EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U1309, Univ Rennes, Rennes, France.
Renal Epidemiology and Information Network (REIN) Registry, Biomedecine Agency, Saint-Denis-La-Plaine, France.
PLoS One. 2023 Sep 14;18(9):e0289134. doi: 10.1371/journal.pone.0289134. eCollection 2023.
Few studies investigated sex-related differences in care consumption after dialysis initiation. Therefore, the aim of this study was to compare the care trajectory in the first year after dialysis start between men and women by taking into account the context of dialysis initiation. All patients who started dialysis in France in 2015 were included. Clinical data of patients and context of dialysis initiation were extracted from the Renal Epidemiology and Information Network (REIN) registry. Data on care consumption in the first year after dialysis start came from the French national health data system (SNDS): hospital stays <24h, hospital stays to prepare or maintain vascular access, hospital stays >24h for kidney problems and hospital stays >24h for other problems, and consultations with a general practitioner. Variables were compared between men and women with the χ2 test and Student's or Welch t-test and logistic regression models were used to identify the factors associated with care consumption after dialysis start. The analysis concerned 8,856 patients (36% of women). Men were less likely to have a hospital stays >24h for kidney problems than women (OR = 0.8, 95% CI = [0.7-0.9]) and less general practitioner consultations (OR = 0.8, 95% CI = [0.8-0.9]), in the year after dialysis initiation, after adjustment on patient's characteristics. Moreover, hospital stays for vascular access preparation or maintenance were longer in women than men (median duration: 2 days [0-2] vs. 1 day [0-2], p < 0.001). In conclusion, despite greater comorbidities in men, this study found few differences in post-dialysis care trajectory between men and women.
很少有研究调查透析开始后护理消耗的性别差异。因此，本研究旨在考虑透析开始的背景，比较透析开始后第一年男女之间的护理轨迹。所有 2015 年在法国开始透析的患者均被纳入研究。患者的临床数据和透析开始的背景数据从肾流行病学和信息网络（REIN）登记处提取。透析开始后第一年护理消耗的数据来自法国国家卫生数据系统（SNDS）：住院时间<24 小时、用于准备或维持血管通路的住院时间、因肾脏问题住院时间>24 小时、因其他问题住院时间>24 小时，以及与全科医生的就诊次数。采用卡方检验和学生或韦尔奇 t 检验比较男女之间的变量，采用逻辑回归模型确定透析开始后护理消耗的相关因素。该分析涉及 8856 名患者（36%为女性）。调整患者特征后，男性因肾脏问题住院时间>24 小时的可能性低于女性（OR=0.8，95%CI=[0.7-0.9]），全科医生就诊次数也较少（OR=0.8，95%CI=[0.8-0.9]）。此外，女性准备或维持血管通路的住院时间长于男性（中位数持续时间：2 天[0-2]比 1 天[0-2]，p<0.001）。总之，尽管男性合并症更多，但本研究发现男性和女性透析后护理轨迹之间几乎没有差异。
