Original InvestigationDialysisAssociation Between a Self-Rated Health Question and Mortality in Young and Old Dialysis Patients: A Cohort Study
Section snippets
Patient Sample
The Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD-2)19, 20 is a prospective observational study investigating the adequacy and quality of care for patients on dialysis treatment in The Netherlands. Between January 1997 and December 2004, incident patients from 38 dialysis centers throughout The Netherlands were recruited with informed consent. Eligibility included age older than 18 years, no previous renal replacement therapy, and survival of the initial 3 months of
Results
Of 1,672 eligible patients, 190 (11%) with missing SRH and 39 (2%) without data for length of follow-up or age were excluded, resulting in a sample of 1,443 patients. Patients were followed up for an average of 2.7 ± 1.8 years. Mean age was 59.7 ± 14.8 years, with 61% men and 69% married or living together (Table 1). Forty-six percent of the sample rated their health as excellent/very good or good. These patients tended to be men and younger, had a higher level of education, were more likely to
Discussion
Our study shows that an SRH item is an independent predictor of mortality in a large sample of incident patients with end-stage renal disease. Patients who rated their health as poor had a significantly increased risk of death, even after controlling for a range of demographic and clinical confounders. This effect was apparent in both age strata (younger and older participants).
The strong associations between SRH and mortality in our study are in line with findings reported by Kutner et al.7
Acknowledgements
The members of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) Study Group include A.J. Apperloo, J.A. Bijlsma, M. Boekhout, W.H. Boer, P.J.M. van der Boog, H.R. Büller, M. van Buren, F.Th. de Charro, C.J. Doorenbos, M.A. van den Dorpel, A. van Es, W.J. Fagel, G.W. Feith, C.W.H. de Fijter, L.A.M. Frenken, W. Grave, J.A.C.A. van Geelen, P.G.G. Gerlag, J.P.M.C. Gorgels, R.M. Huisman, K.J. Jager, K. Jie, W.A.H. Koning-Mulder, M.I. Koolen, T.K. Kremer Hovinga, A.T.J.
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Originally published online as doi:10.1053/j.ajkd.2008.04.001 on May 22, 2008.
A list of the members of the NECOSAD Study Group appears at the end of this article.