The Optimal Cut-off Value of Abdominal Aortic Calcification Score in Predicting Mortality in Chronic Hemodialysis Patients
Wei-Ting Wang；Chieh-Ning Hsi；Hsuan-Jen Lin；Che-Yi Chou；Shi-Heng Wang；Hung-Chih Chen；Chiz-Tzung Chang
AAC score ； abdominal aortic calcification score ； ESRD ； hemodialysis ； mortality
|Volume or Term/Year and Month of Publication||
32卷4期（2018 / 12 / 01）
160 - 166
BACKGROUND: Abdominal aortic calcification (AAC) is associated with increased mortality in hemodialysis (HD) patients. However, the cut-off value of AAC score in predicting all-cause mortality is unknown. We aimed to explore the optimal cut-off value of AAC score in predicting all-cause mortality in HD patients. METHODS: We measured the AAC scores of all HD patients in China Medical University Hospital, and the association between AAC score and all-cause mortality was analyzed using Cox regression. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off of AAC score. RESULTS: A total of 410 patients were enrolled in this study. In the total follow-up time of 59 months, 112 (27.3%) patients died at the end of the study. The AAC score was associated with increased all-cause mortality with an adjusted hazard ratio of 1.052 (95% confidence interval [CI]: 1.019-1.085 for every one-point increase of AAC score) (P = 0.002). The area under the ROC curve was 0.617 (P ＜ 0.001) for AAC score. The sensitivity and specificity of the AAC score were 53.6 and 79.2% with a cut-off of 11. The survival of patients with an AAC score ＜ 11 was better than those with an AAC score of ≥ 11 (log-rank test, P ＜ 0.001). CONCLUSION: A higher AAC score was associated with increased all-cause mortality in chronic HD patients. The optimal cut-off of the AAC score was 11 in predicting all-cause mortality.