In-hospital mortality among incident hemodialysis older patients in Peru. Issue 2 (11th July 2019)

• Record Type: Journal Article
• Authors: Herrera-Añazco, Percy; Ortiz, Pedro J; Peinado, Jesus E; Tello, Tania; Valero, Fabiola; Hernandez, Adrian V; Miranda, J Jaime
• Is Part Of: International health. Volume 12:Issue 2(2020)
• Page Start: 142
• Page End: 147
• Publication Date: 2019-07-11
• Subjects: mortality -- renal dialysis -- health services -- epidemiology -- Peru; World health -- Periodicals; Public health -- Developing countries -- Periodicals; Medical care -- Developing countries -- Periodicals; Medical policy -- Developing countries -- Periodicals; 362.1091724
• DOI: 10.1093/inthealth/ihz037
• Languages: English
• ISSNs: 1876-3413

Abstract

Abstract: Background: Understanding the pattern of mortality linked to end stage renal disease (ESRD) is important given the increasing ageing population in low- and middle-income countries. Methods: We analyzed older patients with ESRD with incident hemodialysis, from January 2012 to August 2017 in one large general hospital in Peru. Individual and health system-related variables were analyzed using Generalized Linear Models (GLM) to estimate their association with in-hospital all-cause mortality. Relative risk (RR) with their 95% confidence intervals (95% CI) were calculated. Results: We evaluated 312 patients; mean age 69 years, 93.6% started hemodialysis with a transient central venous catheter, 1.7% had previous hemodialysis indication and 24.7% died during hospital stay. The mean length of stay was 16.1 days (SD 13.5). In the adjusted multivariate models, we found higher in-hospital mortality among those with encephalopathy (aRR 1.85, 95% CI 1.21-2.82 vs. without encephalopathy) and a lower in-hospital mortality among those with eGFR ≤7 mL/min (aRR 0.45, 95% CI 0.31-0.67 vs. eGFR>7 mL/min). Conclusions: There is a high in-hospital mortality among older hemodialysis patients in Peru. The presence of uremic encephalopathy was associated with higher mortality and a lower estimated glomerular filtration rate with lower mortality.