Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
Departamento de Nefrologia, Hospital Nacional 2 de Mayo, Lima, Peru.
Int Health. 2020 Feb 12;12(2):142-147. doi: 10.1093/inthealth/ihz037.
Understanding the pattern of mortality linked to end stage renal disease (ESRD) is important given the increasing ageing population in low- and middle-income countries.
We analyzed older patients with ESRD with incident hemodialysis, from January 2012 to August 2017 in one large general hospital in Peru. Individual and health system-related variables were analyzed using Generalized Linear Models (GLM) to estimate their association with in-hospital all-cause mortality. Relative risk (RR) with their 95% confidence intervals (95% CI) were calculated.
We evaluated 312 patients; mean age 69 years, 93.6% started hemodialysis with a transient central venous catheter, 1.7% had previous hemodialysis indication and 24.7% died during hospital stay. The mean length of stay was 16.1 days (SD 13.5). In the adjusted multivariate models, we found higher in-hospital mortality among those with encephalopathy (aRR 1.85, 95% CI 1.21-2.82 vs. without encephalopathy) and a lower in-hospital mortality among those with eGFR ≤7 mL/min (aRR 0.45, 95% CI 0.31-0.67 vs. eGFR>7 mL/min).
There is a high in-hospital mortality among older hemodialysis patients in Peru. The presence of uremic encephalopathy was associated with higher mortality and a lower estimated glomerular filtration rate with lower mortality.
由于中低收入国家的人口老龄化不断增加，了解与终末期肾病（ESRD）相关的死亡率模式非常重要。
我们分析了 2012 年 1 月至 2017 年 8 月期间秘鲁一家大型综合医院中接受血液透析的老年 ESRD 患者。使用广义线性模型（GLM）分析个体和与卫生系统相关的变量，以评估其与住院全因死亡率的相关性。计算了相对风险（RR）及其 95％置信区间（95％CI）。
我们评估了 312 名患者；平均年龄为 69 岁，93.6％的患者使用临时中心静脉导管开始血液透析，1.7％的患者有先前的血液透析指征，24.7％的患者在住院期间死亡。平均住院时间为 16.1 天（SD 13.5）。在调整后的多变量模型中，我们发现伴有脑病的患者住院期间死亡率更高（aRR 1.85，95％CI 1.21-2.82 与无脑病相比），而估算肾小球滤过率（eGFR）≤7 mL/min 的患者住院期间死亡率较低（aRR 0.45，95％CI 0.31-0.67 与 eGFR>7 mL/min 相比）。
秘鲁老年血液透析患者的住院期间死亡率较高。尿毒症脑病的存在与更高的死亡率相关，而估计肾小球滤过率较低与较低的死亡率相关。
