Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.3747/pdi.2015.00241 http://hdl.handle.net/11449/221011 |
Resumo: | Background: Simple and low-cost tools to monitor the risk profile of patients on peritoneal dialysis (PD) at high risk of complications and mortality are scarce. One of the tools available to monitor the variation in vitality and dependence levels is the Karnofsky performance status (KPS). This study analyzed the average trends and variation of KPS during the 12 months before death and its independent value in predicting patients’ survival. Methods: The data were compiled from the BRAZPD II multi-center study, performed in Brazil between 2004 and 2011. For the analysis of KPS dynamics, we included patients with at least 12 months of follow-up on PD and who had a fatal event during the follow-up. The following covariables were evaluated: age, gender, ethnicity, educational level, and presence of diabetes. We used the linear regression model to present the results: the log (time) before death was represented by the regression variable and KPS was the response. We also analyzed the independent impact of baseline KPS on patients’ survival. Results: From the population of 9,905 patients enrolled in the BRAZPD study, 4,133 survived 12 months on PD and were included in the analysis. There was a gradual decline in the KPS scores, which accelerated in the last 2 months before death. These changes were similar irrespective of age, race, family income, gender, diabetes, PD modality, and education level. We observed 989 fatal events in this population during the observation period, and the KPS score was identified as an independent predictor for mortality in this cohort. Conclusions: This study demonstrates for the first time the dynamics of KPS before death in PD patients, indicating a progressive and accelerated decline of KPS in the 12 months before patients died. In addition, KPS was an independent predictor of mortality in this population. |
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Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patientsKarnofsky performance statusPeritoneal dialysisBackground: Simple and low-cost tools to monitor the risk profile of patients on peritoneal dialysis (PD) at high risk of complications and mortality are scarce. One of the tools available to monitor the variation in vitality and dependence levels is the Karnofsky performance status (KPS). This study analyzed the average trends and variation of KPS during the 12 months before death and its independent value in predicting patients’ survival. Methods: The data were compiled from the BRAZPD II multi-center study, performed in Brazil between 2004 and 2011. For the analysis of KPS dynamics, we included patients with at least 12 months of follow-up on PD and who had a fatal event during the follow-up. The following covariables were evaluated: age, gender, ethnicity, educational level, and presence of diabetes. We used the linear regression model to present the results: the log (time) before death was represented by the regression variable and KPS was the response. We also analyzed the independent impact of baseline KPS on patients’ survival. Results: From the population of 9,905 patients enrolled in the BRAZPD study, 4,133 survived 12 months on PD and were included in the analysis. There was a gradual decline in the KPS scores, which accelerated in the last 2 months before death. These changes were similar irrespective of age, race, family income, gender, diabetes, PD modality, and education level. We observed 989 fatal events in this population during the observation period, and the KPS score was identified as an independent predictor for mortality in this cohort. Conclusions: This study demonstrates for the first time the dynamics of KPS before death in PD patients, indicating a progressive and accelerated decline of KPS in the 12 months before patients died. In addition, KPS was an independent predictor of mortality in this population.Pontifícia Universidade Católica do Paraná (PUCPR) School of MedicineRenal Research InstitutePontifícia Universidade Católica do Rio Grande do SulUniversidade Federal do Paraná Department of StatisticsUniversidade do Estado de São PauloThe Mount Sinai HospitalFresenius Medical Care North AmericaSchool of MedicineRenal Research InstitutePontifícia Universidade Católica do Rio Grande do SulUniversidade Federal do Paraná (UFPR)Universidade do Estado de São PauloThe Mount Sinai HospitalFresenius Medical Care North AmericaModesto, Ana PaulaUsvyat, LenCalice-Silva, VivianeSpigolon, Dandara NovakowskiFigueiredo, Ana Elizabethde Moraes, Thyago ProençaOlandoski, MarciaShimakura, Silvia EmikoBarreti, PasqualKotanko, PeterPecoits-Filho, Roberto2022-04-28T19:08:41Z2022-04-28T19:08:41Z2018-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article24-29http://dx.doi.org/10.3747/pdi.2015.00241Peritoneal Dialysis International, v. 38, n. 1, p. 24-29, 2018.1718-43040896-8608http://hdl.handle.net/11449/22101110.3747/pdi.2015.002412-s2.0-85041738939Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPeritoneal Dialysis Internationalinfo:eu-repo/semantics/openAccess2022-04-28T19:08:41Zoai:repositorio.unesp.br:11449/221011Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T17:53:31.790914Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
