External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study

Emma Wallace; Ronald McDowell; Kathleen Bennett; Tom Fahey; Susan M. Smith

doi:10.1186/s12877-017-0460-1

External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study

Emma Wallace
, Ronald McDowell
, Kathleen Bennett
, Tom Fahey
, Susan M. Smith

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

10 Downloads (Pure)

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Original language	English
Article number	69
Pages (from-to)	1-8
Number of pages	8
Journal	BMC Geriatrics
Volume	17
Issue number	1
Early online date	20 Mar 2017
DOIs	https://doi.org/10.1186/s12877-017-0460-1
Publication status	Published online - 20 Mar 2017

Bibliographical note

Publisher Copyright:
© 2017 The Author(s).

Data Availability Statement

The datasets generated during and/or analysed during the current study are not publicly available as they are subject to ongoing analysis by the authors’ but are available from the corresponding author on reasonable request.

Funding

Dr Emma Wallace was supported by the Health Research Board (HRB) of Ireland under the Research Training Fellowship for Healthcare Professionals award, grant no. HPF/2012/20. This research was conducted as part of the HRB Scholar’s programme in Health Services Research under grant no. PhD/ 2007/16 at the HRB Centre for Primary Care Research, grant HRC/2007/1. The funders had no role in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript.

Funder number
HPF/2012/20, HRC/2007/1

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10.1186/s12877-017-0460-1

s12877-017-0460-1Final published version, 465 KBLicence: CC BY

Cite this

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title = "External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study",

abstract = "Background: 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. Methods: 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. Results: 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). Conclusions: 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.",

author = "Emma Wallace and Ronald McDowell and Kathleen Bennett and Tom Fahey and Smith, \{Susan M.\}",

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AU - Smith, Susan M.

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N2 - Background: 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. Methods: 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. Results: 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). Conclusions: 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.

AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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.

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ER -

External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study

Abstract

Bibliographical note

Data Availability Statement

Funding

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