Abstract
Objectives
Morbidity is an important risk factor for mortality and a variety of morbidity measures
have been developed to predict patients' health outcomes. The objective of this systematic
review was to compare the capacity of morbidity measures in predicting mortality among
inpatients admitted to internal medicine, geriatric, or all hospital wards.
Design
A systematic literature search was conducted from inception to March 6, 2019 using
4 databases: Medline, Embase, Cochrane, and CINAHL. Articles were included if morbidity
measures were used to predict mortality (registration CRD42019126674).
Setting and Participants
Inpatients with a mean or median age ≥65 years.
Measurements
Morbidity measures predicting mortality.
Results
Of the 12,800 articles retrieved from the databases, a total of 34 articles were included
reporting on inpatients admitted to internal medicine, geriatric, or all hospital
wards. The Charlson Comorbidity Index (CCI) was reported most frequently and a higher
CCI score was associated with greater mortality risk, primarily at longer follow-up
periods. Articles comparing morbidity measures revealed that the Geriatric Index of
Comorbidity was better predicting mortality risk than the CCI, Cumulative Illness
Rating Scale, Index of Coexistent Disease, and disease count.
Conclusions and Implications
Higher morbidity measure scores are better in predicting mortality at longer follow-up
period. The Geriatric Index of Comorbidity was best in predicting mortality and should
be used more often in clinical practice to assist clinical decision making.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Footnotes
Unrestricted funding was provided by the University of Melbourne to Professor Andrea B. Maier.
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
