The online version of this article (doi:10.1186/s12877-017-0460-1) contains supplementary material, which is available to authorized users.
Prospective external validation of the Vulnerable Elder’s Survey (VES-13) in primary care remains limited. The aim of this study is to externally validate the VES-13 in predicting mortality and emergency admission in older community-dwelling adults.
Design: Prospective cohort study with 2 years follow-up (2010–2012). Setting: 15 General Practices (GPs) in the Republic of Ireland. Participants: n = 862, aged ≥70 years, community-dwellers Exposure: VES-13 calculated at baseline, where a score of ≥3 denoted high risk. Outcomes: i) Mortality; ii) ≥1 Emergency admission and ≥1 ambulatory care sensitive (ACS) admission over 2 years. Statistical analysis: Descriptive statistics, model discrimination (c-statistic) and sensitivity/specificity.
Of 862 study participants, a total of 246 (38%) were classified as vulnerable at baseline. Fifty-three (6%) died during follow-up and 246 (29%) had an emergency admission. At the VES-13 cut-point of ≥3 denoting high-risk model discrimination was poor for mortality (c-statistic: 0.61 (95% CI 0.54, 0.67), ≥1 emergency admission (c-statistic: 0.59 (95% CI 0.56, 0.63) and ≥1 ACS emergency admission (c-statistic: 0.63 (95% CI 0.60, 0.67).
In this study the VES-13 demonstrated relatively limited predictive accuracy in predicting mortality and emergency admission. External validation studies examining the tool in different health settings and healthier populations are needed and represent an interesting area for future research.
Biganzoli L, Boni L, Becheri D, Zafarana E, Biagioni C, Cappadona S, et al. Evaluation of the cardiovascular health study (CHS) instrument and the Vulnerable Elders Survey-13 (VES-13) in elderly cancer patients. Are we still missing the right screening tool? Ann Oncol: Off J Eur Soc Med Oncol/ESMO. 2013;24(2):494–500. CrossRef
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9. CrossRef
Purdy S, Paranjothy S, Huntley A, Thomas R, Mann M, Huws D, et al. Interventions to reduce unplanned hospital admissions: a series of systematic reviews. 2012. Available at: http://www.bristol.ac.uk/primaryhealthcare/docs/projects/unplannedadmissions.pdf. Date accessed 12/12/14.
Public Health Division of the Victorian Government Department of Human Services. The Victorian Ambulatory Care Sensitive Conditions Study: Preliminary Analyses. Melbourne: Public Health Division Victorian Government Department of Human Services; 2001.
Kelly A, Teljeur C. The national deprivation index for health & health services research. Small area health research unit, technical report. Dublin: Trinity College; 2007.
Lowenstein LM, Mohile SG, Gil HH, Pandya C, Hemmerich J, Rodin M, et al. Which better predicts mortality among older men, a prostate cancer (PCa) diagnosis or vulnerability on the Vulnerable Elders Survey (VES-13)? A retrospective cohort study. J Geriatr Oncol. 2016;7(6);437–443.
- External validation of the Vulnerable Elder’s Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study
Susan M. Smith
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II