A number of comorbid conditions may impact the survival of a patient undergoing hemodialysis. The authors are from Tufts Medical Center and the University of Michigan.
Clinical trial: Dialysis Outcomes and Practice Pattern Study (DOPPS)
Patient selection: hemodialysis
Conditions within the past year:
(1) hospitalized for CHF in the past year
(2) depression within the past year
(3) substance abuse in the past year
(4) GI bleed within the past year
(5) ascites within the past year
History of:
(6) history of peripheral arterial disease (PAD)
(7) history of acute myocardial infarction
(8) history of cancer
(9) history of amputation due peripheral vascular disease
Conditions:
(10) absence of hypertension
(11) COPD
(12) recurrent cellulitis or gangrene
(13) use of home oxygen
(14) dementia
(15) stroke with neurological deficit
(16) HIV/AIDS
(17) diabetes mellitus treated with insulin
total number of comorbid conditions =
= SUM(number of the conditions present)
Interpretation:
• minimum score: 0
• maximum score: 17
• Survival declines as the number of comorbid conditions increases.
Performance:
• The area under the ROC curve was 0.67.
