Abstract: PO1046
Composite Comorbidity Scoring System to Predict Mortality in a Saudi Dialysis Population
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Abderrahim, Ezzedine, DaVita Saudi Arabia, Riyadh, Saudi Arabia
- Moussa, Ayman S., DaVita Saudi Arabia, Riyadh, Saudi Arabia
- Dridi, Afef, DaVita Saudi Arabia, Riyadh, Saudi Arabia
- Jubran, Ibrahim Abduh, DaVita Saudi Arabia, Riyadh, Saudi Arabia
- Alobaili, Saad S., DaVita Saudi Arabia, Riyadh, Saudi Arabia
- AlAhmadi, Salwa I., DaVita Saudi Arabia, Riyadh, Saudi Arabia
- Al-Badr, Wisam H.A., DaVita Saudi Arabia, Riyadh, Saudi Arabia
Background
Most uremic patients starting hemodialysis (HD) have multiple comorbidities, resulting in a high risk of mortality. Our aim was to establish and evaluate a personal scoring system in which we included associated comorbidities, age and, other HD related factors known to predict mortality.
Methods
All patients referred to DaVita-KSA, from October 2014 to December 2019, to continue hemodialysis therapy, were included in this analysis. Cox proportional hazards model was used to identify factors influencing all-cause mortality. A personal scoring system was established based on the score assigned to each factor, according to its weight as predictor of death, judged on the value of the relative risk generated in the preliminary analysis. An index of co-morbidity was calculated for each patient that corresponded to the sum of scores assigned to each factor.
Patients were divided into 4 groups according to percentile rank of their comorbidity index (Group1: low risk, Group 2: moderate, Group 3: high, Group 4: very high) and compared in terms of global and annual mortality rates and survival using Log rank analysis
Results
3983 patients (2177 males, 55%) were included with a mean age of 52.5± 16.8 years. Diabetic and hypertensive nephropathies accounted for 78.1 % of all causes of ESRD. After a cumulative follow-up period of 7635 years, 15.3% of patients were transferred to other facilities, 8.7% were transplanted and 14.5% were deceased.
Conclusion
This new scoring system appears to be easily established at our clinics and may constitute a good predictor for all-cause mortality in our HD population.
The mortality parameters in the study groups
| Groups | Total | Group 1 | Group 2 | Group 3 | Group 4 | p | |
| Number | 3983 | 882 | 867 | 1237 | 997 | ||
| Comorbidity score | [0-22] | [0-3] | [4-5] | [6-8] | >=9 | ||
| Mortality, % | Rate | 14.5 | 3.6 | 8.4 | 14.5 | 29.4 | <0.0001 |
| CI, 95% | [13.3-15.7] | [2.4-4.9] | [6.5-10.3] | [12.3-16.6] | [26-32.7] | ||
| Annual mortality, % patient-years | Rate | 7.6 | 1.5 | 4.3 | 8.2 | 18.1 | <0.0001 |
| CI, 95% | [6.9-8.2] | [1-2] | [3.5-5.2] | [7-9.4] | [16.1-20.2] | ||
| Survival rate, months | 0 | 100 | 100 | 100 | 100 | 100 | <0.0001 |
| 3 | 98.2 | 99.9 | 99.3 | 98.7 | 95 | ||
| 6 | 96.7 | 99.6 | 98.3 | 97.4 | 89.6 | ||
| 12 | 94 | 98.8 | 97.6 | 94.1 | 89.6 | ||
| 24 | 86.7 | 96.9 | 93.2 | 86.6 | 71 | ||
| 60 | 65.3 | 92.6 | 68.8 | 59 | 37.8 | ||
| Relative mortality risk | Rate | 1 | 2.9 | 5.7 | 12.9 | <0.0001 | |
| Ci, 95% | Reference | [1.9-4.4] | [3.9-8.3] | [8.9-18.5] | |||