Risk equations to predict life expectancy of people with Type 2 diabetes mellitus following major complications: a study from Western Australia
Risk equations to predict life expectancy of people with Type 2 diabetes mellitus following major complications: a study from Western Australia
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DOI：
10.1111/j.1464-5491.2010.03189.x
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发表时间：
2011-04-01
影响因子：
3.5
通讯作者：
Clarke, P. M.
中科院分区：
文献类型：
--
作者：
Hayes, A. J.;Leal, J.;Clarke, P. M.
目的建立预测糖尿病相关主要并发症后预期寿命的模型，并按年龄和性别以简单表格的形式总结这些结果。方法采用12792例糖尿病患者的观察队列，得出预测死亡率的序列，这些患者有以下并发症之一：心肌梗死、中风、心力衰竭、截肢或肾功能衰竭，记录在西澳大利亚州1990年至1999年的行政健康和死亡率数据中。使用逻辑回归来估计事件后第一个月内的死亡率，使用Gompertz比例风险模型来估计患者剩余生命期的生存率。在检查了5年的内部有效性后，这些方程被用来估计特定并发症后按年龄和性别划分的剩余预期寿命。结果在所有并发症中，肾功能衰竭对预期寿命的影响最大，其次是心力衰竭；预后最好的是中风、心肌梗死和截肢。对于一名60岁男性，中风患者的预期寿命为10.1年（95% CI 9.4-10.8年），肾衰竭患者的预期寿命为4.3年（95% CI 3.1-6.1年）。60岁和70岁女性的预期寿命明显低于心肌梗死后的男性，而明显高于70岁和80岁心力衰竭和截肢后的男性。结论该模型可以估计任何年龄的男性和女性的生存率和预期寿命。总结表可以为临床医生和糖尿病专家提供一个有用和简单的参考。
P>AimsTo develop a model for predicting life expectancy following major diabetes-related complications and to summarize these results by age and gender in the form of a simple table.MethodsEquations for forecasting mortality were derived using an observational cohort of 12 792 patients who had one of the following complications of diabetes: myocardial infarction, stroke, heart failure, amputation or renal failure, recorded in administrative health and mortality data from the state of Western Australia between 1990 and 1999. Logistic regression was used to estimate mortality within the first month post-event and a Gompertz proportional hazards model was used to estimate survival over the patients' remaining lifetime. After examining the internal validity over a 5-year period, these equations were used to estimate remaining life expectancy by age and sex following specific complications.ResultsOf the complications examined, renal failure had most impact on life expectancy at all ages, followed by heart failure; the best prognosis was following stroke, myocardial infarction and amputation. For a 60-year-old male, life expectancy immediately post-event ranged from 10.1 years (95% CI 9.4-10.8 years) for stroke to 4.3 years (95% CI 3.1-6.1 years) for renal failure. Life expectancies for women at 60 and 70 years of age were significantly lower than men following myocardial infarction and significantly higher than men following heart failure and amputation at 70 and 80 years of age.ConclusionThe model allows estimation of both survival probability and life expectancy post-event for men and women of any age. The summary table may provide a useful and simple reference for clinicians and diabetes specialists.