Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.
Fukuoka Dental College, Fukuoka, Japan.
PLoS One. 2019 Mar 20;14(3):e0213922. doi: 10.1371/journal.pone.0213922. eCollection 2019.
Assessment of infection-related mortality remains inadequate in patients undergoing peritoneal dialysis. This study was performed to develop a risk model for predicting the 2-year infection-related mortality risk in patients undergoing peritoneal dialysis.
The study cohort comprised 606 patients who started and continued peritoneal dialysis for 90 at least days and was drawn from the Fukuoka Peritoneal Dialysis Database Registry Study in Japan. The patients were registered from 1 January 2006 to 31 December 2016 and followed up until 31 December 2017. To generate a prediction rule, the score for each variable was weighted by the regression coefficients calculated using a Cox proportional hazard model adjusted by risk factors for infection-related mortality, including patient characteristics, comorbidities, and laboratory data.
During the follow-up period (median, 2.2 years), 138 patients died; 58 of them of infectious disease. The final model for infection-related mortality comprises six factors: age, sex, serum albumin, serum creatinine, total cholesterol, and weekly renal Kt/V. The incidence of infection-related mortality increased linearly with increasing total risk score (P for trend <0.001). Furthermore, the prediction model showed adequate discrimination (c-statistic = 0.79 [0.72-0.86]) and calibration (Hosmer-Lemeshow test, P = 0.47).
In this study, we developed a new model using clinical measures for predicting infection-related mortality in patients undergoing peritoneal dialysis.
评估接受腹膜透析患者的感染相关死亡率仍然不够。本研究旨在开发一种风险模型，以预测接受腹膜透析患者的 2 年感染相关死亡率风险。
研究队列包括 606 名患者，他们至少开始并继续接受腹膜透析 90 天，并从日本福冈腹膜透析数据库登记研究中抽取。患者于 2006 年 1 月 1 日至 2016 年 12 月 31 日登记，并随访至 2017 年 12 月 31 日。为了生成预测规则，通过使用 Cox 比例风险模型计算的回归系数对每个变量的分数进行加权，该模型调整了感染相关死亡率的危险因素，包括患者特征、合并症和实验室数据。
在随访期间（中位数为 2.2 年），138 名患者死亡；其中 58 人死于传染病。感染相关死亡率的最终模型包括六个因素：年龄、性别、血清白蛋白、血清肌酐、总胆固醇和每周肾脏 Kt/V。感染相关死亡率的发生率随总风险评分的增加呈线性增加（趋势 P<0.001）。此外，预测模型显示出良好的区分度（c 统计量=0.79[0.72-0.86]）和校准（Hosmer-Lemeshow 检验，P=0.47）。
在这项研究中，我们使用临床措施开发了一种新模型，用于预测接受腹膜透析患者的感染相关死亡率。
