The Impact of Frailty on Prognosis in Elderly Hemodialysis Patients: A Prospective Cohort Study
Y. Li, Dai Zhang, Qing Ma, Zongli Diao, Sha Liu, Xiaotian Shi
Abstract
Purpose: To explore the impact of frailty on adverse outcomes in elderly hemodialysis (HD) patients. Patients and Methods: An observational and prospective cohort study was conducted in elderly patients (≥ 60) with HD, with an average 12-month follow-up. Fried frailty phenotype (FFP) was used to define frailty. Negative binomial regression was used to estimate the impact of frailty on the incidence of emergency visits, hospitalizations, acute cardiovascular events, and falls within a year. Cox regression analysis was used to assess the influence of frailty on all-cause mortality in elderly HD patients. Results: Our study enrolled 150 elderly HD patients, and the prevalence of frailty was 34.7%. After adjustment, frailty was independently associated with increased all-cause mortality [hazard ratio (HR)=4.10, 95% CI: 1.09– 15.43, p =0.037] and emergency visits [incidence rate ratio (IRR)=2.78 95% CI: 1.70– 4.60, p < 0.001]. Gait speed was an independent risk factor for all-cause deaths (HR=5.56 95% CI: 1.41– 22.00, p =0.014), emergency visits (IRR=2.52 95% CI: 1.48– 4.33, p < 0.001), and hospitalizations (IRR=2.24, 95% CI: 1.19– 4.21, p =0.010) in elderly HD patients. Conclusion: Frailty was an independent indicator of all-cause mortality and emergency visits in elderly patients with HD. Keywords: elderly people, frailty, hemodialysis, mortality, emergency visits, hospitalizations