TY - JOUR
T1 - Association between a self-rated health question and mortality in young and old dialysis patients: a cohort study
AU - Thong, Melissa S. Y.
AU - Kaptein, Adrian A.
AU - Benyamini, Yael
AU - Krediet, Raymond T.
AU - Boeschoten, Elisabeth W.
AU - Dekker, Friedo W.
AU - AUTHOR GROUP
AU - Apperloo, A. J.
AU - Bijlsma, J. A.
AU - Boekhout, M.
AU - Boer, W. H.
AU - van der Boog, P. J. M.
AU - Büller, H. R.
AU - van Buren, M.
AU - de Charro, F. Th
AU - Doorenbos, C. J.
AU - van den Dorpel, M. A.
AU - van Es, A.
AU - Fagel, W. J.
AU - Feith, G. W.
AU - de Fijter, C. W. H.
AU - Frenken, L. A. M.
AU - Grave, W.
AU - van Geelen, J. A. C. A.
AU - Gerlag, P. G. G.
AU - Gorgels, J. P. M. C.
AU - Huisman, R. M.
AU - Jager, K. J.
AU - Jie, K.
AU - Koning-Mulder, W. A. H.
AU - Koolen, M. I.
AU - Kremer Hovinga, T. K.
AU - Lavrijssen, A. T. J.
AU - Luik, A. J.
AU - van der Meulen, J.
AU - Parlevliet, K. J.
AU - Raasveld, M. H. M.
AU - van der Sande, F. M.
AU - Schonck, M. J. M.
AU - Schuurmans, M. M. J.
AU - Siegert, C. E. H.
AU - Stegeman, C. A.
AU - Stevens, P.
AU - Thijssen, J. G. P.
AU - Valentijn, R. M.
AU - Vastenburg, G. H.
AU - Verburgh, C. A.
AU - Vincent, H. H.
AU - Vos, P. F.
PY - 2008
Y1 - 2008
N2 - BACKGROUND: Self-rated health (SRH) has been shown to predict mortality in large community-based studies; however, large clinical-based studies of this topic are rare. We assessed whether an SRH item predicts mortality in a large sample of incident dialysis patients beyond sociodemographic, disease, and clinical measures and possible age interaction. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 1,443 predominantly white patients from 38 dialysis centers in The Netherlands participating in the Netherlands Cooperative Study on the Adequacy of Dialysis-2 between 1997 and 2004. PREDICTOR: SRH score completed at 3 months after the start of dialysis therapy (baseline). OUTCOMES & MEASUREMENTS: Cox proportional hazards model estimated the association between SRH and all-cause mortality. Interaction of SRH with age ( <65 and >/=65 years) was examined in an additive model. RESULTS: Mean age of patients was 59.6 +/- 14.8 years, with 61% men and 69% married/living together. Mean follow-up was 2.7 +/- 1.8 years. Deaths per SRH group in the multivariate analyses sample: excellent/very good (9 of 63 patients; 14.3%), good (148 of 473 patients; 31.3%), fair (194 of 508 patients; 38.2%), and poor (45 of 71 patients; 63.4%). Patients with poor, fair, or good health ratings had a greater mortality risk than those with excellent/very good health ratings (adjusted hazard ratio [HR(adj)], 3.56; 95% confidence interval [CI], 1.71 to 7.42; HR(adj), 2.09; 95% CI, 1.06 to 4.12; HR(adj), 1.87; 95% CI, 0.95 to 3.70, respectively) independent of a range of risk factors. No age interaction with SRH was found. LIMITATIONS: Although the SRH-mortality association remained strong despite extensive adjustments, unknown residual confounding could still exist. CONCLUSION: SRH is an independent predictor of mortality in incident dialysis patients. Patients with poor SRH in both age strata had a significantly increased risk of mortality even after controlling for demographic and clinical confounders. Patient self-assessment of health can be an invaluable and economical complement to clinical measures in risk assessment
AB - BACKGROUND: Self-rated health (SRH) has been shown to predict mortality in large community-based studies; however, large clinical-based studies of this topic are rare. We assessed whether an SRH item predicts mortality in a large sample of incident dialysis patients beyond sociodemographic, disease, and clinical measures and possible age interaction. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 1,443 predominantly white patients from 38 dialysis centers in The Netherlands participating in the Netherlands Cooperative Study on the Adequacy of Dialysis-2 between 1997 and 2004. PREDICTOR: SRH score completed at 3 months after the start of dialysis therapy (baseline). OUTCOMES & MEASUREMENTS: Cox proportional hazards model estimated the association between SRH and all-cause mortality. Interaction of SRH with age ( <65 and >/=65 years) was examined in an additive model. RESULTS: Mean age of patients was 59.6 +/- 14.8 years, with 61% men and 69% married/living together. Mean follow-up was 2.7 +/- 1.8 years. Deaths per SRH group in the multivariate analyses sample: excellent/very good (9 of 63 patients; 14.3%), good (148 of 473 patients; 31.3%), fair (194 of 508 patients; 38.2%), and poor (45 of 71 patients; 63.4%). Patients with poor, fair, or good health ratings had a greater mortality risk than those with excellent/very good health ratings (adjusted hazard ratio [HR(adj)], 3.56; 95% confidence interval [CI], 1.71 to 7.42; HR(adj), 2.09; 95% CI, 1.06 to 4.12; HR(adj), 1.87; 95% CI, 0.95 to 3.70, respectively) independent of a range of risk factors. No age interaction with SRH was found. LIMITATIONS: Although the SRH-mortality association remained strong despite extensive adjustments, unknown residual confounding could still exist. CONCLUSION: SRH is an independent predictor of mortality in incident dialysis patients. Patients with poor SRH in both age strata had a significantly increased risk of mortality even after controlling for demographic and clinical confounders. Patient self-assessment of health can be an invaluable and economical complement to clinical measures in risk assessment
U2 - https://doi.org/10.1053/j.ajkd.2008.04.001
DO - https://doi.org/10.1053/j.ajkd.2008.04.001
M3 - Article
C2 - 18511166
SN - 0272-6386
VL - 52
SP - 111
EP - 117
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -