Assessment of One-year Mortality Risk Using the Modified 34-item Rockwood Index
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 2,610
- 试验地点
- 1
- 主要终点
- Overall Survival
研究概览
简要总结
Frailty is a key determinant of prognosis in older adults with complex chronic conditions and in palliative care settings. The Rockwood Frailty Index (RFI), based on the accumulation of health deficits, has demonstrated prognostic value across multiple clinical contexts. This study evaluates the association between the RFI and overall survival in complex chronic and palliative patients (oncologic and non-oncologic) treated in a Hospital-at-Home (HaH) unit.
详细描述
This retrospective longitudinal observational cohort study included patients aged 65 years or older admitted to a Hospital-at-Home (HaH) unit between January 1, 2021 and December 31, 2024. All patients had a recorded modified Rockwood Frailty Index (RFI) at admission and were subsequently followed through a structured case-management program led by nurse case managers via scheduled telephone follow-up.
Patients were classified into three clinical groups: complex chronic patients, non-oncologic palliative patients, and oncologic palliative patients. Non-oncologic palliative status was defined by an RFI ≥0.53, while complex chronic patients had an RFI >0.37 and <0.53. Oncologic palliative patients were classified based on referral from Oncology services regardless of frailty level.
The primary outcome was overall survival, defined as time from discharge from the HaH unit to death from any cause. Survival analyses were conducted using Kaplan-Meier curves and multivariate Cox proportional hazards regression models adjusted for relevant demographic, clinical, and laboratory covariates.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥65 years
- •Admission to the Hospital-at-Home unit during the study period
- •Recorded modified Rockwood Frailty Index at admission
- •Participation in the post-discharge case management follow-up program
排除标准
- •Incomplete data for frailty index calculation
- •Immediate loss to follow-up after discharge
研究组 & 干预措施
Older adults with complex chronic diseases or palliative care needs
All patients must had a recorded modified Rockwood Frailty Index (RFI) at admission and were subsequently followed through a structured case-management program led by nurse case managers via scheduled telephone follow-up.
Patients were classified into three clinical groups: complex chronic patients, non-oncologic palliative patients, and oncologic palliative patients. Non-oncologic palliative status was defined by an RFI ≥0.53, while complex chronic patients had an RFI >0.37 and <0.53. Oncologic palliative patients were classified based on referral from Oncology services regardless of frailty level.
干预措施: Patients identified and followed in this cohort received scheduled supportive telephone calls every two weeks if classified in the oncologic palliative care group, and once monthly in the case of comp (Other)
结局指标
主要结局
Overall Survival
时间窗: 1 year
Time from discharge from the Hospital-at-Home unit to death from any cause.
次要结局
- Association between overall survival and clinical variables (Charlson Comorbidity Index, Barthel Index)(1 year)
- Association between overall survival and laboratory parameters (albumin, C-reactive protein)(1 year)
- Association between survival and demographic variables (age, sex)(1 year)
- Comparative prognostic performance of the Rockwood Frailty Index versus Charlson Comorbidity Index(1 year)
- Association between age and overall survival(1 year)
- Association between sex and overall survival(1 year)
- Association between overall survival and clinical variables (Charlson Comorbidity Index)(1 year)
- Association between overall survival and clinical variables (Barthel Index)(1 year)
- Association between overall survival and laboratory parameters (C-reactive protein)(1 year)
- Association between overall survival and laboratory parameters (albumin)(1 year)
研究者
Vicente Ruiz García
Principal Investigator
Hospital Universitario La Fe