Risk factors of death and construction of a survival prediction model in maintenance hemodialysis patients with corona virus disease 2019
10.3760/cma.j.cn441217-20230313-00321
- VernacularTitle:维持性血液透析患者合并2019冠状病毒病死亡的危险因素及生存预测模型构建
- Author:
Qiuhong SHI
1
;
Shan JIANG
;
Luyan GAO
;
Ying ZENG
;
Lingling LIU
;
Sheng FENG
;
Jia ZHI
;
Kai SONG
Author Information
1. 苏州大学附属第二医院肾内科，苏州 215004
- Keywords:
Renal dialysis;
COVID-19;
Risk factors;
Survival prediction model
- From:
Chinese Journal of Nephrology
2023;39(11):846-850
- CountryChina
- Language:Chinese
-
Abstract:
It was a retrospective cohort study. Eighty maintenance hemodialysis (MHD) patients with corona virus disease 2019 (COVID-19) were enrolled, among whom 48 patients survived and 32 died. The clinical data between the survival and death groups were compared. The Cox regression model was used to analyze the risk factors of death in MHD patients with COVID-19, and a survival prediction model was constructed. The results showed that age, lesion-cumulative number of lung segments, C-reactive protein, procalcitonin, serum ferritin, interleukin-6, D-dimer, serum phosphorus, and proportions of males, diabetes and hypoxemia in the death group were higher than those in the survival group (all P<0.05). Increased age ( HR=1.039, 95% CI 1.007-1.072, P=0.017), diabetes ( HR=2.688, 95% CI 1.018-6.991, P=0.046), increased C-reactive protein ( HR=1.006, 95% CI 1.001-1.011, P=0.012), and increased serum phosphorus ( HR=1.573, 95% CI 1.015-2.438, P=0.043) were independent influencing factors of death in MHD patients with COVID-19. The survival prediction model was established based on age, diabetes, C-reactive protein and blood phosphorus. The area under the receiver operating characteristic curve of the combined model for survival time at 7-day, 14-day, and 21-day were 0.751 (95% CI 0.690-0.811), 0.768 (95% CI 0.712-0.824), and 0.780 (95% CI 0.729-0.831), respectively. The concordance index of cross- validation as internal validation was 0.797 (95% CI 0.757-0.837). Increased age, diabetes, elevated C-reactive protein and elevated blood phosphorus are independent risk factors of COVID-19 death in MHD patients, and the survival prediction model built by those factors has good efficacy.
