Prediction of cardiovascular mortality in functionally disabled elderly: A possible new score

Abstract

Background: We investigated the traditional and new biomarkers as predictors of cardiovascular mortality in the functionally disabled elderly who are living in a community. Methods: This prospective study included 253 participants (78.3% women) aged 65 and over who were monitored for 32 months. Receiver operating curve analysis and the Cox proportional hazard model were used to identify univariate and multivariate predictors of cardiovascular mortality. The Kaplan-Meier survival curve and Log rank test were used for survival analysis. Results: During the study, 43.1% participants died from cardiovascular diseases. Cutoff points of multivariate predictors were used to build a score system. The risk score was positive in patients with three or more of the following predictors: albumin <40 g/L, body mass index <25 kg/m2, total serum bilirubin <10.5 μmol/L, blood urea nitrogen ≥6.5 mmol/L and high-sensitivity C-reactive protein ≥2.25 mg/L. The reIative risk for cardiovascular mortality for someone with a positive vs. negative score was 3.91 (95% CI: 2.55-5.98; P<0.001). There was no change in risk after adjustment for age, sex, traditional cardiovascular risk factors, comorbidities and a number of disabilities. Conclusions: Presence of low grade inflammation, malnutrition and early signs of renal dysfunction are essential for cardiovascular risk among the functionally disabled elderly and may be assessed using the proposed new inflammatory-malnutrition-renal involved score (IMRIS).

Keywords

• cardiovascular risk
• c-reactive protein
• elderly
• malnutrition