The probability of survival in patients with end-stage renal disease requiring dialysis can be predicted from clinical and historical findings.
Parameters:
(1) age
(2) heart failure symptoms
(3) angina or myocardial infarction
(4) arrhythmia
(5) peripheral vascular disease
(6) malignancy
(7) respiratory and neurologic status
(8) hepatic and circulatory status
Parameter |
Finding |
Points |
---|---|---|
age |
<= 50 years |
1 |
|
> 50 and <= 60 years |
2 |
|
> 60 and <= 70 years |
3 |
|
> 70 years |
4 |
heart failure symptoms |
on strenuous exercise or prolonged activity |
1 |
|
history of prior heart failure |
1 |
|
on ordinary activity or at rest |
2 |
|
recurrent admissions in heart failure |
2 |
angina or myocardial infarction |
new onset or stable angina, or myocardial infarction > 6 months previously |
1 |
|
unstable angina, or myocardial infarct < 6 months previously |
2 |
arrhythmia |
treated arrhythmia present |
2 |
peripheral vascular disease |
gangrene, inoperable peripheral vascular disease, or surgery for peripheral vascular disease < 6 months previously |
2 |
malignancy |
metastatic malignancy, refractory myeloma or blood dyscrasia |
2 |
respiratory and neurological status |
requires mechanical ventilation and/or in coma |
4 |
hepatic and circulatory status |
severe liver disease and/or shock present |
4 |
prognostic score =
= (points for age) + (maximum points for heart failure) + (maximum points for angina_MI) + (points for arrhythmia) + (points for peripheral vascular disease) + (points for malignancy) + (points for respiratory_neurological status) + (points for hepatic_circulatory status)
Interpretation:
• minimum score: 1
• maximum score: 22
Score |
Prognosis |
Survival at 100 days |
Survival at 1 year |
---|---|---|---|
1-4 |
low risk |
98% |
90% |
5-9 |
moderate risk |
80% |
64% |
10-22 |
high risk |
48% |
48% |
(estimated from Figure 1, page 217)
Purpose: To predict the probability of survival in patients with end-stage kidney disease requiring dialysis based on the clinical findings and past medical history.
Specialty: Nephrology, Clinical Laboratory
Objective: severity, prognosis, stage
ICD-10: N17,