Prognostic Factors and Prediction of Residual Survival for Hospitalized Elderly Patients

Abstract

The aim of this study, corresponding to a research project on functional decline and mortality of frail elderly patients, is to build a predictive survival process that takes into account the functional and nutritional evolution of the patients over time. We deal with both survival data and repeated measures, but the usual statistical methods for the joint analysis of longitudinal and survival data are not appropriate in this case. As an alternative, we use the multistate survival model approach to evaluate the association between mortality and the recovery, or not, of normal functional and nutritional levels. Once the model is estimated and the prognostic factors of mortality identified, a predictive process is computed that allows predictions to be made of a patient’s survival based on his or her history at a given time. This provides a more exact estimate of the prognosis for each group of patients that may be very helpful to clinicians in the making of decisions.