Healthcare Intensity at Initiation of Chronic Dialysis among Older Adults
| Autor: | William Kreuter, Ann M. O’Hare, Susan P.Y. Wong |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Mechanical ventilation medicine.medical_specialty business.industry medicine.medical_treatment Retrospective cohort study General Medicine Discontinuation Renal Dialysis Nephrology Severity of illness Emergency medicine medicine Humans Clinical Epidemiology Female Cardiopulmonary resuscitation Intensive care medicine business Feeding tube Dialysis Cohort study |
| Zdroj: | Journal of the American Society of Nephrology. 25:143-149 |
| ISSN: | 1046-6673 |
| DOI: | 10.1681/asn.2013050491 |
| Popis: | Little is known about the circumstances under which older adults initiate chronic dialysis and subsequent outcomes. Using national registry data, we conducted a retrospective analysis of 416,657 Medicare beneficiaries aged ≥67 years who initiated chronic dialysis between January 1995 and December 2008. Our goal was to define the relationship between health care intensity around the time of dialysis initiation and subsequent survival and patterns of hospitalization, use of intensive procedures (mechanical ventilation, feeding tube placement, and cardiopulmonary resuscitation), and discontinuation of dialysis before death. We found that most patients (64.5%) initiated dialysis in the hospital, including 36.6% who were hospitalized for ≥2 weeks and 7.4% who underwent one or more intensive procedures. Compared with patients who initiated dialysis in the outpatient setting, those who received the highest intensity of care at dialysis initiation (those hospitalized ≥2 weeks and receiving at least one intensive procedure) had a shorter median survival (0.7 versus 2.1 years; P |
| Databáze: | OpenAIRE |
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