Intraindividual change in SF-36 in ambulatory clinic primary care patients predicted mortality and hospitalizations.

OBJECTIVE: We sought to determine whether change in SF-36 scores over time is associated with the risk of adverse outcomes.

STUDY DESIGN AND SETTING: 7,702 participants in the Ambulatory Care Quality Improvement Project who completed a baseline and 1-year SF-36. Using logistic regression methods we estimated the 1-year risk of hospitalization and death based on previous 1-year changes in the physical (PCS) and mental (MCS) component summary scores.

RESULTS: After adjusting for baseline PCS scores, age, VA hospital site, distance to VA, and comorbidity, a >10-point decrease in PCS score was associated with an increased risk of death (OR 2.3, 95% CI 1.6-3.4) and hospitalization (OR 1.8, 1.4-2.2). An increased risk was also seen with a >10-point decrease in the MCS (OR for death, 1.6, 1.1-2.3; OR for hospitalization 1.5, 1.2-1.8).

CONCLUSION: Change in SF-36 PCS and MCS scores is associated with mortality and hospitalizations, and provides important prognostic information over baseline scores alone.