Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care

2000 ◽  
Vol 26 (12) ◽  
pp. 1824-1831 ◽  
Author(s):  
Maarit Korkeila ◽  
Esko Ruokonen ◽  
Jukka Takala
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Costs Of Care ◽  
Long Term Prognosis

scholarly journals Epidemiology and outcome of elderly patients requiring renal replacement therapy in the intensive care unit: an observational study

2020 ◽  
Author(s):  
Cecile Salathe ◽  
Elettra Poli ◽  
Marco Altarelli ◽  
Nathan Axel Bianchi ◽  
Antoine Guillaume Schneider
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Elderly Patients ◽  
Replacement Therapy ◽  
Age Groups ◽  
High Morbidity ◽  
Predicted Values

Abstract Background Renal replacement therapy (RRT) in critically-ill patients is associated with high morbidity and mortality. The adequacy of its initiation is sometimes questioned in elderly patients particularly those with comorbidities. We therefore sought to evaluate the long-term outcomes and quality of life (QOL) of elderly patients who survived critical illness requiring RRT. Methods We identified all patients > 55 yo who received RRT for acute kidney injury in our intensive care unit (ICU) between January 2015 and April 2018. We assessed their vital status by cross referencing our hospital database and the Swiss national death registry. Patients still alive at the time of the study underwent a phone interview. They were asked about their dialytic status and administered an EQ-5D survey with visual analog scale (VAS). Results were stratified according to patient's age groups (G1: "55-64 yo"; G2: "65-74 yo" and G3: "> 75 yo"). QOL in G3 patients were compared to G1 and G2 and to predicted values (calculated based on a local reference population). Results Among the 352 eligible patients, 171 died during the index hospital admission. After a median follow-up of 2.7 years (IQR 1.6), a further 62 had died (mean time to death for hospital survivors 149.4 days (IQR 450.4). Hence, 119 patients (33.6%) were still alive at the time of the study. We successfully contacted 96 (80.7%) of them and 83 (69.7%) were included in the study (G1: 24, G2: 44 and G3: 15). Only 6 (7.2%) were RRT dependent. Patients in G3 had lower EQ-5D and VAS scores than those in G1 and G2 (p <0.01). These scores were also significantly lower than predicted values (p <0.05). Conclusions Irrespective of age, the need for RRT identifies a population at very high risk of mortality. Among survivors, the rate of RRT dependence is low. Patients >75 yo who survived ICU had a lower quality of life than younger patients. This QOL was also lower than predicted according to age and sex. The adequacy of RRT initiation in elderly patients should be discussed according to their pre-existing QOL and frailty.

scholarly journals Epidemiology And Outcome Of Elderly Patients Requiring Renal Replacement Therapy In The Intensive Care Unit: An Observational Study

2020 ◽  
Author(s):  
Cecile Salathe ◽  
Elettra Poli ◽  
Marco Altarelli ◽  
Nathan Axel Bianchi ◽  
Antoine Guillaume Schneider
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Elderly Patients ◽  
Replacement Therapy ◽  
Age Groups ◽  
High Morbidity ◽  
Predicted Values

Abstract Background: Renal replacement therapy (RRT) in critically-ill patients is associated with high morbidity and mortality. The adequacy of its initiation is sometimes questioned in elderly patients particularly those with comorbidities. We therefore sought to evaluate the long-term outcomes and quality of life (QOL) of elderly patients who survived critical illness requiring RRT.Methods: We identified all patients > 55 yo who received RRT for acute kidney injury in our intensive care unit (ICU) between January 2015 and April 2018. We assessed their vital status by cross referencing our hospital database and the Swiss national death registry. Patients still alive at the time of the study underwent a phone interview. They were asked about their dialytic status and administered an EQ-5D survey with visual analog scale (VAS). Results were stratified according to patient's age groups (G1: "55–64 yo"; G2: "65–74 yo" and G3: "> 75 yo"). QOL in G3 patients were compared to G1 and G2 and to predicted values (calculated based on a local reference population).Results: Among the 352 eligible patients, 171 died during the index hospital admission. After a median follow-up of 2.7 years (IQR 1.6), a further 62 had died (mean time to death for hospital survivors 149.4 days (IQR 450.4). Hence, 119 patients (33.6%) were still alive at the time of the study. We successfully contacted 96 (80.7%) of them and 83 (69.7%) were included in the study (G1: 24, G2: 44 and G3: 15). Only 6 (7.2%) were RRT dependent. Patients in G3 had lower EQ-5D and VAS scores than those in G1 and G2 (p < 0.01). These scores were also significantly lower than predicted values (p < 0.05).Conclusions: Irrespective of age, the need for RRT identifies a population at very high risk of mortality. Among survivors, the rate of RRT dependence is low. Patients > 75 yo who survived ICU had a lower quality of life than younger patients. This QOL was also lower than predicted according to age and sex. The adequacy of RRT initiation in elderly patients should be discussed according to their pre-existing QOL and frailty.

