Multidimensional Prognostic Index and Clinical Outcomes in Geriatric Patients Hospitalized for Respiratory Failure

Background: Respiratory failure in older adults is associated with high mortality. The Multidimensional Prognostic Index (MPI), derived from Comprehensive Geriatric Assessment, is a validated tool for prognostic stratification. This study aimed to evaluate the association between MPI and in-hospital mortality in geriatric patients with respiratory failure. Methods: We conducted a retrospective observational study including older adults hospitalized for respiratory failure. Demographic, clinical data, type of respiratory failure, and MPI at admission were collected. The primary outcome was in-hospital mortality. Logistic regression, bootstrap validation, and penalized models were applied. Discriminative ability was assessed by ROC curve. Results: Higher MPI values at admission were independently associated with increased in-hospital mortality. Each 0.1 increase in MPI significantly increased the risk of death. Bootstrap confirmed robustness of estimates, and penalized regression reduced overfitting. The ROC analysis showed an AUC of 0.74. The type of respiratory failure played a secondary role compared to MPI. Conclusions: MPI is a reliable independent predictor of in-hospital mortality in older patients with respiratory failure. It may serve as a practical tool for risk stratification and clinical decision-making in frail patients.