A simple risk score predicts poor quality of life and non-survival at 1 year follow-up in dialysis patients

Abstract

Background. Quality of life (QoL) in end-stage renal disease patients has become an important focus of attention in evaluating dialysis. We studied risk factors of poor QoL at 1 year follow-up. Methods. Of a baseline sample of 80 dialysis patients, we contacted 60 patients who were alive at 1 year follow-up. QoL data were obtained for 46 (76.7%) of these patients. QoL measured with the SF-36 [physical health component score (PCS) and mental health component score (MCS)] at 1 year-follow-up was predicted by means of multivariate regression analysis by data collected at baseline using INTERMED-an observer-rated method to assess biopsychosocial care needs-and several indicators for disease severity and comorbidity. Results. The regression models explained 32% of the variance in PCS and 40% in MCS. INTERMED score (P < 0.01) was the only independent risk factor for low MCS, while for low PCS, diabetic comorbidity (P = 0.02) and age (P = 0.03) were independent risk factors. A simple risk score consisting of INTERMED ≥21, diabetic comorbidity and age ≥65 was significantly correlated with non-survival (P = 0.02) and with PCS (P < 0.01) and MCS (P < 0.01) in surviving patients, although not with hospital admissions during follow-up. Conclusions. A simple risk score based on INTERMED, age (≥65) and comorbid diabetes (yes/no) can be used to detect patients at risk of poor QoL and non-survival at an early stage of treatment.