| Titre : | Ten-year risk of all-cause mortality : assessment of a risk prediction algorithm in a French general population. (2011) |
| Auteurs : | Emilie Bérard ; Philippe Amouyel ; Dominique ARVEILER ; Vanina BONGARD ; Dominique COTTEL ; Jean DALLONGEVILLE ; FERRIERES (Jean) : FRA. Department of Cardiology B. Centre Hospitalier Universitaire de Toulouse. Toulouse. ; Bernadette Haas ; Jean-Bernard RUIDAVETS ; Aline WAGNER ; Department of Epidemiology and Public Health. Institut Pasteur de Lille. Inserm U774. Université Lille Nord de France. Lille. FRA ; Department of Epidemiology and Public Health. Strasbourg. FRA ; Department of Epidemiology. Health Economics and Public Health. Umr 558 Inserm. Universite de Toulouse. Centre Hospitalier Universitaire de Toulouse. Toulouse. FRA |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 26, n° 5, 2011) |
| Pagination : | 359-368 |
| Langues: | Anglais |
| Mots-clés : | Facteur risque ; Risque ; Facteur ; Mortalité ; Epidémiologie ; France ; Homme ; Population ; Estimation ; Europe |
| Résumé : | [BDSP. Notice produite par INIST-CNRS 8pHR0xII. Diffusion soumise à autorisation]. While assessment of global cardiovascular risk is uniformly recommended for risk factor management, prediction of all-cause death has seldom been considered in available charts. We established an updated algorithm to predict absolute 10-year risk of all-cause mortality in apparently healthy subjects living in France, a country with high life expectancy. Analyses were based on the Third French MONICA Survey on cardiovascular risk factors (1995-1996) carried out in 3,208 participants from the general population aged 35-64. Vital status was obtained 10 years after inclusion and assessment of determinants of mortality was based on multivariable Cox modelling. One-hundred-fifty-six deaths were recorded. Independent determinants of mortality were living area (Northern France), older age, male gender, no high-school completion, smoking, systolic blood pressure>=160 mmHg, LDL-cholesterol>=5.2 mmol/l, and diabetes. Score sheets were developed to easily estimate 10-year risk of death. For example, a non diabetic, heavy smoker, 46-year old man, living in South-Western France, who did not complete high-school, with LDL-cholesterol>=5.2 mmol/l and systolic blood pressure<160 mmHg, has a 17% probability of death in the ten coming years. The C-statistic of the prediction model was 0.76 [95% CI : 0.72-0.80] with a degree of overoptimism estimated at 0.0058 in a bootstrap sample. Calibration was satisfying : P value for Hosmer-Lemeshow khi2 test was 0.483. This prediction algorithm is a simple tool for guiding practitioners towards a more or less aggressive management of risk factors in apparently healthy subjects. |
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