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Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education
BACKGROUND: The incidence of chronic kidney disease (CKD) is rising and is likely to continue to do so for the foreseeable future, with the fastest growth seen among adults ≥75 years of age. Elderly patients with advanced CKD are likely to have a higher burden of comorbidity and frailty, both of whi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792625/ https://www.ncbi.nlm.nih.gov/pubmed/26985387 http://dx.doi.org/10.1093/ckj/sfv150 |
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author | Pugh, Julia Aggett, Justine Goodland, Annwen Prichard, Alison Thomas, Nerys Donovan, Kieron Roberts, Gareth |
author_facet | Pugh, Julia Aggett, Justine Goodland, Annwen Prichard, Alison Thomas, Nerys Donovan, Kieron Roberts, Gareth |
author_sort | Pugh, Julia |
collection | PubMed |
description | BACKGROUND: The incidence of chronic kidney disease (CKD) is rising and is likely to continue to do so for the foreseeable future, with the fastest growth seen among adults ≥75 years of age. Elderly patients with advanced CKD are likely to have a higher burden of comorbidity and frailty, both of which may influence their disease outcome. For these patients, treatment decisions can be complex, with the current lack of robust prognostic tools hindering the shared decision-making process. The current study aims to assess the impact of comorbidity and frailty on the outcomes of patients referred for pre-dialysis education. METHODS: We performed a single-centre study of patients (n = 283) referred for pre-dialysis education between 2010 and 2012. The Charlson Comorbidity Index (CCI) and Clinical Frailty Scale (CFS) were used to assess comorbid disease burden and frailty, respectively. Follow-up data were collected until February 2015. RESULTS: The CCI and CFS scores at the time of referral to the pre-dialysis service were independent predictors of mortality. Within the study follow-up period, 76% of patients with a high CFS score at the time of pre-dialysis education had died, with 63% of these patients not commencing dialysis before death. CONCLUSION: A relatively simple frailty scale and comorbidity score could be used to predict survival and better inform the shared decision-making process for patients with advanced kidney disease. |
format | Online Article Text |
id | pubmed-4792625 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-47926252016-03-16 Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education Pugh, Julia Aggett, Justine Goodland, Annwen Prichard, Alison Thomas, Nerys Donovan, Kieron Roberts, Gareth Clin Kidney J Education BACKGROUND: The incidence of chronic kidney disease (CKD) is rising and is likely to continue to do so for the foreseeable future, with the fastest growth seen among adults ≥75 years of age. Elderly patients with advanced CKD are likely to have a higher burden of comorbidity and frailty, both of which may influence their disease outcome. For these patients, treatment decisions can be complex, with the current lack of robust prognostic tools hindering the shared decision-making process. The current study aims to assess the impact of comorbidity and frailty on the outcomes of patients referred for pre-dialysis education. METHODS: We performed a single-centre study of patients (n = 283) referred for pre-dialysis education between 2010 and 2012. The Charlson Comorbidity Index (CCI) and Clinical Frailty Scale (CFS) were used to assess comorbid disease burden and frailty, respectively. Follow-up data were collected until February 2015. RESULTS: The CCI and CFS scores at the time of referral to the pre-dialysis service were independent predictors of mortality. Within the study follow-up period, 76% of patients with a high CFS score at the time of pre-dialysis education had died, with 63% of these patients not commencing dialysis before death. CONCLUSION: A relatively simple frailty scale and comorbidity score could be used to predict survival and better inform the shared decision-making process for patients with advanced kidney disease. Oxford University Press 2016-04 2016-01-29 /pmc/articles/PMC4792625/ /pubmed/26985387 http://dx.doi.org/10.1093/ckj/sfv150 Text en © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Education Pugh, Julia Aggett, Justine Goodland, Annwen Prichard, Alison Thomas, Nerys Donovan, Kieron Roberts, Gareth Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title | Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title_full | Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title_fullStr | Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title_full_unstemmed | Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title_short | Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
title_sort | frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education |
topic | Education |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792625/ https://www.ncbi.nlm.nih.gov/pubmed/26985387 http://dx.doi.org/10.1093/ckj/sfv150 |
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