Spatiotemporal multilevel joint modeling of longitudinal and survival outcomes in end-stage kidney disease.

ABSTRACT: Individuals with end-stage kidney disease (ESKD) on dialysis experience high mortality and excessive burden of hospitalizations over time relative to comparable Medicare patient cohorts without kidney failure. A key interest in this population is to understand the time-dynamic effects of multilevel risk factors that contribute to the correlated outcomes of longitudinal hospitalization and mortality. For this we utilize multilevel data from the United States Renal Data System (USRDS), a national database that includes nearly all patients with ESKD, where repeated measurements/hospitalizations over time are nested in patients and patients are nested within (health service) regions across the contiguous U.S. We develop a novel spatiotemporal multilevel joint model (STM-JM) that accounts for t

SUBMITTER: Kurum E 

PROVIDER: S-EPMC11502599 | biostudies-literature | 2024 Oct

REPOSITORIES: biostudies-literature