The MDS-CHESS scale: A new measure to predict mortality in institutionalized older people
The MDS-CHESS scale: A new measure to predict mortality in institutionalized older people
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DOI：
10.1034/j.1601-5215.2002.51017.x
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发表时间：
2003-01-01
影响因子：
6.3
通讯作者：
Teare, GF
中科院分区：
文献类型：
--
作者：
Hirdes, JP;Frijters, DH;Teare, GF
目的：设计：基于最小数据集（MDS）2.0和死亡率数据的观察性研究，地点：安大略慢性病医院，对象：所有慢性病医院患者（N = 28，495）在1996年7月强制实施后使用MDS 2.0进行评估，一直持续到1999年5月。MDS 2.0评估作为正常实践的一部分，主要由慢性病医院的注册护士或多学科团队进行。死亡率数据可从随附的出院跟踪form.RESULTS：MDS的变化，在健康，终末期疾病和症状和体征（CHESS）评分是一个复合措施，解决健康，终末期疾病，症状和体征的变化的医疗问题。它是死亡率的强预测因子（P <0.0001），与年龄、性别、日常生活活动能力受损、认知和不复苏命令的影响无关。它还与医生活动、复杂的医疗程序和疼痛密切相关（每个因变量P <0.001）。结论：CHESS评分提供了一种有用的新的基于MDS的测试来预测死亡率和测量健康不稳定性作为临床结果。
OBJECTIVES: To develop a scale predicting mortality and other adverse outcomes associated with frailty.DESIGN: Observational study based on Minimum Data Set (MDS) 2.0 and mortality data.SETTING: Ontario chronic hospitals.PARTICIPANTS: All chronic hospital patients (N = 28,495) assessed with the MDS 2.0 after mandatory implementation in July 1996 followed until May 1999.MEASUREMENTS: MDS 2.0 assessments done as part of normal practice mainly by registered nurses or multidisciplinary teams in a chronic hospital. Mortality data are available from the accompanying discharge tracking form.RESULTS: The MDS-Changes in Health, End-stage disease and Symptoms and Signs (CHESS) score is a composite measure addressing changes in health, end-stage disease, and symptoms and signs of medical problems. It is a strong predictor of mortality (P < .0001) independent of the effects of age, sex, activities of daily living impairment, cognition, and do-not-resuscitate orders. It is also strongly associated with physician activity, complex medical procedures, and pain (P < .001 for each dependent variable).CONCLUSIONS: The CHESS score provides a useful new MDS-based test to predict mortality and to measure instability in health as a clinical outcome.