Predicting Mortality: Researchers Have A Formula
April 12, 2011 by Dr. Marc Darrow, M.D.
Filed under Aging
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.
