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논문분류	춘계학술대회 초록집
제목	Effects of hospitalization events before starting hemodialysis on mortality in dialysis patients
저자	Gwangeon Sim
출판정보	2023; 2023(1):
키워드
초록	Objectives: Hospitalization of the elderly causes fragility, which increases subsequent hospitalization and mortality rates. In this study, we investigated whether dialysis in patients with a history of hospitalization before dialysis affects the mortality rate of dialysis patients. Methods: We studied 2765 patients who visited hemodialysis clinics in 17 teaching hospitals and analyzed the association of mortality with demographic factors, co-morbidity, laboratory findings, and drugs. The HR was calculated through survival analysis to see if hospitalization increases the mortality rate of dialysis patients. Results: 8.0% (n=222) of the subjects experienced 1 month or longer hospitalization within 1 year of starting dialysis. There was no gender difference between the two groups. The hospitalized group was older, and many patients started dialysis using a catheter. The prevalence of cerebrovascular accident, hypertension, dementia, heart failure, and atrial fibrillation was higher. Additionally, this group showed higher platelet and BUN and lower iPTH, Cr, albumin, alkaline phosphatase, and total cholesterol. Also, this group used fewer RAAS CCB anti-platelet agents. In a multivariate analysis controlling for age, sex, vascular access type, dementia, malignancy, ischemic heart disease, cerebrovascular accident, heart failure, atrial fibrillation, liver cirrhosis, fracture, ejection fraction, coronary artery disease, lymphocyte, platelet, BUN, Cr, albumin, phosphorus, total cholesterol, RAS blockade, B-blocker, Calcium channel blocker, warfarin, hyperlipidemia drugs, Calcium-based phosphate binder, sevelamer, anti-depressant, and dementia medication, the HR of the group receiving dialysis with a history of admission was 1.686 [1.162, 2.447]. Conclusions: Patients with a history of hospitalization for more than one month before dialysis had high overall mortality, therefore attention and intensive care are needed for this population.
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