Santos et al reported a model for predicting mortality of an older adult on dialysis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Universidade do Porto and Centro Hospitalar do Porto in Portugal.
Patient selection: >= 65 years of age on dialysis
Parameter:
(1) age of the patient
(2) coronary artery disease
(3) cerebrovascular disease with hemiplegia
(4) serum albumin in g/dL
(5) duration of nephrologist care prior to dialysis in months
Parameters
Findings
Points
age
< 75 years
0
>= 75 years
2
coronary artery disease
no
0
yes
2
stroke with hemiplegia
no
0
yes
2
serum albumin
>= 3.5 g/dL
0
3.0 to 3.49 g/dL
1
< 3.0 g/dL
2
duration of nephrologist care
>= 12 months
0
3 to 11.99
1
< 3 months
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the mortality.
Total Score
Mortality Rate
Mortality within 6 Months of Starting Dialysis
0
3.2%
2%
1
3.3%
5%
2
12%
10%
3
15%
19%
4
37%
33%
5
52%
50%
6
57%
70%
based on numbers shown in Table 5
Performance:
• The area under the ROC curve is 0.79.
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