Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access |
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc |
Journal website http://www.jofem.org |
Original Article
Volume 2, Number 2, April 2012, pages 88-95
Derivation and Validation of a Risk Index to Predict All-Cause Mortality in Type 2 Diabetes Mellitus
Figure
Tables
2 years all-cause mortality, no. (%) of patients | ||||
---|---|---|---|---|
Overall (n = 59,767) | Derivation (n = 29,890) | Validation (n = 29,877) | ||
Patient Variable | ||||
Age Group, yr | ||||
< 45 | 3764 (6.3) | 1838 (6.2) | 1926 (6.4) | |
45 - 54 | 11581 (19.4) | 5828 (19.5) | 5753 (19.2) | |
55 - 64 | 18124 (30.3) | 9053 (30.3) | 9071 (30.3) | |
65 - 74 | 16110 (27) | 8041 (26.9) | 8069 (27) | |
75 - 84 | 8497 (14.2) | 4233 (14.2) | 4264 (14.3) | |
85+ | 1691 (2.8) | 884 (3) | 807 (2.7) | |
Female | 32088 (53.7) | 16101 (53.9) | 15987 (53.5) | |
Race | ||||
Chinese | 42268 (70.7) | 21176 (70.8) | 21092 (70.6) | |
Indian | 7854 (13.1) | 3882 (13.0) | 3972 (13.3) | |
Malay | 7675 (12.8) | 3841 (12.9) | 3834 (12.8) | |
Others | 1970 (3.3) | 991 (3.3) | 979 (3.3) | |
Cancer History | 1601 (2.7) | 827 (2.8) | 774 (2.6) | |
Diabetes Complication Severity Score | ||||
0 | 33227 (55.6) | 16549 (55.4) | 16678 (55.8) | |
1 | 12272 (20.5) | 6133 (20.5) | 6139 (20.5) | |
2 | 7970 (13.3) | 4015 (13.4) | 3955 (13.2) | |
3 | 3123 (5.2) | 1592 (5.3) | 1531 (5.1) | |
4 | 1783 (3.0) | 909 (3.0) | 874 (2.9) | |
5+ | 1392 (2.3) | 692 (2.3) | 700 (2.3) | |
Hypertension | 47087 (78.8) | 23464 (78.5) | 23623 (79.1) | |
Dyslipidiaemia | 57071 (95.5) | 28542 (95.5) | 28529 (95.5) | |
HbA1c, % | ||||
< 7.1 | 27115 (45.4) | 13589 (45.5) | 13526 (45.3) | |
7.1 - 8.0 | 18870 (31.6) | 9473 (31.7) | 9397 (31.5) | |
8.1 - 9.0 | 6616 (11.1) | 3292 (11.0) | 3324 (11.1) | |
9.1 - 10 | 2886 (4.8) | 1459 (4.9) | 1427 (4.8) | |
10.1+ | 3247 (5.4) | 1589 (5.3) | 1658 (5.5) | |
Missing | 1033 (1.7) | 488 (1.6) | 545 (1.8) | |
LDL-c, mmol/L | ||||
< 2.6 | 24541 (41.1) | 12368 (41.4) | 12173 (40.7) | |
2.6 - 3.3 | 17910 (30) | 8952 (29.9) | 8958 (30) | |
3.4 - 4.0 | 6570 (11) | 3304 (11.1) | 3266 (10.9) | |
4.1+ | 3386 (5.7) | 1683 (5.6) | 1703 (5.7) | |
Missing | 7360 (12.3) | 3583 (12.0) | 3777 (12.6) | |
eGFR, mL/min/1.73m2 | ||||
Stage 1 | 13407 (22.4) | 6654 (22.3) | 6753 (22.6) | |
Stage 2 | 25926 (43.4) | 13023 (43.6) | 12903 (43.2) | |
Stage 3 | 10642 (17.8) | 5394 (18.0) | 5248 (17.6) | |
