End-stage renal disease status and critical illness in the elderly.
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES Elderly patients (> 65 years old) are a rapidly growing demographic in the ESRD and intensive care unit (ICU) populations, yet the effect of ESRD status on critical illness in elderly patients remains unknown. Reliable estimates of prognosis would help to inform care and management of this frail and vulnerable population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The effect of ESRD status on survival and readmission rates was examined in a retrospective cohort of 14,650 elderly patients (>65 years old) admitted to 11 ICUs in Winnipeg, Manitoba, Canada between 2000 and 2006. Logistic regression models were used to adjust odds of mortality and readmission to ICU for baseline case mix and illness severity. RESULTS Elderly ESRD patients had twofold higher crude in-hospital mortality (22% versus 13%, P < 0.0001) and readmission rate (6.4 versus 2.7%, P = 0.001). After adjustment for illness severity alone or illness severity and case mix, the odds ratio for mortality decreased to 0.85 (95% CI: 0.57 to 1.25) and 0.82 (95% CI: 0.55 to 1.23), respectively. In contrast, ESRD status remained significantly associated with readmission to ICU after adjustment for other risk factors (OR 2.06 [95% CI: 1.32, 3.22]). CONCLUSIONS Illness severity on admission, rather than ESRD status per se, appears to be the main driver of in-hospital mortality in elderly patients. However, ESRD status is an independent risk factor for early and late readmission, suggesting that this population might benefit from alternative strategies for ICU discharge.
منابع مشابه
Avoidance of Dialysis in an End-Stage Renal Disease Patient Status-post Off-pump Coronary Artery Bypass Grafting
Certain benefits are clearly associated with the use of off-pump coronary artery bypass grafting (CABG) as compared with the on-pump CABG. The superiority is more evident in patients with multiple co morbidities including renal failure.We reviewed the medical records of a 67-year-old male with a past medical history that was significant for multiple cardiovascular diseases and new-onset end-sta...
متن کاملSelf Care of the older adults with Chronic Kidney Diseases referred to selected Educational and Medical Centres of Iran University of Medical Sciences, 2020
Background : Due to the complexities of self-care in the elderly with chronic kidney failure, with information based on scientific evidence and appropriate health planning, the elderly with self-care and self-management of the disease from others will lead to a healthier life and a better quality of life. Therefore, this study aimed to determine self-care in the elderly with chronic renal fail...
متن کاملمقایسه بررسی علل ایجاد کننده END STAGE RENAL DISEASE دربیماران دیالیزی استان گیلان
Background: The etiology of End Stage Renal Disease (ESRD) in every community differ according to genetic, nutrition, and public health status. ESRD,the terminal stage of chronic renal failure,needs replacement therapy otherwise could lead to death. The aim of the study is to determine the relative frequency of ESRD etiology in hemodialysis patients of Gilan province. Methods:This descriptive s...
متن کاملبررسی توان خودمراقبتی بیماران تحت درمان با همودیالیز مراجعه کننده به بیمارستان بوعلی اردبیل در سال 1392
Background: Self- care has an important role in management of patients with chronic renal failure. The present study was implemented to determine self-care agency among patients with chronic renal failure undergoing hemodialysis . Methods: In this descriptive cross-sectional study, 139 End stage renal disease patients undergoing hemodialysis in Boali hospital of Ardebil (22 June -22 July 20...
متن کاملSurvey of Physical Functioning and Prevalence of Chronic Illnesses Among the Elderly People
Objectives: The purpose of this study was to determine the OF physical functioning level and prevalence of chronic illness among elderlypeople in west region of Tehran. Methods & Materials: This study was a descriptive and cross-sectional study. A multi-stage sampling was used and 410 community residents who were over 60 years old were selected from west region of Tehran.Descriptive statisti...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Clinical journal of the American Society of Nephrology : CJASN
دوره 6 3 شماره
صفحات -
تاریخ انتشار 2011