Couchoud et al developed a prognostic score for an elderly adult starting dialysis for end-stage renal disease (ESRD). The authors are from multiple institutions in France.
Patient selection: end-stage renal disease (ESRD) started on dialysis (type not specified), age >= 75 years of age
Outcome: 6-month mortality rate
Parameters:
(1) body mass index (BMI) in kg per square meter
(2) diabetes
(3) congestive heart failure stage III or IV
(4) peripheral vascular disease Stage III or IV
(5) cardiac dysrhythmia
(6) active malignancy
(7) severe behavioral disorder
(8) totally dependent for transfers
(9) initial context for dialysis (planned vs unplanned)
|
Parameter
|
Finding
|
Points
|
|
BMI
|
< 18.5
|
2
|
|
|
>= 18.5
|
0
|
|
diabetes
|
absent
|
0
|
|
|
present
|
1
|
|
CHF Stage III or IV
|
absent
|
0
|
|
|
present
|
2
|
|
PVD Stage III or IV
|
absent
|
0
|
|
|
present
|
2
|
|
cardiac dysrhythmia
|
absent
|
0
|
|
|
present
|
1
|
|
active malignancy
|
absent
|
0
|
|
|
present
|
1
|
|
severe behavioral disorder
|
absent
|
0
|
|
|
present
|
2
|
|
totally dependent for transferss
|
absent
|
0
|
|
|
present
|
3
|
|
initial context
|
planned
|
0
|
|
|
unplanned
|
2
|
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the greater the 6-month mortality.
|
Score
|
6-Month Mortality
|
|
0
|
8%
|
|
1
|
8-10%
|
|
2
|
14-17%
|
|
3 or 4
|
21-26%
|
|
5 or 6
|
33-35%
|
|
7 or 8
|
50%
|
|
9 to 16
|
62-70%
|
Performance:
• The area under the ROC curve is 0.70.
