Cited by 477Frailty in Older AdultsPalliative Care and End-of-Life IssuesGeriatric Care and Nursing Homes

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.

The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people

Hirdes, John P., Frijters, Dinnus H., Teare, Gary F.·2003·Journal of the American Geriatrics Society

DOI 10.1034/j.1601-5215.2002.51017.x

Open this paper in CoChat — free account

Abstract

OBJECTIVES: To develop a scale predicting mortality and other adverse outcomes associated with frailty. DESIGN: Observational study based on Minimum Data Set (MDS) 2.0 and mortality data. SETTING: Ontario chronic hospitals. PARTICIPANTS: All chronic hospital patients (N = 28,495) assessed with the MDS 2.0 after mandatory implementation in July 1996 followed until May 1999. MEASUREMENTS: MDS 2.0 assessments done as part of normal practice mainly by registered nurses or multidisciplinary teams in a chronic hospital. Mortality data are available from the accompanying discharge tracking form. RESULTS: The MDS‐Changes in Health, End‐stage disease and Symptoms and Signs (CHESS) score is a composite measure addressing changes in health, end‐stage disease, and symptoms and signs of medical problems. It is a strong predictor of mortality ( P < . 0001) independent of the effects of age, sex, activities of daily living impairment, cognition, and do‐not‐resuscitate orders. It is also strongly associated with physician activity, complex medical procedures, and pain ( P < . 001 for each dependent variable). CONCLUSIONS: The CHESS score provides a useful new MDS‐based test to predict mortality and to measure instability in health as a clinical outcome.

Integrity signals

Registry

Crossref · 10.1034/j.1601-5215.2002.51017.x

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-rated health: a predictor of mortality among the elderly.
Mossey, J. M., & Shapiro, E. (1982) · American Journal of Public Health · doi:10.2105/ajph.72.8.800 · Cited by 2,145
MDS Cognitive Performance Scale(C)
Morris, J. N., Fries, B. E., Mehr, D. R., Hawes, C., Phillips, C., Mor, V., & Lipsitz, L. A. (1994) · Journal of Gerontology · doi:10.1093/geronj/49.4.m174 · Cited by 1,852
Scaling ADLs Within the MDS
Morris, J. N., Fries, B. E., & Morris, S. A. (1999) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/54.11.m546 · Cited by 1,408
A brief clinical instrument to classify frailty in elderly people
Rockwood, K. J., Stadnyk, K., MacKnight, C., McDowell, I., Hébert, R., & Hogan, D. B. (1999) · The Lancet · doi:10.1016/s0140-6736(98)04402-x · Cited by 914
Development of a minimum data set-based depression rating scale for use in nursing homes
Burrows, A. S. (2000) · Age and Ageing · doi:10.1093/ageing/29.2.165 · Cited by 727
Frailty in elderly people: an evolving concept.
Rockwood, K. J., Fox, R. A., Stolee, P., Robertson, D., & Beattie, B. L. (1994) · PubMed Central · Cited by 598
Comprehensive Clinical Assessment in Community Setting: Applicability of the MDS‐HC
Morris, J. N., Fries, B. E., Steel, K., Ikegami, N., Bernabei, R., Carpenter, G., Gilgen, R., Hirdes, J. P., & Topinková, E. (1997) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1997.tb02975.x · Cited by 566
Self-citation
Minimum Data Set for Home Care
Landi, F., Tua, E., Onder, G., Carrara, B., Sgadari, A., Rinaldi, C., Gambassi, G., Lattanzio, F., & Bernabei, R. (2000) · Medical Care · doi:10.1097/00005650-200012000-00005 · Cited by 491
Principles of Geriatric Medicine and Gerontology
Kerins, G. (2000) · JAMA · doi:10.1001/jama.283.7.930 · Cited by 319
A Commitment to Change: Revision of HCFA's RAI
Morris, J. N., Nonemaker, S., Murphy, K., Hawes, C., Fries, B. E., Mor, V., & Phillips, C. D. (1997) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1997.tb02974.x · Cited by 234

Show all 20 references

Research works printed but not linked: 2

Teare G, 2000, The Quality of Caring: Chronic Care in Ontario
Morris JN, 2000, RAI‐Home Care [RAI‐HC] Assessment Manual for Version 2.0

