Abstract: SA-PO388
Risk Factors of Unplanned Intensive Care Unit Admission Among Hospitalized Patients With Maintenance Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kadota, Nozomi, St. Luke's International Hospital, Tokyo, Japan
- Fujimaru, Takuya, St. Luke's International Hospital, Tokyo, Japan
- Shimoyama, Kotaro, St. Luke's International Hospital, Tokyo, Japan
- Konishi, Kasumi, St. Luke's International Hospital, Tokyo, Japan
- Ito, Yugo, St. Luke's International Hospital, Tokyo, Japan
- Taki, Fumika, St. Luke's International Hospital, Tokyo, Japan
- Nagahama, Masahiko, St. Luke's International Hospital, Tokyo, Japan
- Nakayama, Masaaki, St. Luke's International Hospital, Tokyo, Japan
Background
In general, 6.4% of hospitalized patients were admitted to intensive care unit (ICU) due to deterioration of the clinical condition, and about 40% of these patients die. For all patients, the risk factors of deterioration of the clinical condition were male, older age, complication of diabetes or chronic heart failure, and abnormal vital signs on hospitalization. However, although hemodialysis (HD) patients have higher in-hospital mortality rate than general population, the factors that predict the deterioration of the clinical condition of these patients are not understood.
Methods
We conducted a retrospective study in a single hospital (520 beds, including 25 intensive care beds) in Tokyo, Japan. We investigated the adult patients with maintenance HD who admitted to general ward during January 2003 to November 2022. The patients who discharged within 7 days were excluded. The primary outcome is unplanned ICU admission between 72 hours and 30 days after hospitalization. The secondary outcomes are an unplanned ICU admission or death in the same duration. We used cox proportional regression model for statistical analysis adjusted for age, sex, comorbid conditions, positive blood culture and serum albumin value on hospitalization.
Results
Of the 492 eligible patients, 318 (64%) were male, mean age was 73 years old, mean length of hospital stay was 36.7 days, and 44 (8.9%) patients were admitted to ICU due to deterioration of the clinical condition. Multivariate analysis with Cox proportional regression model showed that patients with cardiovascular disease on hospitalization were significantly admitted to ICU (HR 2.99 (95%CI, 1.54-5.81) P=0.0012). Additionally, ICU admission or in-hospital death was associated with low serum albumin on hospitalization (HR 0.45 (95% CI, 0.31-0.67) P<0.001).
Conclusion
For maintenance HD patients, complication of cardiovascular disease could be the risk factor of deterioration of the clinical condition during hospitalization.