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Abstract: FR-PO811

A Simple Vitality Question, Its Correlates, and Clinical Outcomes in Patients Receiving Hemodialysis: The Japanese Dialysis Outcomes and Practice Pattern Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kurita, Noriaki, Department of Innovative Research and Education for Clinicians and Trainees, Fukushima Medical University Hospital, Fukushima, Japan
  • Akizawa, Tadao, Showa University School of Medicine, Tokyo, Japan
Background

The lack of an assessment of vitality in daily practice may be partially due to inadequate understanding of lack of vitality and the lack of a concise method of assessing it. The aim of this study was to examine the predictability of a simple 1-item vitality question and its correlates.

Methods

This was a cohort study involving hemodialysis patients who participated in the Japan Dialysis Outcomes and Practice Pattern Study (phase 3 to 4 [2005–2011]). Predictor was one-item vitality measured via the 12-item Medical Outcomes Study Short Form survey version 2.0, using a 5-level Likert scale. Outcomes were all-cause mortality and a composite of multiple cardiovascular hospitalization and all-cause mortality. A pooled ordered logit model was fitted to examine correlates of 1-item vitality. Cox and mixed-effects Poisson regression models were fitted for mortality and composite outcomes, respectively.

Results

3,667 patients were analyzed. Decrease in vitality category was associated with tachycardia (≥ 100 vs. 60 to < 70 beats/min) and benzodiazepine, hypnotics, or antidepressant use. In contrast, increase in vitality was associated with increase in single-pool Kt/V, serum albumin, and BMI. Compared with the lowest vitality category, the second highest and middle categories were negatively associated with all-cause mortality (Figure; adjusted hazard ratio [AHR] 0.66, 95% confidence interval [95% CI] 0.47–0.93 and AHR 0.75, 95% CI 0.59–0.96, respectively). A one-category increase in vitality was consistently associated with lower mortality (AHR 0.86, 95% CI 0.78–0.96). The associations between 1-item vitality and multiple cardiovascular hospitalization and mortality were similar to those between vitality and mortality.

Conclusion

1-item vitality predicted all-cause mortality and a composite of multiple cardiovascular hospitalization and all-cause mortality, and correlates with some modifiable factors, including vital signs. Dialysis staff should consider asking this simple question in daily practice to improve patient quality of life and outcomes.

Funding

  • Commercial Support