Ankawi Ghada
Department of medicine, Division of Nephrology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Cureus. 2024 Aug 20;16(8):e67324. doi: 10.7759/cureus.67324. eCollection 2024 Aug.
Background Nephrology services encompass a wide range of day-care procedures. Securing beds for day admissions can be challenging and may lead to significant delays in patient management. Objective This study aims to describe the impact of establishing a dedicated nephrology daycare unit at a tertiary care center. Methods Since January 2021, a dedicated nephrology daycare unit has been operational at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. This observational study retrospectively reviewed the admission records to the KAUH nephrology daycare unit from January 2021 to December 2023. Admissions with missing data were excluded from the analysis. The study outcomes included: 1. the number of patients served in the unit, 2. the scope of services provided, 3. the "time to completion" of immunosuppressive therapy administered in the unit, and 4. the rate of complications related to admission to the unit. Results There were 233 admissions for 157 patients. The scope of procedures included: 1. administration of immunosuppressive therapy (42 doses of cyclophosphamide, 70 doses of rituximab, three doses of methylprednisolone), 2. renal biopsies (25 procedures), 3. tunneled dialysis catheter procedures (40 procedures, both insertion and removal), 4. dialysis access angioplasty (three procedures), 5. IV iron therapy (45 admissions), and 6. other miscellaneous causes (five admissions). Ideal time to completion of cyclophosphamide therapy was achieved in 86% of patients, with the remaining 14% experiencing delays due to reasons other than bed availability. Time to completion of rituximab therapy was achieved without delay in 85% of patients, with a time interval of less than 21 days. There were no reported complications associated with admission to the unit. Conclusions Establishing a dedicated nephrology daycare unit facilitates the delivery of nephrology day-procedures and reduces delays in therapy.
背景 肾脏病服务涵盖广泛的日间护理程序。确保日间入院床位可能具有挑战性，并可能导致患者管理出现显著延迟。目的 本研究旨在描述在一家三级护理中心设立专门的肾脏病日间护理单元的影响。方法 自2021年1月起，沙特阿拉伯吉达的阿卜杜勒阿齐兹国王大学医院（KAUH）设立了一个专门的肾脏病日间护理单元。这项观察性研究回顾性分析了2021年1月至2023年12月期间KAUH肾脏病日间护理单元的入院记录。分析中排除了数据缺失的入院病例。研究结果包括：1. 该单元服务的患者数量；2. 提供的服务范围；3. 该单元进行的免疫抑制治疗的“完成时间”；4. 与该单元入院相关的并发症发生率。结果 157名患者共入院233次。程序范围包括：1. 免疫抑制治疗（42剂环磷酰胺、70剂利妥昔单抗、3剂甲泼尼龙）；2. 肾活检（25例）；3. 带隧道的透析导管操作（40例，包括置入和拔除）；4. 透析通路血管成形术（3例）；5. 静脉铁剂治疗（45例入院）；6. 其他杂项原因（5例入院）。86%的患者实现了环磷酰胺治疗的理想完成时间，其余14%因床位可用性以外的原因出现延迟。85%的患者利妥昔单抗治疗按时完成，时间间隔少于21天。未报告与该单元入院相关的并发症。结论 设立专门的肾脏病日间护理单元有助于提供肾脏病日间程序并减少治疗延迟。
