scholarly journals Factors Associated With Dialysis Withdrawal In Dialysis Patients

2019 ◽  
Author(s):  
Hammad Qazi ◽  
Helen Chen ◽  
Peter Varga ◽  
Ashok Chaurasia ◽  
Mahsa Ebad
Keyword(s):  
Logistic Regression ◽  
Cardiac Disease ◽  
Renal Dialysis ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Voluntary Withdrawal ◽  
Assessment And Monitoring ◽  
Grand River ◽  
Renal Patient ◽  
Dialysis Withdrawal

Abstract Background: Research on the factors associated with dialysis withdrawal in dialysis patients has been limited. Authors have used different definitions for dialysis withdrawal, resulting in inconsistent findings. The objective of this study was to determine the factors associated with dialysis withdrawal in dialysis patients.Methods: This retrospective study extracted patient information from the electronic renal patient management systems at the Grand River Hospital. A total of 723 patients who initiated renal dialysis therapy (> 30 days of duration) in the renal dialysis program at Grand River Hospital (GRH), Ontario, during the period from 1st January 2012 to 30th September 2017 were consecutively included in the study. Logistic regression was used to determine the factors: age, sex, modality, comorbidities, the cause of primary renal disease, dialysis modality, and duration of dialysis-associated with dialysis withdrawal. Dialysis withdrawal was defined as “patient declined further treatment or voluntary withdrawal from the dialysis program”.Results: The mean age of the sample was 64.86 ± 14.89 years, and 62.8% (n = 454) were males. The prevalence of dialysis withdrawal was 9.41% (n = 68). The logistic regression model showed that factors associated with dialysis withdrawal were as follows: cardiac disease [Adjusted Odds Ratio (AOR)= 1.921; 95% CI= 1.126–3.278], hypertension [AOR = 5.711; 95% CI = 1.322- 24.676], dementia [AOR = 3.042; 95% CI = 1.325–6.983], age [AOR = 1.035; 95% CI = 1.012– 1.058] and duration of dialysis [AOR = 0.999; 95% CI = 0.999–1.00].Conclusion: In this study we show that age, cardiac disease, hypertension, and dementia are significant predictors related to dialysis withdrawal. The findings might help in identifying patients who are more likely to withdraw from dialysis at the start of dialysis. Future researchers and nephrologists should design and conduct intervention studies focusing on strategies controlling the severity of comorbidities (cardiac disease and hypertension), regular assessment and monitoring of the progression of dementia, and other dialysis program changes to help patients make more informed decisions regarding dialysis withdrawal. Keywords: dialysis, dialysis withdrawal, maintenance dialysis, hemodialysis, peritoneal dialysis, dementia.

scholarly journals FACTORS ASSOCIATED WITH DIALYSIS WITHDRAWAL IN DIALYSIS PATIENTS

2019 ◽  
Author(s):  
Hammad Qazi
Keyword(s):  
Logistic Regression ◽  
Cardiac Disease ◽  
Renal Dialysis ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Voluntary Withdrawal ◽  
Assessment And Monitoring ◽  
Grand River ◽  
Renal Patient ◽  
Dialysis Withdrawal

Abstract Background: Research on the factors associated with dialysis withdrawal in dialysis patients has been limited. Authors have used different definitions for dialysis withdrawal, resulting in inconsistent findings. The objective of this study was to determine the factors associated with dialysis withdrawal in dialysis patients. Methods: This retrospective study extracted patient information from the electronic renal patient management systems at the Grand River Hospital. A total of 723 patients who initiated renal dialysis therapy (> 30 days of duration) in the renal dialysis program at Grand River Hospital (GRH), Ontario, during the period from 1st January 2012 to 30th September 2017 were consecutively included in the study. Logistic regression was used to determine the factors: age, sex, modality, comorbidities, the cause of primary renal disease, dialysis modality, and duration of dialysis-associated with dialysis withdrawal. Dialysis withdrawal was defined as “patient declined further treatment or voluntary withdrawal from the dialysis program”. Results: The mean age of the sample was 64.86 ± 14.89 years, and 62.8% (n = 454) were males. The prevalence of dialysis withdrawal was 9.41% (n = 68). The logistic regression model showed that factors associated with dialysis withdrawal were as follows: cardiac disease [Adjusted Odds Ratio (AOR)= 1.921; 95% CI= 1.126–3.278], hypertension [AOR = 5.711; 95% CI = 1.322- 24.676], dementia [AOR = 3.042; 95% CI = 1.325–6.983], age [AOR = 1.035; 95% CI = 1.012– 1.058] and duration of dialysis [AOR = 0.999; 95% CI = 0.999–1.00]. Conclusion: In this study we show that age, cardiac disease, hypertension, and dementia are significant predictors related to dialysis withdrawal. The findings might help in identifying patients who are more likely to withdraw from dialysis at the start of dialysis. Future researchers and nephrologists should design and conduct intervention studies focusing on strategies controlling the severity of comorbidities (cardiac disease and hypertension), regular assessment and monitoring of the progression of dementia, and other dialysis program changes to help patients make more informed decisions regarding dialysis withdrawal.

