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Biomarker-based score to predict mortality in persons aged 50 years and older: a new approach in the Swedish AMORIS study
(Regional Cancer Centre)
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2012 (English)In: International journal of molecular epidemiology and genetics, ISSN 1948-1756, Vol. 3, no 1, 66-76 p.Article in journal (Refereed) Published
Abstract [en]


Management of frailty is the cornerstone of geriatric medicine, but there remains a need to identify biomarkers that can predict early death, and thereby lead to effective clinical interventions. We aimed to study the combination of C-reactive protein (CRP), albumin, gamma-glutamyl transferase (GGT), and HDL to predict mortality.


A total of 44,457 persons aged 50+ whose levels of CRP, albumin, GGT, and HDL were measured at baseline were selected from the Swedish Apolipoprotein MOrtality RISk (AMORIS) study. A mortality score, ranging from 0 to 4, was created by adding the number of markers with abnormal values according to the clinical cut-off (CRP > 10 mg/L, albumin < 35 mg/L, GGT > 36 kU/L, HDL < 1.04 mmol/L). Mortality was studied with multivariate Cox proportional hazards models.


2,245 persons died from cancer, 3,276 from circulatory disease, and 1,860 from other causes. There was a positive trend between mortality score and all-cause mortality as well as cancer and circulatory disease-specific death (e.g. HR for all-cause mortality: 1.39 (95%CI: 1.32-1.46), 2.04 (1.89-2.21), and 3.36 (2.87-3.93), for score=1, 2, and 3+, compared to score=0). Among cancer patients with no other co-morbidities (n=1,955), there was a positive trend between the score and mortality (HR: 1.24 (95%CI: 1.0.-1.49), 2.38 (95%CI: 1.76-3.22), and 5.47 (95%CI: 2.98-10.03) for score=1, 2, and 3+ compared to score=0).


By combining biomarkers of different mechanisms contributing to patient frailty, we found a strong marker for mortality in persons aged 50+. Elevated risks among cancer patients with no other co-morbidities prior to biomarker assessment call for validation in other cohorts and testing of different combinations and cut-offs than those used here, in order to aid decision-making in treatment of older cancer patients.

Place, publisher, year, edition, pages
2012. Vol. 3, no 1, 66-76 p.
Keyword [en]
Prostatic neoplasms, Statistics and research design, Randomized controlled trial, Prostatectomy
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-182973PubMedID: 22493753OAI: oai:DiVA.org:uu-182973DiVA: diva2:561593
Available from: 2012-10-19 Created: 2012-10-19 Last updated: 2012-12-04Bibliographically approved

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