Life Expectancy in Complex Multisystem Catastrophic Cases

By James F. Lineback MD, FCCP

Normal Life Expectancy

Determining life expectancy ordinarily starts with the normal expectancy of the individual. For example, a 56 year old male would, according to the Social Security Actuarial Publications Periodic Life Table, live an additional 24 years or a total of 80 years.

Medical Problems

Once a baseline, – or normal life expectancy, is established, the physician expert will want to analyze the medical problems of the individual to determine:

  • The serious conditions the individual had prior to the catastrophic injury.
  • The impact, if any, that these medical conditions would have had on his or her life expectancy.

Medical research will need to be done to determine the impact of the pre-existing medical conditions on the life expectancy of the individual.

Impact on Life Expectancy

Once the medical conditions and their impact on life expectancy are established, the physician expert is then able to opine to a reasonable degree of medical certainty on what the actual life expectancy of the individual was.

Example

Let me offer an example of how this type of analysis is performed:

A 56 year old male with end-stage liver disease, chronic alcoholism, hypertension, adult- onset diabetes mellitus, obesity, and coronary artery disease suffered a severe abdominal injury and died 4 years later.  In this case, I was asked to opine on the 56 year old patient’s life expectancy. 

Loss of Life Expectancy

My research, medical training, and experience led me to the following analysis:

End-stage liver disease 5 year mortality – 71-90%
Chronic alcoholism Years of life lost – 22.6 years
Diabetes Years of life lost – 5.3 years
Hypertension Years of life lost – 5.1 years
Obesity (severe) Years of life lost – 5.8 years

 

Conclusion

I concluded that it was medically probable that this individual would not have lived an additional five years, even absent the injury. 

Individuals with complex multisystem comorbid conditions should be carefully evaluated for their true life expectancy.

NOTES:

  • Scandinavian Journal of Gastroenterology, in September of 2004, Volume 39, page 858
  • Journal of Aten Trinaria, February of 2010, Volume 42, page 95
  • Medical Clinics of Barcelona, June of 2008, Volume 131, page 10
  • British Medical Journal, March of 1995, Volume 11, page 646
  • Journal of Addition, March of 2006, Volume 101, page 373
  • Diabetes and Metabolism, 1993, Volume 19, page 152
  • Diabetes Care, Doctors Gu, et al, July of 1998, Volume 21, page 1138
  • Journal of Hypertension, Doctors Franco, et al, August of 2005, Volume 46, page 280
  • Journal of the American Medical Association, January of 2003, Volume 289, page 187
  • Annals of Internal Medicine, Drs. Peeters, et al, January of 2003, Volume 138, page 24

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About the Author

James F. Lineback MD, FCCP is board certified in internal medicine and pulmonary medicine. He is an Associate Clinical Professor of Medicine at the University of California, Riverside.

© Aug. 2013.  James F. Lineback, MD, FCCP.  All Rights Reserved.  Written for the SEAK Expert Witness Directory.