medical decision support medical decision support
Sign In

Predictive Factors of Ifudu et al for Mortality in Patients Requiring Maintenance Hemodialysis

Purpose: To identify mortality risk in a patient requiring maintenance hemodialysis based on the study of Ifudu et al.

Description

Ifiudu et al identified a number of factors associated with mortality in patients requiring maintenance hemodialysis. This can be help identify patients who may require more aggressive monitoring and management. The authors are from the State University of New York Health Science Center at Brooklyn, New York.


NOTE: In the paper the functional status correlated with mortality. The other 4 factors were used in a Cox model to predict survival; this model did not require or include the functional status.

 

Parameters:

(1) age

(2) race

(3) serum albumin (as a measure of nutritional status)

(4) underlying cause of renal failure

(5) functional status measured with a modified Karnofsky scale

 

Parameters

Finding

Points

age

not advanced

0

 

advanced

1

race

Black or Hispanic

0

 

White

1

serum albumin

>= 4 g/dL

0

 

< 4 g/dL

1

underlying cause for renal disease

other than diabetes mellitus

0

 

diabetes mellitus

1

functional status

independent

0

 

needs assistance or disabled

1

 

where:

• The mean age for Caucasians was 65 years. The mean age for Blacks was 56 years and Hispanics 53 years.

• The risk increased with increasing age. For the implementation I will use > 65 years as indicative of advanced age.

• The risk for functional status corresponded to a modified Karnofsky scale of < 70.

• Ischemic heart disease was the major cause of mortality in the study. Diabetes mellitus would be associated with an increase in ischemic heart disease.

 

total number of risk factors =

= SUM(number of points for all 5 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 5

• The risk of mortality increases with the number of risk factors.


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10