Division of Nephrology and Hypertension, Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
Clin Transplant. 2013 Jul-Aug;27(4):541-5. doi: 10.1111/ctr.12147. Epub 2013 Jun 27.
We sought to determine the accuracy of dialysis medical records in identifying patients' interest in and suitability for transplantation.
Cluster randomized controlled trial.
A total of 167 patients recruited from 23 hemodialysis facilities.
Navigators met with intervention patients to provide transplant information and assistance. Control patients continued to receive usual care.
Agreement at study initiation between medical records and (i) patient self-reported interest in transplantation and (ii) study assessments of medical suitability for transplant referral.
Medical record assessments, self-reports, and study assessments of patient's interest in and suitability for transplantation.
There was disagreement between medical records and patient self-reported interest in transplantation for 66 (40%) of the 167 study patients. In most of these cases, patients reported being more interested in transplantation than their medical records indicated. The study team determined that all 92 intervention patients were medically suitable for transplant referral. However, for 38 (41%) intervention patients, medical records indicated that they were not suitable. About two-thirds of these patients successfully moved forward in the transplant process.
Dialysis medical records are frequently inaccurate in determining patient's interest in and suitability for transplantation.
我们旨在确定透析病历在识别患者对移植的兴趣和适宜性方面的准确性。
集群随机对照试验。
从 23 家血液透析中心招募的共 167 名患者。
导航员与干预组患者会面,提供移植信息和协助。对照组患者继续接受常规护理。
在研究开始时,病历与(i)患者自我报告的对移植的兴趣和(ii)研究评估的适合移植推荐的医学标准之间存在分歧。
病历评估、自我报告以及对患者对移植的兴趣和适宜性的研究评估。
在 167 名研究患者中,有 66 名(40%)患者的病历与自我报告的对移植的兴趣存在差异。在大多数情况下,患者报告的对移植的兴趣比病历所显示的更为强烈。研究小组确定,所有 92 名干预组患者在医学上都适合进行移植推荐。然而,对于 38 名(41%)干预组患者,病历表明他们不适合。这些患者中有大约三分之二成功地推进了移植过程。
透析病历在确定患者对移植的兴趣和适宜性方面经常不准确。