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Journal of Nursing ›› 2018, Vol. 25 ›› Issue (20): 37-41.doi: 10.16460/j.issn1008-9969.2018.20.037

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Prevalence of Frailty in Patients with Maintenance Hemodialysis and Its Effect on Prognosis

DU Lan-yu1, HU Xia2, WANG Xiang-hong3, LIU Hai-na1, REN Lei1, ZHU Xiao-xiu1, DUAN You-ping1   

  1. 1. Blood Purification Center, The First People's Hospital of Zhumadian, Zhumadian 463000, China;
    2. Blood Purification Center, the Central Hospital of Zhumadian, Zhumadian 463000,China;
    3. Blood Purification Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China
  • Received:2018-08-10 Published:2020-07-06

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Abstract: Objective To investigate the prevalence of frailty among maintenance hemodialysis (MHD) patients,and the effect of frailty on the prognosis. Methods A total of 425 MHD inpatients from two tertiary grade A hospitals between May 2010 and April 2013 was assessed using a frailty phenotype(FP). All of them were followed up for 5 years to observe the occurrence of all-cause mortality. Results (1) Clinical data of 380 patients were analyzed. The mean FP score was 2.33±1.53. The prevalence of frailty, pre-frailty and non-frailty were 44.2%, 42.1% and 13.7% respectively. The cumulative survival rate of 5 years in frailty, pre-frailty and non-frailty patients was 38.0%, 82.5% and 90.4% respectively（P<0.001）. (2) FP score was an independent predictor for 5-year survival rate in MHD inpatients after adjustment of age, albumin(ALB), C-reactive protein(CRP), Charlson comorbidity index(CCI) and estimated glomerular filtration rate(eGFR) （HR=1.311, P<0.001）. (3) The area under receiver operating characteristic (ROC) curves (AUC) of FP score which was used to predict the mortality of MHD patients for 5-year survival rate was 0.805, and when compared that with the random areas of 0.5, the difference was statistically significant (P<0.001). When the cut off value of FP score was 2.5 (Youden index was the biggest),the sensitivity,specificity and concordance rate were 0.757, 0.738 and 74.5%, respectively. Conclusion The prevalence of frailty in MHD patients is high. Frailty is an independent risk factor on the prognosis in MHD patients and FP score can provide valuable information for predicting the prognosis. It is suggested that frailty screening,assessment and intervention should be implemented in the management of MHD patients,which may improve the prognosis maximally.

Key words: maintenance hemodialysis, frailty, prognosis, management

CLC Number: 

  • R473.5
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