Predicting 6-Month Mortality in Incident Elderly Dialysis Patients: A Simple Prognostic Score

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Santos, J (Author) Other; oliveira, p (Author) ICBAS; Malheiro, J (Author) Other; Campos, A (Author) Other; Correia, S (Author) Other; Cabrita, A (Author) Other; Lobato, L (Author) Other; Fonseca, I (Author) Other

Journal

Title: Kidney and Blood Pressure Research

Vol. 45

Pages: 38-50

ISSN: 1420-4096

Publisher: Karger

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 3 Citations

Other information

Authenticus ID: P-00R-GV2

DOI: 10.1159/000504136

Abstract (EN): Aim: Mortality in end-stage renal disease (ESRD) remains high, particularly among elderly, who represents the most rapidly growing segment of the ESRD population in wealthier countries. We developed and validated a risk score in elderly patients to predict 6-month mortality after dialysis initiation. Methods: We used data from a cohort of 421 patients, aged 65 years and over who started dialysis between 2009 and 2016, in our Nephrology department. The predictive score was developed using a multivariable logistic regression analysis. A bootstrapping technique was used for internal validation. Results: The overall mortality within 6 months was 14.0%. Five independent predictors were identified, and a points system was constructed: age 75 years or older (2 points), coronary artery disease (2), cerebrovascular disease with hemiplegia (2), time of nephrology care before dialysis (<3.0 months [2]; >= 3 to <12 months [1]), and serum albumin levels (3.0-3.49 g/dL [1]; <3.0 g/dL [2]). A score of 6 identified patients with a 70% risk of 6-month mortality. Model performance was good in both discrimination (area under the curve of 0.793; [95% CI 0.73-0.86]) and validation (concordance statistics of 0.791 [95% CI 0.73-0.85]). Conclusions: We developed a simple prediction score based on readily available clinical and laboratory data that can be a practical and useful tool to assess short-term prognosis in elderly patients starting dialysis. It may help to inform patients and their families about ESRD treatment options and provide a more patient-centered overall approach to care.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13