{"doi":"10.1007/s40520-021-01926-8","title":"Predictors of short- and long-term mortality among acutely admitted older patients: role of inflammation and frailty","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Frailty, demographic and clinical variables linked to incident diseases (e.g., dehydration, inflammation) contribute to poor outcomes in older patients acutely hospitalized. Their predictivity on short-, intermediate- and long-term mortality in a comprehensive model has been scarcely investigated.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Aims</jats:title>\n                <jats:p>To test the performance of a predictive tool considering frailty and inflammation as well as age, sex and impaired hydration status on 1-year mortality in acutely admitted older patients.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>Retrospective observational study including 529 medical patients (age 84.6 ± 7.3 years). At hospital admission, frailty was assessed by the Multidimensional Prognostic Index (MPI). The Glasgow Prognostic Score (GPS) was used to grade systemic inflammation. Serum osmolarity was calculated to assess hydration.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>After adjusting for age, sex, GPS and osmolarity, the severe-risk MPI was a strong predictor for 1-year mortality (OR 4.133; 95% CI 2.273–7.516; <jats:italic>p</jats:italic> &lt; 0.001). Age &gt; 85 years, male sex, GPS-2 and serum osmolarity &gt; 300 mOsm/L were independent predictors of mortality in the same multivariable model. The MPI alone showed a moderate discrimination power (AUC 0.678; 95% CI 0.628–0.729; <jats:italic>p</jats:italic> &lt; 0.001) on 1-year mortality, which increased by 12.5% after the addition of the above predictors in the fully adjusted regression model (AUC 0.763; 95% CI 0.719–0.807; <jats:italic>p</jats:italic> &lt; 0.001). The severe-risk MPI adjusted for the same factors was also an independent predictor of mortality after 60 and 180 days since hospital admission.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Discussion</jats:title>\n                <jats:p>Inflammation and impaired hydration are potentially modifiable risk factors for severe outcomes in older acutely hospitalized patients. A model combining GPS, age, gender, and plasma osmolarity improved the accuracy of MPI at admission in predicting long-term mortality.</jats:p>\n              </jats:sec>","journal":"Aging Clinical and Experimental Research","year":2022,"id":635196,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1647874,"name":"Giovanna Marzaro","orcid":null,"position":1,"is_corresponding":false},{"id":1647875,"name":"Paolo De Colle","orcid":null,"position":2,"is_corresponding":false},{"id":1647876,"name":"Gabriele Toigo","orcid":null,"position":3,"is_corresponding":false},{"id":1647877,"name":"Dario Bianchini","orcid":null,"position":4,"is_corresponding":false},{"id":1647878,"name":"Mariapaola Nastri","orcid":null,"position":5,"is_corresponding":false},{"id":1647880,"name":"Cristina Suriano","orcid":null,"position":6,"is_corresponding":false},{"id":862880,"name":"Rocco Barazzoni","orcid":"0000-0002-4049-2404","position":7,"is_corresponding":false},{"id":703934,"name":"Gianfranco Sanson","orcid":"0000-0001-8319-635X","position":8,"is_corresponding":false},{"id":1195418,"name":"Michela Zanetti","orcid":"0000-0002-2634-6363","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Predictors of short- and long-term mortality among acutely admitted older patients: role of inflammation and frailty","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Frailty, demographic and clinical variables linked to incident diseases (e.g., dehydration, inflammation) contribute to poor outcomes in older patients acutely hospitalized. Their predictivity on short-, intermediate- and long-term mortality in a comprehensive model has been scarcely investigated.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Aims</jats:title>\n                <jats:p>To test the performance of a predictive tool considering frailty and inflammation as well as age, sex and impaired hydration status on 1-year mortality in acutely admitted older patients.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>Retrospective observational study including 529 medical patients (age 84.6 ± 7.3 years). At hospital admission, frailty was assessed by the Multidimensional Prognostic Index (MPI). The Glasgow Prognostic Score (GPS) was used to grade systemic inflammation. Serum osmolarity was calculated to assess hydration.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>After adjusting for age, sex, GPS and osmolarity, the severe-risk MPI was a strong predictor for 1-year mortality (OR 4.133; 95% CI 2.273–7.516; <jats:italic>p</jats:italic> &lt; 0.001). Age &gt; 85 years, male sex, GPS-2 and serum osmolarity &gt; 300 mOsm/L were independent predictors of mortality in the same multivariable model. The MPI alone showed a moderate discrimination power (AUC 0.678; 95% CI 0.628–0.729; <jats:italic>p</jats:italic> &lt; 0.001) on 1-year mortality, which increased by 12.5% after the addition of the above predictors in the fully adjusted regression model (AUC 0.763; 95% CI 0.719–0.807; <jats:italic>p</jats:italic> &lt; 0.001). The severe-risk MPI adjusted for the same factors was also an independent predictor of mortality after 60 and 180 days since hospital admission.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Discussion</jats:title>\n                <jats:p>Inflammation and impaired hydration are potentially modifiable risk factors for severe outcomes in older acutely hospitalized patients. A model combining GPS, age, gender, and plasma osmolarity improved the accuracy of MPI at admission in predicting long-term mortality.</jats:p>\n              </jats:sec>","is_dataset_classified":null,"base_score":3.044522437723423,"endowment":3.044522437723423,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"34255297","pmcid":"PMC8847174","openalex_id":"https://openalex.org/W3178240419","authors":[],"funders":[{"funder_name":"Università degli Studi di Trieste","grant_id":"","title":null}],"total_grants":1,"fwci":1.4042,"citation_percentile":0.78843512,"influential_citations":0,"citation_trend":[{"year":2022,"count":3},{"year":2023,"count":2},{"year":2024,"count":7},{"year":2025,"count":4},{"year":2026,"count":3}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://link.springer.com/content/pdf/10.1007/s40520-021-01926-8.pdf","host_type":"journal"},{"url":"https://link.springer.com/content/pdf/10.1007/s40520-021-01926-8.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1007/s40520-021-01926-8/fulltext.html","host_type":"publisher"},{"url":"https://doi.org/10.1007/s40520-021-01926-8","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/34255297","host_type":"repository"},{"url":"https://link.springer.com/article/10.1007/s40520-021-01926-8","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8847174","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC8847174","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC8847174?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Frailty in Older Adults","Nutrition and Health in Aging","Cardiac, Anesthesia and Surgical Outcomes","Aged","Aged, 80 and over","Frailty","Geriatric Assessment","Hospitalization","Humans","Inflammation","Male","Prognosis","Prospective Studies"],"mesh_terms":["Frailty","Aged","Aged, 80 and over","Hospitalization","Humans","Inflammation","Male","Prognosis","Prospective Studies","Geriatric Assessment"],"keywords":["Medicine","Internal medicine","Observational study","Retrospective cohort study","Mortality","Inflammation","Osmolarity","Hospital","Glasgow Prognostic Score","Multidimensional Prognostic Index"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T14:45:48.961193Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}