Development of a Clinical Risk Prediction Tool for Early Mortality After Dialysis Initiation Among Older Adults
Abstract
Background: Early mortality after dialysis initiation is common among older adults. Information on an individual’s risk of death may influence the decision to initiate dialysis.
Objective: To develop a clinical risk prediction tool for mortality within six and twelve months of dialysis initiation, for older adults.
Methods: Eligible individuals were adults age ≥65 who initiated chronic dialysis between May 1, 2003 and March 31, 2012. Measures of demographics, laboratory values, health-usage and comorbidity were potential predictors of early mortality. We used logistic regression to predict mortality, and created a point score system.
Results: The six- and twelve-month tools included age, glomerular filtration rate, atrial fibrillation, lymphoma, chronic heart failure, prior hospitalization and metastatic cancer. Cirrhosis and late referral to nephrologist were also in the twelve-month score. Model discrimination was 0.72 for each outcome.
Conclusion: These tools may aide decision making for older adults considering dialysis.
Description
Keywords
Epidemiology
Citation
Wick, J. (2015). Development of a Clinical Risk Prediction Tool for Early Mortality After Dialysis Initiation Among Older Adults (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25653