External validation of the PALIAR index for patients with advanced, nononcologic chronic diseases

• Published in: Aging clinical and experimental research Vol. 31; no. 3; pp. 393 - 402
• Main Authors: Gómez-Aguirre, Noelia, Fuertes-Ruiz, Daniel, Gracia-Tello, Borja, Clemente-Sarasa, Carolina, Artajona-Rodrigo, Ester, Cabrerizo-García, José-Luis, de Escalante-Yangüela, Begoña, Bueno-Castel, María-Carmen, Velilla-Marco, José, Díez-Manglano, Jesús
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2019; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Chronic Disease - mortality; Chronic illnesses; Cohort analysis; Female; Geriatrics/Gerontology; Health risk assessment; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Mortality; Original Article; Prospective Studies; Terminal illnesses; Advanced chronic disease; Prognosis; Cohort study; Mortality
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-018-0980-3

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.