scholarly journals Mechanical circulatory support for refractory out-of-hospital cardiac arrest: a Danish nationwide multicenter study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Sivagowry Rasalingam Mørk ◽  
Carsten Stengaard ◽  
Louise Linde ◽  
Jacob Eifer Møller ◽  
Lisette Okkels Jensen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Survival Rate ◽  
Neurological Outcome ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Good Neurological Outcome ◽  
Factors Associated ◽  
National Consensus ◽  
Hospital Cardiac Arrest

Abstract Background Mechanical circulatory support (MCS) with either extracorporeal membrane oxygenation or Impella has shown potential as a salvage therapy for patients with refractory out-of-hospital cardiac arrest (OHCA). The objective of this study was to describe the gradual implementation, survival and adherence to the national consensus with respect to use of MCS for OHCA in Denmark, and to identify factors associated with outcome. Methods This retrospective, observational cohort study included patients receiving MCS for OHCA at all tertiary cardiac arrest centers (n = 4) in Denmark between July 2011 and December 2020. Logistic regression and Kaplan–Meier survival analysis were used to determine association with outcome. Outcome was presented as survival to hospital discharge with good neurological outcome, 30-day survival and predictors of 30-day mortality. Results A total of 259 patients were included in the study. Thirty-day survival was 26%. Sixty-five (25%) survived to hospital discharge and a good neurological outcome (Glasgow–Pittsburgh Cerebral Performance Categories 1–2) was observed in 94% of these patients. Strict adherence to the national consensus showed a 30-day survival rate of 30% compared with 22% in patients violating one or more criteria. Adding criteria to the national consensus such as signs of life during cardiopulmonary resuscitation (CPR), pre-hospital low-flow < 100 min, pH > 6.8 and lactate < 15 mmol/L increased the survival rate to 48%, but would exclude 58% of the survivors from the current cohort. Logistic regression identified asystole (RR 1.36, 95% CI 1.18–1.57), pulseless electrical activity (RR 1.20, 95% CI 1.03–1.41), initial pH < 6.8 (RR 1.28, 95% CI 1.12–1.46) and lactate levels > 15 mmol/L (RR 1.16, 95% CI 1.16–1.53) as factors associated with increased risk of 30-day mortality. Patients presenting signs of life during CPR had reduced risk of 30-day mortality (RR 0.63, 95% CI 0.52–0.76). Conclusions A high survival rate with a good neurological outcome was observed in this Danish population of patients treated with MCS for OHCA. Stringent patient selection for MCS may produce higher survival rates but potentially withholds life-saving treatment in a significant proportion of survivors.

Factors associated with return to work after coronary artery bypass grafting (CABG)

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Raynaldo
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Return To Work ◽  
Coronary Artery Bypass ◽  
Functional Capacity ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Factors Associated ◽  
Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background. Postoperative CABG patients will generally experience improvement in symptoms and functional capacity. Post-CABG patients are expected to be productive again in order to have a positive impact on both patient and the society socio-economically, in addition to other parameters such as morbidity, mortality and serious adverse events. Purpose to determine the factors that associated with return to work in CABG patients in one General Hospital. Methods. We analyzed data from Adam Malik Hospital registry of 68 patients who had undergone CR after coronary artery bypass graft (CABG) in 2017-2020. The outcomes assessed were work status in 6 month after CABG. Patients’ characteristics, sociodemographic, clinical parameters of functional capacity using 6 minutes of walk test (6MWT), T2DM, Hypertension and cholesterol level were assessed. Factors associated with return to work were identified using multivariable logistic regression. Results We identified 68 patients undergoing isolated CABG (2017–2020). One year after discharge for CABG, 40 (58.8%) patients had returned to the workforce. Factors associated with return to work  were identified using bivariate logistic regression. Diabetes mellitus (odds ratio, 10.192; 95% confidence interval, 0.063–0.515). Conclusion Almost 2 from 3 patients after CABG returned to work within 6 months. Diabetes mellitus and functional capacity were associated with a lower likelihood of returning to work.

