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Results

In 22 million sessions, 898 people between 2004 and 2006 and 826 people between 2007 and 2008 died on the day of or day after a dialysis session that was serving as a training or test data session, respectively. A reasonably strong predictor was derived using just predialysis information (concordance statistic= 0.782), which showed modest but significant improvement after inclusion of postdialysis information (concordance statistic= 0.799, P< 0.001). However, risk prediction decreased the farther out that it was forecasted (up to 1 year), and postdialytic information became less important.

Conclusion

Subtle changes in the experience of hemodialysis aid in the assessment of sudden cardiac death and are captured by modern electronic health records. The collected data are better for the assessment of near-term risk as opposed to longer-term risk.