Background: Patients with end-stage renal disease (ESRD) have multiple comorbid conditions. Obtaining comorbidity\ndata from medical records is cumbersome. A self-report comorbidity questionnaire is a useful alternative. Our aim in this\nstudy was to examine the predictive value of a self-report comorbidity questionnaire in terms of survival in ESRD patients.\nMethods: We studied a prospective cross-sectional cohort of 282 haemodialysis (HD) patients in a single centre.\nParticipants were administered the self-report questionnaire during an HD session. Information on their comorbidities was\nsubsequently obtained from an examination of the patientââ?¬â?¢s medical records. Levels of agreement between parameters\nderived from the questionnaire, and from the medical records, were examined. Participants were followed-up for 18\nmonths to collect survival data. The influence on survival of comorbidity scores derived from the self-report data\n(the Composite Self-report Comorbidity Score [CSCS]) and from medical records data - the Charlson Comorbidity Index\n[CCI] were compared.\nResults: The level of agreement between the self-report items and those obtained from medical records was almost\nperfect with respect the presence of diabetes (Kappa score ? 0.97), substantial for heart disease and cancer (? 0.62 and\n? 0.72 respectively), moderate for liver disease (? 0.51), only fair for lung disease, arthritis, cerebrovascular disease, and\ndepression (? 0.34, 0.35, 0.34 and 0.29 respectively). The CSCS was strongly predictive of survival in regression models\n(Nagelkerke R2 value 0.202), with a predictive power similar to that of the CCI (Nagelkerke R2 value 0.211). The influences\nof these two parameters were additive in the models ââ?¬â?? suggesting that these parameters make different contributions\nto the assessment of comorbidity.\nConclusion: This self-report comorbidity questionnaire is a viable tool to collect comorbidity data and may have a role in\nthe prediction of short-term survival in patients with end-stage renal disease on haemodialysis. Further work is required in\nthis setting to refine the tool and define its role.
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