Sorted by citations

Items 201–300 of 476

Dimensionality, Reliability and Validity of the InterRAI Depression Rating Scale in a Canadian Palliative Care Population
Fisher, K., Seow, H. Y., Brazil, K., Smith, T. F., & Guthrie, D. M. (2014) · Social Indicators Research · doi:10.1007/s11205-014-0685-8 · Cited by 16
“1999), and health instability and mortality risk (Hirdes et al. 2003).”
Background
Identification of Safety Outcomes for Canadian Home Care Clients: Evidence from the Resident Assessment Instrument - Home Care reporting system concerning emergency room visits
Doran, D. I., Hirdes, J. P., Poss, J. W., Jantzi, M., Blais, R., Baker, G. R., & Pickard, J. (2009) · Healthcare Quarterly · doi:10.12927/hcq.2009.20965 · Cited by 16
“Using one adverse outcome as an example, we demonstrated that characteristics related to the client (e.g., ADL decline, self-reliance, cancer diagnosis, history of falls) and healthcare services (polypharmacy, receiving an anxiolytic medication, receiving an antidepressant medication) were…”
BackgroundSelf-citation
Quality Indicator Rates for Seriously Ill Home Care Clients: Analysis of Resident Assessment Instrument for Home Care Data in Six Canadian Provinces
Guthrie, D. M., Harman, L. E., Barbera, L. C., Burge, F., Lawson, B. J., McGrail, K. M., Sutradhar, R., & Seow, H. Y. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0022 · Cited by 15
“56 4.”
Using the RUG—III classification system for understanding the resource intensity of persons with intellectual disability residing in nursing homes
Martin, L., Fries, B. E., Hirdes, J. P., & James, M. (2011) · Journal of Intellectual Disabilities · doi:10.1177/1744629511413506 · Cited by 15
“…of key life domains were used, including scales for: cognition (Morris et al., 1994), selfcare (Morris et al., 1999), pain (Hirdes et al., 2006), health instability (Hirdes et al., 2003), possible depression (Burrows et al., 2000; Martin et al., 2007c), and aggression (Perlman and Hirdes, 2008).”
BackgroundMethodSelf-citation
Clinical Profile of Persons with Multiple Sclerosis Across the Continuum of Care
Turcotte, L., Marrie, R. A., Patten, S. B., & Hirdes, J. P. (2017) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2017.274 · Cited by 15
Self-citation
Clinical predictors of protracted length of stay in Ontario Complex Continuing Care hospitals
Turcotte, L., Perlman, C. M., Fries, B. E., & Hirdes, J. P. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4024-2 · Cited by 15
“Long-stay patients were also more clinically stable than regular-stay patients, as determined by CHESS.”
MethodSelf-citation
Hospice use and one-year survivorship of residents in long-term care facilities in Canada: a cohort study
Xiong, B., Freeman, S., Banner, D., & Spirgienė, L. (2019) · BMC Palliative Care · doi:10.1186/s12904-019-0480-z · Cited by 15
Development and validation of a prediction model of poor performance status and severe symptoms over time in cancer patients (PROVIEW+)
Seow, H. Y., Tanuseputro, P., Barbera, L. C., Earle, C. C., Guthrie, D. M., Isenberg, S. R., Juergens, R. A., Myers, J., Brouwers, M. C., Tibebu, S., et al. (2021) · Palliative Medicine · doi:10.1177/02692163211019302 · Cited by 15
Factors associated with caregiver distress among home care clients in New Zealand: Evidence based on data from interRAI Home Care assessment
Abey‐Nesbit, R., Doren, S. V., Ahn, S., Iheme, L., Peel, N. M., Declercq, A., Hirdes, J. P., Allore, H. G., & Jamieson, H. A. (2021) · Australian Journal on Ageing · doi:10.1111/ajag.13011 · Cited by 15
Self-citation
Health status and functional profile at admission of nursing home residents in Iceland over 11‐year period
Hjaltadóttir, I., Hallberg, I. R., Ekwall, A. K., & Nyberg, P. (2011) · International Journal of Older People Nursing · doi:10.1111/j.1748-3743.2011.00287.x · Cited by 15
Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario
Harman, L. E., Guthrie, D. M., Cohen, J., Declercq, A., Fisher, K., Goodridge, D. M., Hirdes, J. P., & Seow, H. Y. (2019) · BMC Palliative Care · doi:10.1186/s12904-018-0389-y · Cited by 15
Self-citation
A Comparison Between End-of-Life Home Care Clients With Cancer and Heart Failure in Ontario
Fernandes, S., & Guthrie, D. M. (2014) · Home Health Care Services Quarterly · doi:10.1080/01621424.2014.995257 · Cited by 14
“A cut-off of 4 or higher was chosen because of its strong ability to predict mortality, which has been shown to be more effective than individual measures of impairments in activities of daily living (ADLs) or cognitive impairment (Hirdes et al., 2003).”
Spending Wisely: Home Care Reassessment Intervals and Cost in Ontario.
Kinsell, H. S., Harman, J. S., Hirdes, J. P., Hogeveen, S. E., Sinn, C. J., Chen, J., Eckel, L., & Poss, J. W. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.12.007 · Cited by 14
Self-citation
The interRAI CHESS scale is comparable to the palliative performance scale in predicting 90-day mortality in a palliative home care population
Williams, N., Hermans, K., Cohen, J., Declercq, A., Jakda, A., Downar, J., Guthrie, D. M., & Hirdes, J. P. (2022) · BMC Palliative Care · doi:10.1186/s12904-022-01059-3 · Cited by 14
“In post-acute settings, each one-point increase on the CHESS Scale is associated with a nearly two-fold increased risk of death[35].”
BackgroundSelf-citation
Impact of patient–family physician language concordance on healthcare utilisation and mortality: a retrospective cohort study of home care recipients in Ontario, Canada
Reaume, M., Batista, R., Sucha, E., Pugliese, M., Roberts, R. L., Rhodes, E., Seale, E., Kendall, C., Bjerre, L. M., Bouchard, L., et al. (2024) · BMJ Public Health · doi:10.1136/bmjph-2023-000762 · Cited by 14
