Scholarlink

Background <p>Infection is a major cause of death in patients undergoing maintenance hemodialysis (HD). We examined whether the high-sensitivity Glasgow prognostic score (hsGPS), derived from serum C-reactive protein (CRP) and albumin, is associated with infection-related mortality.</p> Methods <p>This retrospective cohort study included 3529 patients undergoing maintenance HD enrolled between December 31, 2006 and December 31, 2007 and followed until December 31, 2016. We used a high-sensitivity Glasgow prognostic score (hsGPS), defined using a lower CRP threshold in a GPS-type manner as follows: score 0, CRP ≤ 0.3&#xa0;mg/dL and albumin ≥ 3.5&#xa0;g/dL; score 1, CRP &gt; 0.3&#xa0;mg/dL or albumin &lt; 3.5&#xa0;g/dL; and score 2, CRP &gt; 0.3&#xa0;mg/dL and albumin &lt; 3.5&#xa0;g/dL. Associations were evaluated using Kaplan–Meier analysis, Cox proportional hazards models, Fine–Gray competing-risk models, and restricted cubic spline analyses.</p> Results <p>During a median follow-up of 3199&#xa0;days, 1748 deaths occurred, including 451 infection-related deaths. In descriptive Kaplan–Meier analysis, infection-related death-free survival was lower in higher hsGPS groups. In the multivariable-adjusted Cox model, hazard ratios for infection-related mortality were 1.79 (95% confidence interval [CI] 1.43–2.24) for hsGPS 1 and 2.38 (95% CI 1.71–3.31) for hsGPS 2, compared with hsGPS 0. Competing-risk analyses showed similar trends, although the associations were attenuated. Restricted cubic spline analyses showed higher risk at lower albumin levels and higher CRP levels.</p> Conclusions <p>Higher hsGPS was associated with higher infection-related mortality in patients undergoing maintenance HD. hsGPS may serve as a simple risk stratification tool in this population.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

High-sensitivity Glasgow prognostic score and infection-related mortality in maintenance hemodialysis patients: 10-year outcomes of the Q-Cohort Study

  • 期刊论文

  • 发表日期：

    2026年6月29日

查看全文
  • Yutaro Hirashima,
  • Shunsuke Yamada,
  • Hiromasa Kitamura,
  • Hiroto Hiyamuta,
  • Masatomo Taniguchi,
  • Kazuhiko Tsuruya,
  • Tetsuro Ago,
  • Toshiaki Nakano

摘要

Background

Infection is a major cause of death in patients undergoing maintenance hemodialysis (HD). We examined whether the high-sensitivity Glasgow prognostic score (hsGPS), derived from serum C-reactive protein (CRP) and albumin, is associated with infection-related mortality.

Methods

This retrospective cohort study included 3529 patients undergoing maintenance HD enrolled between December 31, 2006 and December 31, 2007 and followed until December 31, 2016. We used a high-sensitivity Glasgow prognostic score (hsGPS), defined using a lower CRP threshold in a GPS-type manner as follows: score 0, CRP ≤ 0.3 mg/dL and albumin ≥ 3.5 g/dL; score 1, CRP > 0.3 mg/dL or albumin < 3.5 g/dL; and score 2, CRP > 0.3 mg/dL and albumin < 3.5 g/dL. Associations were evaluated using Kaplan–Meier analysis, Cox proportional hazards models, Fine–Gray competing-risk models, and restricted cubic spline analyses.

Results

During a median follow-up of 3199 days, 1748 deaths occurred, including 451 infection-related deaths. In descriptive Kaplan–Meier analysis, infection-related death-free survival was lower in higher hsGPS groups. In the multivariable-adjusted Cox model, hazard ratios for infection-related mortality were 1.79 (95% confidence interval [CI] 1.43–2.24) for hsGPS 1 and 2.38 (95% CI 1.71–3.31) for hsGPS 2, compared with hsGPS 0. Competing-risk analyses showed similar trends, although the associations were attenuated. Restricted cubic spline analyses showed higher risk at lower albumin levels and higher CRP levels.

Conclusions

Higher hsGPS was associated with higher infection-related mortality in patients undergoing maintenance HD. hsGPS may serve as a simple risk stratification tool in this population.