https://scholars.lib.ntu.edu.tw/handle/123456789/629505
標題: | Develop and Apply Electrocardiography-Based Risk Score to Identify Community-Based Elderly Individuals at High-Risk of Mortality | 作者: | TZU-PIN LU Chattopadhyay, Amrita Lu, Kuan-Chen Chuang, Jing-Yuan Yeh, Shih-Fan Sherri Chang, I-Shou Chen, Ching-Yu Julius Wu, I-Chien Hsu, Chih-Cheng Chen, Tzu-Yu Tseng, Wei-Ting Hsiung, Chao Agnes JYH-MING JIMMY JUANG |
關鍵字: | Han Chinese population; community-based; electrocardiographic abnormality score; long-term prognosis; prevalence | 公開日期: | 2021 | 出版社: | FRONTIERS MEDIA SA | 卷: | 8 | 來源出版物: | Frontiers in cardiovascular medicine | 摘要: | With an aging world population, risk stratification of community-based, elderly population is required for primary prevention. This study proposes a combined score developed using electrocardiographic (ECG) parameters and determines its long-term prognostic value for predicting risk of cardiovascular mortality. A cohort-study, conducted from December 2008 to April 2019, enrolled 5,380 subjects in Taiwan, who were examined, using three-serial-12-lead ECGs, and their health/demographic information were recorded. To understand the predictive effects of ECG parameters on overall-survival, Cox hazard regression analysis were performed. The mean age at enrollment was 69.04 ± 8.14 years, and 47.4% were males. ECG abnormalities, LVH [hazard ratio (HR) = 1.39, 95% confidence intervals (CI) = (1.16-1.67), P = 0.0003], QTc [HR = 1.31, CI = (1.07-1.61), P = 0.007] and PR interval [HR = 1.40, CI = (1.01-1.95), P = 0.04], were significantly associated with primary outcome all-cause death. Furthermore, LVH [HR = 2.37, CI = (1.48-3.79), P = 0.0003] was significantly associated with cardiovascular death, while PR interval [HR = 2.63, CI = (1.24- 5.57), P = 0.01] with unexplained death. ECG abnormality (EA) score was defined based on the number of abnormal ECG parameters for each patient, which was used to divide all patients into sub-groups. Competing risk survival analysis using EA score were performed by using the Gray's test, which reported that high-risk EA groups showed significantly higher cumulative incidence for all three outcomes. Prognostic models using the EA score as predictor were developed and a 10-fold cross validation design was adopted to conduct calibration and discrimination analysis, to establish the efficacy of the proposed models. Overall, ECG model could successfully predict people, susceptible to all three death outcomes (P < 0.05), with high efficacy. Statistically significant (P < 0.001) improvement of the c-indices further demonstrated the robustness of the prediction model with ECG parameters, as opposed to a traditional model with no EA predictor. The EA score is highly associated with increased risk of mortality in elderly population and may be successfully used in clinical practice. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/629505 | ISSN: | 2297-055X | DOI: | 10.3389/fcvm.2021.738061 |
顯示於: | 流行病學與預防醫學研究所 |
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