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- Title
Ten-year risk of all-cause mortality: assessment of a risk prediction algorithm in a French general population.
- Authors
Bérard, Emilie; Bongard, Vanina; Arveiler, Dominique; Amouyel, Philippe; Wagner, Aline; Dallongeville, Jean; Haas, Bernadette; Cottel, Dominique; Ruidavets, Jean-Bernard; Ferrières, Jean
- Abstract
While assessment of global cardiovascular risk is uniformly recommended for risk factor management, prediction of all-cause death has seldom been considered in available charts. We established an updated algorithm to predict absolute 10-year risk of all-cause mortality in apparently healthy subjects living in France, a country with high life expectancy. Analyses were based on the Third French MONICA Survey on cardiovascular risk factors (1995-1996) carried out in 3,208 participants from the general population aged 35-64. Vital status was obtained 10 years after inclusion and assessment of determinants of mortality was based on multivariable Cox modelling. One-hundred-fifty-six deaths were recorded. Independent determinants of mortality were living area (Northern France), older age, male gender, no high-school completion, smoking, systolic blood pressure ≥ 160 mmHg, LDL-cholesterol ≥ 5.2 mmol/l, and diabetes. Score sheets were developed to easily estimate 10-year risk of death. For example, a non diabetic, heavy smoker, 46-year old man, living in South-Western France, who did not complete high-school, with LDL-cholesterol ≥ 5.2 mmol/l and systolic blood pressure < 160 mmHg, has a 17% probability of death in the ten coming years. The C-statistic of the prediction model was 0.76 [95% CI: 0.72-0.80] with a degree of overoptimism estimated at 0.0058 in a bootstrap sample. Calibration was satisfying: P value for Hosmer-Lemeshow χ test was 0.483. This prediction algorithm is a simple tool for guiding practitioners towards a more or less aggressive management of risk factors in apparently healthy subjects.
- Subjects
FRANCE; MORTALITY; CARDIOVASCULAR diseases risk factors; ALGORITHMS; PREDICTION theory; CHARTS, diagrams, etc.; PROBABILITY measures; MULTIVARIATE analysis
- Publication
European Journal of Epidemiology, 2011, Vol 26, Issue 5, p359
- ISSN
0393-2990
- Publication type
Article
- DOI
10.1007/s10654-010-9541-6