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: 雜誌貢獻文章同行評審

17 引文 斯高帕斯(Scopus)


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.

頁(從 - 到)513-519
期刊Clinical Journal of the American Society of Nephrology
出版狀態已發佈 - 3月 7 2014

ASJC Scopus subject areas

  • 流行病學
  • 重症監護和重症監護醫學
  • 腎臟病學
  • 移植


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