Lee et al developed an index for predicting the risk of mortality within 4 years for an older adult. This can help identify patients who may benefit from closer monitoring and more aggressive management. The authors are from the San Francisco Veterans Affairs Medical Center and the University of California San Francisco.
Patient selection: community-dwelling adult >= 50 years of age
Parameters:
(1) age in years
(2) gender
(3) diabetes mellitus
(4) cancer
(5) lung disease
(6) heart failure
(7) body mass index (BMI)
(8) current cigarette smoker
(9) ability to bathe self
(10) ability to manage own finances
(11) ability to walk several blocks
(12) ability to push or pull heavy objects
|
Parameter |
Finding |
Points |
|---|---|---|
|
age of the patient |
50 - 59 years |
0 |
|
|
60 - 64 years |
1 |
|
|
65 - 69 years |
2 |
|
|
70 - 74 years |
3 |
|
|
75 - 79 years |
4 |
|
|
80 - 84 years |
5 |
|
|
>= 85 years |
7 |
|
gender |
female |
0 |
|
|
male |
2 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
cancer |
absent |
0 |
|
|
present |
2 |
|
lung disease |
absent |
0 |
|
|
present |
2 |
|
heart failure |
absent |
0 |
|
|
present |
2 |
|
body mass index |
>= 25 kg per square meter |
0 |
|
|
< 25 kg per square meter |
1 |
|
current smoker |
absent |
0 |
|
|
present |
2 |
|
ability to bathe self |
not impaired |
0 |
|
|
impaired |
2 |
|
ability to manage own finances |
not impaired |
0 |
|
|
impaired |
2 |
|
ability to walk several blocks |
not impaired |
0 |
|
|
impaired |
2 |
|
ability to push or pull a heavy object |
not impaired |
0 |
|
|
impaired |
1 |
total score =
= SUM(points for all 12 factors)
Interpretation:
• minimum score: 0
• maximum score: 26
• The higher the score the higher the mortality rate within 4 years.
|
Total Score |
Mortality Risk |
|---|---|
|
0 |
0 - 1% |
|
1 or 2 |
1 - 2% |
|
3 |
3 - 4% |
|
4 |
4 - 6% |
|
5 |
5 - 8% |
|
6 |
9% |
|
7 |
12 - 15% |
|
8 |
19 - 20% |
|
9 |
20 - 24% |
|
10 |
27 - 28% |
|
11 |
43 - 45% |
|
12 |
44 - 48% |
|
13 |
54 - 59% |
|
>= 14 |
64 - 67% |
after Table 4, page 806
Performance:
• The area under the ROC curve was 0.82 (validation cohort) to 0.84 (development cohort).
Purpose: To evaluate an older adult for risk of 4-year mortality using the index of Lee et al.
Specialty: Sports Medicine & Rehabilitation
Objective: risk factors, severity, prognosis, stage, options, selection, prevention
ICD-10: Z91.8,
