Bibliographic record
Abstract
Abstract Background: Research on the factors associated with dialysis withdrawal in dialysis patients has been limited. Authors have used different definitions for dialysis withdrawal, resulting in inconsistent findings. The objective of this study was to determine the factors associated with dialysis withdrawal in dialysis patients. Methods: This retrospective study extracted patient information from the electronic renal patient management systems at the Grand River Hospital. A total of 723 patients who initiated renal dialysis therapy (> 30 days of duration) in the renal dialysis program at Grand River Hospital (GRH), Ontario, during the period from 1st January 2012 to 30th September 2017 were consecutively included in the study. Logistic regression was used to determine the factors: age, sex, modality, comorbidities, the cause of primary renal disease, dialysis modality, and duration of dialysis-associated with dialysis withdrawal. Dialysis withdrawal was defined as “patient declined further treatment or voluntary withdrawal from the dialysis program”. Results: The mean age of the sample was 64.86 ± 14.89 years, and 62.8% (n = 454) were males. The prevalence of dialysis withdrawal was 9.41% (n = 68). The logistic regression model showed that factors associated with dialysis withdrawal were as follows: cardiac disease [Adjusted Odds Ratio (AOR)= 1.921; 95% CI= 1.126–3.278], hypertension [AOR = 5.711; 95% CI = 1.322- 24.676], dementia [AOR = 3.042; 95% CI = 1.325–6.983], age [AOR = 1.035; 95% CI = 1.012– 1.058] and duration of dialysis [AOR = 0.999; 95% CI = 0.999–1.00]. Conclusion: In this study we show that age, cardiac disease, hypertension, and dementia are significant predictors related to dialysis withdrawal. The findings might help in identifying patients who are more likely to withdraw from dialysis at the start of dialysis. Future researchers and nephrologists should design and conduct intervention studies focusing on strategies controlling the severity of comorbidities (cardiac disease and hypertension), regular assessment and monitoring of the progression of dementia, and other dialysis program changes to help patients make more informed decisions regarding dialysis withdrawal.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".