학술논문

Development and validation of a predictive risk model for all-cause mortality in type 2 diabetes.
Document Type
Article
Source
Diabetes Research & Clinical Practice. Jun2015, Vol. 108 Issue 3, p482-488. 7p.
Subject
*TYPE 2 diabetes risk factors
*PEOPLE with diabetes
*PRIMARY care
*RISK assessment
*SURVIVAL analysis (Biometry)
*COHORT analysis
Language
ISSN
0168-8227
Abstract
Aims Type 2 diabetes is common and is associated with an approximate 80% increase in the rate of mortality. Management decisions may be assisted by an estimate of the patient's absolute risk of adverse outcomes, including death. This study aimed to derive a predictive risk model for all-cause mortality in type 2 diabetes. Methods We used primary care data from a large national multi-ethnic cohort of patients with type 2 diabetes in New Zealand and linked mortality records to develop a predictive risk model for 5-year risk of mortality. We then validated this model using information from a separate cohort of patients with type 2 diabetes. Results 26,864 people were included in the development cohort with a median follow up time of 9.1 years. We developed three models initially using demographic information and then progressively more clinical detail. The final model, which also included markers of renal disease, proved to give best prediction of all-cause mortality with a C-statistic of 0.80 in the development cohort and 0.79 in the validation cohort (7610 people) and was well calibrated. Ethnicity was a major factor with hazard ratios of 1.37 for indigenous Maori, 0.41 for East Asian and 0.55 for Indo Asian compared with European ( P < 0.001). Conclusions We have developed a model using information usually available in primary care that provides good assessment of patient's risk of death. Results are similar to models previously published from smaller cohorts in other countries and apply to a wider range of patient ethnic groups. [ABSTRACT FROM AUTHOR]