Spain

    Jesús Díez-Manglano, Araceli Jimeno Saínz & Aránzazu Caudevilla Martínez

  3. Department of Medicine, Dermatology and Psychiatry, University of Zaragoza School of Medicine, Saragossa, Spain

    Jesús Díez-Manglano & Rosa M. Martínez-Álvarez

  4. Internal Medicine Department, Hospital de la Defensa, Saragossa, Spain

    José Luis Cabrerizo García

  5. Geriatric Department, Hospital Nuestra Señora de Gracia, C/Ramón y Cajal no 60, 50003, Saragossa, Spain

    Ernesto García-Arilla Calvo

  6. Internal Medicine Department, Hospital Ernest Lluch, Calatayud, Spain

    Araceli Jimeno Saínz & Aránzazu Caudevilla Martínez

  7. Internal Medicine Department, Hospital San Jorge, Huesca, Spain

    Eva Calvo Beguería

Authors
  1. Jesús Díez-Manglano
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  2. José Luis Cabrerizo García
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  3. Ernesto García-Arilla Calvo
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  4. Araceli Jimeno Saínz
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  5. Eva Calvo Beguería
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  6. Rosa M. Martínez-Álvarez
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  7. Esperanza Bejarano Tello
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  8. Aránzazu Caudevilla Martínez
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Corresponding authors

Correspondence to Jesús Díez-Manglano or Ernesto García-Arilla Calvo.

Additional information

On behalf of the PLUPAR study researchers.

PLUPAR study researchers are listed in appendix.

Appendix: List of researchers of the PLUPAR study

Appendix: List of researchers of the PLUPAR study

Jesús Díez Manglano, Patricia Al-Cheikh Felices, Esperanza Bejarano Tello, Esther del Corral Beamonte, Isabel Fiteni Mera, Vanesa Garcés Horna, Francisco Javier Gomes Martín, Mª Pilar Lambán Aranda, Rosa Mª Martínez Álvarez, Pablo Martínez Rodés, Eulalia Munilla López, Mª Jesús Pardo Díez, Santiago Alfonso Rubio Félix, María Sevil Puras, Carla Toyas Miazza (Internal Medicine Department, Hospital Royo Villanova, Zaragoza), Paz Revillo Pinilla, María Espuelas Monge, Mónica Odriozola Grijalba, Leticia Ollero Domenche (Internal Medicine Department, Hospital Universitario Miguel Servet, Zaragoza), Mercedes Clerencia Sierra (Geriatric Unit, Hospital Universitario Miguel Servet, Zaragoza), Begoña de Escalante Yangüela, María del Mar Rodero Roldán, (Internal Medicine Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza), Mariano Sebastián Royo, José Ramón Puertas, José Luis Cabrerizo García (Internal Medicine Department, Hospital General de la Defensa, Zaragoza), Ernesto García-Arilla Calvo, Beatriz Gamboa Huarte, Teresa Morlanes Navarro, Teresa Villar Sanpio, José Luis Bonafonte Marteles, María Elena Castro Vilela, Raquel Quílez Pina (Geriatric Unit, Hospital Nuestra Señora de Gracia, Zaragoza), Mercedes Giménez López, Rosa Ramos Ibáñez, Concepción Ortiz Domingo (Geriatric Unit, Hospital San Juan de Dios, Zaragoza), Aránzazu Caudevilla Martínez, Araceli Jimeno Sainz (Internal Medicine Department, Hospital Ernest Lluch, Calatayud, Zaragoza), Eva Calvo Beguería, Teresa Omiste Sanvicente (Internal Medicine Department Hospital San Jorge, Huesca), Elena Ubis Díez (Geriatric Unit, Hospital Sagrado Corazón, Huesca), Pablo Sánchez-Rubio Lezcano, Sonia Omatos Mangado, Jesús Santaliestra Grau, Elena Castellar Otín (Internal Medicine Department, Hospital de Barbastro, Huesca), Juan Vallés Noguero, Alfredo Zamora Mur (Geriatric Unit, Hospital de Barbastro, Huesca), Carmen Piqueras Serrano, María Salas Alcántara (Internal Medicine Department, Hospital de Alcañiz, Teruel), Ignacio García-Álvarez García, Javier Lerín Sánchez (Internal Medicine Department, Hospital Obispo Polanco, Teruel), Paloma González García, Sofía Solsona (Geriatric Unit, Hospital San José, Teruel).

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Díez-Manglano, J., Cabrerizo García, J.L., García-Arilla Calvo, E. et al. External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón. Intern Emerg Med 10, 915–926 (2015). https://doi.org/10.1007/s11739-015-1252-2

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