Early death in dialysis patients: risk factors and impact on incidence and mortality rates.
Early death in dialysis patients: risk factors and impact on incidence and mortality rates.
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透析患者早期死亡：危险因素及其对发病率和死亡率的影响。
DOI：
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发表时间：
1996
影响因子：
13.6
通讯作者：
W. McClellan
中科院分区：
文献类型：
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作者：
J. Soucie;W. McClellan
开始透析后前90天内死亡的患者不包括在死亡率中，可能不包括在发病率计数中。为了确定与ESRD透析开始后3个月内死亡率相关的因素，并估计早期死亡对ESRD发病率和死亡率的影响，本研究调查了格鲁吉亚、北卡罗来纳州和南卡罗来纳州开始透析的15，245例患者，为期5年。数据由透析机构工作人员收集并报告给ESRD登记处。6%的新患者在透析开始后90天内死亡（32%的死亡发生在治疗的第一年）。与早死风险增加独立相关的特征包括年龄较大、白色人种、男性、身体和营养缺陷、吸烟、存在癌症、充血性心力衰竭、临床抑郁和心肌梗死病史。根据种族-性别组，当排除早期死亡的患者时，基于该队列的年龄校正死亡率被低估了3%至12%。这些结果表明，某些患者的特征-一些潜在的可修改的-赋予早期死亡的风险增加，并且从美国国家登记处系统排除早期死亡的患者实质上影响ESRD死亡率。
Patients who die within the first 90 days after beginning dialysis are not included in mortality rates and may be absent from incidence counts. To identify factors associated with mortality within 3 months of the initiation of dialysis for ESRD and to estimate the impact of early deaths on ESRD incidence and mortality rates, this study investigated 15,245 patients who began dialysis in Georgia, North Carolina, and South Carolina over a 5-yr period. Data were collected by dialysis facility staff and reported to an ESRD registry. Six percent of all new patients died within 90 days of dialysis initiation (32% of all deaths occurring in the first year of treatment). Characteristics independently associated with increased risk of early death included older age, white race, male gender, physical and nutritional impairment, smoking, and the presence of cancer, congestive heart failure, clinical depression, and history of myocardial infarction. Depending on race-gender group, age-adjusted mortality rates based on this cohort were underestimated by 3 to 12% when patients who died early were excluded. These results suggest that certain patient characteristics-some potentially modifiable-confer increased risk of early death, and that the systematic exclusion of patients who die early from the U.S. national registry substantially influences ESRD mortality rates.