Abstract
Objective
To externally validate the PALIAR index for patients with advanced, nononcologic chronic diseases.
Methods
We performed a prospective, multicenter cohort study that included patients with advanced, nononcologic chronic diseases hospitalized in internal medicine departments and treated consecutively by the researchers between July 1st and December 31st, 2014. Data were collected from each patient on age, sex, advanced disease, Charlson index, comorbidities, Barthel index, terminal illness symptoms, need for caregiver, hospitalization in the past 3 and 12 months and number of drugs. We calculated the PALIAR index and conducted a 6-month follow-up. To analyze the association between the variables and mortality, we constructed several multivariate logistic regression models.
Results
The study included 295 patients with a mean age of 82.7 (8.6) years, 148 (50.2%) of whom were women. Mortality at 6 months was associated with the albumin level (OR 0.52, 95% CI 0.30–0.85, p = 0.011), and the terminal illness (OR 2.75, 95% CI 1.55–4.89, p = 0.001). The PALIAR index showed good discrimination for predicting mortality (statistical C, 0.728, 95% CI 0.670–0.787). A reduced version of the PALIAR index showed similar mortality discriminatory power.
Conclusions
The PALIAR index is a reliable tool for predicting mortality in patients with advanced, nononcologic chronic diseases.
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Acknowledgements
List of researchers of the PALIARAGON Study Jesús Díez-Manglano, José Velilla-Marco, Carmen Bueno-Castel, Alfonso García-Aranda, Ester Artajona-Rodrigo (Internal Medicine Department, Hospital Universitario Miguel Servet, Zaragoza), Carolina Clemente-Sarasa, Daniel Fuertes-Ruiz, Esperanza Bejarano-Tello, Eulalia Munilla-López, María-Pilar Lambán-Aranda (Internal Medicine Department, Hospital Royo Villanova, Zaragoza), Noelia Gómez-Aguirre (Internal Medicine Department, Hospital Ernest Lluch, Calatayud), Begoña De Escalante-Yangüela, Borja Gracia-Tello, Jorge Rubio-Gracia (Internal Medicine Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza), José-Luis Cabrerizo-García, Sandra Yagüe-Vallejo (Internal Medicine Department, Hospital General de la Defensa, Zaragoza).
Funding
The Research Group on Comorbidity and Polypathology in Aragón is co-financed from the European Regional Development Fund.
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We assure that all authors included on a paper fulfill the criteria of authorship. JD-M, JV-M and NG-A designed the study. All authors performed data collection. Data analysis was performed by JD-M. The manuscript was drafted by JD-M, and all authors helped with its revision and gave final approval of this version.
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Statement of human and animal rights
The study was approved by the Clinical Research Ethics Committee of Aragon, and was carried out in accordance with the principles of the Declaration of Helsinki. This article does not contain any studies with animal performed by any of the authors.
Informed consent
All patients (or their caregivers in the case of cognitive impairment) signed a written informed consent form.
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The list of researchers of the PALIARAGON Study are given in Acknowledgements.
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Gómez-Aguirre, N., Fuertes-Ruiz, D., Gracia-Tello, B. et al. External validation of the PALIAR index for patients with advanced, nononcologic chronic diseases. Aging Clin Exp Res 31, 393–402 (2019). https://doi.org/10.1007/s40520-018-0980-3
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DOI: https://doi.org/10.1007/s40520-018-0980-3