6 Month Mortality on HD

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Use the Integrated Prognostic Model to estimate 6-month survival for patients on hemodialysis

Age (yrs)
Albumin
g/dL
g/L
Dementia
Peripheral Vascular Disease
Would I be surprised if this patient died in the next year?

About this calculator

This prognostic tool was developed by Cohen et al in response to the need for prognostic information on survival in patients receiving chronic hemodialysis care.

Despite recommendations by Nephrology associations, nephrologists often do not havediscussions with patients about prognosis and end-of-life care.  The literature, however, suggests that patients want to engage in these discussions.  As well, research suggests that communication ofprognosis reinforces trust and hope, enhances a mutuallyrespectful doctor–patient relationshipand facilitates treatment decisions that are consistent withunderlying values.

This tool combines actuarial factors and the clinician’s prediction of survival to create a validated model that estimates the 6-month mortality of patients receiving hemodialysis.

The five-term multivariable Cox proportional hazards model has strong AUCs for 6-month survival in the derivation cohort (0.87) and validation cohort (0.80).

Note:  For Albumin (in conventional units, g/dL) if <2.5 g/dL, the program will use 2.5; if >4 g/dL, the program will use 4.  However, the formula was not validated in patients with albumin <1.7 g/dL or >5 g/dL.  As well, the formula has not been validated for ages <16 or >92.

Reference

Cohen LM, Ruthazer R, Moss AH, Germain MJ.  Predicting six-month mortality for patients who are on maintenance hemodialysis.  Clin J Am Soc Nephrol. 2010 Jan;5(1):72-9. Epub 2009 Dec 3.