Un nuovo fenotipo di pazienti in dialisi è diventato attuale. Ruolo dei componenti della fragilità sulla qualità di vita in questa popolazione: studio trasversale

Abstract

Most of dialysis patients present components of frailty: comorbidities, disabilities, dependence, malnutrition, cognitive impairment, and poor social conditions. Frailty is suspected to affect the quality of life (QoL) of dialysis patients. This study aims to evaluate this relation. Little is available in the Literature on this topic. We enrolled 203 out of 233 prevalent dialysis patients in the Trieste area. We administered to them the Short-Form 36 (SF-36) questionnaire, applied Activities of Daily Living, Instrumental Activities of Daily Living, Subjective Global Assessment scales, Karnofsky Index, and analyzed their social conditions. Patients (126 males) had a mean age of 72.03+11.9 years, and a dialytic age of 42.6+55.6 months. The physical component of QoL (39.3+10.4) is more compromised than the mental one that is 48.5+8.6 (0–100 scale). Dependence (p<0.001), malnutrition (p=0.001) and disability (p=0.005) had a negative role on many domains of SF-36. Linear regression analysis excluded comorbidities, even significant at an univariate analysis (data adjusted for gender, age and age in dialysis). Living with family (p=0.002), good economic conditions (p=0.01), and, above all, social relationships (p<0.001) were significantly related with a better QoL (test ANOVA). Constant screening of patients, nutritional and functional rehabilitation, prevention of social isolation through social and health services are indispensable to guarantee a satisfactory QoL. (sian) (nursing)