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Table 2 Association of attainment of 6-month clinical performance targets with mortality

From: Attainment of clinical performance targets and improvement in clinical outcomes and resource use in hemodialysis care: a prospective cohort study

Target

% Dead*

Relative Hazard (95% Confidence Interval)

  

Unadjusted

Multivariate Adjusted**

Propensity Score Adjusted***

Individual Targets

Albumin ≥4.0 g/dl (N = 650)

    

   Target not attained

29.9

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

   Target attained

16.1

0.49 (0.37–0.65)

0.55 (0.41–0.75)

0.77 (0.55–1.08)

   P

<0.001

<0.001

<0.001

0.132

Ca-P Product <55 mg2/dl2 (N = 648)

    

   Target not attained

24.4

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

   Target attained

26.4

0.83 (0.65–1.04)

0.74 (0.57–0.95)

0.67 (0.52–0.86)

   P

0.574

0.109

0.020

0.002

Hemoglobin ≥11 g/dl (N = 644)

    

   Target not attained

29.3

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

   Target attained

23.2

0.75 (0.60–0.96)

0.62 (0.48–0.79)

0.67 (0.52–0.87)

   P

0.083

0.020

<0.001

0.002

Dialysis Dose, Kt/V≥1.2 (N = 539)

    

   Target not attained

30.5

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

   Target attained

24.8

0.73 (0.51–1.05)

0.67 (0.45–1.00)

0.56 (0.35–0.88)

   P

0.245

0.089

0.049

0.012

Access Type, fistula (N = 424)

    

   Target not attained

24.5

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

   Target attained

20.0

0.80 (0.57–1.11)

0.96 (0.67–1.36)

1.05 (0.73–1.52)

   P

0.328

0.189

0.806

0.776

Albumin, Ca-P, and Hemoglobin Targets (N = 643)

0 targets attained

29.9

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

1 target attained

28.7

0.81 (0.56–1.16)

0.77 (0.52–1.13)

0.65 (0.44–0.95)

2 targets attained

25.7

0.61 (0.41–0.89)

0.51 (0.34–0.77)

0.49 (0.32–0.73)

3 targets attained

12.9

0.32 (0.19–0.53)

0.27 (0.15–0.47)

0.26 (0.15–0.46)

P for trend

0.009

<0.001

<0.001

<0.001

All Five Targets (N = 344)

0–1 targets attained

27.5

1.00 (Ref.)

1.00 (Ref.)

1.00 (Ref.)

2 targets attained

29.3

0.93 (0.52–1.63)

0.90 (0.50–1.63)

0.93 (0.52–1.67)

3 targets attained

20.5

0.51 (0.28–0.91)

0.49 (0.27–0.91)

0.53 (0.29–0.97)

4–5 targets attained

15.5

0.37 (0.19–0.72)

0.33 (0.16–0.63)

0.41 (0.20–0.83)

P for trend

0.030

<0.001

<0.001

<0.001

  1. Mean at-risk follow-up was 3.3 years (median, 2.8 years). Statistically significant values are in boldface type.
  2. *At median follow-up (2.8 years). P by Pearson's χ2 test (individual targets) or nonparametric trend test (multiple targets).
  3. **Adjusted for first value of target(s) indicated, age, race, index of co-existent disease, and albumin.
  4. ***Propensity score models consisted of:
  5. Albumin target: age, sex, index of co-existent disease, baseline albumin, creatinine, and C-reactive protein;
  6. Ca-P target: age, sex, employment, index of co-existent disease, creatinine, hemoglobin, and baseline Ca-P;
  7. Hemoglobin target: age, sex, race, body mass index, and baseline hemoglobin;
  8. Dialysis dose target: age, sex, race, body mass index, Kt/V, creatinine, hemoglobin, and Ca-P;
  9. Access target: age, sex, race, index of co-existent disease, albumin, creatinine, and C-reactive protein;
  10. Albumin, Ca-P, and hemoglobin targets: age, sex, index of co-existent disease, body mass index, baseline albumin, baseline hemoglobin, baseline Ca-P, and C-reactive protein; and
  11. All five targets: age, sex, index of co-existent disease, body mass index, baseline Kt/V, baseline albumin, baseline hemoglobin, baseline Ca-P, and C-reactive protein.
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BMC Health Services Research

ISSN: 1472-6963

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