Predicting future medical needs and mortality risk in geriatric long-term care patients : Development and validation of the Nascher score and revised Nascher score.

Publisher: Springer Country of Publication: Austria NLM ID: 21620870R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1613-7671 (Electronic) Linking ISSN: 00435325 NLM ISO Abbreviation: Wien Klin Wochenschr Subsets: MEDLINE

Original Publication: Wien ; New York : Springer

Long-Term Care*/statistics & numerical data ; Geriatric Assessment*/methods; Humans ; Female ; Male ; Aged ; Aged, 80 and over ; Risk Assessment ; Reproducibility of Results ; Austria/epidemiology ; Retrospective Studies ; Sensitivity and Specificity ; Needs Assessment ; Cohort Studies ; Risk Factors ; Forecasting ; Prognosis ; Survival Rate

Background: Choosing the right intensity of medical care is a huge challenge particularly in long-term geriatric care. The Nascher score was developed to assess future medical care needs. The aim of this study was to determine whether the Nascher score and a revised version can predict future medical needs.
Methods: In this retrospective cohort study, 396 residents in long-term care hospitals, who were admitted over a period of two years and followed up to two and a half yeare, were analysed. Outcome parameters were: (1) number of medication changes, (2) number of ward doctor documentations and (3) number of acute illnesses treated with antibiotics, and mortality risk. Based on the first results, an alternative scoring of the Nascher score with 12 instead of 26 items was developed, called the revised Nascher score.
Results: The Nascher score significantly correlated with the number of medication changes, the number of ward doctor documentations, and the number of acute ilnesses treated with antibiotics with Spearman correlation coefficients of 0.30, 0.26, and 0.15, respectively. The revised Nascher score showed a higher correlation with correlation coefficients of 0.36, 0.26, and 0.21, respectively. Residents with a Nascher score in the highest quartile had a significantly higher mortality risk than residents in the lowest quartile (hazard ratio, HR 2.97, 95% confidence interval, CI 1.80-4.34). The corresponding values for the revised Nascher score were HR 3.03, 95% CI 2.03-4.54 in the highest and HR 1.80, 95% CI 1.24-2.60 in the middle quartiles.
Conclusion: The Nascher score and even more so the revised Nascher score are well suited to predicting the various parameters of future medical needs and mortality risk.
(© 2024. The Author(s).)

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Keywords: Assessment of medical care needs; Gerontology; Medical effort; Nursing hospital; Risk of death

Date Created: 20240805 Date Completed: 20240911 Latest Revision: 20240914

20240914

PMC11390801

10.1007/s00508-024-02410-9

39102051