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Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension

BACKGROUND: Hypertension-related mortality has been increasing in older adults, resulting in serious burden to society and individual. However, how to identify older adults with hypertension at high-risk mortality remains a great challenge. The purpose of this study is to develop and validate the pr...

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Autores principales: Zhang, Huanrui, Tian, Wen, Sun, Yujiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069777/
https://www.ncbi.nlm.nih.gov/pubmed/35509033
http://dx.doi.org/10.1186/s12877-022-03087-3
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author Zhang, Huanrui
Tian, Wen
Sun, Yujiao
author_facet Zhang, Huanrui
Tian, Wen
Sun, Yujiao
author_sort Zhang, Huanrui
collection PubMed
description BACKGROUND: Hypertension-related mortality has been increasing in older adults, resulting in serious burden to society and individual. However, how to identify older adults with hypertension at high-risk mortality remains a great challenge. The purpose of this study is to develop and validate the prediction nomogram for 5-year all-cause mortality in older adults with hypertension. METHODS: Data were extracted from National Health and Nutrition Examination Survey (NHANES). We recruited 2691 participants aged 65 years and over with hypertension in the NHANES 1999-2006 cycles (training cohort) and 1737 participants in the NHANES 2007-2010 cycles (validation cohort). The cohorts were selected to provide at least 5 years follow-up for evaluating all-cause mortality by linking National Death Index through December 31, 2015. We developed a web-based dynamic nomogram for predicting 5-year risk of all-cause mortality based on a logistic regression model in training cohort. We conducted internal validation by 1000 bootstrapping resamples and external validation in validation cohort. The discrimination and calibration of nomogram were evaluated using concordance index (C-index) and calibration curves. RESULTS: The final model included eleven independent predictors: age, sex, diabetes, cardiovascular disease, body mass index, smoking, lipid-lowering drugs, systolic blood pressure, hemoglobin, albumin, and blood urea nitrogen. The C-index of model in training and validation cohort were 0.759 (bootstrap-corrected C-index 0.750) and 0.740, respectively. The calibration curves also indicated that the model had satisfactory consistence in two cohorts. A web-based nomogram was established (https://hrzhang1993.shinyapps.io/dynnomapp). CONCLUSIONS: The novel developed nomogram is a useful tool to accurately predict 5-year all-cause mortality in older adults with hypertension, and can provide valuable information to make individualized intervention. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-03087-3.
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spelling pubmed-90697772022-05-05 Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension Zhang, Huanrui Tian, Wen Sun, Yujiao BMC Geriatr Research BACKGROUND: Hypertension-related mortality has been increasing in older adults, resulting in serious burden to society and individual. However, how to identify older adults with hypertension at high-risk mortality remains a great challenge. The purpose of this study is to develop and validate the prediction nomogram for 5-year all-cause mortality in older adults with hypertension. METHODS: Data were extracted from National Health and Nutrition Examination Survey (NHANES). We recruited 2691 participants aged 65 years and over with hypertension in the NHANES 1999-2006 cycles (training cohort) and 1737 participants in the NHANES 2007-2010 cycles (validation cohort). The cohorts were selected to provide at least 5 years follow-up for evaluating all-cause mortality by linking National Death Index through December 31, 2015. We developed a web-based dynamic nomogram for predicting 5-year risk of all-cause mortality based on a logistic regression model in training cohort. We conducted internal validation by 1000 bootstrapping resamples and external validation in validation cohort. The discrimination and calibration of nomogram were evaluated using concordance index (C-index) and calibration curves. RESULTS: The final model included eleven independent predictors: age, sex, diabetes, cardiovascular disease, body mass index, smoking, lipid-lowering drugs, systolic blood pressure, hemoglobin, albumin, and blood urea nitrogen. The C-index of model in training and validation cohort were 0.759 (bootstrap-corrected C-index 0.750) and 0.740, respectively. The calibration curves also indicated that the model had satisfactory consistence in two cohorts. A web-based nomogram was established (https://hrzhang1993.shinyapps.io/dynnomapp). CONCLUSIONS: The novel developed nomogram is a useful tool to accurately predict 5-year all-cause mortality in older adults with hypertension, and can provide valuable information to make individualized intervention. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-03087-3. BioMed Central 2022-05-04 /pmc/articles/PMC9069777/ /pubmed/35509033 http://dx.doi.org/10.1186/s12877-022-03087-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhang, Huanrui
Tian, Wen
Sun, Yujiao
Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title_full Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title_fullStr Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title_full_unstemmed Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title_short Development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
title_sort development, validation, and visualization of a web-based nomogram to predict 5-year mortality risk in older adults with hypertension
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069777/
https://www.ncbi.nlm.nih.gov/pubmed/35509033
http://dx.doi.org/10.1186/s12877-022-03087-3
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