Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(14):6867-6875. doi: 10.26355/eurrev_202307_33158.
Kidney failure increases in-hospital mortality (IHM); however, comorbidity is crucial for predicting mortality in dialysis patients. Our aim was to evaluate the impact of comorbidity, assessed by modified Elixhauser index (mEI), Charlson Comorbidity Index (CCI), and age-adjusted CCI, on IHM in a cohort of peritoneal dialysis patients admitted to hospitals of the Emilia Romagna region (ERR) of Italy.
All hospital admissions of peritoneal dialysis patients recorded between 2007 and 2021 in the ERR database were analyzed. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) was used for detecting diagnoses and procedures, and the inclusion criterion was code 5498. Comorbidity burden was evaluated by three different scores, and hemodialysis (HD) treatment need was considered. IHM was our outcome.
During the 15 years of the study, 3,242 hospitalized peritoneal dialysis patients (62.7% males) were evaluated. Mean age was 62.8±20.6 years, 9.6% underwent HD, and IHM was 5.9% (n=192). IHM mortality was stable throughout the study period. Deceased subjects were older, were hospitalized longer, had a higher comorbidity burden, and had a higher percentage of HD treatment needs than survivors. Age, male sex, comorbidity burden, and HD treatment were predictors of IHM. Receiver operating characteristics (ROC) analysis confirmed the impact of comorbidity burden on IHM, especially when age was considered.
We conclude that in male, elderly hospitalized peritoneal dialysis patients with failing dialysis technique, comorbidity burden should be considered being a predictor of IHM.
肾衰竭会增加住院死亡率（IHM）；然而，合并症对于预测透析患者的死亡率至关重要。我们的目的是评估通过改良 Elixhauser 指数（mEI）、Charlson 合并症指数（CCI）和年龄调整的 CCI 评估的合并症对意大利艾米利亚-罗马涅地区（ERR）接受住院治疗的腹膜透析患者队列的 IHM 的影响。
分析了 ERR 数据库中记录的 2007 年至 2021 年间所有腹膜透析患者的住院记录。国际疾病分类，第 9 版，临床修正版（ICD-9-CM）用于检测诊断和程序，纳入标准为代码 5498。使用三种不同的评分评估合并症负担，并考虑血液透析（HD）治疗需求。IHM 是我们的结局。
在研究的 15 年中，评估了 3242 名接受住院治疗的腹膜透析患者（62.7%为男性）。平均年龄为 62.8±20.6 岁，9.6%接受 HD 治疗，IHM 为 5.9%（n=192）。整个研究期间 IHM 死亡率保持稳定。死亡患者年龄较大，住院时间较长，合并症负担较高，且需要 HD 治疗的比例较高。年龄、男性、合并症负担和 HD 治疗是 IHM 的预测因素。受试者工作特征（ROC）分析证实了合并症负担对 IHM 的影响，尤其是在考虑年龄时。
我们得出结论，在男性、老年、正在进行透析技术失败的住院腹膜透析患者中，合并症负担应被视为 IHM 的预测因素。
