A comorbidity index for mortality prediction in Chinese patients with ESRD receiving hemodialysis

Jinn Yang Chen, Shin Hung Tsai, Pei Hung Chuang, Chia Hao Chang, Chiao Lin Chuang, Hui Ling Chen, Ping Ling Chen

研究成果: 雜誌貢獻文章

12 引文 (Scopus)

摘要

Background and objectives Chinese patients with ESRD have different comorbidity patterns than white patients with ESRD and require a validated comorbidity index. The objective of this study was to develop a new index for mortality prediction in 2006-2009 Taiwanese incident hemodialysis patients. Design, setting, participants, & measurements Data were retrieved from 2005 to 2010 Taiwan National Health Insurance claimrecords, and follow-upwas available until December 31, 2010. The same comorbid conditions as the US Renal Data System (USRDS) index that occurred during a 12-month period from 9 months before to 3 months after dialysis initiation were used to construct the index. Integer weight of the comorbid conditions was derived from coefficient estimates of Cox regression for all-cause mortality, and the index was internally validated. The performance of the index was assessed by discrimination, calibration, and reclassification. Results A total of 30,303 hemodialysis patients were included in this study. The weight for individual comorbid conditions of this index differed fromthat of the USRDS index. The performance of this index was similar to that of USRDS and Charlson indices in terms of model fit statistics, overall predictive ability, discrimination, and calibration. Hosmer-Lemeshow test showed that all three indices demonstrated significant differences between predicted and observed mortality rates. When patients were categorized by the predicted 2.5-year survival probabilities, the index achieved a net reclassification improvement of 4.71% (P,0.001), referenced to USRDS index. Conclusions ComparedwithUSRDS index, this new index demonstrated better reclassification ability, but future studies should address the clinical significance.

原文英語
頁(從 - 到)513-519
頁數7
期刊Clinical Journal of the American Society of Nephrology
9
發行號3
DOIs
出版狀態已發佈 - 三月 7 2014

指紋

Chronic Kidney Failure
Renal Dialysis
Comorbidity
Information Systems
Mortality
Kidney
Calibration
Weights and Measures
National Health Programs
Taiwan
Dialysis
Survival

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

引用此文

A comorbidity index for mortality prediction in Chinese patients with ESRD receiving hemodialysis. / Chen, Jinn Yang; Tsai, Shin Hung; Chuang, Pei Hung; Chang, Chia Hao; Chuang, Chiao Lin; Chen, Hui Ling; Chen, Ping Ling.

於: Clinical Journal of the American Society of Nephrology, 卷 9, 編號 3, 07.03.2014, p. 513-519.

研究成果: 雜誌貢獻文章

Chen, Jinn Yang ; Tsai, Shin Hung ; Chuang, Pei Hung ; Chang, Chia Hao ; Chuang, Chiao Lin ; Chen, Hui Ling ; Chen, Ping Ling. / A comorbidity index for mortality prediction in Chinese patients with ESRD receiving hemodialysis. 於: Clinical Journal of the American Society of Nephrology. 2014 ; 卷 9, 編號 3. 頁 513-519.
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abstract = "Background and objectives Chinese patients with ESRD have different comorbidity patterns than white patients with ESRD and require a validated comorbidity index. The objective of this study was to develop a new index for mortality prediction in 2006-2009 Taiwanese incident hemodialysis patients. Design, setting, participants, & measurements Data were retrieved from 2005 to 2010 Taiwan National Health Insurance claimrecords, and follow-upwas available until December 31, 2010. The same comorbid conditions as the US Renal Data System (USRDS) index that occurred during a 12-month period from 9 months before to 3 months after dialysis initiation were used to construct the index. Integer weight of the comorbid conditions was derived from coefficient estimates of Cox regression for all-cause mortality, and the index was internally validated. The performance of the index was assessed by discrimination, calibration, and reclassification. Results A total of 30,303 hemodialysis patients were included in this study. The weight for individual comorbid conditions of this index differed fromthat of the USRDS index. The performance of this index was similar to that of USRDS and Charlson indices in terms of model fit statistics, overall predictive ability, discrimination, and calibration. Hosmer-Lemeshow test showed that all three indices demonstrated significant differences between predicted and observed mortality rates. When patients were categorized by the predicted 2.5-year survival probabilities, the index achieved a net reclassification improvement of 4.71{\%} (P,0.001), referenced to USRDS index. Conclusions ComparedwithUSRDS index, this new index demonstrated better reclassification ability, but future studies should address the clinical significance.",
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