The project investigated the development and use of a risk score tool to estimate the risk of early mortality after dialysis initiation, which will facilitate informed decision-making regarding treatment options. Risk scores can be used to promote patient engagement and empowerment within the clinical decision pathway.
The Abstract can be found here
“Shall I initiate dialysis?”
Chronic kidney disease (CKD) patients are initiating maintenance permanent dialysis at more advanced ages with a higher prevalence of comorbid conditions increasing their risk of poor outcomes. A shared decision-making tool could help elderly advanced CKD patients decide about initiating dialysis. Since mortality may be high in the first few months after initiating dialysis, incorporating early mortality predictors in such a tool would be important for an informed decision. Researchers from the Medical Technology and Practice Patterns Institute (MTPPI) recently developed such a tool which was published in June 2015 in the American Journal of Kidney Diseases. The article, “Predicting Early Death Among Elderly Dialysis Patients: Development and Validation of a Risk Score to Assist Shared Decision Making for Dialysis Initiation” was authored by Dr. Mae Thamer and colleagues including an expert in the development of risk scores from UC Davis, Dr. Heejung Bang. The simple risk score (total score of 0-9) included age (0 to 3 points), low albumin, assistance with daily living, nursing home residence, cancer, heart failure, and hospitalization (1 point each) and predicts the likelihood of dying in the first 3 and 6 months after initiating dialysis. The authors concluded that… “Routinely available information can be used by CKD patients, families and their nephrologists to estimate risk of early mortality after dialysis initiation, which may facilitate informed decision-making regarding treatment options.”
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