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Development and validation of a prediction model for all-cause mortality in maintenance dialysis patients: a multicenter retrospective cohort study

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机构: [1]Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China. [2]Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China. [3]Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.
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关键词: Maintenance dialysis all-cause mortality pleural effusion prediction model

摘要:
The mortality risk varies considerably among individual dialysis patients. This study aimed to develop a user-friendly predictive model for predicting all-cause mortality among dialysis patients.Retrospective data regarding dialysis patients were obtained from two hospitals. Patients in training cohort (N = 1421) were recruited from the Fifth Affiliated Hospital of Sun Yat-sen University, and patients in external validation cohort (N = 429) were recruited from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The follow-up endpoint event was all-cause death. Variables were selected by LASSO-Cox regression, and the model was constructed by Cox regression, which was presented in the form of nomogram and web-based tool. The discrimination and accuracy of the prediction model were assessed using C-indexes and calibration curves, while the clinical value was assessed by decision curve analysis (DCA).The best predictors of 1-, 3-, and 5-year all-cause mortality contained nine independent factors, including age, body mass index (BMI), diabetes mellitus (DM), cardiovascular disease (CVD), cancer, urine volume, hemoglobin (HGB), albumin (ALB), and pleural effusion (PE). The 1-, 3-, and 5-year C-indexes in the training set (0.840, 0.866, and 0.846, respectively) and validation set (0.746, 0.783, and 0.741, respectively) were consistent with comparable performance. According to the calibration curve, the nomogram predicted survival accurately matched the actual survival rate. The DCA showed the nomogram got more clinical net benefit in both the training and validation sets.The effective and convenient nomogram may help clinicians quantify the risk of mortality in maintenance dialysis patients.

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出版当年[2023]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
第一作者:
第一作者机构: [1]Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China. [2]Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.
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通讯作者:
通讯机构: [1]Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China. [2]Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.
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