Evidence map›Paper›PMID 31408861›Full record

ArticleNephron2019

Geriatric Assessment and the Relation with Mortality and Hospitalizations in Older Patients Starting Dialysis.

Ismay N van Loon, Namiko A Goto, Franciscus T J Boereboom, Michiel L Bots, Ellen K Hoogeveen, Laila Gamadia, E F H van Bommel, P J G van de Ven, Caroline E Douma, H H Vincent and 6 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephron, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
2.7field-weighted citation impact, top 10% of its field
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

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 36 citations in OpenAlex.

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  3. Peritoneal dialysis versus haemodialysis for people commencing dialysis.The Cochrane database of systematic reviews · 2024
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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

16 authors at 12 institutions in 1 country.

Ismay N van LoonDianet Dialysis Center, Utrecht, The Netherlands, i.n.vanloon@gmail.com.
Namiko A GotoDepartment of Geriatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Franciscus T J BoereboomDianet Dialysis Center, Utrecht, The Netherlands.
Michiel L BotsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Ellen K HoogeveenDepartment of Internal Medicine Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Laila GamadiaDepartment of Internal Medicine Tergooi Hospital, Hilversum, The Netherlands.
E F H van BommelDepartment of Internal Medicine Albert Schweitzer Hospital, Dordrecht, The Netherlands.
P J G van de VenDepartment of Internal Medicine Maasstad Hospital, Rotterdam, The Netherlands.
Caroline E DoumaDepartment of Internal Medicine Spaarne Gasthuis, Hoofddorp, The Netherlands.
H H VincentDepartment of Internal Medicine Antonius Hospital, Nieuwegein, The Netherlands.
Yvonne C SchramaDepartment of Internal Medicine St. Franciscus Hospital, Rotterdam, The Netherlands.
Joy LipsDepartment of Internal Medicine Bernhoven Hospital, Uden, The Netherlands.
Machiel A SiezengaDepartment of Internal Medicine Gelderse Vallei Hospital, Ede, The Netherlands.
Alferso C AbrahamsDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Marianne C VerhaarDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Marije E HamakerDepartment of Geriatrics University Medical Center Utrecht, Utrecht, The Netherlands.
University Medical Center Utrecht · NLAlbert Schweitzer Ziekenhuis · NLDiakonessenhuis hospital · NLDianet · NLJeroen Bosch Ziekenhuis · NLMaasstad Ziekenhuis · NLSint Franciscus Gasthuis · NLSpaarne Gasthuis · NLSt. Antonius Ziekenhuis · NLTergooi · NLZiekenhuis Bernhoven · NLZiekenhuis Gelderse Vallei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesA geriatric assessment (GA) is a structural method for identifying frail patients. The relation of GA findings and risk of death in end-stage kidney disease (ESKD) is not known. The objective of the GA in OLder patients starting Dialysis Study was to assess the association of GA at dialysis initiation with early mortality and hospitalization. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Patients ≥65 years old were included just prior to dialysis initiation. All participants underwent a GA, including assessment of (instrumental) activities of daily living (ADL), mobility, cognition, mood, nutrition, and comorbidity. In addition, a frailty screening (Fried Frailty Index, [FFI]) was applied. Outcome measures were 6- and 12-month mortality, and 6-month hospitalization. Associations with mortality were assessed with cox-regression adjusting for age, sex, comorbidity burden, smoking, residual kidney function and dialysis modality. Associations with hospitalization were assessed with logistic regression, adjusting for relevant confounders.

resultsIn all, 192 patients were included, mean age 75 ± 7 years, of whom 48% had ≥3 geriatric impairments and were considered frail. The FFI screening resulted in 46% frail patients. Mortality rate was 8 and 15% at 6- and 12-months after enrolment, and transplantation rate was 2 and 4% respectively. Twelve-month mortality risk was higher in patients with ≥3 impairments (hazard ratio [HR] 2.97 [95% CI 1.19-7.45]) compared to less impaired patients. FFI frail patients had a higher risk of 12-month mortality (HR 7.22 [95% CI 2.47-21.13]) and hospitalization (OR 1.93 [95% CI 1.00-3.72]) compared to fit patients. Malnutrition was associated with 12-month mortality, while impaired ADL and depressive symptoms were associated with 12-month mortality and hospitalization.

conclusionsFrailty as assessed by a GA is related to mortality in elderly patients with ESKD. Individual components of the GA are related to both mortality and hospitalization. As the GA allows for distinguishing between frail and fit patients initiating dialysis, it is potentially of added value in the decision-making process concerning dialysis initiation.

Indexed as

Geriatric AssessmentHospitalizationRenal DialysisAgedAged, 80 and overCohort StudiesFemaleFrail ElderlyHumansKidney Failure, ChronicMaleNetherlandsPrognosisProspective StudiesConservative careDialysisElderlyGeriatric assessmentQuality of life

Identifiers

PMID31408861
PMCPMC6878747
OpenAlexW2972408717

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.