21 Pilot Scheme Of Validation Prospective Study Of Multidimensional Prognostic Index (Mpi) In A Elderly Population In Home Care Setting

Derrico G, Iannantuoni L, Lepore D
Aims: The main objective of this pilot observational study is to stratify into different groups with different risk all elderly patients in home care by assigning them on the multidimensional assessment (VMD) geriatric basis a prognostic index (MPI) that can predict, although at short distance (after a follow up of 4 months), "primary outcomes" such as hospitalisation and institutionalisation.
Material and methods: The "tests" that were used are the Activity Daily Living (ADL) and Instrumental Activity Daily Living (IADL) for the functional assessment, the Short Portable Mental Status Questionnaire ( SPMSQ ) for the cognitive study, the Geriatric Depression Scale (GDS) for depression assessment, the Mini Nutritional Assessment (MNA) for the nutritional status assessment, the Cumulative Illness Rating Scale (CIRS) for the comorbidity assessment, the Exton-Smith scale (ESS) for the clinical risk assessment of pressure sores.
Results: The MMG belonging to ASL Foggia Province who took part, as has already been said, to the Study Pilot Project were 18. The study shows that patients with MPI1 are 35 (19%), those with MPI2 109 (about 58%, the largest group representing more than half the cases) and those with MPI3 44 (about 23%). As for the VMD we can say that subjects belonging to the group with the most severe MPI (MPI3) appear to have instead of the other two groups, a prognostic score more negative in various scales, validated and used, that explore different areas or spheres (the functional, cognitive and affective, the biological and the health insurance) which, only together, manage to offer a comprehensive look of a very complex patient, as the frail elderly. In fact, the scores show a greater severity of depressive symptoms (GDS = 9.96 +/- 3.21, P = 0.028), a more severe cognitive deficiency (SPMSQ = 7:41 +/- 2.84, P Conclusions: The data obtained, at the conclusion of the Pilot Project Study, cannot certainly validate the Multidimensional Prognostic Index (MPI) in the population of elderly in home care , in question but they have allowed us to create the bases for a complete, prospective and trusted study, and that will tell us if the Multidimensional Prognostic Index (MPI) in hospital can be equally applied, with the same precision and with the same statistical significance at a local level in an elderly population, managed by MMG, who are in home care.
Pilot scheme of validation prospective study of Multidimensional Prognostic Index (MPI) in a elderly population in home care setting