Development and validation of a predictive mortality risk score from a European hemodialysis cohort.

Détails

ID Serval
serval:BIB_8DD99696350E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Development and validation of a predictive mortality risk score from a European hemodialysis cohort.
Périodique
Kidney international
Auteur(s)
Floege J., Gillespie I.A., Kronenberg F., Anker S.D., Gioni I., Richards S., Pisoni R.L., Robinson B.M., Marcelli D., Froissart M., Eckardt K.U.
ISSN
1523-1755 (Electronic)
ISSN-L
0085-2538
Statut éditorial
Publié
Date de publication
05/2015
Peer-reviewed
Oui
Volume
87
Numéro
5
Pages
996-1008
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
Publication Status: ppublish
Résumé
Although mortality risk scores for chronic hemodialysis (HD) patients should have an important role in clinical decision-making, those currently available have limited applicability, robustness, and generalizability. Here we applied a modified Framingham Heart Study approach to derive 1- and 2-year all-cause mortality risk scores using a 11,508 European incident HD patient database (AROii) recruited between 2007 and 2009. This scoring model was validated externally using similar-sized Dialysis Outcomes and Practice Patterns Survey (DOPPS) data. For AROii, the observed 1- and 2-year mortality rates were 13.0 (95% confidence interval (CI; 12.3-13.8)) and 11.2 (10.4-12.1)/100 patient years, respectively. Increasing age, low body mass index, history of cardiovascular disease or cancer, and use of a vascular access catheter during baseline were consistent predictors of mortality. Among baseline laboratory markers, hemoglobin, ferritin, C-reactive protein, serum albumin, and creatinine predicted death within 1 and 2 years. When applied to the DOPPS population, the predictive risk score models were highly discriminatory, and generalizability remained high when restricted by incidence/prevalence and geographic location (C-statistics 0.68-0.79). This new model offers improved predictive power over age/comorbidity-based models and also predicted early mortality (C-statistic 0.71). Our new model delivers a robust and reproducible mortality risk score, based on readily available clinical and laboratory data.

Mots-clé
Adult, Aged, Aged, 80 and over, Cohort Studies, Europe/epidemiology, Female, Humans, Kidney Failure, Chronic/mortality, Male, Middle Aged, Renal Dialysis/mortality, Risk Assessment
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/03/2016 17:49
Dernière modification de la notice
21/08/2019 6:35
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