Hospitalization in the first year of renal replacement therapy for end-stage renal disease

W. Metcalfe, I. H. Khan, K. Simpson, Gordon James Prescott, Alison Murray MacLeod, Scottish Renal Registry

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: The requirement for hospitalization of patients on dialysis is likely to be a surrogate marker of age and comorbid diseases. It may also reflect the level of care delivered, and substantially increases the cost of this expensive therapy.

Aim: To identify the factors most strongly associated with hospitalization.

Design: Prospective population study.

Methods: Data were recorded for all patients starting RRT in Scotland over one year, including the reasons for and duration of, each hospital admission during the first year of RRT. Factors most strongly associated with hospitalization were determined by Poisson regression analysis.

Results: Overall, 526 patients were admitted to hospital on 1668 occasions (median 3, IQR 1-4) for 13 384 days (median 13, IQR 4-35). Formation of vascular access for haemodialysis (HD) was the most frequent reason for admission, followed by infections. Age, comorbidity, mode of presentation for RRT and primary renal diagnosis were all significantly associated with prolonged hospitalization. Attainment of UK Renal Association standards for urea reduction ratio and serum albumin concentration, and vascular access in the form of arteriovenous fistulae were associated with less hospitalization in patients treated with HD by 90 days.

Discussion: Patients in their first year of RRT have a high requirement for in-patient care, 8.6% of patient treatment days being spent in hospital. Vascular access formation, failure and complications account for a large proportion of this. Age and comorbidity prolong the time spent in hospital. As the RRT population continues to increase, with older patients and those with greater comorbidity, in-patient facilities must also expand.

Original languageEnglish
Pages (from-to)899-909
Number of pages10
JournalQJM
Volume96
Issue number12
DOIs
Publication statusPublished - 2003

Keywords

  • HEMODIALYSIS-PATIENTS
  • DIALYSIS PATIENTS
  • PERITONEAL-DIALYSIS
  • VASCULAR ACCESS
  • MORTALITY
  • MORBIDITY
  • LENGTH
  • COMORBIDITY
  • PREDICTORS
  • OUTCOMES

Cite this

Metcalfe, W., Khan, I. H., Simpson, K., Prescott, G. J., MacLeod, A. M., & Scottish Renal Registry (2003). Hospitalization in the first year of renal replacement therapy for end-stage renal disease. QJM, 96(12), 899-909. https://doi.org/10.1093/qjmed/hcg155

Hospitalization in the first year of renal replacement therapy for end-stage renal disease. / Metcalfe, W.; Khan, I. H.; Simpson, K.; Prescott, Gordon James; MacLeod, Alison Murray; Scottish Renal Registry.

In: QJM, Vol. 96, No. 12, 2003, p. 899-909.

Research output: Contribution to journalArticle

Metcalfe, W, Khan, IH, Simpson, K, Prescott, GJ, MacLeod, AM & Scottish Renal Registry 2003, 'Hospitalization in the first year of renal replacement therapy for end-stage renal disease', QJM, vol. 96, no. 12, pp. 899-909. https://doi.org/10.1093/qjmed/hcg155
Metcalfe, W. ; Khan, I. H. ; Simpson, K. ; Prescott, Gordon James ; MacLeod, Alison Murray ; Scottish Renal Registry. / Hospitalization in the first year of renal replacement therapy for end-stage renal disease. In: QJM. 2003 ; Vol. 96, No. 12. pp. 899-909.
@article{95f5ed8c26c24520bbb16f947fd40cdf,
title = "Hospitalization in the first year of renal replacement therapy for end-stage renal disease",
abstract = "Background: The requirement for hospitalization of patients on dialysis is likely to be a surrogate marker of age and comorbid diseases. It may also reflect the level of care delivered, and substantially increases the cost of this expensive therapy.Aim: To identify the factors most strongly associated with hospitalization.Design: Prospective population study.Methods: Data were recorded for all patients starting RRT in Scotland over one year, including the reasons for and duration of, each hospital admission during the first year of RRT. Factors most strongly associated with hospitalization were determined by Poisson regression analysis.Results: Overall, 526 patients were admitted to hospital on 1668 occasions (median 3, IQR 1-4) for 13 384 days (median 13, IQR 4-35). Formation of vascular access for haemodialysis (HD) was the most frequent reason for admission, followed by infections. Age, comorbidity, mode of presentation for RRT and primary renal diagnosis were all significantly associated with prolonged hospitalization. Attainment of UK Renal Association standards for urea reduction ratio and serum albumin concentration, and vascular access in the form of arteriovenous fistulae were associated with less hospitalization in patients treated with HD by 90 days.Discussion: Patients in their first year of RRT have a high requirement for in-patient care, 8.6{\%} of patient treatment days being spent in hospital. Vascular access formation, failure and complications account for a large proportion of this. Age and comorbidity prolong the time spent in hospital. As the RRT population continues to increase, with older patients and those with greater comorbidity, in-patient facilities must also expand.",
keywords = "HEMODIALYSIS-PATIENTS, DIALYSIS PATIENTS, PERITONEAL-DIALYSIS, VASCULAR ACCESS, MORTALITY, MORBIDITY, LENGTH, COMORBIDITY, PREDICTORS, OUTCOMES",
author = "W. Metcalfe and Khan, {I. H.} and K. Simpson and Prescott, {Gordon James} and MacLeod, {Alison Murray} and {Scottish Renal Registry}",
year = "2003",
doi = "10.1093/qjmed/hcg155",
language = "English",
volume = "96",
pages = "899--909",
journal = "QJM",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "12",

