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Predictive accuracy of comorbidity index models in assessing mortality risk among hemodialysis patients: A

Yanna Yu1,2, Fen Li3, Zhan Wang4

  • 1Department of Nephrology The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou China.

Aging Medicine (Milton (N.S.W))
|January 8, 2025
PubMed

Insights

The Claims-based disease-specific refinements matching translation to ICD-10 and flexibility (CDMF-CCI) model accurately predicts mortality risk in Chinese maintenance hemodialysis (MHD) patients. This comorbidity index model outperforms the Liu model and individual indices for predicting death risk in MHD patients.

Area of Science:

  • Nephrology
  • Public Health
  • Biostatistics

Background:

  • Maintenance hemodialysis (MHD) patients face significant mortality risks.
  • Comorbidity prediction models offer improved death risk assessment over single indices.
  • Application of these models in Chinese MHD populations remains limited.

Purpose of the Study:

  • To evaluate the predictive utility of comorbidity index models for mortality risk in Chinese MHD patients.
  • To compare the performance of the CDMF-CCI model and the Liu model in this population.

Main Methods:

  • A cohort of Chinese MHD patients was studied retrospectively.
  • The Claims-based disease-specific refinements matching translation to ICD-10 and flexibility (CDMF-CCI) model and the Liu model were assessed.
  • Univariate and multivariate Cox regression analyses were employed to evaluate predictive effects on survival rates.

Main Results:

  • The CDMF-CCI model demonstrated superior predictive accuracy for mortality, with a hazard ratio of 1.190 (P = 0.037).
  • The Liu model did not effectively identify high-risk individuals among MHD patients.
  • Leading causes of death included sudden demise, cardiovascular disease, pulmonary infection, and stroke.

Conclusions:

  • The CDMF-CCI model exhibits superior predictive accuracy for mortality in MHD patients compared to univariate parameters and the Liu model.
  • This comorbidity index model can aid in risk stratification and management of Chinese MHD patients.
Abstract

Keywords:
chronic kidney diseaseend‐stage kidney diseasemaintenance hemodialysismortalityrenal function

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