論文

査読有り 国際誌
2018年

Increased Mortality Rate after Hospitalization Among Chronic Hemodialysis Patients: A Prospective Cohort Study.

Nephron
  • Sayaka Shimizu
  • ,
  • Shingo Fukuma
  • ,
  • Tatsuyoshi Ikenoue
  • ,
  • Tadao Akizawa
  • ,
  • Shunichi Fukuhara

140
3
開始ページ
194
終了ページ
202
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1159/000492083

BACKGROUND/AIMS: Hemodialysis patients are at high risk of hospitalization and their condition may worsen with repeated hospitalization. The aim of this study was to evaluate the impact of the cumulative number of hospitalizations on post-discharge mortality. METHODS: This study was a prospective cohort study. We examined 3,359 adult patients on hemodialysis for at least 90 days who participated in the Japanese Dialysis Outcomes and Practice Patterns Study phases 3 and 4 (2005-2012). The patients hospitalized within 3 months before enrollment were excluded. The main exposure was the time-varying cumulative number of hospitalizations during the follow-up period. Hazard ratios (HRs) for all-cause mortality rate after discharge were estimated by time-dependent Cox regressions after adjusting for potential confounders. RESULTS: The median follow-up time was 2.7 years, and 873 (26%) patients experienced at least 1 hospitalization during follow-up. The hospitalization rate was 0.23 per person-year and the mortality rate was 0.036 per person-year. The HR and 95% CI for post-discharge mortality increased as the cumulative number of hospitalizations increased: once, 1.41 (0.99-2.00); and twice or more, 2.27 (1.59-3.23). The cause-specific hospitalization categories, "infectious disease" and "cancer," affected post-discharge mortality HRs in a similar manner: 2.41(1.32-4.41) and 2.70 (1.23-5.93), respectively. CONCLUSION: A higher cumulative number of hospitalizations is associated with increased post-discharge mortality in chronic hemodialysis patients. The cause-specific hospitalizations category of "infectious disease" showed an impact on mortality similar to that of hospitalization for "cancer." Therefore, physicians should pay more attention to reducing preventable hospitalizations.

リンク情報
DOI
https://doi.org/10.1159/000492083
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30153677
ID情報
  • DOI : 10.1159/000492083
  • ISSN : 1660-8151
  • PubMed ID : 30153677

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