May 1, 2017

A Clinical Risk Prediction Tool for 6-Month Mortality After Dialysis Initiation Among Older Adults

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This study derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment using linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada.

A 19-point risk score was developed for 6-month mortality that included age 80 years or older (2 points), glomerular filtration rate of 10 to 14.9 mL/min/1.73 m2 (1 point) or ≥15 mL/min/1.73 m2 (3 points), atrial fibrillation (2 points), lymphoma (5 points), congestive heart failure (2 points), hospitalization in the prior 6 months (2 points), and metastatic cancer (3 points). Model discrimination (C statistic = 0.72) and calibration (Hosmer-Lemeshow χ2 = 10.36; P = 0.2) were reasonable.  This tool has yet to be externally validated, but may be serve as a clinical decision tool in helping older adults with kidney failure make cogent decisions.

 

 

 

 

 

 

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Clinical Nephrology, Hemodialysis