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palliative geriatrics

Walter Index — 1-year Post-Discharge Mortality in Elderly

Validated index for 1-year mortality after non-elective hospital discharge in adults ≥70 (Walter 2001). Sums 6 weighted variables.

Score interpretation

Low 1-year mortality (~4%) 0–1

→ Standard discharge follow-up. Routine outpatient and primary-care review.

Intermediate (~19%) 2–3

→ Discharge with community follow-up; consider telephone review at 1–2 weeks. Polypharmacy review. Carer support.

High (~34%) 4–6

→ Activate community palliative / supportive care. Advance care planning / ReSPECT before discharge. Anticipatory medications. Family meeting.

Very high (~64%) 7–26

→ Strongly consider hospice referral or community end-of-life pathway. Anticipatory medications, preferred place of death, ReSPECT, family bereavement support.

Interpretation bands for the Walter Index. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.