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Prognostic value of Glasgow prognostic score in patients undergoing hemodialysis
Ryosuke Sakamoto1, Kenta Torigoe1, Shinichi Abe2
1Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Nagasaki, Japan.
Insights
The Glasgow prognostic score (GPS) better predicts mortality risk in hemodialysis patients than modified versions. This score effectively identifies patients with poor prognosis, aiding clinical decision-making.
Area of Science:
- Nephrology
- Clinical Prognostics
- Biostatistics
Background:
- The prognostic value of the Glasgow prognostic score (GPS), modified GPS (mGPS), and high-sensitivity mGPS (HS-mGPS) in hemodialysis patients is not well-established.
- Inflammation markers are crucial for predicting outcomes in chronic kidney disease patients.
Purpose of the Study:
- To evaluate the effectiveness of GPS, mGPS, and HS-mGPS in predicting all-cause mortality in patients undergoing hemodialysis.
- To compare the prognostic capabilities of these different scoring systems.
Main Methods:
- Retrospective analysis of 339 hemodialysis patients.
- Calculation of GPS, mGPS, and HS-mGPS.
- Kaplan-Meier and Cox proportional hazards models were used to assess the association with all-cause mortality.
Main Results:
- Survival rates declined with increasing GPS scores (0, 1, and 2).
- No significant difference in survival was observed between mGPS and HS-mGPS.
- Multivariate analysis confirmed GPS, but not mGPS or HS-mGPS, as a significant predictor of all-cause mortality (HR for score 1: 1.76; HR for score 2: 2.87).
Conclusions:
- The Glasgow prognostic score (GPS) demonstrates superior ability in stratifying hemodialysis patients into distinct prognostic risk groups compared to mGPS and HS-mGPS.
- GPS is a valuable tool for predicting mortality risk in this patient population.
Introduction:
Usefulness of the Glasgow prognostic score (GPS), modified GPS (mGPS), and high-sensitivity mGPS (HS-mGPS) in the prognosis of patients undergoing hemodialysis remains unclear. This study aimed to investigate this.
Methods:
The GPS, mGPS, and HS-mGPS were calculated retrospectively in 339 patients undergoing hemodialysis; their association with all-cause mortality was analyzed using the Kaplan-Meier method and Cox proportional hazards models.
Results:
Survival rates decreased according to the GPS (0, 1, and 2), but were similar between the mGPS and HS-mGPS. In the multivariate Cox proportional hazards model, the GPS, not the mGPS or HS-mGPS, was associated with a higher risk of all-cause mortality in patients with scores 1 (hazard ratio [HR]: 1.76, 95% confidence interval [CI]: 1.29-2.42, p = 0.0004) and 2 (HR: 2.87, 95% CI: 1.91-4.32, p < 0.0001) compared with score 0.
Conclusions:
The GPS classified patients into poor prognostic risk groups more clearly than other scores.
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