Dusseux et al used a clinical tool to identify older patients starting dialysis who may be appropriate candidates for renal transplant. The authors are from multiple institutions in France.
Patient: age >= 70 years
Outcome: 3-year survival
Parameters:
(1) sex
(2) age
(3) diabetes
(4) ischemic heart disease
(5) peripheral vascular disease (Leriche classification)
(6) cerebrovascular disease
(7) congestive heart failure (NYHA stage)
(8) dysrhythmia
(9) chronic respiratory disease
(10) active malignancy
(11) severe behavioral disorder
(12) mobility
(13) body mass index in kilograms per square meter
(14) temporary central venous catheter at initiation of dialysis
|
Parameters |
Findings |
Points |
|
sex |
female |
0 |
|
|
male |
1 |
|
age |
70 to 74.99 |
0 |
|
|
75 to 79.99 |
2 |
|
|
80 to 84.99 |
5 |
|
|
>= 85 |
9 |
|
diabetes |
no |
0 |
|
|
yes |
2 |
|
ischemic heart disease |
no |
0 |
|
|
yes |
2 |
|
peripheral vascular disease |
no, Stage I, Stage II |
0 |
|
|
Stage III, Stage IV |
5 |
|
cerebrovascular disease |
no |
0 |
|
|
yes |
1 |
|
congestive heart failure |
no |
0 |
|
|
Stage I, Stage II |
2 |
|
|
Stage III, Stage IV |
4 |
|
dysrhythmia |
no |
0 |
|
|
yes |
2 |
|
chronic respiratory disease |
no |
0 |
|
|
yes |
2 |
|
active malignancy |
no |
0 |
|
|
yes |
5 |
|
severe behavioral disorder |
no |
0 |
|
|
yes |
6 |
|
mobility |
independent |
0 |
|
|
needs assistance with transfers |
4 |
|
|
totally dependent for transfers |
9 |
|
body mass index |
< 21 |
3 |
|
|
21 to 24.99 |
1 |
|
|
>= 25 |
0 |
|
temperoary CVC |
no |
0 |
|
|
yes |
3 |
score =
= SUM(points for all 14 parameters)
Interpretation:
• minimum score: 0
• maximum score: 54
• The higher the score the worse the survival.
|
Total Score |
3-Year Mortality Rate |
|
0 to 6 |
30-33% |
|
7 to 9 |
47% |
|
10 to 12 |
57-61% |
|
13 to 17 |
68-70% |
|
>=18 |
82% |
Performance:
• The area under the ROC curve is 0.70.
Specialty: Nephrology
