Acutely hospitalized older patients have an
increased risk of mortality, but at the moment of presen-
tation this risk is difficult to assess. Early identification of
patients at high risk might increase the awareness of the
physician, and enable tailored decision-making. Existing
screening instruments mainly use either geriatric factors or
severity of disease for prognostication. Predictive perfor-
mance of these instruments is moderate, which hampers
successive interventions. We conducted a retrospective
cohort study among all patients aged 70 years and over
who were acutely hospitalized in the Acute Medical Unit of
the Leiden University Medical Center, the Netherlands in
2012. We developed a prediction model for 90-day mor-
tality that combines vital signs and laboratory test results
reflecting severity of disease with geriatric factors, repre-
sented by comorbidities and number of medications.
Among 517 patients, 94 patients (18.2 %) died within
90 days after admission. Six predictors of mortality were
included in a model for mortality: oxygen saturation,
Charlson comorbidity index, thrombocytes, urea, C-reac-
tive protein and non-fasting glucose. The prediction model
performs satisfactorily with an 0.738 (0.667–0.798). Using
this model, 53 % of the patients in the highest risk decile
(
N
=
51) were deceased within 90 days. In conclusion, we
are able to predict 90-day mortality in acutely hospitalized
older patients using a model with directly available clinical
data describing disease severity and geriatric factors. After
further validation, such a model might be used in clinical
decision making in older patients.