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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 have discussions 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 of prognosis reinforces trust and hope, enhances a mutually respectful doctor-patient relationship and facilitates treatment decisions that are consistent with underlying 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).
References
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.
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