Abstract: Objective   To explore the risk factors for food aspiration during hemodialysis sessions in patients on maintenance hemodialysis (MHD) and to develop a prediction model for the aspiration risk.  Method  A total of 220 MHD patients over 60 years old and treated in a tertiary hospital in Wuxi city were enrolled in this study. Least Absolute Selection and Shrinkage Operator (LASSO) regression analysis was used to select predictors. Multivariate logistic regression was applied to build the risk prediction model, which was also shown as nomogram. Receiver operating characteristic curve (ROC curve) and calibration curve were used to assess the discrimination and calibration abilities of the model.  Results   History of stroke (OR=9.460, 95% CI: 3.218～27.813, P<0.001), pneumonia (OR=6.499, 95% CI: 1.912～22.096, P=0.003), sedative and hypnotic drugs (OR=5.978, 95% CI: 1.323～27.005, P=0.020), drugs for chronic kidney disease-mineral and bone disorder (CKD-MBD; OR=3.069, 95% CI: 1.074～8.773, P=0.036), oxygen saturation <95% (OR=11.545, 95% CI: 3.932～33.901, P＜0.001) and non-solid food (OR=0.253, 95% CI: 0.078～0.826, P=0.023) were the independent risk factors for food aspiration in MHD patients (P＜0.05). The area under curve (AUC) of the ROC curve was 0.917 (95% CI: 0.879～0.955, P＜0.001). The consistency and benefit of the model evaluated by calibration and decision curves obtained better results.  Conclusion  This model has satisfactory effects that provides references for nurses to identify high-risk patients and implement preventive measures.

Key words:  Elderly, Maintenance hemodialysis, Oral feeding, Aspiration, Risk prediction model