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Specific comorbidity risk adjustment was a better predictor of 5-year acute myocardial infarction mortality than general methods.
Grunau, Gilat L; Sheps, Sam; Goldner, Elliot M; Ratner, Pamela A.
Afiliación
  • Grunau GL; Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada. gilat@interchange.ubc.ca
J Clin Epidemiol ; 59(3): 274-80, 2006 Mar.
Article en En | MEDLINE | ID: mdl-16488358
OBJECTIVE: To compare methods of risk adjustment in a population of individuals with acute myocardial infarction (AMI), in order to assist clinicians in assessing patient prognosis. STUDY DESIGN AND SETTING: A historical inception cohort design was established, with follow-up of or=66 years who had an AMI in 1994 or 1995 were selected (n = 4,874). The three risk-adjustment methods were the Ontario AMI prediction rule (OAMIPR), the D'Hoore adaptation of the Charlson Index, and the total number of distinct comorbidities. Logistic regression models were built including each of the adjustment methods, age, sex, socioeconomic status, previous AMI, and cardiac procedures at time of AMI. RESULTS: The OAMIPR had the highest C-statistic and R(2). CONCLUSION: Clinicians are advised to consider the specific comorbidities that are present, not merely their number, and those that emerge over time, not merely those present at the time of the infarct.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comorbilidad / Modelos Logísticos / Ajuste de Riesgo / Infarto del Miocardio Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Clin Epidemiol Asunto de la revista: EPIDEMIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comorbilidad / Modelos Logísticos / Ajuste de Riesgo / Infarto del Miocardio Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Clin Epidemiol Asunto de la revista: EPIDEMIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos