Predictive value of coagulation indexes in maintenance peritoneal dialysis patients on the risk of all-cause death / 国际外科学杂志

ABSTRACT

Objective:To construct nomogram model based on coagulation indicators to predict the risk of all-cause death in maintenance peritoneal dialysis patients.Methods:One hundred and sixty-five patients who underwent maintenance peritoneal dialysis treatment at the Department of Nephrology, Urumqi Friendred Hospital from January 2010 to December 2018 were selected retrospectively as the research objects and were followed up once a month after the start of peritoneal dialysis treatment inpatients were in the patient′s ward; in-home treatment were followed up by telephone. The follow-up time of all the study subjects was until death or 24 months. After the end of the follow-up period, the study subjects were divided into survival group and death group according to whether they died. General information, blood coagulation indicators, renal function indicators, blood lipids, blood potassium, blood calcium, blood phosphorus and blood glucose of the research subjects were recorded and compared the differences between the two groups of patients. The measurement data conforming to the normal distribution were expressed as mean±standarad deviation ( Mean± SD), and the student t-test was used for comparison between groups; the Chi-square test was used for comparison of enumeration data between groups. Two categories Cox regression analysis was used to determine independent risk factors for death in peritoneal dialysis patients, Nomogram prediction model was constructed, and receiver operating characteristic (ROC) was drawn to evaluate the predictive ability of the nomogram model. Results:Combined diabetes, high platelet count, short prothrombin time, short activated partial thrombin time, low international standardization ratio, high fibrinogen level, short thrombin time, high prothrombin activity, high D-dimer level and advanced age were independent risk factors for death in peritoneal dialysis patients. The Nomogram model constructed based on these risk factors had a good fitting effect, and the area under the ROC curve was 0.809 (0.792-0.825), indicating that it had strong predictive ability.Conclusions:Abnormal coagulation indicators were closely related to the risk of death in peritoneal dialysis patients. Diabetes and advanced age also had a certain predictive ability for all-cause death in peritoneal dialysis patients. Nomogram model constructed in this study could be used as a quantitative tool to predict the risk of all-cause death in peritoneal dialysis patients, help to develop individualized treatment plans for peritoneal dialysis patients and improve the prognosis of patients.