Fish oil and postoperative atrial fibrillation: The omega-3 fatty acids for prevention of post-operative atrial fibrillation (OPERA) randomized trial (Journal of the American Medical Association (2012) 308, 19 (2001-2011))

摘要

The Kaplan-Meier survival curves showed that the differences in survival by point score seen at 4 years were magnified at 10 years (Figure).Comment. We validated a mortality index that accurately stratified older adults into groups at varying risk for 10-year mortality. Extending the index from 4 to 10 years did not diminish the model discrimination (validation cohort, C statistics 0.817 vs 0.834; P= .35), suggesting that the risk factors important for 4-year mortality prediction are also important for 10-year mortality prediction. The model compares favorably with other mortality indexes that predict mortality beyond 7 years.One limitation of the index is that it was developed and validated in a single, large, national study and should be validated on a separate population to assess generalizability.Patients identified by this index as having a high risk of 10-year mortality may be more likely to be harmed by preventive interventions with long lag times to benefit, whereas patients identified as having a low risk of 10-year mortality may be good candidates for such interventions.