Incorporating mortality risk into estimates of 5-year glaucoma risk.
OBJECTIVE
To incorporate mortality risk, a potentially important factor to consider when deciding whether to initiate therapy for ocular hypertensives, into estimates of 5-year glaucoma risk.


METHODS
Comparison study of estimates of glaucoma risk that do and do not account for mortality risk.


METHODS
We computed 5-year risk of glaucoma for a set of hypothetical glaucoma suspects. We then determined their 5-year risk of death using the Charlson index, which is based on age and comorbidity, and computed mortality-adjusted 5-year risk that the individual will develop glaucoma before death.


RESULTS
Accounting for mortality risk reduces the risk of developing glaucoma in one's lifetime. For example, a 75-year-old patient with an unadjusted 5-year glaucoma risk of 51.0% can have mortality-adjusted 5-year glaucoma risks of 41.8% (18% relative risk reduction) or 20.2% (60% relative risk reduction) assuming the patient has a Charlson comorbidity score of 1 or 3, respectively.


CONCLUSIONS
Shortened life expectancy reduces 5-year risk of developing glaucoma. Thus, mortality risk is another factor clinicians should consider when deciding whether to initiate treatment of glaucoma suspects.
Griffin
Beth Ann
BA
RAND Corp, Arlington, Virginia, USA. bethg@rand.org
Elliott
Marc N
MN
Coleman
Anne L
AL
Cheng
Eric M
EM
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005901:Glaucoma / Q000453:epidemiology* / Q000628:therapy; D006304:Health Status; D006801:Humans; D007429:Intraocular Pressure; D008017:Life Expectancy / Q000639:trends*; D008875:Middle Aged; D008954:Models, Biological; D009026:Mortality / Q000639:trends*; D009798:Ocular Hypertension / Q000453:epidemiology / Q000628:therapy; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology