A simple risk score predicts poor quality of life and non-survival at 1 year follow-up in dialysis patients.
BACKGROUND
Quality of life (QoL) in end-stage renal disease patients has become an important focus of attention in evaluating dialysis. We studied risk factors of poor QoL at 1 year follow-up.


METHODS
Of a baseline sample of 80 dialysis patients, we contacted 60 patients who were alive at 1 year follow-up. QoL data were obtained for 46 (76.7%) of these patients. QoL measured with the SF-36 [physical health component score (PCS) and mental health component score (MCS)] at 1 year-follow-up was predicted by means of multivariate regression analysis by data collected at baseline using INTERMED-an observer-rated method to assess biopsychosocial care needs-and several indicators for disease severity and comorbidity.


RESULTS
The regression models explained 32% of the variance in PCS and 40% in MCS. INTERMED score (P < 0.01) was the only independent risk factor for low MCS, while for low PCS, diabetic comorbidity (P = 0.02) and age (P = 0.03) were independent risk factors. A simple risk score consisting of INTERMED > or =21, diabetic comorbidity and age > or =65 was significantly correlated with non-survival (P = 0.02) and with PCS (P < 0.01) and MCS (P < 0.01) in surviving patients, although not with hospital admissions during follow-up.


CONCLUSIONS
A simple risk score based on INTERMED, age (> or =65) and comorbid diabetes (yes/no) can be used to detect patients at risk of poor QoL and non-survival at an early stage of treatment.
de Jonge
Peter
P
Department of Psychiatry, University of Groningen, Hanzeplein 1 Gebouw 32, Postbus 30001, 9700 RB Groningen, The Netherlands. p.de.jonge@med.rug.nl
Ruinemans
G Maarten-Friso
GM
Huyse
Frits J
FJ
ter Wee
Piet M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D006435:Renal Dialysis / Q000401:mortality*; D016019:Survival Analysis