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Table 4 Crude and multivariable adjusted hazards ratios (95% confidence intervals) for mortality among incident dialysis patients ≥ 75 years old (n = 27,913)

From: Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk

 

Crude

Multivariable adjusted

NH Status – by MDS*

  

 No MDS (n = 20,112)

1 (ref)

1 (ref)

 MDS (n = 7,801)

1.81 (1.76, 1.86)

1.47 (1.42, 1.52)

NH Status – by CMS-2728 **

  

 No 2728 (n = 24,692)

1 (ref)

1 (ref)

 2728 (n = 3,221)

1.85 (1.78, 1.92)

1.35 (1.28, 1.42)

NH status agreement***

  

 MDS/2728

2.08 (1.99, 2.17)

1.55 (1.46, 1.64)

 MDS/No 2728

1.75 (1.69, 1.81)

1.48 (1.42, 1.54)

 No MDS/2728

1.97 (1.82, 2.13)

1.38 (1.25, 1.52)

 No MDS/No 2728

1 (ref)

1(ref)

Age, years

  

 75 – 79

1 (ref)

1 (ref)

 80 – 84

1.23 (1.19, 1.26)

1.17 (1.13, 1.21)

 85 – 89

1.51 (1.46, 1.57)

1.40 (1.34, 1.46)

 ≥90

1.93 (1.81, 2.06)

1.69 (1.57, 1.82)

Women

0.96 (0.93, 0.98)

0.87 (0.85, 0.90)

Hispanic or Latino

0.85 (0.81, 0.89)

0.75 (0.70, 0.79)

Race

  

 White

1 (ref)

1 (ref)

 Black or African American

0.79 (0.76, 0.81)

0.77 (0.74, 0.81)

 American Indian/Alaska Native

0.82 (0.67, 1.02)

0.89 (0.70, 1.14)

 Asian

0.71 (0.66, 0.77)

0.77 (0.70, 0.84)

 Other

0.72 (0.62, 0.83)

0.65 (0.53, 0.79)

Medicaid

1.01 (0.97, 1.04)

1.03 (0.99, 1.08)

Region of residence

  

 Northeast

1.10 (1.06, 1.14)

0.97 (0.92, 1.01)

 South

1.15 (1.11, 1.19)

1.09 (1.04, 1.14)

 Midwest

1.11 (1.07, 1.15)

0.95 (0.90, 0.99)

 West

1 (ref)

1 (ref)

Primary cause of ESRD (diabetes vs. other)

1.01 (0.98, 1.03)

1.02 (0.99, 1.06)

CVD Comorbidity

  

 Congestive heart failure

1.37 (1.34, 1.41)

1.18 (1.14, 1.22)

 Atherosclerotic heart disease

1.16 (1.13, 1.19)

1.03 (0.99, 1.06)

 Cerebrovascular disease

1.22 (1.17, 1.26)

1.06 (1.01, 1.11)

 Peripheral vascular disease

1.21 (1.17, 1.24)

1.08 (1.03, 1.12)

 Other

1.26 (1.22, 1.29)

1.09 (1.06, 1.13)

Functional impairment†

1.60 (1.55, 1.65)

1.25 (1.20, 1.31)

Serum albumin (g/dL)

0.75 (0.73, 0.76)

0.85 (0.83, 0.87)

Serum creatinine (mg/dL)

0.95 (0.95, 0.96)

0.97 (0.96, 0.97)

Hemoglobin (g/dL)

0.97 (0.97, 0.98)

0.99 (0.98, 1.00)

Dialysis facility/Center (vs. SNF)

0.65 (0.57, 0.74)

1.17 (0.99, 1.38)

Predialysis nephrology care (vs. No care)

0.74 (0.72, 0.76)

0.90 (0.87, 0.94)

Arteriorvenous fistula (vs. Graft)

0.92 (0.86, 0.99)

0.91 (0.84, 0.99)

  1. CVD = cardiovascular disease, SNF = skilled nursing facility.
  2. †includes one of more of inability to ambulate, inability to transfer, or needs assistance with daily activities.
  3. *Model 1 – NH status defined by MDS alone.
  4. **Model 2 – NH status defined by CMS-2728 alone.
  5. ***Model 3 – NH status defined by MDS/2728 agreement category.
  6. For each model multivariable adjustment includes age, sex, ethnicity, race, Medicaid coverage, region of residence, primary cause of dialysis, CVD comorbidity, functional impairment, serum albumin, serum creatinine, hemoglobin, primary dialysis setting, predialysis nephrology care, initial type of dialysis access and incident ESRD year.
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BMC Nephrology

ISSN: 1471-2369

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