Prevalence and Correlates of Cardiovascular Medication Use Among Nursing Home Residents With Ischemic Heart Disease: Results From the SHELTER Study
Foebel, A. D., Liperoti, R., Gambassi, G., Gindin, J., Israel, J. B., Bernabei, R., & Onder, G. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.12.085 · Cited by 14
Measuring health status and decline in at-risk seniors residing in the community using the Health Utilities Index Mark 2
Zhang, J. X., Walker, J. D., Wodchis, W. P., Hogan, D. B., Feeny, D. H., & Maxwell, C. J. (2006) · Quality of Life Research · doi:10.1007/s11136-006-0007-y · Cited by 14
“The CHESS score provides a measure of health or clinical instability based on a sum of MDS items related to cognitive and functional (ADL) decline, the presence of 1 or more health symptoms (vomiting, edema, shortness of breath, weight loss, poor food/fluid intake) and end-stage disease.”
MethodInfluential
Staff opinions about the components of a good death in long-term care
Gibson, M., Gutmanis, I., Clarke, H., Wiltshire, D., Feron, A. M., & Gorman, E. (2008) · International Journal of Palliative Nursing · doi:10.12968/ijpn.2008.14.7.30772 · Cited by 14
Profile of patients with amyotrophic lateral sclerosis across continuum of care
Kehyayan, V., Korngut, L., Jetté, N., & Hirdes, J. P. (2014) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100016656 · Cited by 14
Self-citation
Clinical Complexity and Use of Antipsychotics and Restraints in Long-Term Care Residents with Parkinson’s Disease
Heckman, G. A., Crizzle, A. M., Chen, J., Pringsheim, T. M., Jetté, N., Kergoat, M., Eckel, L., & Hirdes, J. P. (2016) · Journal of Parkinson s Disease · doi:10.3233/jpd-160931 · Cited by 14
“…Self-Performance Hierarchy Scale (range 0–6) [58]; (iii) the Changes in Health, End-stage Disease, and Signs and Symptoms (CHESS) Scale (range 0–5) [59, 60]; (iv) the Depression Rating Scale (DRS) (range 0–14) [55]; (v) the Pain scale (range 0–3) [61, 62], and (vi) the Aggressive Behaviour Scale…”
Self-citation
Beta‐Blocker Use in U.S. Nursing Home Residents After Myocardial Infarction: A National Study
Zullo, A. R., Lee, Y., Daiello, L. A., Mor, V., Boscardin, W. J., Dore, D. D., Miao, Y., Fung, K. Z., Komaiko, K. D. R., & Steinman, M. A. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14671 · Cited by 14
Association of Physician Specialty with Hospice Referral for Hospitalized Nursing Home Patients with Advanced Dementia
Ankuda, C. K., Mitchell, S. L., Gozalo, P. L., Mor, V., Meltzer, D. O., & Teno, J. M. (2017) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14888 · Cited by 15
Predictors of Influenza Immunization Among Home Care Clients in Ontario
Hirdes, J. P., Dalby, D. M., Steel, R. K., Carpenter, G., Bernabei, R., Morris, J. N., & Fries, B. E. (2006) · Canadian Journal of Public Health · doi:10.1007/bf03405616 · Cited by 14
Self-citation
Optimising the care for older persons with complex chronic conditions in home care and nursing homes: design and protocol of I-CARE4OLD, an observational study using real-world data
Hoogendijk, E. O., Onder, G., Smalbil, L., Vetrano, D. L., Hirdes, J. P., Howard, E., Morris, J. N., Fialová, D., Szczerbińska, K. E., Kooijmans, E. C. M., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072399 · Cited by 13
Self-citation
Functional Decline in Long-Term Care Homes in the First Wave of the COVID-19 Pandemic: A Population-based Longitudinal Study in Five Canadian Provinces
Egbujie, B. A., Turcotte, L., Heckman, G. A., Morris, J. N., & Hirdes, J. P. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.09.007 · Cited by 13
Self-citation
Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic
Maxwell, C. J., Dampf, H., Alkabbani, W., Cotton, C. A., Gamble, J., Hogan, D. B., Gruneir, A., McArthur, E., Youngson, E. R. E., Hsu, Z. Y., et al. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.09.009 · Cited by 13
Clinical, Demographic and Functional Characteristics Associated with Pharmacotherapy for Heart Failure in Older Home Care Clients
Foebel, A. D., Heckman, G. A., Hirdes, J. P., Tyas, S. L., Tjam, E. Y., McKelvie, R. S., & Maxwell, C. J. (2011) · Drugs & Aging · doi:10.2165/11592420-000000000-00000 · Cited by 13
Self-citation
The Work of the RN Minimum Data Set Coordinator in its Organizational Context
Dellefield, M. E. (2008) · Research in Gerontological Nursing · doi:10.3928/19404921-20080101-04 · Cited by 13
Predictors of Societal Costs of Older Care-Dependent Adults Living in the Community in 11 European Countries
van Lier, L. I., van der Roest, H. G., Oosten, B. S. H., Garms-Homolová, V., Onder, G., Finne‐Soveri, H., Jónsson, P. V., Ljunggren, G., Henrard, J., Topinková, E., et al. (2019) · Health Services Insights · doi:10.1177/1178632918820947 · Cited by 13
Effects of dipeptidyl peptidase‐4 inhibitors and sulphonylureas on cognitive and physical function in nursing home residents
Zullo, A. R., Duprey, M. S., Smith, R. J., Gutman, R., Berry, S. D., Munshi, M. N., & Dore, D. D. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14573 · Cited by 13
“characteristics, care preferences, and a mortality risk index: Changes in Health, End-stage Disease, and Symptoms Scale (CHESS) score.(38) We used the OSCAR data to evaluate a variety All rights reserved.”
Method
Prevalence and predictors of influenza vaccination in long-term care homes: a cross-national retrospective observational study
Mulla, R. T., Turcotte, L., Wellens, N. I. H., Angevaare, M. J., Weir, J., Jantzi, M., Hébert, P. C., Heckman, G. A., van Hout, H. P. J., Millar, N., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057517 · Cited by 13
Self-citation
A Cross-Sectional Study to Compare Caregiver Distress Among Korean Canadian, Chinese Canadian, and Other Canadian Home Care Clients
Chang, B. W., & Hirdes, J. P. (2015) · SAGE Open · doi:10.1177/2158244015591824 · Cited by 17
Self-citation
The impact of dementia and language on hospitalizations: a retrospective cohort of long-term care residents
Riad, K., Webber, C., Batista, R., Reaume, M., Rhodes, E., Knight, B. D., Prud’homme, D., & Tanuseputro, P. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01806-2 · Cited by 13
Assessing Health Status Differences Between Veterans Affairs Home-Based Primary Care and State Medicaid Waiver Program Clients
Wharton, T., Nnodim, J. O., Hogikyan, R. V., Mody, L., James, M., Montagnini, M., & Fries, B. E. (2012) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.10.015 · Cited by 13
Identifying potential long-stay residents in veterans health administration nursing homes
Mills, W. L., Ying, J., & Kunik, M. E. (2018) · Geriatric Nursing · doi:10.1016/j.gerinurse.2018.06.004 · Cited by 12
Assessing multidimensional complexity in home care: congruencies and discrepancies between patients and nurses
Busnel, C., Vallet, F., Ashikali, E., & Ludwig, C. (2022) · BMC Nursing · doi:10.1186/s12912-022-00942-x · Cited by 12
Oral health of nursing home residents in Flanders, Belgium, and its associated factors
Vandenbulcke, P. A. I., Mello, J. D. A., Schoebrechts, E., Lepeleire, J. D., Declercq, A., Declerck, D., & Duyck, J. A. J. (2025) · Scientific Reports · doi:10.1038/s41598-025-89910-4 · Cited by 14
“A score of 3 on the interRAI scale represents minor depressive disorders 47 and the cut-off of 3 on the interRAI CHESS scale denotes that the resident has at least moderate health instability 48 .”
Identifying Fallers among Home Care Clients with Dementia and Parkinson’s Disease
Bansal, S., Hirdes, J. P., Maxwell, C. J., Παπαϊωάννου, Α., & Giangregorio, L. (2016) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980816000325 · Cited by 12
Self-citation
Prevalence of Preventive Cardiovascular Medication Use In Nursing Home Residents. Room for Deprescribing? The SHELTER Study
Makan, A. M., van Hout, H. P. J., Onder, G., Finne‐Soveri, H., van der Roest, H. G., & van Marum, R. J. (2017) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.06.022 · Cited by 12
Pharmacological management of osteoporosis in nursing home residents: the Shelter study
Makan, A. M., van Hout, H. P. J., Onder, G., van der Roest, H. G., Finne‐Soveri, H., Topinková, E., Denkinger, M. D., Gindin, J., & van Marum, R. J. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.10.020 · Cited by 12
Resident loneliness, social isolation and unplanned emergency department visits from supportive living facilities: a population-based study in Alberta, Canada
Chamberlain, S. A., Bronskill, S. E., Hsu, Z. Y., Youngson, E. R. E., & Gruneir, A. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02718-5 · Cited by 14
“The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people.”
Method
Discontinuation of Unnecessary Medications in Older Adults
Brandt, N., & Stefanacci, R. G. (2011) · The Consultant Pharmacist · doi:10.4140/tcp.n.2011.845 · Cited by 12
Cancer and Aging
Balducci, L., Johnson, D. J., & Beghé, C. (2006) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-48007-7_4 · Cited by 12
The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia
Mörttinen-Vallius, H., Hartikainen, S., Seinelä, L., & Jämsen, E. (2021) · Aging Clinical and Experimental Research · doi:10.1007/s40520-020-01627-8 · Cited by 10
Longitudinal construct validity of the minimum data set health status index
Jones, A., Feeny, D. H., & Costa, A. P. (2018) · Health and Quality of Life Outcomes · doi:10.1186/s12955-018-0932-9 · Cited by 11
Site of Death Among Veterans Living in Veterans Affairs Nursing Homes
Levy, C. R., Hutt, E., & Pointer, L. (2011) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2011.08.004 · Cited by 11
Sex Differences in Care Need and Survival in Patients Admitted to Nursing Home Poststroke
Yu, A., Maclagan, L. C., Diong, C. C., Austin, P. C., Kapral, M. K., Swartz, R. H., & Bronskill, S. E. (2020) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2019.335 · Cited by 11
The effects of acute care hospitalization on health and cost trajectories for nursing home residents: A matched cohort study
Amaral, A. C. K.-B., Hill, A. D., Pinto, R. L., Fu, L., Morinville, A., Heckman, G. A., Hébert, P. C., & Hirdes, J. P. (2022) · Medicine · doi:10.1097/md.0000000000031021 · Cited by 11
Self-citation
The Role of Medications in Predicting Activity Restriction Due to a Fear of Falling
Guthrie, D. M., Fletcher, P. C., Berg, K., Williams, E., Boumans, N., & Hirdes, J. P. (2011) · Journal of Aging and Health · doi:10.1177/0898264311422598 · Cited by 11
Self-citation
To What Degree Does Provider Performance Affect a Quality Indicator? The Case of Nursing Homes and ADL Change
Phillips, C. D., Chen, M., & Sherman, M. H. (2008) · The Gerontologist · doi:10.1093/geront/48.3.330 · Cited by 11
Predicting Adverse Outcomes After Discharge From Complex Continuing Care Hospital Settings to the Community
Sinn, C. J., Tran, J., Pauley, T., & Hirdes, J. P. (2016) · Professional Case Management · doi:10.1097/ncm.0000000000000148 · Cited by 11
“The Ontario hospital system underwent major restructuring during the mid-1990s and had begun to stabilize by the mid-2000s ( Hirdes et al., 2003 ).”
BackgroundSelf-citation
The Post-Acute Delayed Discharge Risk Scale: Derivation and Validation With Ontario Alternate Level of Care Patients in Ontario Complex Continuing Care Hospitals
