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Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services

Background: Frailty is an aging-associated state of increased vulnerability, which raises the risk of adverse outcomes. Chronic kidney disease is associated with higher prevalence of frailty. Our aim was to estimate frailty prevalence in a hemodialysis population and its influence on short-term outc...

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Autores principales: Garcia-Canton, Cesar, Rodenas, Ana, Lopez-Aperador, Celia, Rivero, Yaiza, Anton, Gloria, Monzon, Tania, Diaz, Noa, Vega, Nicanor, Loro, Juan F., Santana, Angelo, Esparza, Noemi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598473/
https://www.ncbi.nlm.nih.gov/pubmed/31234684
http://dx.doi.org/10.1080/0886022X.2019.1628061
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author Garcia-Canton, Cesar
Rodenas, Ana
Lopez-Aperador, Celia
Rivero, Yaiza
Anton, Gloria
Monzon, Tania
Diaz, Noa
Vega, Nicanor
Loro, Juan F.
Santana, Angelo
Esparza, Noemi
author_facet Garcia-Canton, Cesar
Rodenas, Ana
Lopez-Aperador, Celia
Rivero, Yaiza
Anton, Gloria
Monzon, Tania
Diaz, Noa
Vega, Nicanor
Loro, Juan F.
Santana, Angelo
Esparza, Noemi
author_sort Garcia-Canton, Cesar
collection PubMed
description Background: Frailty is an aging-associated state of increased vulnerability, which raises the risk of adverse outcomes. Chronic kidney disease is associated with higher prevalence of frailty. Our aim was to estimate frailty prevalence in a hemodialysis population and its influence on short-term outcomes. Design: Observational prospective longitudinal study of 277 prevalent hemodialysis patients. Frailty was estimated through the Edmonton Frail Scale (EFS). Demographic and clinical data, comorbidity index, and laboratory parameters were recorded. A 29-month follow-up was conducted on mortality, including hospitalization, and visits to hospital emergency services in the first 12 months of this period. Results: According to the EFS, 82 patients (29.6%) were frail, 53 (19.1%) were vulnerable, and 142 (51.3%) were non-frail. During follow-up, 58.5% frail patients, 30.2% vulnerable, and 16.2% non-frail ones died (p < .005). In the analysis of survival using an adjusted Cox model, a higher hazard of mortality was observed in frail than in non-frail patients (HR 2.34; 95% CI 1.39–3.95; p = .001). During follow-up the hospitalization rate was 852 episodes/1000 patient-years for frail patients, 784 episodes/1000 patient-years for vulnerable patients, and 417 episodes/1000 patient-years for non-frail patients (p = .0005). The incidence ratio of visits to emergency services was 3216, 1735, and 1545 visits/1000 patient-years for each group (p < .001). Conclusions: Hemodialysis patients present high frailty prevalence. Frailty is associated with poor short-term outcomes and higher rates of mortality, visits to hospital emergency services, and hospitalization.
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spelling pubmed-65984732019-07-03 Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services Garcia-Canton, Cesar Rodenas, Ana Lopez-Aperador, Celia Rivero, Yaiza Anton, Gloria Monzon, Tania Diaz, Noa Vega, Nicanor Loro, Juan F. Santana, Angelo Esparza, Noemi Ren Fail Clinical Study Background: Frailty is an aging-associated state of increased vulnerability, which raises the risk of adverse outcomes. Chronic kidney disease is associated with higher prevalence of frailty. Our aim was to estimate frailty prevalence in a hemodialysis population and its influence on short-term outcomes. Design: Observational prospective longitudinal study of 277 prevalent hemodialysis patients. Frailty was estimated through the Edmonton Frail Scale (EFS). Demographic and clinical data, comorbidity index, and laboratory parameters were recorded. A 29-month follow-up was conducted on mortality, including hospitalization, and visits to hospital emergency services in the first 12 months of this period. Results: According to the EFS, 82 patients (29.6%) were frail, 53 (19.1%) were vulnerable, and 142 (51.3%) were non-frail. During follow-up, 58.5% frail patients, 30.2% vulnerable, and 16.2% non-frail ones died (p < .005). In the analysis of survival using an adjusted Cox model, a higher hazard of mortality was observed in frail than in non-frail patients (HR 2.34; 95% CI 1.39–3.95; p = .001). During follow-up the hospitalization rate was 852 episodes/1000 patient-years for frail patients, 784 episodes/1000 patient-years for vulnerable patients, and 417 episodes/1000 patient-years for non-frail patients (p = .0005). The incidence ratio of visits to emergency services was 3216, 1735, and 1545 visits/1000 patient-years for each group (p < .001). Conclusions: Hemodialysis patients present high frailty prevalence. Frailty is associated with poor short-term outcomes and higher rates of mortality, visits to hospital emergency services, and hospitalization. Taylor & Francis 2019-06-25 /pmc/articles/PMC6598473/ /pubmed/31234684 http://dx.doi.org/10.1080/0886022X.2019.1628061 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Garcia-Canton, Cesar
Rodenas, Ana
Lopez-Aperador, Celia
Rivero, Yaiza
Anton, Gloria
Monzon, Tania
Diaz, Noa
Vega, Nicanor
Loro, Juan F.
Santana, Angelo
Esparza, Noemi
Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title_full Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title_fullStr Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title_full_unstemmed Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title_short Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
title_sort frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598473/
https://www.ncbi.nlm.nih.gov/pubmed/31234684
http://dx.doi.org/10.1080/0886022X.2019.1628061
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