To explore the influencing factors of short-term mortality in elderly maintenance hemodialysis (MHD) patients and the predictive role of nomogram prediction model.

The clinical data of 344 elderly patients who received MHD treatment in our hospital from January 2018 to August 2021 were retrospectively analyzed. According to the patients′ survival within one year after starting hemodialysis treatment, they were divided into a death group and a survival group. The two groups were compared in the clinical data. Logistic regression model was used to analyze influencing factors of short-term mortality in the elderly MHD patients. And a nomogram model was constructed by the R software. The area under the curve (AUC) of the receiver operating curve (ROC) was applied to evaluate the predictive effect of the model, and the goodness-of-fit test was also carried out.

After starting hemodialysis, 84 patients (24.42%) died within one year. There were significant differences between the two groups in terms of hemodialysis starting age, vascular access type, the proportion of Charlson comorbidity index (CCI) >3, systolic blood pressure (SBP), fasting plasma glucose (FPG), serum albumin (Alb), estimated glomerular filtration rate (eGFR), and the proportion of urea clearance index (Kt/V) <1.3 (P<0.05). Logistic regression analysis showed that the main influencing factors for short-term mortality in the elderly MHD patients included hemodialysis starting age(OR 1.263, 95%CI: 1.010-1.534), vascular access type(OR 2.097, 95%CI: 1.025-4.774), Alb(OR 0.463, 95%CI: 0.262-0.817), eGFR(OR 0.416, 95%CI: 0.269-0.644), and Kt/V(OR 2.254, 95%CI: 1.292-5.252). After the above five main influencing factors were introduced into the R software to construct a nomogram model, the analysis results showed that the AUC was 0.820(95%CI: 0.775-0.866) while the goodness-of-fit test displayed good fitting effect (χ²=6.208, P=0.624).

The nomogram model constructed based on five main influencing factors including hemodialysis starting age, vascular access type, Alb, eGFR, and Kt/V might have a role for predicting the risk of short-term mortality in the elderly MHD patients.