Ysis physicians based on patients' clinical course and subjective health condition, without referencing laboratory findings

Ysis physicians based on patients’ clinical course and subjective health condition, without referencing laboratory findings or determining ADL using validated methods. Covariates were fixed baseline parameters at initiation of HD, with age, sex, and the cause of ESKD as case-mix variables, and the following variables were used for multivariable analysis: body mass index, systolic blood pressure, comorbid conditions (i.e., congestive heart failure, ischemic heart disease, stroke, diabetes mellitus, malignancy, dementia, and liver disease), history of amputation, treatment time of dialysis, type of vascular access, late referral to a nephrologist (defined as 90 days from the first visit to initiation of dialysis) [16], and laboratory findings (the estimated glomerular filtration rate [eGFR] calculated from the formula for Japanese: 194 ?[serum creatinine, mg/dL]-1.094 ?[age, years]-0.287, and ?0.739 if female [17]; and levels of albumin, hemoglobin, C-reactive protein [CRP], calcium [albumin-adjusted: calcium + 4.0 lbumin, if the albumin level is <4.0 g/dL] [18], and phosphorus).During the 3 to 6 months after starting hemodialysis, 105 patients terminated hemodialysis and 65 received transplantation; during the 6 to 12 months after starting hemodialysis, 38 patients terminated hemodialysis and 73 received transplantation. doi:10.1371/journal.pone.0156951.tIn our main analysis, we computed risk ratios and 95 confidence intervals (CIs) for early mortality among patient groups with different levels of PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21114769 functional disability at initiation of HD. To adjust for the distribution of covariates among those groups, we used modified Poisson regression with robust variance [19]. Considering the potential for misclassifying FS, especially between mild/none and moderate, we conducted a sensitivity analysis between the severe and non-severe groups (mild/none + moderate). To IDE1 site analyze the relationship between FS and early death with regard to age, we used four age categories (<60, 60?9, 70?9, and 80 years) with three FS levels (mild/none, moderate, and severe) to obtain 12 categories for use as variables. Finally, we used multivariable regression analysis to determine the relationship between FS and early death according to each age category. The data sets used to analyze the relationship between FS and early death (n = 7,664) had several missing values (Table 1). For covariate data missing at baseline, we used multiple imputation by IVEware (University of Michigan; http://www.isr.umich.edu/src/smp/ive/) to account for this uncertainty. Missing data were sequentially imputed based on multiple regression models with other variables as covariates, according to the type of variable missing. Each imputed data set was then constructed by repeating this sequential procedure for 10 iterations. Results were obtained using Rubin's formula with five imputed data sets [20]. P-values <0.05 were considered statistically significant. Statistical analysis was performed with SAS, version 9.2 (SAS Institute, Cary, NC, USA).Results Early deaths among Japanese patients on incident HDThe median age of initiation of HD was 69 years (IQR, 59?7 years), and the prevalence of incident HD among women was 35 . The incidence of early deaths was 2,358 (7.1 ) of 33,PLOS ONE | DOI:10.1371/journal.pone.0156951 June 7,4 /Early Mortality Was Highly and Strongly Associated with FS in Incident Japanese HD PatientsFig 1. Cumulative probability of early mortality 3, 6, and 12 months after the.