A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts

• Verfasst von: Quinzler, Renate [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Verfasst von: Freund, Tobias [VerfasserIn]
• Verfasst von: Schöttker, Ben [VerfasserIn]
• Verfasst von: Szecsenyi, Joachim [VerfasserIn]
• Verfasst von: Haefeli, Walter E. [VerfasserIn]
• Verfasst von: Freitag, Michael H. [VerfasserIn]
• Titel: A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts
• Verf.angabe: Renate Quinzler, Michael H. Freitag, Birgitt Wiese, Martin Beyer, Hermann Brenner, Anne Dahlhaus, Angela Döring, Tobias Freund, Margit Heier, Hildtraud Knopf, Melanie Luppa, Jana Prokein, Steffi G. Riedel-Heller, Ingmar Schäfer, Christa Scheidt-Nave, Martin Scherer, Ben Schöttker, Joachim Szecsenyi, Petra Thürmann, Hendrik van den Bussche, Jochen Gensichen, Walter E. Haefeli
• Jahr: 2019
• Umfang: 13 S.
• Fussnoten: Gesehen am 15.11.2018 ; Available online: 22 September 2018
• Titel Quelle: Enthalten in: Journal of clinical epidemiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1988
• Jahr Quelle: 2019
• Band/Heft Quelle: 105(2019), Seite 112-124
• ISSN Quelle: 1878-5921
• DOI: doi:10.1016/j.jclinepi.2018.09.004
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Elderly
• Sach-SW: Medication-based chronic disease score
• Sach-SW: Mortality
• Sach-SW: Multimorbidity
• Sach-SW: Risk assessment
• K10plus-PPN: 1583765220

Abstract

Objectives - On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. - Study Design and Setting - Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. - Results - The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). - Conclusions - A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.