Progression in comorbidity before hemodialysis initiation is a valuable predictor of survival in incident patients.

نویسندگان

  • Yee-Yung Ng
  • Yen-Ni Hung
  • Shiao-Chi Wu
  • Po-Jen Ko
  • Shiuh-Ming Hwang
چکیده

BACKGROUND Most studies investigate the association between the baseline Romano-Charlson comorbidity index (CCI) and survival on hemodialysis (HD). Few consider the effect of progression in the CCI score (CCIp) on patient survival before HD initiation. That is CCIp = CCI-1 - CCI-3, where CCI(-1) is the CCI score in the first year before HD initiation, and CCI-3 is the CCI score in the third year before HD initiation. The present study investigated whether CCIp affects the survival of incident HD patients. METHODS Using the National Health Insurance (NHI) Research Database of Taiwan, we recruited 7391 adult incident HD patients in the year 2006 for this historical cohort study. We followed the cohort until the end of 2007. Using the Romano-Charlson method, each comorbidity was assigned a score of 1, 2, 3 or 6. The scores were then summed to produce a total score (CCI), which predicts mortality. The log-rank test and a Cox regression model were used to analyze the association between CCIp and survival, and the risk markers of survival. RESULTS Diabetes, ulcers, congestive heart failure, chronic pulmonary disease and cerebrovascular disease were the most common comorbid conditions. The median CCI-3 was 2 (interquartile range 0-3). The overall survival rate in 1 year was 82.8%. In incident patients with a CCI-3 score of <3, the rate was 85.1%, and in patients with a CCI-3 score of ≥ 3, the rate was 76.8%. Each increase of one point in the CCI-3 score (HR = 1.69, 95% CI 1.42-2.01) and the CCIp (HR = 1.22, 95% CI 1.17-1.27) affected survival in HD patients. CONCLUSIONS The CCI-3 and CCIp before HD initiation are valuable predictors of survival in incident patients.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

High Cost and Low Survival Rate in High Comorbidity Incident Elderly Hemodialysis Patients

BACKGROUND The comorbidity index is a predictor of mortality in dialysis patients but there are few reports for predicting elderly dialysis mortality and national population-based cost studies on elderly dialysis. The aim of this study was to evaluate the long-term mortality of incident elderly dialysis patients using the Deyo-Charlson comorbidity index (CCI) and to assess the inpatient and out...

متن کامل

An association between depressive symptoms and survival in incident dialysis patients.

BACKGROUND Depression in end-stage renal disease patients is detrimental to quality of life, and is also associated with adverse clinical outcomes. The aim of this study was to examine whether depression symptoms in 'incident dialysis' patients predicted survival. METHODS One hundred and sixty incident haemodialysis and peritoneal dialysis patients completed a self-report depression questionn...

متن کامل

نقش انواع فیلتر در میزان هیپوکسمی بیماران همودیالیزی

Introduction: One of the main complications of hemodialysis in patients with chronic renal failure is hypoxemia which is related to several factors including the type of filter. The aim of this study was to evaluate the hypoxemia levels in patients undergoing hemodialysis with focus on the type of filter. Methods: In a crossover clinical trial, 29 patients from emodialysis ward of Fatemieh hos...

متن کامل

اندکس کوموربیدیتی چارلسون به‌عنوان فاکتور پیش‌گویی‌کننده قوی مرگ و میر در بیماران همودیالیز مزمن

Background and Objective: Mortality of hemodialysis patients is still high, which can be estimated using the Charlson Comorbidity Index (CCI) and serum albumin. Materials and Methods: This prospective cohort study was conducted on adult chronic hemodialysis patients (n=532) from 9 hemodialysis (HD) facilities in September 2012. The obtained data included demographic factors and laboratory data...

متن کامل

Prognostic value of various metabolic parameters on pre-treatment 18-F-FDG PET/CT in patients with stage I-III non-small cell lung cancer

Background: the aim of this study was to investigate the prognostic value of 18Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters in both overall survival and progression-free survival in Stage I-III non-small cell lung cancer (NSCLC). Materials and Methods: In this retrospective study, 267 patients who were diagnosed as Stage I-III non-smal...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

دوره 28 4  شماره 

صفحات  -

تاریخ انتشار 2013