Physical performance strongly predicts all-cause mortality risk in a real-world population of older diabetic patients: machine learning approach for mortality risk stratification.
Front Endocrinol (Lausanne)
; 15: 1359482, 2024.
Article
en En
| MEDLINE
| ID: mdl-38745954
ABSTRACT
Background:
Prognostic risk stratification in older adults with type 2 diabetes (T2D) is important for guiding decisions concerning advance care planning. Materials andmethods:
A retrospective longitudinal study was conducted in a real-world sample of older diabetic patients afferent to the outpatient facilities of the Diabetology Unit of the IRCCS INRCA Hospital of Ancona (Italy). A total of 1,001 T2D patients aged more than 70 years were consecutively evaluated by a multidimensional geriatric assessment, including physical performance evaluated using the Short Physical Performance Battery (SPPB). The mortality was assessed during a 5-year follow-up. We used the automatic machine-learning (AutoML) JADBio platform to identify parsimonious mathematical models for risk stratification.Results:
Of 977 subjects included in the T2D cohort, the mean age was 76.5 (SD 4.5) years and 454 (46.5%) were men. The mean follow-up time was 53.3 (SD15.8) months, and 209 (21.4%) patients died by the end of the follow-up. The JADBio AutoML final model included age, sex, SPPB, chronic kidney disease, myocardial ischemia, peripheral artery disease, neuropathy, and myocardial infarction. The bootstrap-corrected concordance index (c-index) for the final model was 0.726 (95% CI 0.687-0.763) with SPPB ranked as the most important predictor. Based on the penalized Cox regression model, the risk of death per unit of time for a subject with an SPPB score lower than five points was 3.35 times that for a subject with a score higher than eight points (P-value <0.001).Conclusion:
Assessment of physical performance needs to be implemented in clinical practice for risk stratification of T2D older patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación Geriátrica
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Diabetes Mellitus Tipo 2
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Aprendizaje Automático
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Rendimiento Físico Funcional
Límite:
Aged
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Aged80
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Female
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Humans
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Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Front Endocrinol (Lausanne)
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia