Use of health-related, quality-of-life metrics to predict mortality and hospitalizations in community-dwelling seniors
Use of health-related, quality-of-life metrics to predict mortality and hospitalizations in community-dwelling seniors
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DOI：
10.1111/j.1532-5415.2006.00681.x
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发表时间：
2006-04-01
影响因子：
6.3
通讯作者：
Clayton, PD
中科院分区：
文献类型：
--
作者：
Dorr, DA;Jones, SS;Clayton, PD
目的：调查是否健康相关的生活质量（HRQoL）分数在初级保健人口可以作为未来的医院利用率和mortality.DESIGN的预测：前瞻性队列研究测量简表12（SF-12）得分使用邮寄调查。SF-12评分、年龄和合并症评分用于预测老年患者在随后的28个月期间的住院率和死亡率，使用多变量逻辑回归和考克斯比例风险。参与者是患有一种或多种慢性疾病的老年患者，居住在社区，最初在初级保健诊所接受治疗。测量：SF-12调查版本1。3,042人（43%）被退回。在返回的调查中，2，166份（71%）是完整的和可评分的。对于应答组，多变量分析表明，年龄较大、男性、合并症评分较高以及SF-12的精神和身体汇总指标较低预测死亡率和住院率较高。平均而言，无应答者年龄较大，有较高的合并症评分和死亡率比responders.CONCLUSION：SF-12调查提供了额外的预测能力，为未来的住院和死亡率。这种预测能力可能有助于先发制人的干预措施，改变这部分人群的疾病进程。然而，无应答者偏倚可能会限制邮寄SF-12调查在某些人群中的效用。
OBJECTIVES: To investigate whether health-related quality-of-life (HRQoL) scores in a primary care population can be used as a predictor of future hospital utilization and mortality.DESIGN: Prospective cohort study measuring Short Form 12 (SF-12) scores obtained using a mailed survey. SF-12 scores, age, and a comorbidity score were used to predict hospitalization and mortality rate using multivariable logistic regression and Cox proportional hazards during the ensuing 28-month period for elderly patients.SETTING: Intermountain Health Care, a large integrated-delivery network serving a population of more than 150,000 seniors.PARTICIPANTS: Participants were senior patients who had one or more chronic diseases, were community dwelling, and were initially treated in primary care clinics.MEASUREMENTS: SF-12 survey Version 1.RESULTS: Seven thousand seventy-six surveys were sent to eligible participants; 3,042 (43%) were returned. Of the returned surveys, 2,166 (71%) were complete and scoreable. For the respondent group, a multivariable analysis demonstrated that older age, male sex, higher comorbidity score, and lower mental and physical summary measures of SF-12 predicted higher mortality and hospitalization. On average, nonresponders were older and had higher comorbidity scores and mortality rates than responders.CONCLUSION: The SF-12 survey provided additional predictive ability for future hospitalizations and mortality. Such predictive ability might facilitate preemptive interventions that would change the course of disease in this segment of the population. However, nonresponder bias may limit the utility of mailed SF-12 surveys in certain populations.