|
Predicting Mortality: Researchers Have A Formula
Lee SJ, Lindquist K, Segal MR, Covinsky KE, Development and
Validation of a Prognostic Index for 4-Year Mortality in Older
Adults. JAMA. 2006;295:801-808.
From the Journal of the American Medical Association (JAMA)
ABSTRACT: "Context Both comorbid conditions and functional
measures predict mortality in older adults, but few prognostic
indexes combine both classes of predictors. Combining easily
obtained measures into an accurate predictive model could be
useful to clinicians advising patients, as well as policy makers
and epidemiologists interested in risk adjustment.
Objective: To develop and validate a prognostic index for 4-year
mortality using information that can be obtained from patient
report.
Results:...Twelve independent predictors of mortality were
identified: 2 demographic variables (age: 60-64
years, 1 point; 65-69 years, 2 points; 70-74 years, 3 points;
75-79 years, 4 points; 80-84 years, 5 points, >85 years, 7
points and (being male), 2 points), 6 comorbid
conditions (diabetes, 1 point; cancer,
2 points; lung disease, 2 points; heart
failure, 2 points; current tobacco use, 2
points; and body mass index <25, 1 point), and
difficulty with 4 functional variables (bathing, 2
points; walking several blocks, 2 points;
managing money, 2 points, and pushing large
objects, 1 point. Scores on the risk index were strongly
associated with 4-year mortality in the validation cohort, with
0 to 5 points predicting a less than
4% risk, 6 to 9 points predicting a 15% risk, 10 to 13 points
predicting a 42% risk, and 14 or more points predicting a 64%
risk....
Conclusion: This prognostic index, incorporating age, sex,
self-reported comorbid conditions, and functional measures,
accurately stratifies community-dwelling older adults into
groups at varying risk of mortality.
|
