Identification of Mortality Risks in the Advancement of Old Age: Application of Proportional Hazard Models Based on the Stepwise Variable Selection and the Bayesian Model Averaging Approach

Nutrients. 2021 Mar 27;13(4):1098. doi: 10.3390/nu13041098.

Abstract

Identifying factors that affect mortality requires a robust statistical approach. This study's objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person's mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level.

Keywords: Bayesian model averaging; Charlson Comorbidity Index; GNRI; TUG; geriatrics; lymphocytes; survival; vitamin D.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bayes Theorem
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Mortality*
  • Nutrition Assessment*
  • Nutritional Status*
  • Proportional Hazards Models
  • Risk Factors
  • Social Factors