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Background: The malnutrition-inflammation score (MIS) is an indicator of malnutrition-inflammation complex syndrome and an outcome predictor in maintenance hemodialysis patients. However, its utility in peritoneal dialysis (PD) patients and its association with the Charlson comorbidity index (CCI) have not yet been examined. Methods: All chronic stable PD outpatients in the PD center of the National Taiwan University Hospital in January 2006 were studied and followed for up to 18 months. The baseline MIS and CCI at the beginning of the study and the dates and causes of mortality or hospitalization during the study period were obtained. Results: A total of 141 PD patients were enrolled. During the study period, 8 patients died and 40 patients had at least one fatal or nonfatal major cardiovascular or infection event. The CCI correlated positively and significantly with the MIS (r = +0.344, p < 0.001). The MIS and CCI were both independent predictors of cardiovascular and infection events in the multivariate Cox proportional hazard model. For every unit increase in the MIS, the adjusted hazard ratio for mortality was 1.177 (95% confidence interval, CI, 1.050–1.320, p = 0.005). For every unit increase in the CCI, the adjusted hazard ratio for mortality was 1.180 (95% CI, 1.046–1.330, p = 0.007). Conclusions: MIS can predict fatal and nonfatal cardiovascular and infection events in chronic stable PD patients. The CCI, which is closely associated with the MIS, is an independent determinant of cardiovascular and infection events as well. Interventional studies are indicated to confirm the utility of the MIS in PD populations who undergo nutritional or anti-inflammatory treatments.

Background: The malnutrition-inflammation score (MIS) is an indicator of malnutrition-inflammation complex syndrome and an outcome-predictor in maintenance hemodialysis (MHD) patients. However, its utility in peritoneal dialysis (PD) patients and its association with the Charlson comorbidity index (CCI) have not yet been examined. Methods: All chronic stable PD outpatients in the PD center of National Taiwan University Hospital in January 2006 were studied and followed for up to 18 months. The baseline MIS and CCI at the beginning of the study and the dates and causes of mortality or hospitalization during the study period were obtained. Results: A total of 141 PD patients were enrolled. During the study period, 8 patients died and 40 patients had major cardiovascular or infection events. The CCI correlated positively and significantly with the MIS (r = +0.344, p < 0.001). The MIS and CCI were both independent predictors of cardiovascular and infection events in the multivariate Cox proportional hazard model. For every one unit increase in the MIS, the adjusted hazard ratio for mortality was 1.177 (95% CI 1.050–1.320, p = 0.005). For every one unit increase in the CCI, the adjusted hazard ratio for mortality was 1.180 (95% CI 1.046–1.330, p = 0.007). Conclusions: MIS can predict fatal and nonfatal cardiovascular and infection events in chronic stable PD patients. The CCI, which is closely associated with the MIS, is an independent determinant of cardiovascular and infection events as well. Interventional studies are indicated to confirm the utility of the MIS in PD populations who undergo nutritional or anti-inflammatory treatments.

How long esophageal screening should be performed for, and on which subgroups of head and neck cancer (HNC) survivors, remains uncertain. This retrospective study analyzed data from the Taiwan National Health Insurance Research Database from 1999 to 2013. A total of 68,131 newly-diagnosed HNC patients were enrolled. Subjects who received esophageal endoscopic screening within 6 months after their diagnosis date of index HNC were identified. The incidence trends of secondary primary EC were analyzed using a Cochran-Armitage trend test. Among the 9,707 patients who received index esophageal endoscopy screening, 101 (1.0%) cases of synchronous EC were diagnosed. The 5-and 10-year cumulative incidence rates of metachronous ECs were 1.4% and 2.7%, respectively in those with an initial negative index endoscopic finding. Patients with oropharynx or hypopharynx cancers were at significantly higher risk of developing metachronous ECs compared with those with oral or larynx cancers (10-year incidence rate: 3.3% vs. 0.9%, respectively; hazard ratio: 2.15; 95% confidence intervals: 1.57-2.96). Metachronous EC continues to develop in patients with HNC even at 10-years after treatment for primary HNC. HNC patients, especially those with oropharynx or hypopharynx cancer, may require long-term endoscopic surveillance.