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加权多病共患指数可预测老年女性的死亡率、医疗服务利用情况及健康相关生活质量。

Weighted multimorbidity indexes predicted mortality, health service use, and health-related quality of life in older women.

作者信息

Tooth Leigh, Hockey Richard, Byles Julie, Dobson Annette

机构信息

School of Population Health, University of Queensland, Queensland 4072, Australia.

出版信息

J Clin Epidemiol. 2008 Feb;61(2):151-9. doi: 10.1016/j.jclinepi.2007.05.015. Epub 2007 Oct 15.

Abstract

OBJECTIVE

To develop indexes of multimorbidity, based on self-reported data, to predict mortality, health service use, help with activities of daily living (ADL), and health-related quality of life (HRQOL) in older women.

STUDY DESIGN AND SETTING

Cross-sectional survey of 10,434 women, aged 73-78 years, in the Australian Longitudinal Study of Women's Health in 1999, with mortality follow-up to 2005. For analysis, the sample was equally split into a development and validation sample. Weighted and unweighted multimorbidity indexes were developed and tested.

RESULTS

Outcomes ranged from 14% for mortality to 47% for specialist doctor visits. Mortality was predicted by heart disease, stroke, low iron, diabetes, cancer (nonskin), bronchitis/emphysema, and Alzheimer's disease. Different patterns of morbidities were associated with the other outcomes. Weighted and unweighted multimorbidity index scores were linearly related to increasing risk of each outcome. For each outcome, the weighted scores fitted the data better and had a wider range of possible values.

CONCLUSION

These multimorbidity indexes predict mortality, health service use, help with ADL, and HRQOL in older women. The indexes could be used as covariates in research with weighted scores having a better chance of discriminating between patient groups than unweighted scores.

摘要

目的

基于自我报告数据制定多种疾病并存指数,以预测老年女性的死亡率、医疗服务利用情况、日常生活活动(ADL)帮助情况及健康相关生活质量(HRQOL)。

研究设计与背景

1999年对澳大利亚女性健康纵向研究中10434名73 - 78岁女性进行横断面调查,并对其进行至2005年的死亡率随访。为进行分析,样本被等分为一个开发样本和一个验证样本。制定并测试了加权和未加权的多种疾病并存指数。

结果

死亡率为14%,专科医生就诊率为47%。死亡率由心脏病、中风、低铁、糖尿病、癌症(非皮肤癌)、支气管炎/肺气肿和阿尔茨海默病预测。不同的疾病模式与其他结果相关。加权和未加权的多种疾病并存指数得分与每种结果风险增加呈线性相关。对于每种结果,加权得分与数据拟合得更好,且可能值范围更广。

结论

这些多种疾病并存指数可预测老年女性的死亡率、医疗服务利用情况、ADL帮助情况及HRQOL。这些指数可在研究中用作协变量,加权得分比未加权得分更有可能区分不同患者群体。

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