Research on the construction of a risk early warning model for frailty risk in maintenance hemodialysis patients

ZHUANG Jianhong; GU Liya; LIN Ping; XU Min; WANG Jing; GAO Meiling

doi:10.3969/j.issn.1671-315x.2023.12.013

Abstract：Objective To analyze the related risk factors of frailty in maintenance hemodialysis patients,establish a risk early warning model and verify it.Methods Totally,220 patients with maintenance hemodialysis admitted to a hospital from June 2019 to June 2022 were selected into the modeling group as the study object,and were divided into the frailty group and the non-frailty group according to the results of frailty.Logistic regression was used to analyze the risk factors of frailty in the modeling group and establish a risk early warning model.The model was evaluated by the subject's working characteristic curve,and the goodness of fit of the model was judged by Hosmer-Lemeshow test.In addition,94 maintenance hemodialysis patients in the verification group were selected for external verification of the model.Results In the modeling group,119 patients(54.09%)suffered from asthenia.Logistic regression analysis showed that age,Charlson comorbidibility index,sarcopenia,serum albumin,nutritional risk screening 2002(NRS 2002)score and grip strength were independent influencing factors for frailty(P＜0.05).ROC results showed that the area under the curve(AUC)was 0.875,the sensitivity was 86.700%,and the specificity was 83.200%.The Hosmer-Lemeshow fitting test showed that x2=12.337,P=0.137.The model had good fitting validity and high prediction value.The results of model validation set showed that the external prediction efficiency of the model was good.Conclusion Age,Charlson comorbid-ities index,sarcopenia and NRS 2002 score are independent risk factors for frailty in maintenance hemodialysis patients,and serum albumin and grip strength are protective factors.The established risk early warning model has been proved to have good predictive efficiency and has certain clinical application value.