Evidence map›Paper›PMID 40033449›Full record

ArticleDiagnostic and prognostic research2025

Development and internal validation of a new life expectancy estimator for multimorbid older adults.

Viktoria Gastens, Arnaud Chiolero, Martin Feller, Douglas C Bauer, Nicolas Rodondi, Cinzia Del Giovane

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Article in Diagnostic and prognostic research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02986425 (OPERAM), which is not on this map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02986425 nacompletednot on this map

OPERAM: OPtimising thERapy to Prevent Avoidable Hospital Admissions in the Multimorbid Older People: a Cluster Randomised Controlled Trial

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2016 to 2019Enrolled2,009Conditions3 or More Chronic Conditions for 6 Months or Longer, 5 or More Regular DrugsArmsSTRIP intervention, Control
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Viktoria GastensInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. viktoria.gastens@unifr.ch.ORCID http://orcid.org/0000-0002-6421-9867
Arnaud ChioleroInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Martin FellerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Douglas C BauerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Cinzia Del GiovaneInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.

Funding

Horizon 2020 6342388Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 320030_188549/01Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 325130_204361Staatssekretariat für Bildung, Forschung und Innovation 15.0137
6 · The paper itself

Abstract

backgroundAs populations are aging, the number of older patients with multiple chronic diseases demanding complex care increases. Although clinical guidelines recommend care to be personalized accounting for life expectancy, there are no tools to estimate life expectancy among multimorbid patients. Our objective was therefore to develop and internally validate a life expectancy estimator specifically for older multimorbid adults.

methodsWe analyzed data from the OPERAM (OPtimising thERapy to prevent avoidable hospital admissions in multimorbid older people) study in Bern, Switzerland. Participants aged 70 years old or more with multimorbidity (3 or more chronic medical conditions) and polypharmacy (use of 5 drugs or more for > 30 days) were included. All-cause mortality was assessed during 3 years of follow-up. We built a 3-year mortality prognostic index and transformed this index into a life expectancy estimator. Mortality risk candidate predictors included demographic variables (age, sex), clinical characteristics (metastatic cancer, number of drugs, body mass index, weight loss), smoking, functional status variables (Barthel-Index, falls, nursing home residence), and hospitalization. We internally validated and optimism corrected the model using bootstrapping techniques. We transformed the mortality prognostic index into a life expectancy estimator using the Gompertz survival function.

resultsEight hundred five participants were included in the analysis. During 3 years of follow-up, 292 participants (36%) died. Age, metastatic cancer, number of drugs, lower body mass index, weight loss, number of hospitalizations, and lower Barthel-Index (functional impairment) were selected as predictors in the final multivariable model. Our model showed moderate discrimination with an optimism-corrected C statistic of 0.70. The optimism-corrected calibration slope was 0.96. The Gompertz-predicted mean life expectancy in our sample was 5.4 years (standard deviation 3.5 years). Categorization into three life expectancy groups led to visually good separation in Kaplan-Meier curves. We also developed a web application that calculates an individual's life expectancy estimation.

conclusionA life expectancy estimator for multimorbid older adults based on an internally validated 3-year mortality risk index was developed. Further validation of the score among various populations of multimorbid patients is needed before its implementation into practice.

trial registrationClinicalTrials.gov NCT02986425. First submitted 21/10/2016. First posted 08/12/2016.

Identifiers

PMID40033449
PMCPMC11877760

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