title |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
spellingShingle |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients Modesto, Ana Paula Karnofsky performance status Peritoneal dialysis |
title_short |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
title_full |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
title_fullStr |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
title_full_unstemmed |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
title_sort |
Impact of the karnofsky performance status on survival and its dynamics during the terminal year of peritoneal dialysis patients |
author |
Modesto, Ana Paula |
author_facet |
Modesto, Ana Paula Usvyat, Len Calice-Silva, Viviane Spigolon, Dandara Novakowski Figueiredo, Ana Elizabeth de Moraes, Thyago Proença Olandoski, Marcia Shimakura, Silvia Emiko Barreti, Pasqual Kotanko, Peter Pecoits-Filho, Roberto |
author_role |
author |
author2 |
Usvyat, Len Calice-Silva, Viviane Spigolon, Dandara Novakowski Figueiredo, Ana Elizabeth de Moraes, Thyago Proença Olandoski, Marcia Shimakura, Silvia Emiko Barreti, Pasqual Kotanko, Peter Pecoits-Filho, Roberto |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
School of Medicine Renal Research Institute Pontifícia Universidade Católica do Rio Grande do Sul Universidade Federal do Paraná (UFPR) Universidade do Estado de São Paulo The Mount Sinai Hospital Fresenius Medical Care North America |
dc.contributor.author.fl_str_mv |
Modesto, Ana Paula Usvyat, Len Calice-Silva, Viviane Spigolon, Dandara Novakowski Figueiredo, Ana Elizabeth de Moraes, Thyago Proença Olandoski, Marcia Shimakura, Silvia Emiko Barreti, Pasqual Kotanko, Peter Pecoits-Filho, Roberto |
dc.subject.por.fl_str_mv |
Karnofsky performance status Peritoneal dialysis |
topic |
Karnofsky performance status Peritoneal dialysis |
description |
Background: Simple and low-cost tools to monitor the risk profile of patients on peritoneal dialysis (PD) at high risk of complications and mortality are scarce. One of the tools available to monitor the variation in vitality and dependence levels is the Karnofsky performance status (KPS). This study analyzed the average trends and variation of KPS during the 12 months before death and its independent value in predicting patients’ survival. Methods: The data were compiled from the BRAZPD II multi-center study, performed in Brazil between 2004 and 2011. For the analysis of KPS dynamics, we included patients with at least 12 months of follow-up on PD and who had a fatal event during the follow-up. The following covariables were evaluated: age, gender, ethnicity, educational level, and presence of diabetes. We used the linear regression model to present the results: the log (time) before death was represented by the regression variable and KPS was the response. We also analyzed the independent impact of baseline KPS on patients’ survival. Results: From the population of 9,905 patients enrolled in the BRAZPD study, 4,133 survived 12 months on PD and were included in the analysis. There was a gradual decline in the KPS scores, which accelerated in the last 2 months before death. These changes were similar irrespective of age, race, family income, gender, diabetes, PD modality, and education level. We observed 989 fatal events in this population during the observation period, and the KPS score was identified as an independent predictor for mortality in this cohort. Conclusions: This study demonstrates for the first time the dynamics of KPS before death in PD patients, indicating a progressive and accelerated decline of KPS in the 12 months before patients died. In addition, KPS was an independent predictor of mortality in this population. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 2022-04-28T19:08:41Z 2022-04-28T19:08:41Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.3747/pdi.2015.00241 Peritoneal Dialysis International, v. 38, n. 1, p. 24-29, 2018. 1718-4304 0896-8608 http://hdl.handle.net/11449/221011 10.3747/pdi.2015.00241 2-s2.0-85041738939 |
url |
http://dx.doi.org/10.3747/pdi.2015.00241 http://hdl.handle.net/11449/221011 |
identifier_str_mv |
Peritoneal Dialysis International, v. 38, n. 1, p. 24-29, 2018. 1718-4304 0896-8608 10.3747/pdi.2015.00241 2-s2.0-85041738939 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Peritoneal Dialysis International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
24-29 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128873060106240 |