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. 2011 Aug;59(8):1444-51.
doi: 10.1111/j.1532-5415.2011.03523.x. Epub 2011 Jul 28.

External validation of an index to predict up to 9-year mortality of community-dwelling adults aged 65 and older

Mara A Schonberg  1 , Roger B Davis, Ellen P McCarthy, Edward R Marcantonio
Affiliations

External validation of an index to predict up to 9-year mortality of community-dwelling adults aged 65 and older

Mara A Schonberg et al. J Am Geriatr Soc. 2011 Aug.

Abstract

Objectives: To further validate an index predicting mortality in community-dwelling older adults.

Design: A comparison of the performance of the index in predicting mortality among new respondents to the National Health Interview Survey (NHIS, 2001-2004) with that of respondents from the original development and validation cohorts (1997-2000) and a test of its performance over extended follow-up (up to 9 years) using the original cohorts. Follow-up mortality data were available through 2006.

Setting: NHIS.

Participants: Twenty-two thousand fifty-seven new respondents to the NHIS (2001-2004) and 24,139 respondents from the original development and validation cohorts (1997-2000).

Measurements: A risk score was calculated for each respondent based on the presence or absence of 11 factors (function, illnesses, behaviors, demographics) that make up the index. Using the Kaplan-Meier method, 5-year mortality estimates were computed for the new and original cohort respondents and 9-year mortality estimates for the original cohorts.

Results: New respondents were similar to original cohort respondents but were slightly more likely to be aged 85 and older, report diabetes mellitus, and have a body mass index of 25.0 kg/m² or greater. The model performed as well in the new cohort as it had in the original cohort. New respondents with risk scores of 0 to 1 had a 2% risk of 5-year mortality, whereas respondents who scored 18 or higher had a 69% risk of 5-year mortality (range 3-71% risk of 5-year mortality in the development cohort). The index also demonstrated excellent calibration and discrimination in predicting 9-year mortality (range 7% risk for scores of 0-1 to 92% risk for scores of ≥ 18, original validation cohort extended).

Conclusion: These results further justify use of this index to estimate life expectancy in clinical decision-making.

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Figures

Figure 1
Figure 1
Calibration of the 5-Year Mortality Index
Figure 2
Figure 2
Calibration of the Development and Original Validation Cohort with 9-year Mortality
Appendix B
Appendix B
Probability of 9-year Survival by Quintiles of Risk.
See this image and copyright information in PMC

Comment in

References

    1. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–2756. - PubMed
    1. Wolf AM, Wender RC, Etzioni RB, et al. American Cancer Society guideline for the early detection of prostate cancer: update 2010. CA Cancer J Clin. 60(2):70–98. - PubMed
    1. Huang ES, Zhang Q, Gandra N, Chin MH, Meltzer DO. The effect of comorbid illness and functional status on the expected benefits of intensive glucose control in older patients with type 2 diabetes: a decision analysis. Ann Intern Med. 2008;149(1):11–19. - PMC - PubMed
    1. Mohan IV, Harris PL. When not to operate for abdominal aortic aneurysms. Semin Interv Cardiol. 2000;5(1):15–9. - PubMed
    1. Karuppiah SV, Banaszkiewicz PA, Ledingham WM. The mortality, morbidity and cost benefits of elective total knee arthroplasty in the nonagenarian population. Int Orthop. 2008;32(3):339–43. - PMC - PubMed

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