External Validation of an Index to Predict Up to 9-Year Mortality of Community-Dwelling Adults Aged 65 and Older

• Autores: Mara A. Schonberg, Roger B. Davis, Ellen P. McCarthy, Edward R. Marcantonio
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 59, Nº. 8, 2011, págs. 1444-1451
• Idioma: inglés
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• Resumen

  • 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.