Elisa Heikkilä1,2, Marika Salminen3,4, Anna Viljanen5,6, Taina Katajamäki7,8, Marja-Kaisa Koivula7,8,9, Kari Pulkki10, Raimo Isoaho3,11, Sirkka-Liisa Kivelä3,12, Matti Viitanen6, Minna Löppönen13, Tero Vahlberg14, Laura Viikari4,6, Kerttu Irjala7. 1. Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland. etmhei@utu.fi. 2. Tykslab, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland. etmhei@utu.fi. 3. Department of Clinical Medicine, Faculty of Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland. 4. City of Turku, Welfare Division, 20101, Turku, Finland. 5. Municipality of Lieto, Health Care Center, 21420, Lieto, Finland. 6. Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, Turku City Hospital, University of Turku, 20700, Turku, Finland. 7. Department of Clinical Medicine, Faculty of Medicine, Unit of Clinical Chemistry, Turku University, 20521, Turku, Finland. 8. Tykslab, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland. 9. HUS Diagnostic Center, Helsinki University Hospital, Hospital District of Helsinki and Uusimaa (HUS), 00029, Helsinki, Finland. 10. Diagnostic Center, Clinical Chemistry and Hematology, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland. 11. City of Vaasa, Social and Health Care, 65101, Vaasa, Finland. 12. Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland. 13. City of Raisio, Social and Health Care for Elderly, 21200, Raisio, Finland. 14. Department of Clinical Medicine, Faculty of Medicine, Unit of Biostatistics, University of Turku, Turku, Finland.
Abstract
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.
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.
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