Abstract
BackgroundThe worldwide elderly (≥65 years old) dialysis population has grown significantly. This population is expected to have more comorbid conditions and shorter life expectancies than the general elderly population. Predicting outcomes for this population is important for decision-making. Recently, a new comorbidity index (nCI) with good predictive value for patient outcomes was developed and validated in chronic dialysis patients regardless of age. Our study examined the nCI outcome predictability in elderly dialysis patients.Methods and FindingsFor this population-based cohort study, we used Taiwan's National Health Insurance Research Database of enrolled elderly patients, who began maintenance dialysis between January 1999 and December 2005. A total of 21,043 incident dialysis patients were divided into 4 groups by nCI score (intervals ≤3, 4–6, 7–9, ≥10) and followed nearly for 10 years. All-cause mortality and life expectancy were analyzed. During the follow-up period, 11272 (53.55%) patients died. Kaplan-Meier curves showed significant group difference in survival (log-rank: P<0.001). After stratification by age, life expectancy was found to be significantly longer in groups with lower nCI scores.ConclusionThe nCI, even without the age component, is a strong predictor of mortality in elderly dialysis patients. Because patients with lower nCI scores may predict better survival, more attention should paid to adequate dialysis rather than palliative care, especially in those without obvious functional impairments.
Highlights
The worldwide dialysis population is growing considerably, and its mortality rate is much higher than that of the general population [1]
Because patients with lower new comorbidity index (nCI) scores may predict better survival, more attention should paid to adequate dialysis rather than palliative care, especially in those without obvious functional impairments
Dialysis patients have a high prevalence of comorbidities, including atherosclerotic cardiovascular disease (ACVD), congestive heart failure (CHF), hypertension (HTN), diabetes mellitus (DM), and cognitive and functional impairment, which in itself is often one of the risk factors for mortality [1,2]
Summary
The worldwide dialysis population is growing considerably, and its mortality rate is much higher than that of the general population [1]. Elderly ($65 years old) patients have been the most rapidly rising age group in the dialysis population in many developed and developing countries [1]. Because this population has always been known to have multiple comorbid illnesses and a higher mortality rate than the general population, palliative care has always been considered the primary means of treating them [5]. The worldwide elderly ($65 years old) dialysis population has grown significantly This population is expected to have more comorbid conditions and shorter life expectancies than the general elderly population. Our study examined the nCI outcome predictability in elderly dialysis patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
