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Development and Validation of a Clinical Prediction Tool for Estimating the Risk of 1-Year Mortality Among Hospitalized Patients with Dementia
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Development and Validation of a Clinical Prediction Tool for Estimating the Risk of 1-Year Mortality Among Hospitalized Patients with Dementia
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Development and Validation of a Clinical Prediction Tool for Estimating the Risk of 1-Year Mortality Among Hospitalized Patients with Dementia
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Dissertation
Development and Validation of a Clinical Prediction Tool for Estimating the Risk of 1-Year Mortality Among Hospitalized Patients with Dementia
2023
Overview
Advance care planning (ACP) has an established benefit among dementia patients though may happen infrequently, which could contribute to goal-discordant end-of-life care. A prognostic tool could serve as a trigger for ACP. We sought to develop and test a clinical tool to predict the risk of 1-year mortality among hospitalized dementia patients. Population-level linked healthcare administrative databases in Ontario were used. In a cohort of 235667 patients hospitalized from 2009-2017, we developed a tool with 76 predictor variables (sociodemographic factors, comorbidities, previous interventions, functional status, nutritional status, admission-specific information, previous healthcare utilization). In a cohort of 62909 patients hospitalized from 2018-2019, the tool demonstrated acceptable discrimination (c statistic=0.796). It demonstrated acceptable calibration in the validation cohort (mean relative difference=-3.29%) and subgroups of meaning to clinicians and policy-makers. This model could be integrated into electronic medical records as an automated prognostic tool, which could prompt ACP among hospitalized dementia patients.
Publisher
ProQuest Dissertations & Theses
Subject
ISBN
9798379763053
