Porock et al developed a model for predicting death in a nursing home based on the minimum data set. This Minimum Data Set Mortality Index can help to identify patients who may benefit from more aggressive management. The authors are from the University of Nottingham and the University of Missouri at Columbia.
Parameters:
(1) age in years without cancer vs age in years with cancer
(2) MDS cognitive performance scale (CPS)
(3) admission or deteriorating
(4) number of activities of daily living (ADL) requiring assistance (0 to 7)
(5) shortness of breath
(6) appetite
(7) gender
(8) weight loss
(9) chronic heart failure
(10) renal failure
(11) dehydration
(12) Alzheimer’s disease
|
Parameter |
Finding |
Points |
|
age and cancer |
<= 69 without cancer |
1 |
|
|
70 to 78 without cancer |
2 |
|
|
79 to 88 without cancer |
3 |
|
|
89 to 98 without cancer |
4 |
|
|
>= 99 without cancer |
5 |
|
|
<= 74 with cancer |
8 |
|
|
85 to 84 with cancer |
7 |
|
|
85 to 94 with cancer |
6 |
|
|
>= 95 with cancer |
5 |
|
CPS score |
0 or 1 (intract to borderline) |
0 |
|
|
2 to 4 (mild to moderate impairment) |
1 |
|
|
5 or 6 (severe impairment) |
2 |
|
admission or deteriorating |
recent admission |
3 |
|
|
deteriorating |
3 |
|
|
both |
4 |
|
|
neither |
0 |
|
ADL score |
0 to 7 |
< ADL > |
|
shortness of breath |
absent |
0 |
|
|
present |
3 |
|
appetite |
not poor |
0 |
|
|
poor |
2 |
|
gender |
female |
0 |
|
|
male |
2 |
|
weight loss |
absent |
0 |
|
|
present |
2 |
|
chronic heart failure |
absent |
0 |
|
|
present |
2 |
|
renal failure |
absent |
0 |
|
|
present |
2 |
|
dehydration |
absent |
0 |
|
|
present |
2 |
|
Alzheimer’s disease |
absent |
0 |
|
|
present |
-1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimm score: 0
• maximum score: 35 (highest indicated in study 29)
• The higher the score the greater the 6 month mortality.
|
Score |
Percent Survival |
|
0 to 13 |
(0.1614 * ((score)^2)) - (0.3765 * (points)) + 2.191 |
|
13 to 18 |
(5.591 * (points)) – 48.35 |
|
18 to 29 |
(-0.2871 * ((score)^2)) + (17.32 * (points)) – 166.3 |
|
> 29 |
> 95% |
Purpose: To use the Minimum Data Set Mortality Risk Index of Porock et al to predict 6-month mortality for a nursing home resident.
Objective: risk factors, severity, prognosis, stage
ICD-10: ,