Stage 4 | 1155 (1.9) | 581 (1.9) | 574 (1.9) | |
Stage 5 | 331(0.6) | 159 (0.5) | 172 (0.6) | |
Missing | 8306 (13.9) | 4079 (13.6) | 4227 (14.1) | |
HDL-c, mmol/L, mean (SD) | 1.26 (0.34) | 1.26 (0.34) | 1.26 (0.34) | |
Triglycerides, mmol/L, mean (SD) | 1.55 (0.92) | 1.55 (0.94) | 1.54 (0.89) | |
Body Mass Index (BMI), kg/m2 | ||||
Underweight | 21110 (35.3) | 10575 (35.4) | 10535 (35.3) | |
Normal | 960 (1.6) | 456 (1.5) | 504 (1.7) | |
Obese I | 19867 (33.2) | 9967 (33.3) | 9900 (33.1) | |
Obese II | 6660 (11.1) | 3343 (11.2) | 3317 (11.1) | |
Overweight | 2126 (3.6) | 1035 (3.5) | 1091 (3.7) | |
Missing | 9044 (15.1) | 4514 (15.1) | 4530 (15.2) | |
Systolic BP, mm Hg, mean (SD) | 132 (14) | 132 (14) | 132 (14) | |
Diastolic BP, mm Hg, mean (SD) | 77 (8) | 77 (8) | 78 (8) | |
Insulin use | 5958 (10.0) | 2934 (9.8) | 3024 (10.1) | |
Admission Variable | ||||
Hospitalization during previous 1 year | 6934 (11.6) | 3512 (11.7) | 3422 (11.5) | |
Visits to emergency department during previous 1 year | 9757 (16.4) | 4891 (16.4) | 4866 (16.3) | |
Visits to specialist outpatient consultation | 27251 (45.6) | 13836 (46.3) | 13415 (44.9) |
Variable | Odds ratio (95% CI) |
---|---|
Age | 1.07 (1.06 - 1.07) |
Cancer history | 6.97 (5.81 - 8.36) |
Diabetes Complication Severity Score | |
Category | |
1 | 1.95 (1.65 - 2.30) |
2 | 2.69 (2.28 - 3.18) |
3 | 3.93 (3.22 - 4.80) |
4 | 7.13 (5.79 - 8.80) |
5+ | 13.88 (11.28 - 17.09) |
Risk factor | Value | Points |
---|---|---|
Age ("A") | < 40 | 0 |
40 - 49 | 1 | |
50 - 59 | 3 | |
60 - 69 | 5 | |
70 - 79 | 6 | |
80+ | 8 | |
Cancer history ("C") Diabetes-related Complication (Diabetes Complication Severity Score ) ("C") | Yes | 5 |
0 | 0 | |
1 | 2 | |
2 | 3 | |
3 | 4 | |
4 | 5 | |
5+ | 7 |
ACC score | Observed probability | Expected probability | Sensitivity | Specificity |
---|---|---|---|---|
0 | 0.2 | 0.3 | 99.9 | 1.8 |
1 | 0.3 | 0.4 | 99.4 | 10.2 |
2 | 1.6 | 0.6 | 99.3 | 10.7 |
3 | 0.7 | 0.9 | 99.3 | 10.7 |
4 | 1.7 | 1.3 | 96.2 | 32.2 |
5 | 1.4 | 1.9 | 90.2 | 54.6 |
6 | 3.7 | 2.8 | 90.2 | 54.6 |
7 | 3.0 | 4.0 | 77.3 | 73.6 |
8 | 5.8 | 5.8 | 63.7 | 85.2 |
9 | 9.2 | 8.4 | 54.4 | 90.0 |
10 | 13.5 | 11.9 | 41.6 | 94.3 |
11 | 19.7 | 16.6 | 30.0 | 96.8 |
12 | 24.0 | 22.8 | 22.8 | 98.0 |
13 | 31.2 | 30.3 | 11.8 | 99.3 |
14 | 25.7 | 39.1 | 11.8 | 99.3 |
15 | 48.5 | 48.7 | 4.1 | 99.8 |
16 | 49.1 | 58.3 | 4.1 | 99.8 |
17 | 41.9 | 67.4 | 1.4 | 100.0 |
18 | 59.1 | 75.3 | 1.4 | 100.0 |
20 | 80.0 | 86.9 | 0.0 | 100.0 |