About MPI-SVAMA

The MPI-SVAMA is a prognostic index of mortality in the short (1 month) and long-term (1 year) based on information contained in the SVAMA Board (for the Multidimensional Assessment of adults and Older).

The MPI-SVAMA index is the evolution of the Multidimensional Prognostic Index (MPI), a prognostic index of mortality in the short (1 month) and long-term (1 year), based on information obtained from the Multidimensional Assessment (VMD) of the elderly . The MPI-SVAMA index is calculated from the content tab SVAMA that evaluates the following nine domains of the elderly:

  1. Age (years)
  2. Gender
  3. Nursing, 11 items (VIP)
  4. Risk of pressure sores: Exton-Smith scale, 5 items (VPIA)
  5. Cognitive status: Short Portable Mental Status Questionnaire, 10 items (SPMSQ) (VCOG)
  6. Functional Status, Activities of Daily Living (Barthel ADL), 6 items (VADL)
  7. Functional motility, motility Barthel scale, 3 items (VMOB)
  8. Support of the social network, 1 item (VSOC)
  9. Main pathology

What is the MPI-SVAMA? 

With this index it is possible to calculate the risk of mortality in the short and long term of an elderly patient, it is also possible to identify the subject for a different degree of risk of mortality, mild to moderate to severe. The evaluation of the prognosis of the elderly can facilitate clinical decision making and/or welfare of the subject providing a type of customized intervention as much as possible. 

How it was built and validated

L 'MPI-SVAMA was constructed using the information from the card SVAMA of a population of more than 7,800 elderly people of the ULSS 16 Padua-Italy aged ≥ 65 years living at home, and underwent a SVAMA evaluation from 2004 to 2010 to access health and social services provided by the Italian National Health System (home care, institutionalization). Sequentially applying mathematical models RECPAM and logistic regression we obtained the best value of MPI-SVAMA predictor of mortality. The MPI-SVAMA was then validated on a separate population of over 4000 elderly subjects aged ≥ 65 years living at home with results similar to those obtained with the first cohort of patients.

How to use the "Calculate MPI-Svama"

With the link below you can download the program "Calculate MPI-SVAMA" to calculate the MPI-SVAMA. The program “Calculates MPI-SVAMA” is an executable consisting of a main form where you can enter numeric values of the nine domains that contribute to the formation of the Index itself. The program provides an opportunity to fill out the necessary tests to obtain the numerical value of the single domain (age, gender, VIP, VPIA, VCOG, VADL, VMOB, VSOC, prevalent pathologies) from which the value of MPI-SVAMA results. The tests are available on the SVAMA board available in PDF format by following the link from this page. The program provides the ability to print the final result of MPI-SVAMA and store it.

Interpretation of results

Both indices MPI-SVAMA (1 month MPI-SVAMA and 1 year MPI-SVAMA) have a value between 0.0 (lowest risk) to 1.0 (maximum risk of mortality). Through appropriate cut-off is possible to have three different degrees of risk of mortality. The cut-off for risk of mortality in the short term (1 month) are: MPI-SVAMA between 0.0 and 0.41 = low risk, MPI-SVAMA between 0.42 and 0.53 = moderate risk, MPI-SVAMA between 0.54 and 1.00 = severe risk. The cut-off for risk of long-term mortality (1 year)are: MPI-SVAMA between 0 and 0.33 = low risk, MPI-SVAMA between 0.34 and 0.47 = moderate risk, MPI-SVAMA between 0.48 and 1.00 = severe risk.

Technical specifications required for the optimal functioning of the program

Operating System: Windows XP, Vista
Property Settings screen: no less than 1024 X 768 pixels

References

  • Gill TM. The central role of prognosis in clinical decision making. JAMA 2012; 307: 199-200
  • Pilotto A, Ferrucci L, Franceschi M et al. Development and Validation of a Multidimensional Prognostic Index for One-Year Mortality from Comprehensive Geriatric Assessment in Hospitalized Older Patients. Rejuvenation Res 2008;11:151-161.
  • Pilotto A, Rengo F, Marchionni N, Sancarlo D, Fontana A, Panza F, Ferrucci L on behalf of the FIRI-SIGG Study group. Comparing the prognostic accuracy for all-cause mortality of the Frailty Instruments: a multicentre 1-year follow-up in hospitalized older patients. PLosOne 2012; 7(1): e29090 (1-9).
  • Pilotto A, Panza F, Ferrucci L. A Multidimensional Prognostic Index in Common Conditions Leading to Death in Older Patients. Arch Intern Med 2012; 172 (7): 594-5.
  • Siontis GC, Tzoulaki I, Ioannidis JP. Predicting death: an empirical evaluation of predictive tools for mortality. Arch Intern Med 2011; 171: 1721-6.
  • Yourman LC, Lee SJ, Schonberg MA, Widera EW, Smith AK. Prognostic indices for older adults. A systematic review. JAMA 2012; 307: 182-92.