Turcotte, L., Daniel, I., & Hirdes, J. P. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.12.022 · Cited by 11
Self-citation
Pain-related health care costs for long-term care residents
Guliani, H., Hadjistavropoulos, T., Jin, S., & Lix, L. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02424-2 · Cited by 10
“A high CHESS score is shown to be a predictive of mortality in the LTC population [38].”
Background
Death in Long-term Care: A Brief Report Examining Factors Associated with Death within 31 Days of Assessment
Brink, P., & Kelley, M. L. (2015) · Palliative Care Research and Treatment · doi:10.4137/pcrt.s20347 · Cited by 11
Seniors and Alternative Level of Care: Building on Our Knowledge
Jutan, N., Langlois, L., & Damiano, N. (2013) · Healthcare Quarterly · doi:10.12927/hcq.2013.23503 · Cited by 11
“Predicting ALC Days among Persons Admitted to Residential Care Medical stability, as measured by the Changes in Health, End-Stage Disease and Symptoms and Signs (CHESS) scale (Hirdes et al. 2003), was the strongest predictor of ALC days among those admitted to residential care (Figure 2).”
Method
Delirium: pathophysiology, recognition, prevention and treatment
Rabinowitz, T., Murphy, K. M., Nagle, K. J., Bodor, C. I., Kennedy, S. M., & Hirdes, J. P. (2003) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.3.3.343 · Cited by 11
Self-citation
In-Hospital Patient Harm Across Linguistic Groups: A Retrospective Cohort Study of Home Care Recipients.
Reaume, M., Batista, R., Talarico, R., Guérin, E., Rhodes, E., Carson, S. J., Prud’homme, D., & Tanuseputro, P. (2022) · PubMed · doi:10.1097/pts.0000000000000726 · Cited by 10
“First, approximately 93% of Franco-Ontarians can conduct a conversation in English, which means that most Franco-Ontarians do not face a severe language barrier.49 This point is supported by the fact that only 7.7% of Francophones in our cohort were deemed to have low English proficiency, compared with 52.8% of Alloph…”
BackgroundInfluential
Diagnostic Testing in Long-Term Care and Resident Emergency Department Visits: A Retrospective Cohort Study
Kunkel, E., Tanuseputro, P., Hsu, A. T., Talarico, R., Lapenskie, J., Calder‐Sprackman, S., & Kobewka, D. M. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.09.043 · Cited by 10
Profile of Residents with Mental Disorders in Canadian Long-Term Care Facilities: A Cross-Sectional Study
Kehyayan, V., Chen, J., & Hirdes, J. P. (2021) · Journal of Long-Term Care · doi:10.31389/jltc.47 · Cited by 10
Self-citation
Incidence of Lower‐Extremity Fractures in US Nursing Homes
Sine, K., Lee, Y., Zullo, A. R., Daiello, L. A., Zhang, T., & Berry, S. D. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15825 · Cited by 10
“Residents’ severity of illness was described according to the MDS–Changes in Health, EndStage Disease and Symptoms and Signs score.(20) We also measured individual comorbidities using the MDS.”
Method
Prevalence and Risk Factors of Breathlessness Across Canada: A National Retrospective Cohort Study in Home Care and Nursing Home Populations
Seow, H. Y., Dutta, P., Johnson, M. J., McMillan, K., Guthrie, D. M., Costa, A. P., & Currow, D. C. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.11.034 · Cited by 10
Risk factors of readmission after geriatric hospital care: An interRAI-based cohort study in Finland
Kerminen, H., Jäntti, P., Valvanne, J., Huhtala, H., & Jämsen, E. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104350 · Cited by 10
Evaluating the Implementation of the Conversation Starter Kit in Long Term Care
Kaasalainen, S., Sussman, T., Nicula, M., Lawrence, J., Thompson, G. N., McCleary, L., Wickson‐Griffiths, A., You, J. J., & the SPA-LTC team (2021) · SAGE Open Nursing · doi:10.1177/23779608211051824 · Cited by 10
“The average Charlson Comorbidity Index score was 5.4 (SD: 1.89; Table 1) with the majority having a CHESS score of 0 (55%), indicating low tonohealth instability (Hirdes et al., 2003).”
BackgroundInfluential
Individuals with neurological diseases are at increased risk of fractures within 180 days of admission to long-term care in Ontario
Jantzi, M., Maher, A. C., Ioannidis, G., Hirdes, J. P., Giangregorio, L., & Παπαϊωάννου, Α. (2014) · Age and Ageing · doi:10.1093/ageing/afu156 · Cited by 10
“Scale scores were also reported and were derived from assessment items: Cognitive Performance Scale (CPS) (0–6) measures cognition [17]; Activities of Daily Living Hierarchy (ADL-H) scale (0–6) measures the ability to perform daily tasks [18]; Changes in Health, End Stage disease, Signs and Symptoms (CHESS) scale (0–5…”
MethodSelf-citation
The computational Patient has diabetes and a COVIDPreprint
Barbiero, P., & Lió, P. (2020) · medRxiv · doi:10.1101/2020.06.10.20127183 · Cited by 14
“One aspect is a dedicated CHESS-(“Changes in Health, End-stage disease, and Signs and Symptoms” (CHESS) scale based on all the variables and observable considered considered by the model(s) [75, 76].”
Inter-provincial variation in older home care clients and their pathways: a population-based retrospective cohort study in Canada
Mitchell, L., Poss, J. W., MacDonald, M., Burke, R., & Keefe, J. M. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04097-5 · Cited by 11
“Selected measures and several embedded scales from the RAI-HC clinical data informed client health status indicators at baseline and over time: information about informal caregiving (hours and co-residing with a caregiver) and caregiver distress (a caregiver is unable to continue, or the primary caregiver expresses de…”
Method
