How accurate is the terminal prognosis in the minimum data set?

被引:9
作者
Finne-Soveri, UH
Tilvis, RS
机构
[1] Univ Helsinki, Dept Med, Div Geriatr, FIN-00290 Helsinki, Finland
[2] Helsinki City Hosp, Helsinki, Finland
关键词
D O I
10.1111/j.1532-5415.1998.tb02762.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To determine the sensitivity and specificity of terminal prognosis in institutional long-term care (LTC) DESIGN: The Minimum Data Set (MDS 1.0). Data in regard to deaths were collected 6 and 12 months after the assessment. SETTING: A geriatric hospital responsible for all hospital-based LTC services in one health district (population 71,000) in Helsinki, Finland. PARTICIPANTS: All LTC patients (N = 656; 81% female; mean age = 83 years) in treatment during a 1-week period. RESULTS: One-fourth (n = 164) of the 656 LTC patients had a terminal prognosis. Of these patients, 70.7% survived 6 months, and 58.5% were still alive after 1 year. Consequently, terminal prognosis was associated with a four-fold risk of 6-month mortality. The sensitivity of the terminal prognosis diagnosis was only 29%, whereas the specificity was 89%. The positive predictive accuracy was 47%, but the negative predictive accuracy was 79%. CONCLUSIONS: Terminal prognosis was clearly overdiagnosed. More information is needed about short-term mortality in terminal prognosis patients and whether this diagnosis affects survival rates.
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页码:1023 / 1024
页数:2
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