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Abstract: TH-PO793

Prediction Model for 6-Month Mortality in Incident Older Hemodialysis Patients: Data From the Korean Society of Geriatric Nephrology

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Cho, Jang-Hee, Kyungpook National University School of Medicine, Daegu, Korea (the Republic of)
  • Yu, Byung chul, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Han, Miyeun, National Medical Center, Seoul, Korea (the Republic of)
  • Song, Sang Heon, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Ko, Gang-Jee, Korea University College of Medicine and School of Medicine, Seoul, Korea (the Republic of)
  • Yang, Jae Won, Yonsei University Wonju College of Medicine, Wonju, Gyeonggi-do, Korea (the Republic of)
  • Chung, Sungjin, The Catholic University of Korea, Seoul, Korea (the Republic of)
  • Hong, Yu Ah, The Catholic University of Korea, Daejeon, Korea (the Republic of)
  • Hyun, Young Youl, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Bae, Eunjin, Gyeongsang National University Graduate School of Medicine, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Sun, In O, Presbyterian Medical Center, Jeonju, Jeollabuk-do , Korea (the Republic of)
  • Kim, Hyunsuk, Hallym University College of Medicine, Chuncheon, Gangwon, Korea (the Republic of)
  • Hwang, Won Min, Konyang University Hospital, Daejeon, Korea (the Republic of)
  • Shin, Sung Joon, Dongguk University School of Medicine, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Kwon, Soon hyo, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
  • Yoo, Kyung Don, University of Ulsan College of Medicine, Ulsan, Korea (the Republic of)

Group or Team Name

  • Korean Society of Geriatric Nephrology
Background

Early mortality following hemodialysis initiation is a barrier to improving patient survival. We aimed to develop a clinical risk model to predict the early mortality of older hemodialysis patients.

Methods

Hemodialysis patients aged >70 years were recruited from a retrospective cohort from the Korean Society of Geriatric Nephrology (KSGN). A prognostic score for 6-month mortality risk after dialysis initiation was developed, named the KSGN score. Multivariate Cox regression analysis was used to select risk factors from 20 clinical variables. β-coefficients were converted to natural logarithms for the final risk score model.

Results

Among the 1,967 incident hemodialysis patients, the crude 6-month mortality rate was 15.7% (n=309). In the multivariate Cox analysis, independent risk factors for 6-month mortality and each score were as follows: the body mass index (<18.5 kg/m2 (0), 18.5≤, <23 kg/m2 (0)), age at dialysis initiation (<80 years (0), ≥85 years (1)), status of malignancy (curative state (0), palliative treatment (1)), hypertension (0), nursing hospital care at dialysis initiation (0), vascular access at dialysis initiation (arteriovenous graft (-1)), vascular access on maintenance dialysis (arteriovenous fistula (-1), arteriovenous graft (-1)), and serum albumin (0)). According to the KSGN score, mortality rate was 4.8%, 8.6%, 32.0%, 60.3%, and 66.7% for -2, -1, 0, 1, and 2 points, respectively. The area under the curve of the KSGN score was significantly higher than that of either the Alberta or United States Renal Data System scores.

Conclusion

The KSGN score is a simple tool to predict early mortality after dialysis initiation in older patients with end-stage kidney disease and may be useful to support decision-making and management in older adults starting dialysis.

Comparison of ROC curve between the prognostic models