A practical laboratory index to predict institutionalization and mortality - an 18-year population-based follow-up study.


Journal

BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548

Informations de publication

Date de publication:
25 02 2021
Historique:
received: 30 10 2020
accepted: 05 02 2021
entrez: 26 2 2021
pubmed: 27 2 2021
medline: 27 4 2021
Statut: epublish

Résumé

Previously, several indexes based on a large number of clinical and laboratory tests to predict mortality and frailty have been produced. However, there is still a need for an easily applicable screening tool for every-day clinical practice. A prospective study with 10- and 18-year follow-ups. Fourteen common laboratory tests were combined to an index. Cox regression model was used to analyse the association of the laboratory index with institutionalization and mortality. The mean age of the participants (n = 1153) was 73.6 (SD 6.8, range 64.0-100.0) years. Altogether, 151 (14.8%) and 305 (29.9%) subjects were institutionalized and 422 (36.6%) and 806 (69.9%) subjects deceased during the 10- and 18-year follow-ups, respectively. Higher LI (laboratory index) scores predicted increased mortality. Mortality rates increased as LI scores increased both in unadjusted and in age- and gender-adjusted models during both follow-ups. The LI did not significantly predict institutionalization either during the 10- or 18-year follow-ups. A practical index based on routine laboratory tests can be used to predict mortality among older people. An LI could be automatically counted from routine laboratory results and thus an easily applicable screening instrument in clinical settings.

Sections du résumé

BACKGROUND
Previously, several indexes based on a large number of clinical and laboratory tests to predict mortality and frailty have been produced. However, there is still a need for an easily applicable screening tool for every-day clinical practice.
METHODS
A prospective study with 10- and 18-year follow-ups. Fourteen common laboratory tests were combined to an index. Cox regression model was used to analyse the association of the laboratory index with institutionalization and mortality.
RESULTS
The mean age of the participants (n = 1153) was 73.6 (SD 6.8, range 64.0-100.0) years. Altogether, 151 (14.8%) and 305 (29.9%) subjects were institutionalized and 422 (36.6%) and 806 (69.9%) subjects deceased during the 10- and 18-year follow-ups, respectively. Higher LI (laboratory index) scores predicted increased mortality. Mortality rates increased as LI scores increased both in unadjusted and in age- and gender-adjusted models during both follow-ups. The LI did not significantly predict institutionalization either during the 10- or 18-year follow-ups.
CONCLUSIONS
A practical index based on routine laboratory tests can be used to predict mortality among older people. An LI could be automatically counted from routine laboratory results and thus an easily applicable screening instrument in clinical settings.

Identifiants

pubmed: 33632124
doi: 10.1186/s12877-021-02077-1
pii: 10.1186/s12877-021-02077-1
pmc: PMC7905906
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

139

Commentaires et corrections

Type : CommentIn

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Auteurs

Elisa Heikkilä (E)

Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland. etmhei@utu.fi.
Tykslab, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland. etmhei@utu.fi.

Marika Salminen (M)

Department of Clinical Medicine, Faculty of Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.
City of Turku, Welfare Division, 20101, Turku, Finland.

Anna Viljanen (A)

Municipality of Lieto, Health Care Center, 21420, Lieto, Finland.
Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, Turku City Hospital, University of Turku, 20700, Turku, Finland.

Taina Katajamäki (T)

Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland.
Tykslab, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland.

Marja-Kaisa Koivula (MK)

Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland.
Tykslab, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland.
HUS Diagnostic Center, Helsinki University Hospital, Hospital District of Helsinki and Uusimaa (HUS), 00029, Helsinki, Finland.

Kari Pulkki (K)

Diagnostic Center, Clinical Chemistry and Hematology, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland.

Raimo Isoaho (R)

Department of Clinical Medicine, Faculty of Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.
City of Vaasa, Social and Health Care, 65101, Vaasa, Finland.

Sirkka-Liisa Kivelä (SL)

Department of Clinical Medicine, Faculty of Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.
Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland.

Matti Viitanen (M)

Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, Turku City Hospital, University of Turku, 20700, Turku, Finland.

Minna Löppönen (M)

City of Raisio, Social and Health Care for Elderly, 21200, Raisio, Finland.

Tero Vahlberg (T)

Department of Clinical Medicine, Faculty of Medicine, Unit of Biostatistics, University of Turku, Turku, Finland.

Laura Viikari (L)

City of Turku, Welfare Division, 20101, Turku, Finland.
Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, Turku City Hospital, University of Turku, 20700, Turku, Finland.

Kerttu Irjala (K)

Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland.

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Classifications MeSH