The multidimensional prognostic index in hospitalized older adults: practicability with regard to time needs.

"Declarations Conflict of interestNone of the authors report a conflict of interest. Conflict of interest None of the authors report a conflict of interest."

"Funding Open Access funding enabled and organized by Projekt DEAL. No specific funding was received for this work."

"The study was approved by the Ethics Committee of the University of Cologne (EK 17-101) and registered accordingly (DRKS00017071). Inclusion criteria were an age older than 65 years, multimorbidity (i.e., more than two chronic conditions requiring long-term treatment), hospitalization in the geriatric unit and providing informed consent. Reason for exclusion was inability to give consent (e.g., by decisional impairment in case of advanced dementia). MPI data were collected by 1 investigator in 90 older multimorbid patients hospitalized between September 2017 and October 2019. Three geriatric departments of hospitals in Cologne, Germany participated in the study: Malteser Krankenhaus St. Hildegardis (cohort 1); Evangelisches Krankenhaus Kalk (cohort 2); St. Marien Hospital (cohort 3). In the aforementioned sequel, the three participating departments were visited sequentially. A cohort of 30 patients, each, was investigated en bloc as shown in the flowchart of the study (Fig. ). After signing informed consent, patients underwent a structured evaluation including the eight domains of co-habitation status, number of drugs taken, functions (Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL)), cognition (Short Portable Mental Status Questionnaire (SPMSQ)), pressure ulcer risk (Exton-Smith-Scale (ESS)), multimorbidity (Cumulative Index Rating Scale (CIRS)), and nutritional status (Mini Nutritional Assessment—Short Form (MNA-SF)) as previously described [, ]. The scores were included in a mathematical algorithm delivering the MPI and its three mortality risk subgroups: low (MPI 1: 0.00–0.33), moderate (MPI 2: 0.34–0.66) and severe risk (MPI 3: 0.67–1.0) []. During the assessment, the time expenditure to collect the scores for all MPI domains and subsequently to calculate the MPI-score was recorded: time needed to perform MPI (tnpMPI) in minutes (min). An assessment time that was considered feasible in clinical practice was not specified before data collection and analysis were undertaken, in terms of a hypothesis-free approach. Additionally, demographics (age, gender) and health-related data (individual need of care, admission date and admission diagnosis) were recorded. The main objective of the study was to assess the time needed to perform MPI (tnpMPI). Since the MPI is a prognostic tool predicting mortality as described before [], we performed a follow-up as a descriptive, secondary objective. Rehospitalisations, individual need of care, falls, medication and mortality were assessed by a telephone call at 6 months after the initial interview.Fig. 1Flowchart of the study—design of the feasibility study investigating the time requirements for the performance of the Multidimensional Prognostic Index (MPI)"