}

TY - JOUR

T1 - Hospitalization in the first year of renal replacement therapy for end-stage renal disease

AU - Metcalfe, W.

AU - Khan, I. H.

AU - Simpson, K.

AU - Prescott, Gordon James

AU - MacLeod, Alison Murray

AU - Scottish Renal Registry

PY - 2003

Y1 - 2003

N2 - Background: The requirement for hospitalization of patients on dialysis is likely to be a surrogate marker of age and comorbid diseases. It may also reflect the level of care delivered, and substantially increases the cost of this expensive therapy.Aim: To identify the factors most strongly associated with hospitalization.Design: Prospective population study.Methods: Data were recorded for all patients starting RRT in Scotland over one year, including the reasons for and duration of, each hospital admission during the first year of RRT. Factors most strongly associated with hospitalization were determined by Poisson regression analysis.Results: Overall, 526 patients were admitted to hospital on 1668 occasions (median 3, IQR 1-4) for 13 384 days (median 13, IQR 4-35). Formation of vascular access for haemodialysis (HD) was the most frequent reason for admission, followed by infections. Age, comorbidity, mode of presentation for RRT and primary renal diagnosis were all significantly associated with prolonged hospitalization. Attainment of UK Renal Association standards for urea reduction ratio and serum albumin concentration, and vascular access in the form of arteriovenous fistulae were associated with less hospitalization in patients treated with HD by 90 days.Discussion: Patients in their first year of RRT have a high requirement for in-patient care, 8.6% of patient treatment days being spent in hospital. Vascular access formation, failure and complications account for a large proportion of this. Age and comorbidity prolong the time spent in hospital. As the RRT population continues to increase, with older patients and those with greater comorbidity, in-patient facilities must also expand.

AB - Background: The requirement for hospitalization of patients on dialysis is likely to be a surrogate marker of age and comorbid diseases. It may also reflect the level of care delivered, and substantially increases the cost of this expensive therapy.Aim: To identify the factors most strongly associated with hospitalization.Design: Prospective population study.Methods: Data were recorded for all patients starting RRT in Scotland over one year, including the reasons for and duration of, each hospital admission during the first year of RRT. Factors most strongly associated with hospitalization were determined by Poisson regression analysis.Results: Overall, 526 patients were admitted to hospital on 1668 occasions (median 3, IQR 1-4) for 13 384 days (median 13, IQR 4-35). Formation of vascular access for haemodialysis (HD) was the most frequent reason for admission, followed by infections. Age, comorbidity, mode of presentation for RRT and primary renal diagnosis were all significantly associated with prolonged hospitalization. Attainment of UK Renal Association standards for urea reduction ratio and serum albumin concentration, and vascular access in the form of arteriovenous fistulae were associated with less hospitalization in patients treated with HD by 90 days.Discussion: Patients in their first year of RRT have a high requirement for in-patient care, 8.6% of patient treatment days being spent in hospital. Vascular access formation, failure and complications account for a large proportion of this. Age and comorbidity prolong the time spent in hospital. As the RRT population continues to increase, with older patients and those with greater comorbidity, in-patient facilities must also expand.

KW - HEMODIALYSIS-PATIENTS

KW - DIALYSIS PATIENTS

KW - PERITONEAL-DIALYSIS

KW - VASCULAR ACCESS

KW - MORTALITY

KW - MORBIDITY

KW - LENGTH

KW - COMORBIDITY

KW - PREDICTORS

KW - OUTCOMES

U2 - 10.1093/qjmed/hcg155

DO - 10.1093/qjmed/hcg155

M3 - Article

VL - 96

SP - 899

EP - 909

JO - QJM

JF - QJM

SN - 1460-2725

IS - 12

ER -