Abstract: SA-PO294
Short Physical Performance Battery, Mortality, and Hospitalization in Patients on Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Uchida, Juri, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Suzuki, Yuta, National Institute of Public Health, Saitama, Japan
- Imamura, Keigo, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Yoshikoshi, Shun, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Nakajima, Takuya, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Fukuzaki, Narumi, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Harada, Manae, Sagami Circulatory Organ Clinic, Sagamihara, Japan
- Matsunaga, Atsuhiko, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
Background
Patients on hemodialysis (HD) are more frail compared with the general old population. Frailty increases vulnerability to stressors; however, appropriate intervention can restore the robust state. Hence, regularly evaluating the physical functions of patients on HD to detect frailty at an early stage is critical. Short Physical Performance Battery (SPPB) is a widely known practical tool for assessing physical functions in patients on HD. However, there is limited clear clinical data examining the association between SPPB and long-term health outcomes in patients on HD. This study examined the association between SPPB and adverse health outcomes in patients on HD.
Methods
A retrospective cohort study involving 326 outpatients (mean age: 68 years; 62% men) who received maintenance HD was conducted. They were categorized into two groups: low SPPB (≤ 9) or high SPPB (> 9). We examined the association of SPPB score with all-cause death, all-cause hospitalization, and cardiovascular hospitalization using the Cox proportional hazards model. In addition, we calculated the population attributable fraction (PAF) to estimate the attributable fraction of low SPPB to health outcomes.
Results
Patients in the low SPPB group demonstrated a higher risk of all-cause death (hazard ratio (HR): 3.19; 95% confidence interval (CI), 1.89–5.38), all-cause hospitalization (HR: 2.01; 95% CI, 1.44–2.82), and cardiovascular hospitalizations (HR: 2.20; 95% CI, 1.45–3.35). PAF suggested that 42.1% of all-cause deaths, 19.8% of all-cause hospitalizations, and 28.5% of cardiovascular hospitalizations were attributable to low SPPB.
Conclusion
Low SPPB was associated with a higher risk for all-cause death, all-cause hospitalization, and cardiovascular hospitalization in patients on HD. SPPB is useful for assessing physical frailty and prognostic management. Treatments to prevent low SPPB may be an effective disease management strategy to control the high mortality and admission rates in patients on HD.