FUNCTIONAL STATUS AND QUALITY-OF-LIFE - PREDICTORS OF EARLY MORTALITY AMONG PATIENTS ENTERING TREATMENT FOR END STAGE RENAL-DISEASE
FUNCTIONAL STATUS AND QUALITY-OF-LIFE - PREDICTORS OF EARLY MORTALITY AMONG PATIENTS ENTERING TREATMENT FOR END STAGE RENAL-DISEASE
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DOI：
10.1016/0895-4356(91)90204-m
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发表时间：
1991-01-01
影响因子：
7.2
通讯作者：
TUTTLE, E
中科院分区：
文献类型：
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作者：
MCCLELLAN, WM;ANSON, C;TUTTLE, E
我们调查了新入院的透析患者的功能状态和生活质量以及随后死亡风险之间的关系。我们从东南部两个州(n=294)的37个透析机构招募患者。采用卡诺夫斯基功能评定量表(KPS)评定功能状态，斯皮策生活质量指数(SQLI)评定生活质量。在平均479.6(109.4)天的随访期内，49名患者(16.4%)死亡。存活患者的KPS评分(SE)为7.31(0.11)，死亡患者为5.89(0.26)，P<；0.0001。存活患者的平均生活质量指数为6.74(0.15)，死亡患者为4.95(0.28)，P<；0.0001。在这两项测量中，死亡风险都有很强的梯度。在控制了其他协变量，包括年龄、种族、性别、肾功能衰竭的主要原因和合并症的存在后，KPS和SQLI评分都与死亡风险独立相关。我们得出结论，功能状态和生活质量是新透析患者随后死亡的强烈独立危险因素。这些是易于测量的指标，可以用来预测随后的死亡风险或调整病例组合估计，以便在透析人群之间进行比较。
We investigated the association between functional status and quality of life is newly-entered dialysis patients and the subsequent risk of mortality. We enrolled the patients from 37 dialysis facilities in two southeastern states (n = 294). Functional status was assessed by the Karnofsky Performance Scale (KPS) and quality of life by the Spitzer Quality of Life Index (SQLI). During a mean (SE) follow-up of 479.6 (109.4) day 49 patients (16.4%) of the cohort died. The mean KPS score (SE) for survivors was 7.31 (0.11) and for non-survivors was 5.89 (0.26), P < 0.0001. The mean SQLI score (SE) for survivors was 6.74 (0.15) and non-survivors was 4.95 (0.28), P < 0.0001. Strong gradients of the risk of mortality were found for both measurements. After controlling for other covariates including age, race, sex, primary cause of renal failure and the presence of comorbidity, both the KPS and SQLI scores were independently correlated with risk of mortality.We conclude that functional status and quality of life are strong independent risk factors for subsequent mortality in new dialysis patients. These are easily measured indicators which may serve to predict subsequent risk of mortality or adjust case-mix estimates for comparisons between dialysis populations.