Wick et al developed a score for predicting 6-month mortality for an older adult starting maintenance dialysis therapy. This can help to identify a patient who may benefit from more aggressive management. The authors are from University of Calgary.
Patient selection: >- 65 years of age starting dialysis
Outcome: mortality at 6 months
Parameters:
(1) age in years
(2) eGFR in mL per minute per 1.73 square meter
(3) atrial fibrillation
(4) congestive heart failure
(5) malignant lymphoma
(6) metastatic cancer
(7) hospital stay in the past 6 months
Parameter
Finding
Points
age in years
65 to 79
0
>= 80
2
eGFR
0 to 9.9
0
10 to 14.9
1
>= 15
3
atrial fibrillation
no
0
yes
2
congestive heart failure
no
0
yes
2
lymphoma
no
0
yes
5
metastatic cancer
no
0
yes
3
hospital stay
no
0
yes
2
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
• The higher the score the greater the mortality.
X =
= (0.2607 * (score)) - 2.795
probability of mortality by 6 months =
= 1/(1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.72.
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