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缩短医患接触时间对早期腹膜透析相关感染的影响。

The impact of shortening patient-doctor contact duration on early peritoneal dialysis-related infections.

机构信息

Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Department of Statistics, Kyungpook National University, Daegu, Republic of Korea.

出版信息

Sci Rep. 2024 Oct 3;14(1):22955. doi: 10.1038/s41598-024-74205-x.

Abstract

Early peritoneal dialysis (PD)-related infection is a severe complication. This study investigated the relationship between patient-doctor contact (PDC) duration and early PD-related infection. In the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) Korea, incident dialysis patients receiving PD were divided into two groups based on PDC duration (< 15 min versus ≥ 15 min), which was defined as the duration a nephrologist typically spends with a patient receiving PD during each visit according to the facility practice pattern. Early risks of PD-related infections, such as peritonitis and catheter-related infection (onset within 3 and 12 months of PD), were compared to the PDC duration using Cox regression. The study included 276 patients (184 [66.7%] in the shorter PDC group [< 15 min] and 92 [33.3%] in the longer PDC group [≥ 15 min]). The average age did not differ between the groups. The incidences of 3- and 12-month PD-related infections were significantly lower in the longer PDC group than in the shorter PDC group (3 months: 1.1% versus 9.8%, P = 0.007; 12 months: 9.8% versus 23.4%, P = 0.007). Longer PDC was independently associated with a lower risk of PD-related infections at 3 and 12 months (3 months: adjusted hazard ratio [aHR], 0.11; 95% confidence interval [CI], 0.02-0.85, P = 0.034; 12 months: aHR, 0.43; 95% CI 0.19-0.99, P = 0.048). Overall, a longer PDC duration was associated with a significantly lower risk of early PD-related infection.

摘要

早期腹膜透析(PD)相关感染是一种严重的并发症。本研究探讨了患者-医生接触(PDC)时间与早期 PD 相关感染之间的关系。在韩国腹膜透析结局和实践模式研究(PDOPPS Korea)中,接受 PD 的新透析患者根据 PDC 时间分为两组(<15 分钟与≥15 分钟),根据机构实践模式,PDC 时间定义为每位接受 PD 的患者每次就诊时,肾病医生通常与患者相处的时间。使用 Cox 回归比较了 PD 相关感染(腹膜炎和导管相关感染,在 PD 开始后 3 个月和 12 个月内发生)的早期风险与 PDC 时间之间的关系。该研究纳入了 276 名患者(184 名(66.7%)患者的 PDC 时间较短(<15 分钟),92 名(33.3%)患者的 PDC 时间较长(≥15 分钟))。两组的平均年龄无差异。较长 PDC 组的 3 个月和 12 个月 PD 相关感染发生率明显低于较短 PDC 组(3 个月:1.1%比 9.8%,P=0.007;12 个月:9.8%比 23.4%,P=0.007)。较长的 PDC 与 3 个月和 12 个月时 PD 相关感染的风险降低独立相关(3 个月:调整后的危险比[aHR],0.11;95%置信区间[CI],0.02-0.85,P=0.034;12 个月:aHR,0.43;95%CI 0.19-0.99,P=0.048)。总体而言,较长的 PDC 时间与早期 PD 相关感染的风险显著降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d6b/11449936/0332bd425807/41598_2024_74205_Fig1_HTML.jpg

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