Self-perceived quality of life predicts mortality risk better than a multi-biomarker panel, but the combination of both does best

BMC Medical Research Methodology

Thomas Kohlmann²  Henri Wallaschofski¹  Matthias Nauck¹  Marcus Dörr³  Henry Völzke²  Jörn Moock²  You-Shan Feng²  Robin Haring² 

[1] Institute for Clinical Chemistry and Laboratory Medicine, University of Greifswald, (Ferdinand-Sauerbruch Str.), Greifswald, (17475), Germany;Institute for Community Medicine, University of Greifswald, (Walther Rathenau Str. 48), Greifswald, (17487), Greifswald, Germany;Department of Cardiology; University of Greifswald, (Friedrich-Loefflerstraße 23a), Greifswald, (17489), Greifswald, Germany

关键词: population-based cohort;    SF-12;    all-cause mortality;    multiple biomarker panel;    Health-related quality of life;   

Others  :  1140112
DOI  :  10.1186/1471-2288-11-103

 received in 2011-02-09, accepted in 2011-07-12,  发布年份 2011

【 摘 要 】

Background

Associations between measures of subjective health and mortality risk have previously been shown. We assessed the impact and comparative predictive performance of a multi-biomarker panel on this association.

Methods

Data from 4,261 individuals aged 20-79 years recruited for the population-based Study of Health in Pomerania was used. During an average 9.7 year follow-up, 456 deaths (10.7%) occurred. Subjective health was assessed by SF-12 derived physical (PCS-12) and mental component summaries (MCS-12), and a single-item self-rated health (SRH) question. We implemented Cox proportional-hazards regression models to investigate the association of subjective health with mortality and to assess the impact of a combination of 10 biomarkers on this association. Variable selection procedures were used to identify a parsimonious set of subjective health measures and biomarkers, whose predictive ability was compared using receiver operating characteristic (ROC) curves, C-statistics, and reclassification methods.

Results

In age- and gender-adjusted Cox models, poor SRH (hazard ratio (HR), 2.07; 95% CI, 1.34-3.20) and low PCS-12 scores (lowest vs. highest quartile: HR, 1.75; 95% CI, 1.31-2.33) were significantly associated with increased risk of all-cause mortality; an association independent of various covariates and biomarkers. Furthermore, selected subjective health measures yielded a significantly higher C-statistic (0.883) compared to the selected biomarker panel (0.872), whereas a combined assessment showed the highest C-statistic (0.887) with a highly significant integrated discrimination improvement of 1.5% (p < 0.01).

Conclusion

Adding biomarker information did not affect the association of subjective health measures with mortality, but significantly improved risk stratification. Thus, a combined assessment of self-reported subjective health and measured biomarkers may be useful to identify high-risk individuals for intensified monitoring.

【 授权许可】

   
2011 Haring et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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