Post–Intensive Care Syndrome in Family Decision Makers of Long-term Acute Care Hospital Patients

2017 ◽  
Vol 26 (5) ◽  
pp. 416-422 ◽  
Author(s):  
Amy Petrinec
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Summary Score ◽  
Decision Makers ◽  
Family Decision ◽  
Post Intensive Care Syndrome

Background Family members of critically ill patients experience indications of post–intensive care syndrome, including anxiety, depression, and posttraumatic stress disorder. Despite increased use of long-term acute care hospitals for critically ill patients, little is known about the impact of long-term hospitalization on patients’ family members. Objectives To examine indications of post–intensive care syndrome, coping strategies, and health-related quality of life among family decision makers during and after patients’ long-term hospitalization. Methods A single-center, prospective, longitudinal descriptive study was undertaken of family decision makers of adult patients admitted to long-term acute care hospitals. Indications of post–intensive care syndrome and coping strategies were measured on the day of hospital admission and 30 and 60 days later. Health-related quality of life was measured by using the Short Form-36, version 2, at admission and 60 days later. Results The sample consisted of 30 family decision makers. On admission, 27% reported moderate to severe anxiety, and 20% reported moderate to severe depression. Among the decision makers, 10% met criteria for a provisional diagnosis of posttraumatic stress disorder. At admission, the mean physical summary score for quality of life was 47.8 (SD, 9.91) and the mean mental summary score was 48.00 (SD, 10.28). No significant changes occurred during the study period. Problem-focused coping was the most frequently used coping strategy at all time points. Conclusion Family decision makers of patients in long-term acute care hospitals have a significant prevalence of indications of post–intensive care syndrome.

scholarly journals Long-term prognosis in Crohn's disease: factors that affect quality of life

2006 ◽  
Vol 23 (3) ◽  
pp. 377-385 ◽  
Author(s):  
C. CANAVAN ◽  
K. R. ABRAMS ◽  
B. HAWTHORNE ◽  
D. DROSSMAN ◽  
J. F. MAYBERRY
Keyword(s):  
Quality Of Life ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Long Term Prognosis

Costs and quality of life effects of the first year of renal replacement therapy in one Finnish treatment centre

2009 ◽  
Vol 12 (2) ◽  
pp. 136-140 ◽  
Author(s):  
Taru Hallinen ◽  
Erkki J. O. Soini ◽  
Janne A. Martikainen ◽  
Risto Ikäheimo ◽  
Olli-Pekka Ryynänen
Keyword(s):  
Quality Of Life ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
First Year ◽  
Treatment Centre

Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection

2006 ◽  
Vol 34 (2) ◽  
pp. 354-362 ◽  
Author(s):  
H A. Cense ◽  
J B. F. Hulscher ◽  
A G. E. M. de Boer ◽  
D A. Dongelmans ◽  
H W. Tilanus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Esophageal Resection ◽  
Term Survival ◽  
Long Term Survival

Quality of Life and Health Status among those receiving Renal Replacement Therapy in Trinidad and Tobago. West Indies.

2020 ◽  
Author(s):  
Sharlene Maria Sanchez ◽  
Surujpal Teelucksingh ◽  
Ronan Ali ◽  
Henry Bailey ◽  
George Legall
Keyword(s):  
Quality Of Life ◽  
Renal Replacement Therapy ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Trinidad And Tobago ◽  
Replacement Therapy ◽  
Health State ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

Abstract Background A cross sectional study was conducted over a 1-year period in order to evaluate quality of life and health state for patients receiving renal replacement therapy in a resource constrained Caribbean island of Trinidad and Tobago. Methods Five hundred and thirty patients were enlisted in the study. For those who had received renal transplants (n=100) and for those on peritoneal dialysis (n=80), all were included. Among the 1000-odd patients who were receiving haemodialysis 350 were studied using convenience sampling. To be included, one had to be on renal replacement therapy for 3 months or more and at least 18 years of age. The Kidney Disease Quality of Life (KDQOL-36) and the EuroQol (EQ-5D-3L) instruments were administered after demographic data were collected. Transplant recipients were further evaluated with the Kidney Transplant Questionnaire (KTQ). Inferential analysis of data included 95% confidence intervals, hypothesis testing, multiple regression and analysis of variance. SPSS24, STATA14 and MINITAB18 were used. Results Of the 530 patients, 52.5% were male and 37.5% were in the 56-65 years age group. Hypertension (68.9%) and type 2 diabetes mellitus (50.5%) were reported as the main causes of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement (p=0.000), age (p=0.001), Charlson’s Comorbidity Index (p=0.001), income (p=0.000) and employment status (p=0.000). Transplant patients performed the best in the KDQOL-36. The mean visual analogue scale and index scores from the EQ-5D-3L were highest among renal transplant recipients (p=0.000). Conclusion Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago.

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