Khalid Usman, Zaidi Aeliya, Cheang Adrian, Horvath Szabolcs, Szabo Laszlo, Ilham Mohamed A, Stephens Michael R
Dialysis Access Service, Cardiff & Vale University Health Board, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, United Kingdom
Dialysis Access Service, Cardiff & Vale University Health Board, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
Perit Dial Int. 2018 Jul-Aug;38(4):251-256. doi: 10.3747/pdi.2017.00098. Epub 2018 Apr 19.
Socioeconomic deprivation is an important factor in determining poor health and is associated with a higher prevalence of many chronic diseases, including renal failure, and often poorer outcomes for patients with such conditions. The aim of this study was to investigate the effect of deprivation on peritonitis episodes following peritoneal dialysis (PD)-catheter insertion.
The Welsh Index of Multiple Deprivation (WIMD) was used to assess the influence of socioeconomic deprivation on outcomes following 233 consecutive first PD-catheter insertions from a single institution in the United Kingdom, performed between 2010 and 2015. The primary outcome measure was the presence of peritonitis episodes.
Peritoneal dialysis catheters were inserted in 243 patients, of which data were available for 233. Fifty-four patients experienced at least 1 episode of peritonitis. Overall, more patients in the most deprived group (vs least deprived) experienced peritonitis, although this was not statistically significant. When analyzing the severity of the peritonitis, within the 'Education' domain of the WIMD, significantly more patients from the most deprived group (compared with the least deprived group) experienced '2 or more peritonitis' episodes ( = 0.04) and were hospitalized for antibiotics ( = 0.02).
This study has shown that patients who live in more 'educationally' deprived areas are more likely to have multiple episodes of peritonitis requiring hospital admission following PD-catheter insertions.
社会经济剥夺是决定健康状况不佳的一个重要因素,与包括肾衰竭在内的许多慢性病的较高患病率相关,并且患有此类疾病的患者往往预后较差。本研究的目的是调查剥夺对腹膜透析(PD)导管插入术后腹膜炎发作的影响。
使用威尔士多重剥夺指数(WIMD)评估社会经济剥夺对2010年至2015年间在英国一家机构连续进行的233例首次PD导管插入术后结果的影响。主要结局指标是腹膜炎发作的情况。
243例患者插入了腹膜透析导管,其中233例有可用数据。54例患者经历了至少1次腹膜炎发作。总体而言,最贫困组(与最不贫困组相比)中有更多患者发生腹膜炎,尽管这在统计学上不显著。在分析腹膜炎的严重程度时,在WIMD的“教育”领域内,最贫困组(与最不贫困组相比)中有显著更多患者经历了“2次或更多次腹膜炎”发作(P = 0.04)并因抗生素治疗而住院(P = 0.02)。
本研究表明,生活在“教育”程度较低贫困地区的患者在PD导管插入术后更有可能多次发生需要住院治疗的腹膜炎。