Population: Long stay (1 year or longer) nursing home residents aged 65 and older
Outcome: All cause 1 year mortality
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This index was developed in 22,749 nursing home residents from New York State in the 1990s (49% >84 years old, 74% female, 83% white, 21% 1-year mortality)
The index was internally validated in 40,328 nursing home residents from the same sample (46%>84 years old, 73% female, 82% white, 22% 1-year mortality)
This index was externally validated in 130 nursing home resident in 2007 (mean age 83, 61% female).
Discrimination: This risk calculator sorts patients who died from patients who lived correctly 71% of the time (c-statistic). The discrimination was the same in the independent validation study.
Calibration: The model was well calibrated except at the highest risk levels. For patients with an estimated mortality risk the calibration was very good, with less than 5% difference estimated and actual mortality rates. At the highest risk level the risk calculator's calibration was not as good, with a 20% difference between estimated and actual mortality.