A simple clinical index can be used to assess chances for survival in patients with acute renal failure starting a dialysis program.
Patient population:
(1) 126 patients at the University of Kansas Medical Center from November, 1979 through October, 1985.
(2) included patients undergoing hemodialysis and/or peritoneal dialysis
Clinical Indicators: status measured before starting dialysis:
(1) systolic blood pressure
(2) need for assisted ventilation
(3) congestive heart failure
(4) sepsis
(5) gastrointestinal tract function
|
Clinical Indicator |
Finding |
Points |
|
systolic blood pressure |
> 110 mm Hg |
0 |
|
|
<= 110 mm Hg |
1 |
|
assisted ventilation required |
no |
0 |
|
|
yes |
1 |
|
congestive heart failure |
absent |
0 |
|
|
present |
1 |
|
sepsis |
absent |
0 |
|
|
proven or suspected |
1 |
|
gastrointestinal tract function |
normal |
0 |
|
|
abnormal |
1 |
where:
• Abnormal gastrointestinal tract function includes bleeding, ileus, obstruction, or recent abdominal surgery.
clinical index
= SUM(points for the 5 clinical indicators)
Interpretation
• minimum score: 0
• maximum score: 5
|
Clinical Index |
Percent Survival |
|
0 |
62% |
|
1 |
44% |
|
2 |
30% |
|
3 |
19% |
|
4 |
0% |
|
5 |
6% |
"Survival" period not well defined. Deaths occurred 0-96 days (mean 20 days) after starting dialysis.
Specialty: Nephrology, Clinical Laboratory
