A self-report comorbidity questionnaire for haemodialysis patients

Article English OPEN
Sridharan, Sivakumar ; Berdeprado, Jocelyn ; Vilar, Enric ; Roberts, Justin ; Farrington, Ken (2014)
  • Publisher: Springer Nature
  • Journal: BMC Nephrology, volume 15, pages 134-134 (eissn: 1471-2369)
  • Related identifiers: pmc: PMC4140824, doi: 10.1186/1471-2369-15-134
  • Subject: Nephrology | Questionnaire | Research Article | Comorbidity | Survival | Haemodialysis | End-stage renal disease

Abstract\ud \ud \ud BACKGROUND: \ud \ud Patients with end-stage renal disease (ESRD) have multiple comorbid conditions. Obtaining comorbidity data from medical records is cumbersome. A self-report comorbidity questionnaire is a useful alternative. Our aim in this study was to examine the predictive value of a self-report comorbidity questionnaire in terms of survival in ESRD patients.\ud \ud METHODS: \ud \ud We studied a prospective cross-sectional cohort of 282 haemodialysis (HD) patients in a single centre. Participants were administered the self-report questionnaire during an HD session. Information on their comorbidities was subsequently obtained from an examination of the patient's medical records. Levels of agreement between parameters derived from the questionnaire, and from the medical records, were examined. Participants were followed-up for 18 months to collect survival data. The influence on survival of comorbidity scores derived from the self-report data (the Composite Self-report Comorbidity Score [CSCS]) and from medical records data--the Charlson Comorbidity Index [CCI] were compared.\ud \ud RESULTS: \ud \ud The level of agreement between the self-report items and those obtained from medical records was almost perfect with respect the presence of diabetes (Kappa score κ 0.97), substantial for heart disease and cancer (κ 0.62 and κ 0.72 respectively), moderate for liver disease (κ 0.51), only fair for lung disease, arthritis, cerebrovascular disease, and depression (κ 0.34, 0.35, 0.34 and 0.29 respectively). The CSCS was strongly predictive of survival in regression models (Nagelkerke R(2) value 0.202), with a predictive power similar to that of the CCI (Nagelkerke R(2) value 0.211). The influences of these two parameters were additive in the models--suggesting that these parameters make different contributions to the assessment of comorbidity.\ud \ud CONCLUSION: \ud \ud This self-report comorbidity questionnaire is a viable tool to collect comorbidity data and may have a role in the prediction of short-term survival in patients with end-stage renal disease on haemodialysis. Further work is required in this setting to refine the tool and define its role.
  • References (14)
    14 references, page 1 of 2

    1. van Manen JG, Korevaar JC, Dekker FW, Boeschoten EW, Bossuyt PM, Krediet RT: How to adjust for comorbidity in survival studies in ESRD patients: a comparison of different indices. Am J Kidney Dis 2002, 40(1):82-89.

    2. Khan IH, Catto GR, Edward N, Fleming LW, Henderson IS, MacLeod AM: Influence of coexisting disease on survival on renal-replacement therapy. Lancet 1993, 341(8842):415-418.

    3. Khan IH: Comorbidity: the major challenge for survival and quality of life in end-stage renal disease. Nephrol Dial Transplant 1998, 13(Suppl 1):76-79.

    4. Rattanasompattikul M, Feroze U, Molnar MZ, Dukkipati R, Kovesdy CP, Nissenson AR, Norris KC, Kopple JD, Kalantar-Zadeh K: Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients. Int Urol Nephrol 2012, 44(6):1813-1823.

    5. Chandna SM, Schulz J, Lawrence C, Greenwood RN, Farrington K: Is there a rationale for rationing chronic dialysis? A hospital based cohort study of factors affecting survival and morbidity. BMJ 1999, 318(7178):217-223.

    6. Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987, 40(5):373-383.

    7. Goodkin DA, Bragg-Gresham JL, Koenig KG, Wolfe RA, Akiba T, Andreucci VE, Saito A, Rayner HC, Kurokawa K, Port FK, Held PJ, Young EW: Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Am Soc Nephrol 2003, 14(12):3270-3277.

    8. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN: The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 2003, 49(2):156-163.

    9. Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Meas 1960, 20(1):37-46.

    10. Cavanaugh KL, Merkin SS, Plantinga LC, Fink NE, Sadler JH, Powe NR: Accuracy of patients' reports of comorbid disease and their association with mortality in ESRD. Am J Kidney Dis 2008, 52(1):118-127.

  • Metrics
    No metrics available
Share - Bookmark