Frailty Predicts Hemodialysis Mortality Risk
Frailty, Not Age, Predicts Mortality With Hemodialysis
Among patients undergoing hemodialysis, frailty is an independent predictor of mortality and hospitalization, regardless of age, according to a study published online in the Journal of the American Geriatrics Society.
To examine the correlation between frailty in adults undergoing chronic hemodialysis and adverse outcomes of mortality and hospitalization, Mara A. McAdams-DeMarco, Ph.D., from Johns Hopkins University in Baltimore, and colleagues followed 146 individuals undergoing hemodialysis, enrolled between January 2009 and March 2010, through August 2012.
The researchers found that half of older (≥65 years) and 35.4 percent of younger (<65 years) individuals undergoing hemodialysis were frail at enrollment. In addition, 35.9 and 29.3 percent, respectively, were considered intermediately frail. For non-frail, intermediately frail, and frail participants, three-year mortality was 16.2, 34.4, and 40.2 percent, respectively.
The risk of death was increased significantly with intermediate frailty (2.7-fold) and frailty (2.6-fold), independent of age, sex, comorbidity, and disability. There was a median of one hospitalization in the year after enrollment. Of those with two or more hospitalizations, 28.2 percent were non-frail, 25.5 percent were intermediately frail, and 42.6 percent were frail. Frailty, but not intermediate frailty, correlated with 1.4 times more hospitalizations (P = 0.049) independent of age, sex, comorbidity, and disability. The correlation between frailty and mortality and hospitalizations was similar for older and younger participants.
"Adults of all ages undergoing hemodialysis have a high prevalence of frailty," the authors write. "In this population, regardless of age, frailty is a strong, independent predictor of mortality and number of hospitalizations."