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External validation of the PALIAR index for patients with advanced, nononcologic chronic diseases

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Abstract

Objective

To externally validate the PALIAR index for patients with advanced, nononcologic chronic diseases.

Methods

We performed a prospective, multicenter cohort study that included patients with advanced, nononcologic chronic diseases hospitalized in internal medicine departments and treated consecutively by the researchers between July 1st and December 31st, 2014. Data were collected from each patient on age, sex, advanced disease, Charlson index, comorbidities, Barthel index, terminal illness symptoms, need for caregiver, hospitalization in the past 3 and 12 months and number of drugs. We calculated the PALIAR index and conducted a 6-month follow-up. To analyze the association between the variables and mortality, we constructed several multivariate logistic regression models.

Results

The study included 295 patients with a mean age of 82.7 (8.6) years, 148 (50.2%) of whom were women. Mortality at 6 months was associated with the albumin level (OR 0.52, 95% CI 0.30–0.85, p = 0.011), and the terminal illness (OR 2.75, 95% CI 1.55–4.89, p = 0.001). The PALIAR index showed good discrimination for predicting mortality (statistical C, 0.728, 95% CI 0.670–0.787). A reduced version of the PALIAR index showed similar mortality discriminatory power.

Conclusions

The PALIAR index is a reliable tool for predicting mortality in patients with advanced, nononcologic chronic diseases.

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Acknowledgements

List of researchers of the PALIARAGON Study Jesús Díez-Manglano, José Velilla-Marco, Carmen Bueno-Castel, Alfonso García-Aranda, Ester Artajona-Rodrigo (Internal Medicine Department, Hospital Universitario Miguel Servet, Zaragoza), Carolina Clemente-Sarasa, Daniel Fuertes-Ruiz, Esperanza Bejarano-Tello, Eulalia Munilla-López, María-Pilar Lambán-Aranda (Internal Medicine Department, Hospital Royo Villanova, Zaragoza), Noelia Gómez-Aguirre (Internal Medicine Department, Hospital Ernest Lluch, Calatayud), Begoña De Escalante-Yangüela, Borja Gracia-Tello, Jorge Rubio-Gracia (Internal Medicine Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza), José-Luis Cabrerizo-García, Sandra Yagüe-Vallejo (Internal Medicine Department, Hospital General de la Defensa, Zaragoza).

Funding

The Research Group on Comorbidity and Polypathology in Aragón is co-financed from the European Regional Development Fund.

Author information

Authors and Affiliations

  1. Internal Medicine Department, Hospital Ernest Lluch, Calatayud, Spain

    Noelia Gómez-Aguirre

  2. Research Group on Comorbidity and Polyphatology in Aragón, Aragón Health Sciences Institute, Avda San Juan Bosco 13 (CIBA), 50009, Zaragoza, Spain

    Noelia Gómez-Aguirre, José-Luis Cabrerizo-García, Begoña de Escalante-Yangüela & Jesús Díez-Manglano

  3. Internal Medicine Department, Hospital Royo Vilanova, Zaragoza, Spain

    Daniel Fuertes-Ruiz & Carolina Clemente-Sarasa

  4. Internal Medicine Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

    Borja Gracia-Tello & Begoña de Escalante-Yangüela

  5. Internal Medicine Department, Hospital Miguel Servet, Zaragoza, Spain

    Ester Artajona-Rodrigo, María-Carmen Bueno-Castel, José Velilla-Marco & Jesús Díez-Manglano

  6. Internal Medicine Department, Hospital General de la Defensa, Zaragoza, Spain

    José-Luis Cabrerizo-García

Authors
  1. Noelia Gómez-Aguirre
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  2. Daniel Fuertes-Ruiz
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  3. Borja Gracia-Tello
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  4. Carolina Clemente-Sarasa
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  5. Ester Artajona-Rodrigo
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  7. Begoña de Escalante-Yangüela
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  8. María-Carmen Bueno-Castel
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  10. Jesús Díez-Manglano
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Consortia

the researchers of the PALIARAGON Study

  • Jesús Díez-Manglano
  • , José Velilla-Marco
  • , Carmen Bueno-Castel
  • , Alfonso García-Aranda
  • , Ester Artajona-Rodrigo
  • , Carolina Clemente-Sarasa
  • , Daniel Fuertes-Ruiz
  • , Esperanza Bejarano-Tello
  • , Eulalia Munilla-López
  • , María-Pilar Lambán-Aranda
  • , Noelia Gómez-Aguirre
  • , Begoña De Escalante-Yangüela
  • , Borja Gracia-Tello
  • , Jorge Rubio-Gracia
  • , José-Luis Cabrerizo-García
  •  & Sandra Yagüe-Vallejo

Contributions

We assure that all authors included on a paper fulfill the criteria of authorship. JD-M, JV-M and NG-A designed the study. All authors performed data collection. Data analysis was performed by JD-M. The manuscript was drafted by JD-M, and all authors helped with its revision and gave final approval of this version.

Corresponding author

Correspondence to Jesús Díez-Manglano.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Statement of human and animal rights

The study was approved by the Clinical Research Ethics Committee of Aragon, and was carried out in accordance with the principles of the Declaration of Helsinki. This article does not contain any studies with animal performed by any of the authors.

Informed consent

All patients (or their caregivers in the case of cognitive impairment) signed a written informed consent form.

Additional information

The list of researchers of the PALIARAGON Study are given in Acknowledgements.

Electronic supplementary material

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Supplementary material 1 (DOCX 75 KB)

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Gómez-Aguirre, N., Fuertes-Ruiz, D., Gracia-Tello, B. et al. External validation of the PALIAR index for patients with advanced, nononcologic chronic diseases. Aging Clin Exp Res 31, 393–402 (2019). https://doi.org/10.1007/s40520-018-0980-3

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  • DOI: https://doi.org/10.1007/s40520-018-0980-3

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