Frailty and Mortality in Dialysis: Evaluation of a XXXX .

@entity1 @entity2316 @entity204 @entity922 @entity454
BACKGROUND AND OBJECTIVES: Frailty is associated with poor outcomes for @entity1 on dialysis; however, previous studies have not taken into account the severity of frailty as a predictor of outcomes. The purpose of this study was to assess if there was an association between the degree of frailty and mortality among @entity1 on incident dialysis. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: A cohort study of incident chronic dialysis @entity1 was conducted between January of 2009 and June of 2013 (last follow-up in December of 2013). On the basis of overall clinical impression, the @entity922 ( @entity922 ) score was determined for @entity1 at the start of dialysis by their primary nephrologist. This simple scale allocates a single point to different states of frailty (1, very fit; 2, well; 3, managing well; 4, vulnerable; 5, mildly frail; 6, moderately frail; 7, severely frail or terminally ill) with an emphasis on function of the assessed individual. The primary outcome was time to @entity204 . @entity1 were censored at the time of transplantation. RESULTS: The cohort consisted of 390 @entity1 with completed @entity922 scores (mean age of 63  15 years old). Most were Caucasian (89%) and @entity1 (67%), and 30% of @entity1 had @entity454 caused by @entity2316 . The median Charlson Comorbidity Index score was 4 (interquartile range =3-6), and the median @entity922 score was 4 (interquartile range =2-5). There were 96 deaths over 750 @entity1 -years at risk. In an adjusted Cox survival analysis, the hazard ratio associated with each 1-point increase in the @entity922 was 1.22 (95% confidence interval, 1.04 to 1.43; P=0.02). CONCLUSIONS: A higher severity of frailty (as defined by the @entity922 ) at dialysis initiation is associated with higher mortality.
