• Antonio Brucato, Alberto Ferrari, Mara Tiraboschi, Alberto Zucchi, Chiara Cogliati, Daniela Torzillo, Francesco Dentali, Luca Tavecchia, Vera Gessi, Alessandro Squizzato, Sara Moretti, Eleonora Tamborini Permunian, Alessandra Carobbio, Luca Pasina, Fabio De Stefano, Enrico Tombetti, Davide Cumetti, Gianni Tognoni, and Tiziano Barbui.
• Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi d Milano, Ospedale Fatebenefratelli, Italy; Ospedale Papa Giovanni XXIII, Bergamo, Italy. Electronic address: antonio.brucato@unimi.it.
• Eur. J. Intern. Med. 2020 Feb 1; 72: 60-66.

ObjectiveTo predict the 3-months mortality in permanently bedridden medical non-oncologic inpatients.Patients And Methods2788 consecutive patients admitted in 5 Italian Internal Medicine units from January 2016 through January 2017 were prospectively screened; 644 oncologic patients were excluded; 2144 non-oncologic patients (1021 female) were followed-up for mortality for 6 months. Main outcome was 3-months mortality in permanently bedridden inpatients with at least 2 of: creatinine clearance <35 ml/min; albumin < 2.5 g/dl; at least 2 hospital admissions in the previous 6 months. Advanced dementia and dysphagia were also recorded.ResultsMean age of the 2144 patients was 73.9 (SD, 14.9) years; 374 (17%) were permanently bedridden, 435 (20%) had a creatinine clearance <35 ml/min, 217 (10%) albumin <2,5 g/dl, 112 (5%) at least 2 hospital admissions in the previous 6 months. Seventy-seven (4%) patients were permanently bedridden with at least 2 of the above mentioned items, and 48 of them died within 3 months (62%) (p < 0.001;95% CI 51-73%). Regression coefficients of the variables associated with 3-months mortality in multivariate analysis in 998 patients of unit 1 (training cohort) were used to create a simple score, which was validated in the 1146 patients of the other units (validation cohort) and performed well in predicting the 3-months mortality (https://www.ejcrim.com/beclap/).ConclusionsApproximately two out of three non-oncologic medical patients permanently bedridden having 2 of the abovementioned items are dead 3 months after index admission; a simple score including bedridden status, creatinine clearance, albumin, dysphagia, age and sex may help discuss management priorities.Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

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