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Evaluación de la comorbilidad en el adulto mayor
Resumen
El objetivo de este trabajo es brindar a los clínicos e investigadores de nuestro medio, una revisión sobre los instrumentos disponibles para evaluar la comorbilidad en el adulto mayor. Para esto se realizó una búsqueda sistemática en Medline mediante palabras clave. Por medio de un consenso de expertos (conformado por geriatras y médicos internistas) se evaluaron cada uno de los instrumentos con base en su estructura, utilidad clínica y propiedades clinimétricas, todos con enfoque en el adulto mayor. Para fines de este trabajo se consideraron cuatro instrumentos: Índice de Charlson, Índice Geriátrico de Comorbilidad, Índice de Kaplan-Feinstein y Escala de Puntuación Acumulativa de Enfermedad en Geriatría (CIRS-G). Todos han demostrado adecuadas propiedades clinimétricas, CIRS-G requiere mayor preparación clínica para ser aplicado; todos han demostrado adecuada validez predictiva para deterioro funcional y mortalidad. La elección del instrumento dependerá del contexto en que se realice cada investigación.
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