Contribution of Individual Diseases to Death in Older Adults with Multiple Diseases.
Objectives To determine empirically the diseases contributing most commonly and strongly to death in older adults, accounting for coexisting diseases. Design Longitudinal. Setting United States. Participants Twenty-two thousand eight hundred ninety Medicare Current Beneficiary Survey participants, a...
| Publicado en: | Journal of the American Geriatrics Society Vol. 60; no. 8; pp. 1448 - 1457 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Wiley-Blackwell
Aug2012
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=78436067&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 78436067 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Aug2012 vid: 60 iid: 8 pid: 480 pub: Wiley-Blackwell artinfo: ui: 78436067 10.1111/j.1532-5415.2012.04077.x ppf: 1448 ppct: 9 formats: tig: atl: Contribution of Individual Diseases to Death in Older Adults with Multiple Diseases. aug: au: Tinetti, Mary E. McAvay, Gail J. Murphy, Terrence E. Gross, Cary P. Lin, Haiqun Allore, Heather G. affil: Department of Internal Medicine, School of Medicine School of Public Health, Yale University su: Chronic diseases Interviewing Medicare Mortality Empirical research Confidence intervals Longitudinal method Multivariate analysis Research funding Statistics Comorbidity Logistic regression analysis Health insurance reimbursement Proportional hazards models Acute diseases Data analysis software Descriptive statistics Disease complications sug: subj: Chronic diseases Interviewing Medicare Mortality Empirical research Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) Confidence intervals Longitudinal method Multivariate analysis Research funding Statistics Comorbidity Logistic regression analysis Health insurance reimbursement Proportional hazards models Acute diseases Data analysis software Descriptive statistics Disease complications keyword: coexisting diseases death multiple chronic conditions coexisting diseases death multiple chronic conditions ab: Objectives To determine empirically the diseases contributing most commonly and strongly to death in older adults, accounting for coexisting diseases. Design Longitudinal. Setting United States. Participants Twenty-two thousand eight hundred ninety Medicare Current Beneficiary Survey participants, a national representative sample of Medicare beneficiaries, enrolled during 2002 to 2006. Measurements Information on chronic and acute diseases was ascertained from Medicare claims data. Diseases contributing to death during follow-up were identified empirically using regression models for all diseases with a frequency of 1% or greater and hazard ratio for death of greater than 1. The additive contributions of these diseases, adjusting for coexisting diseases, were calculated using a longitudinal extension of average attributable fraction; 95% confidence intervals were estimated from bootstrapping. Results Fifteen diseases and acute events contributed significantly to death, together accounting for nearly 70% of death. Heart failure (20.0%), dementia (13.6%), chronic lower respiratory disease (12.4%), and pneumonia (5.3%) made the largest contributions to death. Cancer, including lung, colorectal, lymphoma, and head and neck, together contributed to 5.6% of death. Other diseases and events included acute kidney injury, stroke, septicemia, liver disease, myocardial infarction, and unintentional injuries. Conclusion The use of methods that focus on determining a single underlying cause may lead to underestimation of the extent of the contribution of some diseases such as dementia and respiratory disease to death in older adults and overestimation of the contribution of other diseases. Current conceptualization of a single underlying cause may not account adequately for the contribution to death of coexisting diseases that older adults experience. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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