Psychological, social, and somatic prognostic indicators in old patients undergoing long-term dialysis.
Psychological, social, and somatic prognostic indicators in old patients undergoing long-term dialysis.
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接受长期透析的老年患者的心理、社会和躯体预后指标。
DOI：
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发表时间：
1987
影响因子：
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通讯作者：
C. Kjellstrand
中科院分区：
文献类型：
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作者：
D. G. Husebye;L. Westlie;Thomas J. Styrvoky;C. Kjellstrand
我们前瞻性地研究了人口统计学、社会、心理和躯体因素对78例70岁以上长期透析患者生存的影响。前瞻性评估3年后，54%的患者死亡。只有四个因素，都是社会心理因素，对预后有重要影响。存活的患者在Karnofsky评分中得分较高（85分对78分），两次透析之间体重增加较少（1.5公斤对1.9公斤），更经常进行家庭透析（44%对21%），更不经常希望移植（28%对57%）。在逐步回归和多元回归分析中，家庭透析和Karnofsky量表的拟合效果最好。没有体细胞变量预测结果。三年后，31名患者再次接受了采访。当时，更多的患者患有抑郁症，收入较低，想要移植的人更少，有5人失去了活着的伴侣。自己做饭、在户外活动、去教堂或有业余爱好的患者数量有所减少。Karnofsky量表的活跃度从87分降至84分。家庭透析患者的健康感知从3.9分下降到3.4分。我们的研究表明，在接受透析的老年患者的生存中，社会心理变量（而非躯体变量）对预后有重要影响，并且在三年的随访期间，这些变量有明显的下降。
We prospectively studied the influence of 29 demographic, social, psychological, and somatic factors on survival of 78 patients over age 70 years receiving long-term dialysis. Three years after the prospective evaluation, 54% of the patients had died. Only four factors, all psychosocial, were prognostically important. The patients who survived rated higher on the Karnofsky scale (85 vs 78 points), gained less weight between dialyses (1.5 vs 1.9 kg), more often underwent home dialysis (44% vs 21%), and less often wished for transplantation (28% vs 57%). In stepwise and multiple regression analysis, home dialysis and Karnofsky scale resulted in best fit. No somatic variable predicted outcome. Thirty-one patients were reinterviewed three years later. At that time, more patients were depressed and had a lower income, fewer wanted a transplant, and five had lost their living companion. There was a decrease in the number of patients who cooked their own meals, spent time outdoors, went to church, or had hobbies. Activity on the Karnofsky scale decreased from 87 to 84 points. The home dialysis patients' perceived health decreased from 3.9 to 3.4 points. Our study shows that psychosocial, but not somatic variables, are prognostically important in survival of older patients undergoing dialysis, and there is a measurable decline in these variables during a three-year follow-up period.