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Related Concept Videos

Comparing the Survival Analysis of Two or More Groups01:20

Comparing the Survival Analysis of Two or More Groups

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Related Experiment Videos

Associations between selected laboratory tests and all-cause mortality.

Guizhou Hu1, Ashlee W Duncan

  • 1BioSignia, Inc., 1822 East NC Hwy 54, Suite 350, Durham, NC 27713, USA. ghu@biosignia.com

Journal of Insurance Medicine (New York, N.Y.)
|September 28, 2013
PubMed
Summary

Even clinically normal albumin, alkaline phosphatase (AP), and blood urea nitrogen (BUN) levels can predict mortality risk. These key laboratory tests offer valuable insights for mortality assessment, especially in underwriting.

Related Experiment Videos

Area of Science:

  • Biostatistics
  • Epidemiology
  • Clinical Chemistry

Background:

  • Laboratory tests are crucial for assessing health status.
  • Understanding the predictive value of laboratory results for mortality is vital for public health and insurance underwriting.
  • Previous studies often focused on abnormal test results, leaving the predictive power of 'normal' ranges less explored.

Purpose of the Study:

  • To evaluate the association of selected laboratory tests, including liver function, kidney function, bilirubin, and albumin, with all-cause mortality.
  • To determine if laboratory test results within the normal clinical range can differentiate mortality risk.
  • To assess the utility of continuous laboratory values versus categorized results in predicting mortality.

Main Methods:

  • Utilized two large longitudinal datasets: NHANES III and a life insurance policy dataset.
  • Employed Cox proportional hazards models to calculate hazard ratios for selected laboratory tests.
  • Adjusted for covariates such as age, gender, and health conditions, and analyzed results both within and outside normal clinical ranges.

Main Results:

  • Laboratory tests outside the normal clinical range were associated with increased mortality.
  • Within the normal clinical range, albumin and blood urea nitrogen (BUN) showed a negative association with mortality (lower risk).
  • Alkaline phosphatase (AP) within the normal range showed a positive association with mortality (higher risk), independent of other factors and consistent across datasets.

Conclusions:

  • Abnormal laboratory results are significant predictors of mortality.
  • Albumin, AP, and BUN test results, even when within the normal clinical range, provide valuable mortality differentiation.
  • These findings support using continuous values of albumin, AP, and BUN in underwriting for mortality risk assessment.