在加拿大老龄化纵向研究中,对预测住院和死亡率的三个脆弱度量进行比较
Romain Pasquet1, Mengting Xu1,2, Marie-Pierre Sylvestre1,2
1Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 1000, Rue Saint-Denis, Montréal, QC, H2X 0C1, Canada.
Aging clinical and experimental research
|February 28, 2024
概括
三种脆弱度量显示,加拿大老年人住院和死亡率的预测能力相似. 在这项大型队列研究中,抓握强度,脆弱表型和脆弱指数都表现相似.
科学领域:
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 有限的研究存在,比较脆弱度的措施来预测不良健康结果.
- 预测医疗保健利用率,包括住院和死亡率的最佳脆弱性评估尚未得到充分确立.
研究的目的:
- 为了比较三个脆弱性指标的预测性能:握力,脆弱性表型和脆弱性指数.
- 评估这些措施来预测中年和老年加拿大人的住院和死亡率.
主要方法:
- 来自加拿大老龄化纵向研究 (CLSA) 的30097名参与者 (年龄45-85岁) 的分析.
- 调整为多病症,年龄和性别的后勤回归模型被用于预测住院和死亡风险.
- 评估了模型歧视 (哈雷尔的c统计) 和校准.
主要成果:
- 这三种脆弱性测量都显示了医院住院和死亡率的类似预测性能.
- 模型歧视 (c-统计) 范围为住院治疗的0.67-0.69和死亡率的0.79-0.80.
- 在所有脆弱性测量方法中观察到强大的模型校准.
结论:
- 握力强度,脆弱表型和脆弱指数对不良结果具有可比的预测效用.
- 虽然医院住院的歧视程度不高,但对预测死亡率的歧视程度更高.
- 死亡率的客观性质可能解释了与复杂的医疗保健利用率指标相比的优异预测.
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