Kim Nan H, Cho Hyun J, Kim Soriul, Seo Ji H, Lee Hyun J, Yu Ji H, Chung Hye S, Yoo Hye J, Seo Ji A, Kim Sin Gon, Baik Sei Hyun, Choi Dong Seop, Shin Chol, Choi Kyung Mook
From the Department of Internal Medicine, Division of Endocrinology and Metabolism, College of Medicine, Korea University, Seoul (NHK, HJC, JHS, HJL, JHY, HSC, HJY, JAS, SGK, SHB, DSC, KMC); Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Center for Disease Control and Prevention, Cheongju (SK); Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, College of Medicine, Korea University, Seoul, Korea (CS).
Medicine (Baltimore). 2016 Feb;95(5):e2696. doi: 10.1097/MD.0000000000002696.
There are very few predictive indexes for long-term mortality among community-dwelling elderly Asian individuals, despite its importance, given the rapid and continuous increase in this population. We aimed to develop 10-year predictive mortality indexes for community-dwelling elderly Korean men and women based on routinely collected clinical data.We used data from 2244 elderly individuals (older than 60 years of age) from the southwest Seoul Study, a prospective cohort study, for the development of a prognostic index. An independent longitudinal cohort of 679 elderly participants was selected from the Korean Genome Epidemiology Study in Ansan City for validation.During a 10-year follow-up, 393 participants (17.5%) from the development cohort died. Nine risk factors were identified and weighed in the Cox proportional regression model to create a point scoring system: age, male sex, smoking, diabetes, systolic blood pressure, triglyceride, total cholesterol, white blood cell count, and hemoglobin. In the development cohort, the 10-year mortality risk was 6.6%, 14.8%, 18.2%, and 38.4% among subjects with 1 to 4, 5 to 7, 8 to 9, and ≥10 points, respectively. In the validation cohort, the 10-year mortality risk was 5.2%, 12.0%, 16.0%, and 16.0% according to these categories. The C-statistic for the point system was 0.73 and 0.67 in the development and validation cohorts, respectively.The present study provides valuable information for prognosis among elderly Koreans and may guide individualized approaches for appropriate care in a rapidly aging society.
尽管社区居住的亚洲老年人数量迅速且持续增加,长期死亡率的预测指标却非常少,尽管这一指标很重要。我们旨在基于常规收集的临床数据,为社区居住的韩国老年男性和女性制定10年预测死亡率指标。我们使用了来自首尔西南部研究(一项前瞻性队列研究)的2244名60岁以上老年人的数据来制定预后指标。从安山市的韩国基因组流行病学研究中选取了679名老年参与者组成独立的纵向队列进行验证。在10年的随访期间,来自开发队列的393名参与者(17.5%)死亡。在Cox比例回归模型中确定了九个风险因素并进行加权,以创建一个评分系统:年龄、男性、吸烟、糖尿病、收缩压、甘油三酯、总胆固醇、白细胞计数和血红蛋白。在开发队列中,得分1至4分、5至7分、8至9分和≥10分的受试者10年死亡风险分别为6.6%、14.8%、18.2%和38.4%。在验证队列中,根据这些类别,10年死亡风险分别为5.2%、12.0%、16.0%和16.0%。该评分系统在开发队列和验证队列中的C统计量分别为0.73和0.67。本研究为韩国老年人的预后提供了有价值的信息,并可能为快速老龄化社会中适当护理的个体化方法提供指导。