Profiling the medical, functional, cognitive, and psychosocial care needs of adults assessed for home care in Ontario, Canada: The case for long-term ‘life care’ at home
Saari, M., Giosa, J., Holyoke, P., Heckman, G. A., & Hirdes, J. P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0300521 · Cited by 9
Self-citation
Correlates and Predictors of Changes in Dyspnea Symptoms Over Time Among Community-Dwelling Palliative Home Care Clients
Freeman, S., Hirdes, J. P., Stolee, P., Garcia, J., & Smith, T. F. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2015.06.016 · Cited by 9
Self-citation
Predictive factors of nonfatal self-harm among community-dwelling older adults assessed for support services
Cheung, G., Chai, Y., Troya, M. I., & Luo, H. (2020) · International Psychogeriatrics · doi:10.1017/s1041610220003853 · Cited by 9
“Scores of CHESS Scale range from 0 (stable) to 5 (highly unstable) (Hirdes et al., 2003).”
Background
Classifying home care clients’ risk of unplanned hospitalization with the resident assessment instrument
Rönneikkö, J. K., Huhtala, H., Finne‐Soveri, H., Valvanne, J., & Jämsen, E. (2022) · European Geriatric Medicine · doi:10.1007/s41999-022-00665-x · Cited by 9
Should frail older adults be in long-term care facilities?
Sørbye, L. W., Sverdrup, S., & Pay, B. B. (2018) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s155372 · Cited by 9
“Changes in health status, illness, and symptoms were determined by the Changes in Health, End-stage disease and Symptoms and Signs (CHESS) scale.(12) The depression rating scale (DRS) was used as a marker of depression.”
Comparing Changes and Transitions of Home Care Clients in Retirement Homes and Private Homes
Poss, J. W., Sinn, C. J., Grinchenko, G., Salam-White, L., & Hirdes, J. P. (2019) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980819000473 · Cited by 9
“…homes; while we adjusted using the CHESS score (a validated scale of health instability that predicts hospitalization and death among frail elderly; Hirdes, Frijters, & Teare, 2003), we did not adjust for specific conditions such as cancer or renal failure, or for the presence of advance…”
Self-citation
Social Engagement and Distress Among Home Care Recipients During the COVID-19 Pandemic in Ontario, Canada: A Retrospective Cohort Study
McArthur, C., Turcotte, L., Sinn, C. J., Berg, K., Morris, J. N., & Hirdes, J. P. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.04.005 · Cited by 11
Self-citation
Prevalence and Correlates of Urinary Incontinence in a Large Cohort of Psychiatric Inpatients
Rabinowitz, T., Martin, L., Montague, P., & Hirdes, J. P. (2011) · Psychiatric Services · doi:10.1176/ps.62.1.pss6201_0097 · Cited by 9
Self-citation
Prevention of Incontinence-Associated Skin Damage in Nursing Homes
Bliss, D. Z., Gurvich, O. V., Mathiason, M. A., Eberly, L. E., Savik, K., Harms, S. L., Mueller, C., Wyman, J. F., & Virnig, B. A. (2016) · Western Journal of Nursing Research · doi:10.1177/0193945916666065 · Cited by 9
Predictors of 3-Year Mortality in Institutionalized Nonagenarians: The NonaSantfeliu Study
Formiga, F., Riera‐Mestre, A., Chivite, D., Pujol, R., Ferrer, A., & López‐Soto, A. (2009) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2009.03.013 · Cited by 9
Integrating a Standardized Self-Report Tool into Geriatric Medicine Practice during the COVID-19 Pandemic: A Mixed-Methods Study
Northwood, M., Didyk, N., Hogeveen, S. E., Nova, A., Kalles, E., & Heckman, G. A. (2023) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980823000387 · Cited by 8
Use of the Resident Assessment Instrument to Measure Depression in Indigenous Home Care Clients
Maranzan, K. A., & Stones, M. J. (2013) · Clinical Gerontologist · doi:10.1080/07317115.2013.816814 · Cited by 8
“Physical Health The CHESS scale assesses instability in health and frailty (Hirdes et al., 2003).”
Background
The Changing Landscape of Continuing Care in Alberta: Staff and Resident Characteristics in Supportive Living and Long-Term Care
Slaughter, S. E., Jones, C., Eliasziw, M., Ickert, C., Estabrooks, C. A., & Wagg, A. (2018) · Healthcare policy · doi:10.12927/hcpol.2018.25549 · Cited by 8
“1994); Changes in Health, EndStage Disease, Signs, and Symptoms scale (CHESS), a six-level scale ranging from no health instability to very high health instability (Hirdes et al. 2003); and the ADLs longform scale, a 28-level scale ranging from total independence to total dependence in ADLs (Morris et al.”
BackgroundMethod
Using a self-directed workbook to support advance care planning with long term care home residents
Sussman, T., Kaasalainen, S., Lawrence, J., Hunter, P. V., Bourgeois-Guérin, V., & Howard, M. (2021) · BMC Palliative Care · doi:10.1186/s12904-021-00815-1 · Cited by 8
Prognostic Association Between Frailty and Post-Arrest Health Outcomes in Patients Receiving Home Care: A Population-Based Retrospective Cohort Study
Mowbray, F., Turcotte, L., Strum, R. P., de Wit, K., Griffith, L. E., Worster, A., Foroutan, F., Heckman, G. A., Hébert, P. C., Schumacher, C., et al. (2023) · Resuscitation · doi:10.1016/j.resuscitation.2023.109766 · Cited by 8
Metformin Safety Warnings and Diabetes Drug Prescribing Patterns for Older Nursing Home Residents
Zullo, A. R., Dore, D. D., Gutman, R., Mor, V., Álvarez, C. A., & Smith, R. J. (2017) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.05.020 · Cited by 8
“21) Stroke No 2,327/2,549 (78) 651/2,978 (22) Reference Reference Yes 739/802 (76) 230/969 (24) 1.”
Influential
How Often, Where, and by Which Specialty Do Long-Term Care Home Residents Receive Specialist Physician Care? A Retrospective Cohort Study
