Abstract: SA-PO787

A Six Month Program of Intradialytic Exercise Is Effective in Reducing Length of Hospital Stay in Hemodialysis Patients

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • March, Daniel Scott, University of Leicester, Leicester, United Kingdom
  • Grantham, Charlotte E., University of Leicester, Leicester, United Kingdom
  • Graham-Brown, Matthew P.M., University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, LEICESTER, United Kingdom
  • Young, Hannah ML, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, LEICESTER, United Kingdom
  • Cooper, Nicola, University of Leicester, Leicester, United Kingdom
  • Burton, James, University of Leicester, Leicester, United Kingdom
Background

Hemodialysis (HD) patients have a greater risk for hospital admission than the general population with a longer length of in-patient stay (LOS). Intradialytic exercise (IDE) programs have shown improvements in patient related outcomes but there is little evidence regarding the utilisation of health services or cost effectiveness of such programs.

Methods

We performed a retrospective analysis on a subset of 35 patients enrolled in a randomised controlled trial investigating the effect of IDE on cardiac structure and function. The IDE group (n=14) performed 6 months of cycling exercise during HD for 30 mins thrice weekly. Usual care was continued for the control group (n=21). In addition to demographic data, hospital admissions (elective and non-elective stay), and LOS were collected from patient’s medical records for 6 months (6M) pre (baseline), 6M during and 6M post IDE.

Results

Hospital admissions in the exercise group stayed the same over the length of the study, there was a small reduction in hospital admissions in the control group for 6M during and 6M post IDE (Table 1). There was a small reduction (11%) in LOS for the control group during the 6M IDE period compared to 6M pre. However, for the exercise group there was a 73% reduction in LOS (3.3 days) during the 6M IDE, which regressed towards baseline for the 6M post period.

Conclusion

We have shown a 3 d reduction in LOS in HD patients while participating in a program of IDE. Based on the current estimates, an additional day of in-patient care costs the UK NHS around £373. An annual reduction of in-hospital care of 3 d for each of the 23,000 UK HD patients would amount to a cost saving of ~£25.7m for the UK health economy.

Total Hospital admissions and length of stays for patients
 6M pre6M during6M post
Hospital Admissions
Control1.5 ± 1.51.0 ± 1.4 (-33%)1.3 ± 1.8 (-13%)
IDE0.6 ± 0.90.6 ± 0.9 (0%)0.6 ± 0.9 (0%)
Length of Stay
Control8.0 ± 17.17.1 ± 18.4 (-11%)7.8 ± 12.0 (-2%)
IDE4.5 ± 8.91.2 ± 1.7 (-73%)3.4 ± 6.7 (-24%)

Mean ± SD (% change from 6M pre)