OBJECTIVE: The objective of this study was to generate clinically useable mortality risk estimates among adults with CP to inform clinical decision making.
METHODS: This retrospective cohort study, using a fee-for-service Medicare database, identified adults ≥18-years-old with CP from 01/01/2008-12/31/2010 and followed through 12/31/2019 for death. Mortality risk at 1-, 3-, 5-, and 9-year intervals were selected based on common clinical length of time to reasonably benefit from preventive care. Sex-stratified analyses assessed risk estimates by narrow age group (18-25/26-34/35-44/45-54/55-64/65-74/≥75 years old) and multi-morbidity group (Whitney Comorbidity Index score 0-2/3/4-6/≥7).
RESULTS: Of 24,767 adults with CP, n = 12,962 were men (mean [SD] age = 48.3 [15.0] years) and n = 11,805 were women (age = 49.7 [15.8] years). Loss to follow-up was rare. 1-year risk was similar between men and women (3.4 % vs. 3.3 %), but increased slightly more for men than women through 9-years (30.1 % vs. 28.0 %). As expected, the mortality risk increased with older age and higher WCI scores. The probability of death (and survival) is presented per age and multi-morbidity group for men and women with CP.
CONCLUSIONS: Mortality risk estimates were reported at clinically relevant intervals by age, sex, and multi-morbidity status. This information can be used to weigh harm-to-benefit ratios of screening and treatment strategies based on mortality expectancy estimates.
目的:本研究的目的是在CP患者中生成临床可用的死亡风险估计值,以指导临床决策。
方法:这项回顾性队列研究,使用按服务收费的Medicare数据库,从2008年1月1日至2010年12月31日确定≥18岁的成年人患有CP,并随访至2019年12月31日死亡。1-的死亡风险,3-,5-,和9年的间隔是根据常见的临床时间长度选择的,以合理地从预防性护理中获益.性别分层分析按狭窄年龄组(18-25/26-34/35-44/45-54/55-64/65-74/≥75岁)和多发病率组(惠特尼合并症指数评分0-2/3/4-6/≥7)评估风险估计。
结果:在24,767名患有CP的成年人中,n=12,962为男性(平均[SD]年龄=48.3[15.0]岁),n=11,805为女性(年龄=49.7[15.8]岁)。随访损失很少。男性和女性的1年风险相似(3.4%vs.3.3%),但在9岁期间,男性的增幅略高于女性(30.1%vs.28.0%)。不出所料,死亡风险随着年龄的增长和WCI评分的提高而增加.对于患有CP的男性和女性,按年龄和多发病率组列出了死亡(和生存)的可能性。
结论:按年龄在临床相关间隔报告死亡率风险估计值,性别,和多发病状态。该信息可用于根据预期死亡率估计来衡量筛查和治疗策略的利弊比。