The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.

<h4>Background</h4>The worldwide elderly (≥ 65 years old) dialysis population has grown significantly. This population is expected to have more comorbid conditions and shorter life expectancies than the general elderly population. Predicting outcomes for this population is important for...

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Autores principales:	Wei-Chih Kan, Jhi-Joung Wang, Shuo-Yu Wang, Yih-Min Sun, Chien-Ya Hung, Chin-Chen Chu, Chin-Li Lu, Shih-Feng Weng, Chung-Ching Chio, Chih-Chiang Chien
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fad535072c384e77ab2fb3e9250de462
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spelling	oai:doaj.org-article:fad535072c384e77ab2fb3e9250de4622021-11-18T09:01:03ZThe new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.1932-620310.1371/journal.pone.0068748https://doaj.org/article/fad535072c384e77ab2fb3e9250de4622013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23936310/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The worldwide elderly (≥ 65 years old) dialysis population has grown significantly. This population is expected to have more comorbid conditions and shorter life expectancies than the general elderly population. Predicting outcomes for this population is important for decision-making. Recently, a new comorbidity index (nCI) with good predictive value for patient outcomes was developed and validated in chronic dialysis patients regardless of age. Our study examined the nCI outcome predictability in elderly dialysis patients.<h4>Methods and findings</h4>For this population-based cohort study, we used Taiwan's National Health Insurance Research Database of enrolled elderly patients, who began maintenance dialysis between January 1999 and December 2005. A total of 21,043 incident dialysis patients were divided into 4 groups by nCI score (intervals ≤ 3, 4-6, 7-9, ≥ 10) and followed nearly for 10 years. All-cause mortality and life expectancy were analyzed. During the follow-up period, 11272 (53.55%) patients died. Kaplan-Meier curves showed significant group difference in survival (log-rank: P<0.001). After stratification by age, life expectancy was found to be significantly longer in groups with lower nCI scores.<h4>Conclusion</h4>The nCI, even without the age component, is a strong predictor of mortality in elderly dialysis patients. Because patients with lower nCI scores may predict better survival, more attention should paid to adequate dialysis rather than palliative care, especially in those without obvious functional impairments.Wei-Chih KanJhi-Joung WangShuo-Yu WangYih-Min SunChien-Ya HungChin-Chen ChuChin-Li LuShih-Feng WengChung-Ching ChioChih-Chiang ChienPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 8, p e68748 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wei-Chih Kan Jhi-Joung Wang Shuo-Yu Wang Yih-Min Sun Chien-Ya Hung Chin-Chen Chu Chin-Li Lu Shih-Feng Weng Chung-Ching Chio Chih-Chiang Chien The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
description	<h4>Background</h4>The worldwide elderly (≥ 65 years old) dialysis population has grown significantly. This population is expected to have more comorbid conditions and shorter life expectancies than the general elderly population. Predicting outcomes for this population is important for decision-making. Recently, a new comorbidity index (nCI) with good predictive value for patient outcomes was developed and validated in chronic dialysis patients regardless of age. Our study examined the nCI outcome predictability in elderly dialysis patients.<h4>Methods and findings</h4>For this population-based cohort study, we used Taiwan's National Health Insurance Research Database of enrolled elderly patients, who began maintenance dialysis between January 1999 and December 2005. A total of 21,043 incident dialysis patients were divided into 4 groups by nCI score (intervals ≤ 3, 4-6, 7-9, ≥ 10) and followed nearly for 10 years. All-cause mortality and life expectancy were analyzed. During the follow-up period, 11272 (53.55%) patients died. Kaplan-Meier curves showed significant group difference in survival (log-rank: P<0.001). After stratification by age, life expectancy was found to be significantly longer in groups with lower nCI scores.<h4>Conclusion</h4>The nCI, even without the age component, is a strong predictor of mortality in elderly dialysis patients. Because patients with lower nCI scores may predict better survival, more attention should paid to adequate dialysis rather than palliative care, especially in those without obvious functional impairments.
format	article
author	Wei-Chih Kan Jhi-Joung Wang Shuo-Yu Wang Yih-Min Sun Chien-Ya Hung Chin-Chen Chu Chin-Li Lu Shih-Feng Weng Chung-Ching Chio Chih-Chiang Chien
author_facet	Wei-Chih Kan Jhi-Joung Wang Shuo-Yu Wang Yih-Min Sun Chien-Ya Hung Chin-Chen Chu Chin-Li Lu Shih-Feng Weng Chung-Ching Chio Chih-Chiang Chien
author_sort	Wei-Chih Kan
title	The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
title_short	The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
title_full	The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
title_fullStr	The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
title_full_unstemmed	The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
title_sort	new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/fad535072c384e77ab2fb3e9250de462
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The new comorbidity index for predicting survival in elderly dialysis patients: a long-term population-based study.

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