Advanced search
1 file | 306.99 KB

Association between changes in quality of life and mortality in hemodialysis patients : results from the DOPPS

Author
Organization
Abstract
Background: Cross-sectional health-related quality of life (HRQOL) measures are associated with mortality in hemodialysis (HD) patients. The impact of changes in HR-QOL on outcomes remains unclear. We describe the association of prior changes in HR-QOL with subsequent mortality among HD patients. Methods: A total of 13 784 patients in the Dialysis Outcomes and Practice Patterns Study had more than one measurement of HR-QOL. The impact of changes between two measurements of the physical (PCS) and mental (MCS) component summary scores of the SF-12 on mortality was estimated with Cox regression. Results: Mean age was 62 years (standard deviation: 14 years); 59% were male and 32% diabetic. Median time between HRQOL measurements was 12 months [interquartile range (IQR): 11, 14]. Median initial PCS and MCS scores were 37.5 (IQR: 29.4, 46.2) and 46.4 (IQR: 37.2, 54.9); median changes in PCS and MCS scores were -0.2 (IQR: -5.5, 4.7) and -0.1 (IQR: -6.8, 5.9), respectively. The adjusted hazard ratio (HR) for a 5-point decline in HR-QOL score was 1.09 [95% confidence interval (CI): 1.06-1.12] for PCS and 1.05 (95% CI: 1.03-1.08) for MCS. Adjusting for the second QOL score, the change was not associated with mortality: HR = 1.01 (95% CI: 0.98-1.05) for delta PCS and 1.01 (95% CI: 0.98-1.03) for delta MCS. Categorizing the first and second scores as predictors, only the second PCS orMCS score was associated with mortality. Conclusions: In our study, only the most recent HR-QOL score was associated with mortality. Hence, the predictive power of a measurement of HR-QOL is not affected by changes in HRQOL prior to thatmeasurement; more frequent HR-QOLmeasurements are needed to improve the prediction of outcomes in HD. Further studies are needed to determine the optimal frequency and appropriate instrument to be used for serial measurements.
Keywords
Dialysis Outcomes Practice Patterns Study, hemo-dialysis, quality of life, survival, STAGE RENAL-DISEASE, CHRONIC PERITONEAL-DIALYSIS, PRACTICE PATTERNS, DEPRESSION, OUTCOMES, HOSPITALIZATION, PREDICTOR, DIAGNOSIS, SURVIVAL, FAILURE

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 306.99 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Perl, Jeffrey, Angelo Karaboyas, Hal Morgenstern, Ananda Sen, Hugh C Rayner, Raymond Vanholder, Christian Combe, et al. 2017. “Association Between Changes in Quality of Life and Mortality in Hemodialysis Patients : Results from the DOPPS.” Nephrology Dialysis Transplantation 32 (3): 521–527.
APA
Perl, Jeffrey, Karaboyas, A., Morgenstern, H., Sen, A., Rayner, H. C., Vanholder, R., Combe, C., et al. (2017). Association between changes in quality of life and mortality in hemodialysis patients : results from the DOPPS. NEPHROLOGY DIALYSIS TRANSPLANTATION, 32(3), 521–527.
Vancouver
1.
Perl J, Karaboyas A, Morgenstern H, Sen A, Rayner HC, Vanholder R, et al. Association between changes in quality of life and mortality in hemodialysis patients : results from the DOPPS. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2017;32(3):521–7.
MLA
Perl, Jeffrey, Angelo Karaboyas, Hal Morgenstern, et al. “Association Between Changes in Quality of Life and Mortality in Hemodialysis Patients : Results from the DOPPS.” NEPHROLOGY DIALYSIS TRANSPLANTATION 32.3 (2017): 521–527. Print.
@article{8502635,
  abstract     = {Background: Cross-sectional health-related quality of life (HRQOL) measures are associated with mortality in hemodialysis (HD) patients. The impact of changes in HR-QOL on outcomes remains unclear. We describe the association of prior changes in HR-QOL with subsequent mortality among HD patients. 
Methods: A total of 13 784 patients in the Dialysis Outcomes and Practice Patterns Study had more than one measurement of HR-QOL. The impact of changes between two measurements of the physical (PCS) and mental (MCS) component summary scores of the SF-12 on mortality was estimated with Cox regression. 
Results: Mean age was 62 years (standard deviation: 14 years); 59\% were male and 32\% diabetic. Median time between HRQOL measurements was 12 months [interquartile range (IQR): 11, 14]. Median initial PCS and MCS scores were 37.5 (IQR: 29.4, 46.2) and 46.4 (IQR: 37.2, 54.9); median changes in PCS and MCS scores were -0.2 (IQR: -5.5, 4.7) and -0.1 (IQR: -6.8, 5.9), respectively. The adjusted hazard ratio (HR) for a 5-point decline in HR-QOL score was 1.09 [95\% confidence interval (CI): 1.06-1.12] for PCS and 1.05 (95\% CI: 1.03-1.08) for MCS. Adjusting for the second QOL score, the change was not associated with mortality: HR = 1.01 (95\% CI: 0.98-1.05) for delta PCS and 1.01 (95\% CI: 0.98-1.03) for delta MCS. Categorizing the first and second scores as predictors, only the second PCS orMCS score was associated with mortality. 
Conclusions: In our study, only the most recent HR-QOL score was associated with mortality. Hence, the predictive power of a measurement of HR-QOL is not affected by changes in HRQOL prior to thatmeasurement; more frequent HR-QOLmeasurements are needed to improve the prediction of outcomes in HD. Further studies are needed to determine the optimal frequency and appropriate instrument to be used for serial measurements.},
  author       = {Perl, Jeffrey and Karaboyas, Angelo and Morgenstern, Hal and Sen, Ananda and Rayner, Hugh C and Vanholder, Raymond and Combe, Christian and Hasegawa, Takeshi and Finkelstein, Fredric O and Lopes, Antonio A and Robinson, Bruce M and Pisoni, Ronald L and Tentori, Francesca},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {Dialysis Outcomes Practice Patterns Study,hemo-dialysis,quality of life,survival,STAGE RENAL-DISEASE,CHRONIC PERITONEAL-DIALYSIS,PRACTICE PATTERNS,DEPRESSION,OUTCOMES,HOSPITALIZATION,PREDICTOR,DIAGNOSIS,SURVIVAL,FAILURE},
  language     = {eng},
  number       = {3},
  pages        = {521--527},
  title        = {Association between changes in quality of life and mortality in hemodialysis patients : results from the DOPPS},
  url          = {http://dx.doi.org/10.1093/ndt/gfw233},
  volume       = {32},
  year         = {2017},
}

Altmetric
View in Altmetric
Web of Science
Times cited: