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Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients
BACKGROUND: Among aging hemodialysis patients, loss of physical function has become a major issue. We developed and validated a model of predicting loss of physical function among elderly hemodialysis patients. METHODS: We conducted a cohort study involving maintenance hemodialysis patients ≥65 yea...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070092/ https://www.ncbi.nlm.nih.gov/pubmed/28992129 http://dx.doi.org/10.1093/ndt/gfx260 |
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author | Fukuma, Shingo Shimizu, Sayaka Shintani, Ayumi Kamitani, Tsukasa Akizawa, Tadao Fukuhara, Shunichi |
author_facet | Fukuma, Shingo Shimizu, Sayaka Shintani, Ayumi Kamitani, Tsukasa Akizawa, Tadao Fukuhara, Shunichi |
author_sort | Fukuma, Shingo |
collection | PubMed |
description | BACKGROUND: Among aging hemodialysis patients, loss of physical function has become a major issue. We developed and validated a model of predicting loss of physical function among elderly hemodialysis patients. METHODS: We conducted a cohort study involving maintenance hemodialysis patients ≥65 years of age from the Dialysis Outcomes and Practice Pattern Study in Japan. The derivation cohort included 593 early phase (1996–2004) patients and the temporal validation cohort included 447 late-phase (2005–12) patients. The main outcome was the incidence of loss of physical function, defined as the 12-item Short Form Health Survey physical function score decreasing to 0 within a year. Using backward stepwise logistic regression by Akaike’s Information Criteria, six predictors (age, gender, dementia, mental health, moderate activity and ascending stairs) were selected for the final model. Points were assigned based on the regression coefficients and the total score was calculated by summing the points for each predictor. RESULTS: In total, 65 (11.0%) and 53 (11.9%) hemodialysis patients lost their physical function within 1 year in the derivation and validation cohorts, respectively. This model has good predictive performance quantified by both discrimination and calibration. The proportion of the loss of physical function increased sequentially through low-, middle-, and high-score categories based on the model (2.5%, 11.7% and 22.3% in the validation cohort, respectively). The loss of physical function was strongly associated with 1-year mortality [adjusted odds ratio 2.48 (95% confidence interval 1.26–4.91)]. CONCLUSIONS: We developed and validated a risk prediction model with good predictive performance for loss of physical function in elderly hemodialysis patients. Our simple prediction model may help physicians and patients make more informed decisions for healthy longevity. |
format | Online Article Text |
id | pubmed-6070092 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-60700922018-08-09 Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients Fukuma, Shingo Shimizu, Sayaka Shintani, Ayumi Kamitani, Tsukasa Akizawa, Tadao Fukuhara, Shunichi Nephrol Dial Transplant Original Articles BACKGROUND: Among aging hemodialysis patients, loss of physical function has become a major issue. We developed and validated a model of predicting loss of physical function among elderly hemodialysis patients. METHODS: We conducted a cohort study involving maintenance hemodialysis patients ≥65 years of age from the Dialysis Outcomes and Practice Pattern Study in Japan. The derivation cohort included 593 early phase (1996–2004) patients and the temporal validation cohort included 447 late-phase (2005–12) patients. The main outcome was the incidence of loss of physical function, defined as the 12-item Short Form Health Survey physical function score decreasing to 0 within a year. Using backward stepwise logistic regression by Akaike’s Information Criteria, six predictors (age, gender, dementia, mental health, moderate activity and ascending stairs) were selected for the final model. Points were assigned based on the regression coefficients and the total score was calculated by summing the points for each predictor. RESULTS: In total, 65 (11.0%) and 53 (11.9%) hemodialysis patients lost their physical function within 1 year in the derivation and validation cohorts, respectively. This model has good predictive performance quantified by both discrimination and calibration. The proportion of the loss of physical function increased sequentially through low-, middle-, and high-score categories based on the model (2.5%, 11.7% and 22.3% in the validation cohort, respectively). The loss of physical function was strongly associated with 1-year mortality [adjusted odds ratio 2.48 (95% confidence interval 1.26–4.91)]. CONCLUSIONS: We developed and validated a risk prediction model with good predictive performance for loss of physical function in elderly hemodialysis patients. Our simple prediction model may help physicians and patients make more informed decisions for healthy longevity. Oxford University Press 2018-08 2017-09-05 /pmc/articles/PMC6070092/ /pubmed/28992129 http://dx.doi.org/10.1093/ndt/gfx260 Text en © The Author 2017. 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 | Original Articles Fukuma, Shingo Shimizu, Sayaka Shintani, Ayumi Kamitani, Tsukasa Akizawa, Tadao Fukuhara, Shunichi Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title | Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title_full | Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title_fullStr | Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title_full_unstemmed | Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title_short | Development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
title_sort | development and validation of a prediction model for loss of physical function in elderly hemodialysis patients |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070092/ https://www.ncbi.nlm.nih.gov/pubmed/28992129 http://dx.doi.org/10.1093/ndt/gfx260 |
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