Janssen et al reported the Cooper Clinic Mortality Risk Index for evaluating the risk of mortality in adult males. This can help to identify a patient who may benefit from more aggressive management. The authors are from Cooper Institute (Dallas) and Queen's University (Kingston, Ontario).
Patient selection: male from 20 to 69 years
Outcome: 15 year mortality rate
Parameters:
(1) age in years
(2) heart rate in beats per minute
(3) blood pressure in mm Hg
(4) diabetes
(5) smoking
(6) body mass index in kg per square meter
(7) cardiorespiratory fitness
|
Parameter |
Finding |
Points |
|
age |
20 to 44 years |
0 |
|
|
45 to 49 years |
3 |
|
|
50 to 54 years |
6 |
|
|
55 to 59 years |
8 |
|
|
60 to 64 years |
9 |
|
|
65 to 69 years |
10 |
|
heart rate |
< 80 beats per minute |
0 |
|
|
>= 80 beats per minute |
2 |
|
blood pressure |
systolic < 140, diastolic < 90 mm Hg |
0 |
|
|
other |
2 |
|
diabetes |
no |
0 |
|
|
yes |
4 |
|
smoker |
no |
0 |
|
|
former |
1 |
|
|
current |
4 |
|
body mass index |
< 35 kg per sq m |
0 |
|
|
>= 35 kg per sq m3 |
3 |
|
cardiopulmonary fitness |
low |
2 |
|
|
moderate |
0 |
|
|
high |
0 |
score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 27
• The higher the score the greater the 15 year mortality risk.
|
Score |
15-Year Mortality Risk |
|
0 |
1.8% |
|
1 |
2.2% |
|
2 |
3.6% |
|
3 |
3.1% |
|
4 |
3.7% |
|
5 |
4.4% |
|
6 |
5.4% |
|
7 |
6.5% |
|
8 |
7.9% |
|
9 |
9.7% |
|
10 |
11.8% |
|
11 |
14% |
|
12 |
16.5% |
|
13 |
20.4% |
|
14 |
23.2% |
|
15 |
28.1% |
|
16 |
32.1% |
|
>= 17 |
46.7% |
|
Age in Years |
Average 15-Year Mortality Risk |
|
20 to 34 years |
2.4% |
|
35 to 44 years |
2.6% |
|
45 to 49 years |
4.6% |
|
50 to 54 years |
8.2% |
|
55 to 59 years |
12.6% |
|
60 to 64 years |
16.1% |
|
65 to 69 years |
18.1% |
relative risk =
= (patient's absolute risk) / (absolute risk for age group)
Performance:
• The area under the ROC curves is 0.72 for 15-year mortality rate.
