Your browser doesn't support javascript.
loading
Pre-Kidney Transplant Lower Extremity Impairment and Post-Kidney Transplant Mortality.
Nastasi, A J; McAdams-DeMarco, M A; Schrack, J; Ying, H; Olorundare, I; Warsame, F; Mountford, A; Haugen, C E; González Fernández, M; Norman, S P; Segev, D L.
Afiliación
  • Nastasi AJ; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • McAdams-DeMarco MA; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Schrack J; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Ying H; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Olorundare I; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Warsame F; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Mountford A; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Haugen CE; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • González Fernández M; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Norman SP; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
  • Segev DL; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
Am J Transplant ; 18(1): 189-196, 2018 01.
Article en En | MEDLINE | ID: mdl-28710900
Prediction models for post-kidney transplantation mortality have had limited success (C-statistics ≤0.70). Adding objective measures of potentially modifiable factors may improve prediction and, consequently, kidney transplant (KT) survival through intervention. The Short Physical Performance Battery (SPPB) is an easily administered objective test of lower extremity function consisting of three parts (balance, walking speed, chair stands), each with scores of 0-4, for a composite score of 0-12, with higher scores indicating better function. SPPB performance and frailty (Fried frailty phenotype) were assessed at admission for KT in a prospective cohort of 719 KT recipients at Johns Hopkins Hospital (8/2009 to 6/2016) and University of Michigan (2/2013 to 12/2016). The independent associations between SPPB impairment (SPPB composite score ≤10) and composite score with post-KT mortality were tested using adjusted competing risks models treating graft failure as a competing risk. The 5-year posttransplantation mortality for impaired recipients was 20.6% compared to 4.5% for unimpaired recipients (p < 0.001). Impaired recipients had a 2.30-fold (adjusted hazard ratio [aHR] 2.30, 95% confidence interval [CI] 1.12-4.74, p = 0.02) increased risk of postkidney transplantation mortality compared to unimpaired recipients. Each one-point decrease in SPPB score was independently associated with a 1.19-fold (95% CI 1.09-1.30, p < 0.001) higher risk of post-KT mortality. SPPB-derived lower extremity function is a potentially highly useful and modifiable objective measure for pre-KT risk prediction.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Riñón / Extremidad Inferior / Rendimiento Físico Funcional / Rechazo de Injerto / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Riñón / Extremidad Inferior / Rendimiento Físico Funcional / Rechazo de Injerto / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos