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KIDNEY INT:血液透析患者的早期再入院与随后的死亡率相关!

2017-05-21 xing.T MedSci原创

因此,透析提供者早期介入和预防再入院的机会可能有限。在这个人群中,无论时机如何,再入院似乎与死亡风险大幅增加独立相关。

在美国透析提供者可能很快将为他们的病人30天再住院而负责。然而,很少有研究评估再入院的时间,这决定了透析提供者可以有时间来采取行动以防止再入院。近日,肾脏病领域权威杂志kidney international上发表了一篇研究文章,研究人员在美国全国性注册中心的285795名成人医疗保险主要血液透析患者中评估了美国血液透析患者再入院的时间,以及其与死亡率之间的关系。

患者在2010-2013年期间至少有一次住院,并且存活30天以上。再住院时间被定义为出院后0-7天,8-14天,或15-30天。研究人员采用多变量Cox比例风险模型估计再入院的时间与死亡率之间的相关性,在一年后进行审查。

总体而言,23.1%的患者在出院后30天内再次入院,其中超过三分之一(35.9%)的再入院患者发生在第一周。无论再入院时间,再入院患者在一年以内有更高的死亡风险,相比那些没有再入院的患者,在出院后15-30天期间再入院患者的风险比为2.04(95%可信区间为2.00-2.09);8-14天再入院的风险比为1.98(1.93-2.04);0-7天再入院的风险比为1.76(1.71-1.80)。

因此,透析提供者早期介入和预防再入院的机会可能有限。在这个人群中,无论时机如何,再入院似乎与死亡风险大幅增加独立相关。

原始出处:

Laura C. Plantinga,et al. Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.kidney-international.2017. http://www.kidney-international.org/article/S0085-2538(17)30228-4/fulltext

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    2017-05-23 habb
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    2017-05-23 gwc389
  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Mon May 22 08:44:15 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201137, encodeId=aee720113e5c, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Mon May 22 08:17:24 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201122, encodeId=749b20112235, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Mon May 22 07:59:36 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201079, encodeId=fa492010e931, content=学习并分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon May 22 07:11:08 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201073, encodeId=09c02010e3a1, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 22 07:07:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201043, encodeId=eb4f2010436a, content=好学习了哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuLuc8S5RMt9ZExKtFteCNL6gK27WrafW6OC8OZkF3dic4lHUf2OxZiaWFhEfNtNPFC8AWia2uJm8TLQ/0, createdBy=08cc2048658, createdName=tt199, createdTime=Mon May 22 06:06:03 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200948, encodeId=f9e6200948d3, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun May 21 19:29:50 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-22 半夏微凉

    学习了谢谢分享

    0

  5. 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    2017-05-22 榄枷檬

    谢谢分享

    0

  6. 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    2017-05-22 184****9840

    学习了谢谢分享。

    0

  7. 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channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 22 07:07:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201043, encodeId=eb4f2010436a, content=好学习了哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuLuc8S5RMt9ZExKtFteCNL6gK27WrafW6OC8OZkF3dic4lHUf2OxZiaWFhEfNtNPFC8AWia2uJm8TLQ/0, createdBy=08cc2048658, createdName=tt199, createdTime=Mon May 22 06:06:03 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200948, encodeId=f9e6200948d3, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun May 21 19:29:50 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-22 杨利洪

    学习并分享了

    0

  8. 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channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 22 07:07:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201043, encodeId=eb4f2010436a, content=好学习了哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuLuc8S5RMt9ZExKtFteCNL6gK27WrafW6OC8OZkF3dic4lHUf2OxZiaWFhEfNtNPFC8AWia2uJm8TLQ/0, createdBy=08cc2048658, createdName=tt199, createdTime=Mon May 22 06:06:03 CST 2017, time=2017-05-22, status=1, ipAttribution=), 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    2017-05-22 tanxingdoctor

    学习啦谢谢分享

    0

  9. 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channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 22 07:07:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201043, encodeId=eb4f2010436a, content=好学习了哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuLuc8S5RMt9ZExKtFteCNL6gK27WrafW6OC8OZkF3dic4lHUf2OxZiaWFhEfNtNPFC8AWia2uJm8TLQ/0, createdBy=08cc2048658, createdName=tt199, createdTime=Mon May 22 06:06:03 CST 2017, time=2017-05-22, status=1, ipAttribution=), 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    2017-05-22 tt199

    好学习了哦

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=200948, encodeId=f9e6200948d3, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun May 21 19:29:50 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-21 laymankey

    感谢分享一下!!

    0

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在日本与西方国家报道的糖尿病血液透析患者HbA1c水平差异很大。因此,该研究结果强调了针对种族和国家的血糖控制指南的重要性。

常规血液透析化验详解

肌酐肌酐是肾病患者最重要的一个指标,尿毒症判断的标杆,但透析后相对指标的解读会发生变化:1、化验的时间,每个月的固定时间,就是透析间隔时间的长短一致;2、透析前、透析后都要化验;3、透析前的指标和以往指标比较,稳定就好,不要太大升降,如果上升明显,说明透析效果不佳,如果下降明显,说明身体肌肉量减少,就要找一下原因了;4、透析前、透析后比较就可以看出透析效果,一般会降低60-70%;5、

JASN:维持性血液透析患者住院存在性别差异!

这些研究结果表明,接受维持性血液透析的妇女住院和30天再入院的风险明显高于男性。在这个队列中,在年龄最小的患者中性别差异最大,并且考虑血清白蛋白水平反映的健康状况的不同后,住院的性别差异有所减弱。

Plos One:急性肾损伤患者进行持续静脉血液透析的影响因素

一些因素可以影响急性肾损伤(AKI)的结果,特别是在重症监护病房(ICU)的患者。在这种情况下,使用连续性肾脏替代疗法(CRRT)可以控制代谢紊乱和血容量。了解这一事实,可能会改变疾病的进程并降低患者的高死亡率。基于此,近期,一项发表在杂志Plos One上的研究旨在评估需要进行CRRT的AKI患者死亡的主要危险因素。此项研究是对ICU中接受初步透析模式为持续静脉血液透析滤过(CVVHDF)的AK

JASN:血液透析期间低血压与脑缺血有啥关系?

这项预试验的结果表明血液透析性脑缺血发生频繁,并不能从血压变化中轻易发现和预测,但其可能具有一定的临床意义。

Am J Kidney Dis:血液透析患者心胸比和全因死亡率与心血管事件有啥关系?

较高的心胸比与血液透析患者全因死亡率和心血管事件风险增加相关。

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