Evidence map›Paper›PMID 29936648›Full record

Observational studyJournal of nephrology2018

Subjective Global Assessment-Dialysis Malnutrition Score and cardiovascular risk in hemodialysis patients: an observational cohort study.

Leonardo Spatola, Silvia Finazzi, Albania Calvetta, Francesco Reggiani, Emanuela Morenghi, Silvia Santostasi, Claudio Angelini, Salvatore Badalamenti, Giacomo Mugnai

Abstract readComparative StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Status of Nutrition In Hemodialysis Patients Survey (SNIPS): Malnutrition risk by diabetes status.Diabetic medicine : a journal of the British Diabetic Association · 2021
    Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Leonardo SpatolaDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy. Leonardo.spatola@humanitas.it.ORCID http://orcid.org/0000-0002-8883-4776
Silvia FinazziDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Albania CalvettaDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Francesco ReggianiDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Emanuela MorenghiDivision of Biostatistics, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Silvia SantostasiDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Claudio AngeliniDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Salvatore BadalamentiDivision of Nephrology and Hemodialysis, Humanitas Clinical and Research Hospital, via Manzoni 56, 20089, Rozzano, MI, Italy.
Giacomo MugnaiElectrophysiology and Cardiac Pacing Unit, Ospedale Civile di Mirano, via Luigi Mariutto 76, 30035, Mirano, VE, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalnutrition is an important risk factor for cardiovascular mortality in hemodialysis (HD) patients. However, current malnutrition biomarkers seem unable to accurately estimate the role of malnutrition in predicting cardiovascular risk. Our aim was to investigate the role of the Subjective Global Assessment-Dialysis Malnutrition Score (SGA-DMS) compared to two well-recognized comorbidity scores-Charlson Comorbidity Index (CCI) and modified CCI (excluding age-factor) (mCCI)-in predicting cardiovascular events in HD patients.

methodsIn 86 maintenance HD patients followed from June 2015 to June 2017, we analyzed biohumoral data and clinical scores as risk factors for cardiovascular events (acute heart failure, acute coronary syndrome and stroke). Their impact on outcome was investigated by linear regression, Cox regression models and ROC analysis.

resultsCardiovascular events occurred in 26/86 (30%) patients during the 2-year follow-up. Linear regression showed only age and dialysis vintage to be positively related to SGA-DMS: B 0.21 (95% CI 0.01; 0.30) p 0.05, and B 0.24 (0.09; 0.34) p 0.02, respectively, while serum albumin, normalized protein catabolic rate (nPCR) and dialysis dose (Kt/V) were negatively related to SGA-DMS: B - 1.29 (- 3.29; - 0.81) p 0.02; B - 0.08 (- 1.52; - 0.35) p 0.04 and B - 2.63 (- 5.25; - 0.22) p 0.03, respectively. At Cox regression analysis, SGA-DMS was not a risk predictor for cardiovascular events: HR 1.09 (0.9; 1.22), while both CCI and mCCI were significant predictors: HR 1.43 (1.13; 1.87) and HR 1.57 (1.20; 2.06) also in Cox adjusted models. ROC analysis reported similar AUCs for CCI and mCCI: 0.72 (0.60; 0.89) p 0.00 and 0.70 (0.58; 0.82) p 0.00, respectively, compared to SGA-DMS 0.56 (0.49; 0.72) p 0.14.

conclusionsSGA-DMS is not a superior and significant prognostic tool compared to CCI and mCCI in assessing cardiovascular risk in HD patients, even it allows to appraise both malnutrition and comorbidity status.

Indexed as

Decision Support TechniquesNutritional StatusNutrition AssessmentRenal DialysisAgedAged, 80 and overAge FactorsCardiovascular DiseasesComorbidityFemaleHumansItalyKidney DiseasesMaleMalnutritionMiddle AgedAcute heart failureArrhythmiasCardiovascular riskHaemodialysis patientsMalnutritionSGA-DMS

Identifiers

PMID29936648

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.