• Atencion primaria · Jun 2014

    Multicenter Study

    [Validation of a prognostic model for polypathological patients (PP) in Primary Health Care: "PROFUND STUDY-AP"].

    • ColomboPilar BohórquezPBDistrito Sanitario de Atención Primaria Aljarafe-Sevilla Norte, Sevilla, España. Electronic address: pilarbohorquez@hotmail.com., María Dolores Nieto Martín, Beatriz Pascual de la Pisa, M José García Lozano, M Angeles Ortiz Camúñez, and Máximo Bernabéu Wittel.
    • Distrito Sanitario de Atención Primaria Aljarafe-Sevilla Norte, Sevilla, España. Electronic address: pilarbohorquez@hotmail.com.
    • Aten Primaria. 2014 Jun 1; 46 Suppl 3: 41-8.

    Aimsto validate the PROFUND index in PP in Primary Health Care (PHC).Designtwo-year prospective multicenter study.Locationthree health care centers in Seville Province (Spain).Subjects Of The AssessmentPP with signed informed consent.Samplen=446 (p=20%; α=5%; β=99%); consecutive sampling.MeasurementDependent variable: mortality (2 years).Independent Variablessocio-demography, clinic, anthropometric, laboratory, pharmacologic prescriptions, functional, cognitive and socio-familiar evaluation and the use of health resources.Information Sourceinterview with patients and clinical charts.Statistical Analysisuni and multivariate analysis according to the variables; Accuracy was assessed in the cohort by risk terciles calibration, and discrimination power, by ROC curves. Finally, accuracy of the index was compared with that of the Charlson index.Results446 subjects were included (53.8% men); average age was 75.44yr (Confidence interval 95% 74.58-76.31). Average of diagnostic categories was 2.37 (Confidence interval 95% 2.30-2.44). Prevalent categories were: A (64.1%), F (41.7%) and E (33.5%). Mortality within 2 years was 24.1%. Calibration in predicted/observed mortality along the three established risk strata was 16%/16.7% for PP with 0-2 points, 22%/19.5% for PP with 3-6, and 34%/36% for PP with 7 or more points (Hosmer-Lemeshow test with p=0.119). Discrimination power of PHC PROFUND's by area under the curve was (AUC) ROC was 0.622 (Confidence interval 95% 0.556-0.689; p<0.001), and that of Charlson index 0.510 (Confidence interval 95% 0.446 - 0.575; p>0.005).ConclusionsThe PROFUND index is a good indicative tool in the stratification of 2-year mortality risk polypathological patients in PHC.Copyright © 2014 Elsevier España, S.L. All rights reserved.

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