Table 1. Baseline characteristics of study participants
|
Total
(n=960)
|
Non-hospitalized Participants
(n=701)
|
Hospitalized Participants
(n=259)
|
Age (years), mean [SD]
|
64.9 [10.7]
|
64.3 [10.8]
|
66.6 [10.2]
|
Male, n (%)
|
616 (64.2)
|
446 (63.6)
|
170 (65.6)
|
Dialysis vintage (years), median [IQR]
|
5.4 [1.9–11.6]
|
5.4 [1.9–11.4]
|
5.4 [2.2–12.6]
|
BMI (kg/m2), n (%)
|
|
|
|
<18.5
|
207 (21.6)
|
143 (20.4)
|
64 (24.7)
|
≥18.5 to <25
|
622 (64.8)
|
458 (65.3)
|
164 (63.3)
|
≥25
|
131 (13.6)
|
100 (14.3)
|
31 (12.0)
|
Functional status score, median [IQR]
|
13 [12–13]
|
13 [12–13]
|
13 [11.5–13]
|
Comorbidities, n (%)
|
|
|
|
Diabetes
|
347 (36.1)
|
239 (34.1)
|
108 (41.7)
|
Cerebrovascular diseases
|
81 (8.4)
|
57 (8.1)
|
24 (9.3)
|
Coronary heart disease
|
224 (23.3)
|
151 (21.5)
|
73 (28.2)
|
Other cardiovascular diseases
|
193 (20.1)
|
130 (18.5)
|
63 (24.3)
|
Congestive heart disease
|
145 (15.1)
|
96 (13.7)
|
49 (18.9)
|
Cancer other than skin cancer
|
102 (10.6)
|
73 (10.4)
|
29 (11.2)
|
Neurological disease
|
38 (4.0)
|
26 (3.7)
|
12 (4.6)
|
Peripheral vascular disease
|
116 (12.1)
|
68 (9.7)
|
48 (18.5)
|
Dementia
|
4 (0.4)
|
2 (0.3)
|
2 (0.8)
|
Psychiatric disorder
|
34 (3.5)
|
23 (3.3)
|
11 (4.2)
|
Albumin (g/dL), mean [SD]
|
3.7 [0.4]
|
3.7 [0.4]
|
3.6 [0.4]
|
Phosphorus (mg/dL), mean [SD]
|
5.3 [1.3]
|
5.3 [1.3]
|
5.3 [1.4]
|
Creatinine (mg/dL), mean [SD]
|
10.7 [2.6]
|
10.8 [2.6]
|
10.4 [2.6]
|
SD, standard deviation; IQR, interquartile range;
Table 2. Association between cumulative length of hospital stay and decline in ADLs
|
BADLs
|
IADLs
|
|
|
Crude RR
[95% CI]
|
Adjusted RRa
[95% CI]
|
|
Crude RR
[95% CI]
|
Adjusted RRa
[95% CI]
|
Cumulative length of hospital stay (per 30 days)
|
1.49
[1.20 to 1.85]
|
1.42
[1.17 to 1.73]
|
|
1.44
[1.22 to 1.71]
|
1.30
[1.10 to 1.54]
|
Age (per 10 years)
|
|
1.20
[0.96 to 1.50]
|
|
|
1.27
[1.05 to 1.54]
|
Diabetes
|
|
1.46
[1.06 to 2.02]
|
|
|
1.38
[1.05 to 1.81]
|
|
|
|
|
|
|
|
ADL, activities of daily living; BADL, basic activities of daily living; IADL, instrumental activities of daily living; RR, risk ratio; CI, confidence interval.
aAdjusted for sex, dialysis vintage, body mass index (<18.5, ≥18.5 to <25, ≥25), functional status score, comorbidities (cerebrovascular diseases, coronary heart disease, other cardiovascular diseases, congestive heart disease, cancer other than skin cancer, neurologic disease, peripheral vascular disease, dementia, and psychiatric disorder), albumin, phosphorus, and creatinine.
Table 3. Association between number of hospitalizations and decline in ADLs
|
BADLs
|
|
IADLs
|
|
Incidence
|
Crude RR
[95% CI]
|
Adjusted RRa
[95% CI]
|
|
Incidence
|
Crude RR
[95% CI]
|
Adjusted RRa
[95% CI]
|
Number of hospitalizations
|
|
|
|
|
|
|
|
0
|
13.6%
(95/701)
|
ref
|
ref
|
|
21.0%
(147/701)
|
ref
|
ref
|
1
|
22.3%
(35/157)
|
1.64
[1.16 to 2.33]
|
1.60
[1.13 to 2.27]
|
|
30.6%
(48/157)
|
1.46
[1.11 to 1.92]
|
1.40
[1.07 to 1.84]
|
≥2
|
34.3%
(35/102)
|
2.53
[1.83 to 3.51]
|
2.17
[1.55 to 3.04]
|
|
36.3%
(37/102)
|
1.73
[1.29 to 2.32]
|
1.34
[0.97 to 1.83]
|
BADL, basic activities of daily living; IADL, instrumental activities of daily living; RR, risk ratio; CI, confidence interval; ref, reference.
aAdjusted for age, sex, dialysis vintage, body mass index (<18.5, ≥18.5 to <25, ≥25), functional status score, comorbidities (diabetes, cerebrovascular diseases, coronary heart disease, other cardiovascular diseases, congestive heart disease, cancer other than skin cancer, neurologic disease, peripheral vascular disease, dementia, and psychiatric disorder), albumin, phosphorus, and creatinine.
Table 4. Association between hospitalization and decline in ADLs by age group
|
BADLs
|
IADLs
|
|
<65 years
(n=460)
|
≥65 years
(n=500)
|
<65 years
(n=460)
|
≥65 years
(n=500)
|
|
Adjusted RRa [95% CI]
|
Cumulative length of hospital stay (per 30 days)
|
1.44
[1.06 to 1.94]
|
1.57
[1.21 to 2.05]
|
1.62
[1.24 to 2.13]
|
1.12
[0.92 to 1.38]
|
Number of hospitalizations
|
|
|
|
|
0
|
ref
|
ref
|
ref
|
ref
|
1
|
1.67
[0.95 to 2.92]
|
1.49
[0.97 to 2.29]
|
1.54
[1.01 to 2.35]
|
1.24
[0.95 to 1.61]
|
≥2
|
2.33
[1.36 to 3.99]
|
2.22
[1.54 to 3.21]
|
1.56
[1.01 to 2.43]
|
1.24
[0.82 to 1.86]
|
BADL, basic activities of daily living; IADL, instrumental activities of daily living; RR, risk ratio; CI, confidence interval; ref, reference.
aAdjusted for age, sex, dialysis vintage, body mass index (<18.5, ≥18.5 to <25, ≥25), functional status score, comorbidities (diabetes, cerebrovascular diseases, coronary heart disease, other cardiovascular diseases, congestive heart disease, cancer other than skin cancer, neurologic disease, peripheral vascular disease, dementia, and psychiatric disorder), albumin, phosphorus, and creatinine.