Shaver, N., Lapenskie, J., Smith, G. A., Hsu, A. T., Liddy, C. E., & Tanuseputro, P. (2020) · Journal of Applied Gerontology · doi:10.1177/0733464819901255 · Cited by 8
“, 1994); and Changes in Health, End-Stage Disease, Signs, and Symptoms Scale (CHESS) score (Hirdes et al., 2003).”
Background
Hospice Utilization Among Residents in Long-Term Care Facilities
Xiong, B., Freeman, S., Banner, D., & Spirgienė, L. (2020) · Journal of Palliative Care · doi:10.1177/0825859720907415 · Cited by 8
“This study found CHESS was a good predictor of hospice use in LTCFs, consistent with previous findings that CHESS was a strong predictor of death.(45) The predictive model developed in this study was superior than CHESS alone, as clinical needs were not the only determinants of hospice use.”
Result
Using Machine Learning to Plan Rehabilitation for Home Care Clients: Beyond “Black-Box” Predictions
Zhu, M., Lu, C. Z., Armstrong, J. J., Poss, J. W., Hirdes, J. P., & Stolee, P. (2013) · Intelligent systems reference library · doi:10.1007/978-3-642-40017-9_9 · Cited by 8
Self-citation
Benchmarking European Home Care Models for Older Persons on Societal Costs: The IBenC Study
van Lier, L. I., van der Roest, H. G., Garms-Homolová, V., Onder, G., Jónsson, P. V., Declercq, A., Hertogh, C. M. P. M., van Hout, H. P. J., & Bosmans, J. E. (2021) · Health Services Insights · doi:10.1177/11786329211022441 · Cited by 9
Analysis of Racial and Ethnic Disparities as Possible Risk Factors for Development of Incontinence by Nursing Home Residents
Bliss, D. Z., Gurvich, O. V., Savik, K., Eberly, L. E., Harms, S. L., Wyman, J. F., Mueller, C., Garrard, J. M., & Virnig, B. A. (2015) · Research in Nursing & Health · doi:10.1002/nur.21680 · Cited by 7
A Cross-Sectional Examination of the Association Between Dyspnea and Distress as Experienced by Palliative Home Care Clients and Their Informal Caregivers
Freeman, S., Hirdes, J. P., Stolee, P., & Garcia, J. (2016) · Journal of Social Work in End-of-Life & Palliative Care · doi:10.1080/15524256.2016.1156604 · Cited by 7
Self-citation
Care Needs and Health Care Burden of Persons With Epilepsy Receiving Home Care Services
Kehyayan, V., & Hirdes, J. P. (2018) · Home Health Care Management & Practice · doi:10.1177/1084822318806291 · Cited by 8
Self-citation
Developing a Fracture Risk Clinical Assessment Protocol for Long-Term Care: A Modified Delphi Consensus Process
McArthur, C., Hillier, L. M., Ioannidis, G., Adachi, J. D., Giangregorio, L., Hirdes, J. P., & Παπαϊωάννου, Α. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.08.015 · Cited by 7
Self-citation
Examining the Effect of the First Wave of the COVID-19 Pandemic on Home Care Recipients’ Instrumental Activities of Daily Living Capacity
McArthur, C., Faller-Saunders, A., Turcotte, L., Sinn, C. J., Berg, K., Morris, J. N., & Hirdes, J. P. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.06.015 · Cited by 7
Self-citation
Racial and Ethnic Disparities in Time to Cure of Incontinence Present at Nursing Home Admission.
Bliss, D. Z., Gurvich, O. V., Savik, K., Eberly, L. E., Harms, S. L., & Wyman, J. F. (2014) · PubMed · Cited by 7
The association between receipt of home care rehabilitation services and acute care hospital utilization in clients with multimorbidity following an acute care unit discharge: a retrospective cohort study
Mofina, A., Miller, J., Tranmer, J., Li, W., & Donnelly, C. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09116-0 · Cited by 6
Age‐dependent determinants of antipsychotic use among newly admitted residents of skilled nursing facilities: A population‐based study
Jester, D. J., Hyer, K., Molinari, V., Andel, R., & Rozek, E. K. (2018) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4934 · Cited by 6
Factors That Predict 1-Year Incident Hip and Non-Hip Fractures for Home Care Recipients: A Linked-Data Retrospective Cohort Study
McArthur, C., Ioannidis, G., Jantzi, M., Hillier, L. M., Adachi, J. D., Giangregorio, L., Hirdes, J. P., & Παπαϊωάννου, Α. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.08.023 · Cited by 6
Self-citation
Factors Associated With Hospital Presentation of Self-Harm Among Older Canadians in Long-Term Care: A 12-Year Cohort Study
Chai, Y., Luo, H., Yip, P. S. F., Perlman, C. M., & Hirdes, J. P. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.12.022 · Cited by 7
Self-citation
Falls Risk in Long-Term Care Residents With Cognitive Impairment: Effects of COVID-19 Pandemic
Cheung, G., Beyene, K. A., Chan, A. H. Y., Drayton, B., Jamieson, H. A., Lyndon, M., Hikaka, J., Ma’u, E., Meehan, B., Walker, X. J., et al. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.11.006 · Cited by 6
Factores pronósticos en pacientes pluripatológicos de edad avanzada en un hospital de asistencia a crónicos de media y larga estancia (HACMLE)
Sanz, R. N., Martel, P. J., Bernal, V. S.-B., & Vela, E. C. (2006) · Anales de Medicina Interna · doi:10.4321/s0212-71992006001100005 · Cited by 6
Post-acute stroke patient outcomes in Ontario, Canada complex continuing care settings
Tourangeau, A. E., Squires, M., Wodchis, W. P., McGilton, K. S., Teare, G. F., & Widger, K. A. (2010) · Disability and Rehabilitation · doi:10.3109/09638288.2010.486466 · Cited by 6
Self-citation
An investigation of factors predicting the type of bladder antimuscarinics initiated in Medicare nursing homes residents
Moga, D. C., Wu, Q., Doshi, P. A., & Goodin, A. J. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0690-2 · Cited by 6
“Specifically, we used imputation techniques to assign that variable ’ s mode to the missing value (e.g., if a patient record had a missing CHESS score, the mode of the CHESS variable was imputed for that patient record).”
Influential

