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Abstract: PO1278

Strategies to Prevent Infection-Related Losses in US Peritoneal Dialysis Programs by More Actionable Predictive Data Reporting

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Schreiber, Martin J., DaVita Inc, Denver, Colorado, United States
  • Cassin, Michelle, DaVita Inc, Denver, Colorado, United States
  • Van hout, Bram, DaVita Inc, Denver, Colorado, United States
  • Zywno, Meredith L., DaVita Inc, Denver, Colorado, United States
  • Rane, Tanvi, DaVita Inc, Denver, Colorado, United States
Background

Peritoneal dialysis (PD)–associated peritonitis (PTN) accounts for a significant percentage of patients who transition to hemodialysis due to infection-related technique failure. Data reporting to individual PD home programs on PTN rates is designed to drive a proactive approach for optimizing infection rates in PD programs.

Methods

Between 2016 and 2020, a standardized reporting of PD-related PTN was carried out for 1487 affiliated PD programs across the United States (66,687 patients). Currently, PTN is reported on a 3-month rolling average for each program, with a current average PTN rate of 1 event/66 patient-months; 32% of PTN events fall into the hospitalization criterion bucket, with 3% already having cultures drawn prior to admission. Among all episodes with an associated hospitalization, 90% have an associated culture. For non-hospitalization events, 64% had an associated culture among other criteria for event diagnosis.

Beginning in 2020, an effort to advance PTN preventive strategies with a more in-depth characterization of PTN events was implemented. These additional data included reporting rates as episodes/patient-year; PD catheter removal rate post PTN/infection; culture-negative PTN rate; organism-specific PTN reporting, with patient loss by organism; percentage of patients PTN-free (cumulative patient-months without an infection); percentage of patients with >1 episode/year; percentage of events occurring at <30 days or 30 to 90 days; PTN-associated hospitalization rates and length of stay; time at risk calculation (>day 1 training); and PTN-associated mortality rates.

Results

The table displays PTN from 2019 and preliminary results of the PTN additional data report from January through March 2020.

Conclusion

Reporting on PTN events with these additional metrics, on a program-by-program basis, could assist in aligning specific action steps critical to reducing infection related PD failure. These data could be incorporated into an early warning system to predict PD loss.