A Multidimensional Risk Score to Predict All-Cause Hospitalization in Community-Dwelling Older Individuals With Obstructive Lung Disease

BACKGROUND

Both respiratory and nonrespiratory hospitalizations are common and costly events in older individuals with obstructive lung disease. Prevention of any hospitalization in these individuals is essential. We aimed to construct a prediction model for all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease.

METHODS

We studied 268 community-dwelling individuals with obstructive lung disease (defined as FEV1/FVC<LLN) who participated in the observational Health, Aging, and Body Composition Study and constructed a prediction model for 9-year all-cause hospitalization risk using a weighted linear combination based on beta coefficients.

RESULTS

There were 225 individuals with 1 or more hospitalizations and 43 individuals free from hospitalization during the follow-up. Heart and vascular disease (H), objectively measured lower extremity dysfunction (O), systemic inflammation (S), dyspnea (P), impaired renal function (I), and tobacco exposure (T) were independent predictors for all-cause hospitalization (ALL). These factors were combined into the HOSPITALL score (0-23 points), with an area under the curve in ROC analysis of 0.70 (P < .001). The hazard ratio for all-cause hospitalization per 1-point increase in the HOSPITALL score was 1.15 (95% confidence interval, 1.11-1.19, P = .001). Increasing HOSPITALL score was further associated with shorter time to first admission, increased admission rate, and more respiratory admissions.

CONCLUSION

The HOSPITALL score is a multidimensional score to predict all-cause hospitalization risk in community-dwelling older individuals with obstructive lung disease that may aid in patient counseling and prevention to reduce burden and health care costs.