Authors: Hirdes, J. P., Frijters, D. H., & Teare, G. F.
Affiliations: University of Waterloo (CA)
Vrije Universiteit Amsterdam (NL)
University of Toronto (CA)
Corresponding author: Hirdes, John P.
ORCID: Hirdes, John P.
Teare, Gary F.
Venue: Journal of the American Geriatrics Society
Publisher: Wiley
Published: 2003-01
Volume: 51
Issue: 1
Pages: 96-100
ISSN: 0002-8614 (ISSN-L)
1532-5415
DOI: 10.1034/j.1601-5215.2002.51017.x
OpenAlex: W1997637125
Cited by: 477
References: 20
Citations by year: 2026: 22 · 2025: 22 · 2024: 32 · 2023: 18 · 2022: 22 · 2021: 24 · 2020: 41 · 2019: 23 · 2018: 24 · 2017: 26 · 2016: 29 · 2015: 23 · 2014: 28 · 2013: 26 · 2012: 17
FWCI: 4.44
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 13 d)
Locations: Journal of the American Geriatrics Society (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
Keywords: mortality prediction, frailty, institutionalized elderly, end-stage disease, symptoms and signs, activities of daily living, do-not-resuscitate orders, pain, nursing assessment
MeSH terms: Activities of Daily Living, Aged, Aged, 80 and over, Canada, Chronic Disease, Female, Humans, Institutionalization, Male, Middle Aged, Mortality, Severity of Illness Index, Geriatric Assessment, Comorbidity, Proportional Hazards Models, Frail Elderly

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks