Nihon Toseki Igakkai Zasshi
Online ISSN : 1883-082X
Print ISSN : 1340-3451
ISSN-L : 1340-3451
The impact of Functional Independence Measure score on the mortality of hemodialysis patients
Takuya MurakamiYuya NakamuraMasaki HaraMisako EndoHideki TsukaharaYoshinobu WatanabeTatsuo ShimizuMichiyasu InoueYoshiyuki MatsuokaTsutomu AsanoHiromichi GotohYoshikazu Goto
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2014 Volume 47 Issue 2 Pages 129-136

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Abstract
【Background】Decreased activities of daily living (ADL) have been associated with mortality in the general population. Additionally, decreased ADL are more common among hemodialysis patients than in the general population. Therefore, the correlation between ADL and mortality in hemodialysis patients needs to be studied. We assessed the level of ADL using functional independence measure (FIM), which is one of the major surrogate markers of ADL, and the association between the FIM score and all-cause mortality in hemodialysis patients. 【Methods】A total of 132 patients on maintenance hemodialysis (77 men and 55 women ; mean age, 72.3±0.8 years) were enrolled. ADL was assessed using FIM score (total points, 126), which comprises 13 motor items (total points, 91) and 5 cognitive items (total points, 35). A multivariable linear regression model was constructed to determine factors associated with the FIM score. A survival curve was drawn using Kaplan-Meier analysis and stratified into 4 groups using the interquartile range value of FIM score. The Cox proportional hazards analysis was used to calculate mortality hazard ratio and its 95% confidence interval. 【Results】The mean total FIM score was 60.0±2.2, and the scores for FIM motor and cognitive items decreased (34.8±1.5 and 25.7±1.0, respectively). Cerebrovascular disease and Cr were significantly associated with FIM score. Cumulative mortality rate was significantly higher in groups with FIM scores 40—60 and≤39 than in groups with FIM scores 84≤. FIM score, hsCRP, and hANP were significantly associated with mortality, and FIM was the strongest related factor. 【Conclusions】The FIM score decreased by half in hemodialysis patients, especially in motor items. The FIM score is a novel predictive marker in these patients. Our findings suggest the need for comprehensive strategies that could increase the ADL in hemodialysis patients.
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© 2014 The Japanese Society for Dialysis Therapy
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