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Develop and Validate a Prognostic Index With Laboratory Tests to Predict Mortality in Middle-Aged and Older Adults

Chi-Hsien Huang1,2, Yao-Hwei Fang3, Shu Zhang4

  • 1Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|February 13, 2024
PubMed
Summary

A new machine learning-based prognostic index (MARBE-PI) using routine blood tests effectively predicts mortality risk in older adults. This tool aids clinical decision-making by identifying individuals needing closer monitoring.

Keywords:
BiomarkersFrailtyGeriatric assessmentMortality predictionRoutine blood examination

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Area of Science:

  • Gerontology
  • Biostatistics
  • Machine Learning in Healthcare

Background:

  • Personalized health predictions require effective prognostic indices.
  • A simple, practical, and reproducible tool for clinical use is currently lacking.
  • This study addresses the need for a reliable prognostic tool for older adults.

Purpose of the Study:

  • To develop a machine learning-based prognostic index for predicting all-cause mortality.
  • To create a practical tool for risk stratification in community-dwelling older individuals.

Main Methods:

  • Utilized the Healthy Aging Longitudinal Study in Taiwan (HALST) cohort (5,663 participants).
  • Developed a machine learning-based routine blood examination prognostic index (MARBE-PI) using common laboratory tests.
  • Externally validated MARBE-PI with an independent Japanese cohort.

Main Results:

  • Six laboratory tests (LDL, albumin, AST, lymphocyte count, hs-CRP, creatinine) were key predictors of 5-year mortality.
  • MARBE-PI demonstrated strong predictive accuracy (AUCs ranging from 0.756 to 0.809) in internal and external validation.
  • Stratified risk categories showed a dose-response association with mortality.

Conclusions:

  • MARBE-PI is a highly applicable measure for risk stratification in clinical settings.
  • The index can identify older individuals at elevated mortality risk.
  • MARBE-PI supports clinical decision-making for proactive health management.