Journal article
Development and validation of a nursing home mortality index to identify nursing home residents nearing the end of life in dental clinics
Special care in dentistry, Vol.43(2), pp.125-135
03/2023
DOI: 10.1111/scd.12758
PMID: 35904402
Appears in UI Libraries Support Open Access
Abstract
Background: Nursing home (NH) residents seek care at dental offices, yet many of them are at the end of life. The uncertain life expectancy further complicates the care of NH residents. This study aimed to develop and validate a Nursing Home Mortality Index (NHMI) to identify NH residents in the last year of life.
Methods: Logistic modeling was used to develop predictive models for death within 1 year after initial appointment by utilizing the new patient examination data and mortality data of 903 Minnesota NH residents. The final model was selected based on areas under the curve (AUC) and then validated using data from 586 Iowa NH residents. Based on the final model, the NHMI was developed with the estimated 1-year mortality for the low, medium and high risk group.
Results: One-year mortalities were 21% and 26% in the development and validation cohorts, respectively. Predictors included age, gender, communication capacity, physical mobility, congestive heart failure, peripheral vascular disease, cancer, cerebrovascular disease, chronic renal disease and liver disease. AUCs for the development and validation models were 0.73 and 0.68, respectively. For the validation cohort, the sensitivity and specificity were 0.79 and 0.53, respectively. The estimated 1-year mortality risks for three risk groups were 0%-10%, 11%-19%, and >= 20%, respectively
Conclusion: The high mortality rate of NH residents following a dental exam highlighted a need to incorporate patients' prognoses in treatment planning along with normative needs and patients' preferences. The NHMI provides a practical way to guide treatment decisions for end-of-life NH residents.
Details
- Title: Subtitle
- Development and validation of a nursing home mortality index to identify nursing home residents nearing the end of life in dental clinics
- Creators
- Xi Chen - University of IowaDaniel J. Caplan - University of IowaCarissa L. Comnick - University of IowaJennifer Hartshorn - University of IowaStephen K. Shuman - University of MinnesotaXian-Jin Xie - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Special care in dentistry, Vol.43(2), pp.125-135
- DOI
- 10.1111/scd.12758
- PMID
- 35904402
- NLM abbreviation
- Spec Care Dentist
- ISSN
- 0275-1879
- eISSN
- 1754-4505
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- K23DE022470 / National Institute of Dental and Craniofacial Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) Iowa Department of Public Health University of Minnesota Oral Health Services for Older Adults Program University of Iowa Geriatric and Special Needs Dentistry Program
- Language
- English
- Electronic publication date
- 07/29/2022
- Date published
- 03/2023
- Academic Unit
- Preventive and Community Dentistry; Biostatistics; Dental Research
- Record Identifier
- 9984323231702771
Metrics
18 Record Views