Kerri L. Cavanaugh|Sharon Stein Merkin|Laura Plantinga|Nancy E. Fink|John H. Sadler|Neil R. Powe
Accuracy of Patients' Reports of Comorbid Disease and Their Association With Mortality in ESRD
Vanderbilt University|University of California, Los Angeles|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University
patient awareness chronic diseases low unawareness may represent poor understanding chronic illness may associated poor outcomes patients endstage renal disease esrdconcurrent prospective national cohort studyincident hemodialysis peritoneal dialysis patients enrolled choices healthy outcomes caring esrd study followed 2004inaccurate patient selfreport 8 comorbid diseases compared medical recordallcause mortality primary outcome cox proportional hazard models used assess contribution demographics clinical measures relation inaccurate selfreport mortalityin 965 patients proportion inaccurate selfreporters ranged 3 diabetes mellitus 35 congestive heart failure generally inaccurate selfreporters older chronic diseases greater risk death found inaccurate selfreporters ischemic heart disease hazard ratio hr 134 95 confidence interval 112 159 p 0001 coronary intervention hr 146 95 confidence interval 108 197 p 001 chronic obstructive pulmonary disease hr 140 95 confidence interval 114 170 p 0001 greater risk death remained significant chronic obstructive pulmonary disease hr 136 95 confidence interval 111 166 p 0003 adjustment age sex race patients receiving peritoneal dialysis greater risk death hr 206 95 confidence interval 134 315 p 0001 found inaccurate selfreporters ischemic heart diseaseincludes potential residual confounding medical record error misclassification patient accuracy selfreport low inaccurate selfreport chronic diseases reducing power measure associationsaccuracy selfreport depends specific comorbid disease patients esrd especially receiving peritoneal dialysis inaccurately report heart disease may less aware chronic comorbid disease may greater risk mortality compared accurately report comorbid disease