Abstract: TH-PO882
Association of Low Molecular Weight Heparin Compared to Unfractionated Heparin and the Risk of Dialysis-Related Infection and Septicemia among Hemodialysis Patients
Session Information
- Dialysis: Infection
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 610 Dialysis: Infection
Authors
- Lazrak, Hind Harrak, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
- Rene, Emilie, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
- Elftouh, Naoual, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
- Nadeau-Fredette, Annie-Claire, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
- Laurin, Louis-Philippe, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
- Lafrance, Jean-Philippe, Maisonneuve-Rosemont Hospital , Montreal, Quebec, Canada
Background
Hemodialysis patients have a higher risk of infection compared to the general population. The administration of low molecular weight heparin (LMWH) for the extracorporeal circuit anticoagulation requires less manipulation in comparison with unfractionated heparin (UFH), which may result in a reduced bacterial contamination. The aim of this study is to evaluate the association between the use of LMWH and dialysis-related infection and septicemia compared to UFH among chronic hemodialysis patients.
Methods
We conducted a retrospective cohort study of 6012 adult chronic hemodialysis patients (prevalent and incident) using an administrative database in Quebec, Canada. Hospitalizations due to dialysis-related infections or septicemia were identified using ICD-10 codes. Patients’ exposure to LMWH or UFH was determined at the facility level. Infection rates were calculated as person-year and risk of infection was estimated using Cox proportional hazard ratios (HR) and 95% confidence interval adjusting for demographics, prior hospitalizations, comorbidities and steroids use.
Results
The incidence rate of hospitalizations for dialysis-related infections and septicemia was 0.044 patient-year. From the total cohort, 37% of patients were exposed to LMWH. Compared to UFH, LMWH was associated with a statistically significant decrease of infection risk (HR=0.79, 95%CI: 0.64-0.96). Moreover, younger age (HR=0.99, 95%CI: 0.98-1.00), hospitalization in prior year (HR=1.26, 95%CI: 1.00-1.58), chronic pulmonary disease (HR=1.36, 95%CI: 1.09-1.70) and diabetes (HR=1.26, 95%CI: 1.03-1.54) increased the infection risk among chronic hemodialysis patients.
Conclusion
Among hemodialysis patients, LMWH use decreased the risk of hospitalization for dialysis-related infection and septicemia compared to UFH.