Journal of Hebei Medical University

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Analysis of clinical risk factors for readmission in maintenance hemodialysis patients

  

  1. 1.The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China; 2.Department of
    Nephropathy, the First Hospital of Lanzhou University, Lanzhou 730000, China
  • Online:2018-02-25 Published:2018-02-06

Abstract: [Abstract]〓Objective〖HTSS〗〓To analyze the clinical risk factors of readmission within 6months among patients on maintenance hemodialysis for chronic renal failure so as to provide guidance for clinical prevention.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 83 hemodialysis patients were enrolled in the study. The patients were divided into readmission group and nonreadmission group according to whether there were two or more hospital admissions within 6months. The clinical data of all patients were retrospectively analyzed to identify readmission risk factors.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Among 83 patients, 42(50.6%) had a 6months hospital readmission. The readmission group had 14(33.3%) patients of cardiovascular complications, 11(26.2%) patients of infection, 8(19.0%) patients of digestive tract symptoms, 5(11.9%) patients of poor vascular access, 2(4.8%) patients of respiratory failure, 2(4.8%) patients of stroke. The utilization rate of central venous catheter in the readmission group was higher than that in the nonreadmission group. The proportion of medical insurance between urban and rural residents in the readmission group was higher than that in the nonreadmission group. The admission hemoglobin level was lower than that of the nonreadmission group, and the levels of admission serum phosphorus, Nterminal pro brain natriuretic peptide, hypersensitivity C reactive protein were higher than those of the non readmission group. The discharge hemoglobin and albumin levels were lower than those of the non readmission group, the difference was statistically significant(P<0.05). The logstic regression analysis indicated that the risk factors for the readmission included vascular access, Nterminal pro brain natriuretic peptide, hypersensitivity C reactive protein, and the protective factors included discharge hemoglobin.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The readmission rate was 50.6% in 6months in the maintenance hemodialysis patients, and the major causes of readmission were cardiovascular complications and infection. The risk factors for readmission include vascular access, Nterminal pro brain natriuretic peptide, hypersensitivity C reactive protein and discharge hemoglobin levels. The risk factors of readmission are influenced by many factors. Comprehensive intervention should be carried out according to the risk factors to reduce the incidence of readmission and improve the quality of life of patients.

Key words: renal dialysis, patient readmission, risk factors