scholarly journals Factors Associated with Free Hospital Outpatient Service Use among Middle-Aged and Older Urban Homeless Adults in Taipei

2021 ◽  
Vol 18 (10) ◽  
pp. 5330
Author(s):  
Lan-Ping Lin ◽  
Li-Yun Wang ◽  
Tai-Wen Wang ◽  
Yun-Cheng Chen ◽  
Jin-Ding Lin
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
Chronic Diseases ◽  
Service Use ◽  
Outpatient Service ◽  
Homeless People ◽  
Cross Sectional Survey ◽  
Factors Associated ◽  
Hospital Outpatient ◽  
Outpatient Visits

Homeless individuals have many negative experiences with inequality regarding access to and the use of primary healthcare services, so policies to eliminate the disparities in and barriers to primary care access for these people are needed. The aim of this study was to explore the use and determinants of free hospital outpatient services for homeless people, in order to describe the provision of free healthcare policies for this vulnerable population in Taipei. One cross-sectional survey was conducted to recruit homeless people aged 45 years old and over in Taipei in 2018. A structured questionnaire was used, and face-to-face interviews were conducted by three social workers to collect the data. Finally, 129 participants were recruited in the study. The results show that 81.4% of the homeless people had made free hospital outpatient care visits (mean = 5.9 visits) in the last three months. An unadjusted logistic regression analysis showed that those homeless people who reported having usual healthcare providers, with higher depressive symptom scores, who used medication and had been hospitalized within one year, and had more chronic diseases, were significantly more likely to make free hospital outpatient visits. The adjusted logistic regression model indicates that homeless people with severe depressive symptoms (odds ratio (OR) = 9.32, 95% CI = 1.15–56.07), who had received medication (OR = 3.93; 95% CI = 1.06–14.52), and who had more than five chronic diseases (OR = 1.06, 95% CI = 1.35–13.27), were significantly more likely to make free hospital outpatient visits than their counterparts. The findings highlight that homeless people have higher healthcare requirements than the general population, and the healthcare system should pay more attention to factors associated with higher outpatient service use, such as homelessness, severe depressive symptoms, the receipt of medication and chronic diseases.

scholarly journals Knowledge, attitudes, practices, and influencing factors of anxiety among pregnant women in Wuhan during the outbreak of COVID-19: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenping Ding ◽  
Jianmei Lu ◽  
Yan Zhou ◽  
Weizhong Wei ◽  
Zhihong Zhou ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Influencing Factors ◽  
Information Source ◽  
Influential Factors ◽  
Public Health Issue ◽  
Cross Sectional ◽  
Factors Associated ◽  
Attitudes And Practices ◽  
Prenatal Anxiety

Abstract Background Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context. Methods Pregnant subjects’ KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson’s chi-square test and multivariable logistic regression analyses. Results The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule. Conclusion Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.

scholarly journals Relationship between Vascular Calcification, Protein-Energy Wasting Syndrome, and Sarcopenia in Maintenance Automated Peritoneal Dialysis

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 666
Author(s):  
Gustavo Leal-Alegre ◽  
Claudia Lerma ◽  
Gabriela Leal-Escobar ◽  
Bernardo Moguel-González ◽  
Karen Belén Martínez-Vázquez ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Vascular Calcification ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Wasting Syndrome ◽  
Protein Energy ◽  
Inflammation Score

Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.

scholarly journals Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reem M. Elsaid ◽  
Ashraqat S. Namrouti ◽  
Ahmad M. Samara ◽  
Wael Sadaqa ◽  
Sa’ed H. Zyoud
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Binary Logistic Regression ◽  
Nausea And Vomiting ◽  
Prior History ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
History Of

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

52 IMPLANTABLE CARDIAC DEFIBRILLATORS IN RENAL DIALYSIS PATIENTS.

2004 ◽  
Vol 52 (Suppl 2) ◽  
pp. S354.5-S354
Author(s):  
J. Robin ◽  
K. Weinberg ◽  
J. Tiongson ◽  
M. Quadrini ◽  
C. Ciaccio ◽  
...  
Keyword(s):  
Renal Dialysis ◽  
Dialysis Patients ◽  
Implantable Cardiac Defibrillators
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