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Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality

BACKGROUND: The Intermountain Risk Score (IMRS), composed of the complete blood count (CBC) and basic metabolic profile (BMP), predicts mortality and morbidity in medical and general populations. Whether longitudinal repeated measurement of IMRS is useful for prognostication is an important question...

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Autores principales: Horne, Benjamin D., Lappé, Donald L., Muhlestein, Joseph B., May, Heidi T., Ronnow, Brianna S., Brunisholz, Kimberly D., Kfoury, Abdallah G., Bunch, T. Jared, Alharethi, Rami, Budge, Deborah, Whisenant, Brian K., Bair, Tami L., Jensen, Kurt R., Anderson, Jeffrey L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714235/
https://www.ncbi.nlm.nih.gov/pubmed/23874899
http://dx.doi.org/10.1371/journal.pone.0069160
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author Horne, Benjamin D.
Lappé, Donald L.
Muhlestein, Joseph B.
May, Heidi T.
Ronnow, Brianna S.
Brunisholz, Kimberly D.
Kfoury, Abdallah G.
Bunch, T. Jared
Alharethi, Rami
Budge, Deborah
Whisenant, Brian K.
Bair, Tami L.
Jensen, Kurt R.
Anderson, Jeffrey L.
author_facet Horne, Benjamin D.
Lappé, Donald L.
Muhlestein, Joseph B.
May, Heidi T.
Ronnow, Brianna S.
Brunisholz, Kimberly D.
Kfoury, Abdallah G.
Bunch, T. Jared
Alharethi, Rami
Budge, Deborah
Whisenant, Brian K.
Bair, Tami L.
Jensen, Kurt R.
Anderson, Jeffrey L.
author_sort Horne, Benjamin D.
collection PubMed
description BACKGROUND: The Intermountain Risk Score (IMRS), composed of the complete blood count (CBC) and basic metabolic profile (BMP), predicts mortality and morbidity in medical and general populations. Whether longitudinal repeated measurement of IMRS is useful for prognostication is an important question for its clinical applicability. METHODS: Females (N = 5,698) and males (N = 5,437) with CBC and BMP panels measured 6 months to 2.0 years apart (mean 1.0 year) had baseline and follow-up IMRS computed. Survival analysis during 4.0±2.5 years (maximum 10 years) evaluated mortality (females: n = 1,255 deaths; males: n = 1,164 deaths) and incident major events (myocardial infarction, heart failure [HF], and stroke). RESULTS: Both baseline and follow-up IMRS (categorized as high-risk vs. low-risk) were independently associated with mortality (all p<0.001) in bivariable models. For females, follow-up IMRS had hazard ratio (HR) = 5.23 (95% confidence interval [CI] = 4.11, 6.64) and baseline IMRS had HR = 3.66 (CI = 2.94, 4.55). Among males, follow-up IMRS had HR = 4.28 (CI = 3.51, 5.22) and baseline IMRS had HR = 2.32 (CI = 1.91, 2.82). IMRS components such as RDW, measured at both time points, also predicted mortality. Baseline and follow-up IMRS strongly predicted incident HF in both genders. CONCLUSIONS: Repeated measurement of IMRS at baseline and at about one year of follow-up were independently prognostic for mortality and incident HF among initially hospitalized patients. RDW and other CBC and BMP values were also predictive of outcomes. Further research should evaluate the utility of IMRS as a tool for clinical risk adjustment.
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spelling pubmed-37142352013-07-19 Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality Horne, Benjamin D. Lappé, Donald L. Muhlestein, Joseph B. May, Heidi T. Ronnow, Brianna S. Brunisholz, Kimberly D. Kfoury, Abdallah G. Bunch, T. Jared Alharethi, Rami Budge, Deborah Whisenant, Brian K. Bair, Tami L. Jensen, Kurt R. Anderson, Jeffrey L. PLoS One Research Article BACKGROUND: The Intermountain Risk Score (IMRS), composed of the complete blood count (CBC) and basic metabolic profile (BMP), predicts mortality and morbidity in medical and general populations. Whether longitudinal repeated measurement of IMRS is useful for prognostication is an important question for its clinical applicability. METHODS: Females (N = 5,698) and males (N = 5,437) with CBC and BMP panels measured 6 months to 2.0 years apart (mean 1.0 year) had baseline and follow-up IMRS computed. Survival analysis during 4.0±2.5 years (maximum 10 years) evaluated mortality (females: n = 1,255 deaths; males: n = 1,164 deaths) and incident major events (myocardial infarction, heart failure [HF], and stroke). RESULTS: Both baseline and follow-up IMRS (categorized as high-risk vs. low-risk) were independently associated with mortality (all p<0.001) in bivariable models. For females, follow-up IMRS had hazard ratio (HR) = 5.23 (95% confidence interval [CI] = 4.11, 6.64) and baseline IMRS had HR = 3.66 (CI = 2.94, 4.55). Among males, follow-up IMRS had HR = 4.28 (CI = 3.51, 5.22) and baseline IMRS had HR = 2.32 (CI = 1.91, 2.82). IMRS components such as RDW, measured at both time points, also predicted mortality. Baseline and follow-up IMRS strongly predicted incident HF in both genders. CONCLUSIONS: Repeated measurement of IMRS at baseline and at about one year of follow-up were independently prognostic for mortality and incident HF among initially hospitalized patients. RDW and other CBC and BMP values were also predictive of outcomes. Further research should evaluate the utility of IMRS as a tool for clinical risk adjustment. Public Library of Science 2013-07-17 /pmc/articles/PMC3714235/ /pubmed/23874899 http://dx.doi.org/10.1371/journal.pone.0069160 Text en © 2013 Horne et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Horne, Benjamin D.
Lappé, Donald L.
Muhlestein, Joseph B.
May, Heidi T.
Ronnow, Brianna S.
Brunisholz, Kimberly D.
Kfoury, Abdallah G.
Bunch, T. Jared
Alharethi, Rami
Budge, Deborah
Whisenant, Brian K.
Bair, Tami L.
Jensen, Kurt R.
Anderson, Jeffrey L.
Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title_full Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title_fullStr Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title_full_unstemmed Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title_short Repeated Measurement of the Intermountain Risk Score Enhances Prognostication for Mortality
title_sort repeated measurement of the intermountain risk score enhances prognostication for mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714235/
https://www.ncbi.nlm.nih.gov/pubmed/23874899
http://dx.doi.org/10.1371/journal.pone.0069160
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