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Primary Care Prognostic (PCP) Index of 11-Year Mortality Risk: Development and Validation of a Brief Prognostic Tool.
- Source :
-
JGIM: Journal of General Internal Medicine . 2021, Vol. 36 Issue 1, p62-68. 7p. 5 Charts, 1 Graph. - Publication Year :
- 2021
-
Abstract
- Background: Healthcare providers use a life expectancy of at least 5 to 10 years in shared clinical decision-making with older adults about cancer screening, major surgeries, and disease prevention interventions. At present, few prognostic indexes predict long-term mortality beyond 10 years or are suited for use in primary care settings. Objective: We developed and validated an 8-item multidimensional index predicting 11-year mortality for use in primary care. Design, Setting, and Participants: Using data from the Singapore Longitudinal Ageing Studies (SLAS), we developed a Primary Care Prognostic (PCP) Index for predicting 11-year mortality risk in a development cohort (n = 1550) and validated it in a geographically different cohort (n = 928). Main Measures: The PCP Index was derived from eight indicators (body mass loss, weakness, slow gait, comorbidity, polypharmacy, IADL/BADL dependency, low albumin, low total cholesterol, out of 25 candidate indicators) using stepwise Cox proportional hazard models. Key Results: In the developmental cohort, the mortality hazard ratio increased by 53% per PCP point score increase, independent of age and sex. Across risk categories, absolute risks of mortality increased from 5% (score 0) to 67.9% (scores 7–9), with area under curve (AUC = 0.77 (95% CI 0.73–0.80)). The PCP Index also predicted mortality in the validation cohort, with AUC = 0.70 (95% CI 0.64–0.75). Conclusions: The PCP Index using simple clinical assessments and point scoring is a potentially useful prognostic tool for predicting long-term mortality and is well suited for risk stratification and shared clinical decision-making with older adults in primary care. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08848734
- Volume :
- 36
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- JGIM: Journal of General Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 148469977
- Full Text :
- https://doi.org/10.1007/s11606-020-06132-2