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.
RAND Corp, Arlington, Virginia, USA. bethg@rand.org
Beth Ann
BA
Griffin
Marc N
MN
Elliott
Anne L
AL
Coleman
Eric M
EM
Cheng
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