Objective: To retrospectively analyze the early
mortality and related
risk factors in
adult patients with
maintenance hemodialysis (MHD).
Methods: Adult MHD
patients from 2008 to 2018 were enrolled and divided into
training data group and validation data group. In
training data group, multivariate
logistic regression was used to analyze the
risk factors of early
death within 120 days after
hemodialysis and establish a prediction model. The
receiver operating characteristic (ROC) curve was applied to evaluate the prediction
ability of the model.
Results: A total of 4 885
patients were included. The cumulative
mortality within 120 days was 20.97/100
person years, and that within 365 days was 12.25/100
person years. A total of 3 603
patients in the
training data group were analyzed. The following
risk factors were correlated with early
mortality (all P<0.05), including age at start of
dialysis over 60 years old ( OR=1.792), non-chronic
glomerulonephritis ( OR=2.214), cardio-
cerebrovascular disease ( OR=2.695),
plasma albumin less than 35 g/L ( OR=1.358),
platelet count less than 120×10 9/L ( OR=2.194),
serum creatinine less than 600 μmol/L ( OR=1.652),
blood urea nitrogen over 30 mmol/L ( OR=1.887),
blood phosphorus less than 1.13 mmol/L ( OR=1.783),
pulse pressure over 55 mmHg(1 mmHg=0.133 kPa) ( OR=1.656),
low density lipoprotein less than 1.5 mmol/L ( OR=1.873), and
blood calcium over 2.5 mmol/L ( OR=1.876).
Risk prediction model was established. The other 1 282 cases in the validation data group were verified. The area under
ROC curve was 0.810, with
sensitivity 85.7%, and
specificity 62.5%.
Conclusion: The mortality rate of
adult MHD
patients within 120 days after
dialysis is high. The established prediction model can effectively predict the
risk of early
death .