Emergency Room Visits in Patients with Left Ventricular Dysfunction Receiving Hemodialysis : A Case Control Study
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Keywords

LVD
Renal failure
Mortality
Emergency room
ICU

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1.
Albeshri M, Alsallum M, Daiwali M, Seraj H, Bana H, Alhozali H, Alghalayini K. Emergency Room Visits in Patients with Left Ventricular Dysfunction Receiving Hemodialysis : A Case Control Study. Integr J Med Sci [Internet]. 2018 Feb. 7 [cited 2022 Oct. 5];5. Available from: https://www.mbmj.org/index.php/ijms/article/view/118

Abstract

Introduction: Chronic kidney disease (CKD) prevalence in Saudi Arabia has been rising over the past few years. The risk of developing left ventricular dysfunction is high in patients with CKD on hemodialysis. Our aim is to study the frequency of emergency room visits and the length of ER stay in patients with LVD on hemodialysis.
Methods: All patients who were on hemodialysis between the period of January 2011 and November 2016 were included in our study. Patients’ demographic, medical, and laboratory data were extracted for all patients. Patients were classified into three groups according to their ejection fraction (EF<40%, EF= 40-49%, and EF≥50%). Descriptive statistics were done for all variables. Logistic regression was used to assess the outcome while adjusting for confounder.
Results: Analysis included 333 patients. Two hundred and fifty-seven patients had an EF ³50% and 36 patients with EF 40-49% and 40 patients with EF <40 %. Age was significantly higher in patients with EF<50% compared to patients with EF ³50% (P=0.002). Comorbidities were more prevalent in patients with EF<40% and EF 40-49%. The number of ER visits and length of stay were significantly different between the three groups (P=0.005, P=0.023) ICU admissions show a statistically significant difference between the three groups (P=0.013).
Conclusion: Patients with low EF on hemodialysis have a higher rate of ER visits and length of stay in ER when compared to patients with EF≥50.

https://doi.org/10.15342/ijms.v5ir.213
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References

Al-Sayyari AA, Shaheen FA. End stage chronic kidney disease in Saudi Arabia. A rapidly changing scene. Saudi Med J. 2011 Apr; 32(4):339-46. [Accessed 2021 Jul 06]. Available From: https://d1wqtxts1xzle7.cloudfront.net/50181619/endstage_CKD_in_KSA.pdf1478595438=&responsecontentdisposition=inline%3B+filename%3DEnd_stage_chronic_kidney_disease_in_Saud.pdf&Expires=1625572231&Signature=XxDve2lzuGBnwsl~3lQ3Nrv8d8C3~BSH100gKg9ZINTaVQh2Mx2oIVvycFWUfNLJ7DDIClrCm8KsBVf8Goo2XICYs3ixHutaKrg6CAmfb0S0mRi3FimyrV2GHoM~RkKVGiv3lhZiIeSwalPWC3tfdlLHgmjlZ0eJyRyFV8Y3lNGAasS8vl8DF0DjTisiY4OQPa16L5zoLesb~LJrd7hUqBK1xmE0H0BiJAITuupbbaSZhU7rZ5U4FlFpcgQvJnlGrBUdsJcRZPDSbFJtgnCjgInzTS1DW94q7nvED6lhdsgQL8lYvBJSdOS0R59UmQT5uB0IjGqs85km5OvdWjtg__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

Dialysis in the Kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl. 2013 Jul ;24(4):853-61.

Jassal SV, Trpeski L, Zhu N, Fenton S, Hemmelgarn B. Changes in survival among elderly patients initiating dialysis from 1990 to 1999. CMAJ. 2007 Oct 23;177(9):1033-8. https://doi.org/10.1503/cmaj.061765

Stack AG, Bloembergen WE . A cross-sectional study of the prevalence and clinical correlates of congestive heart failure among incident US dialysis patients. Am J Kidney Dis. 2001 Nov; 38(5):992-1000. https://doi.org/10.1053/ajkd.2001.28588

Harnett JD, Foley RN, Kent GM, Barre PE, Murray D, Parfrey PS. Congestive heart failure in dialysis patients: prevalence, incidence, prognosis and risk factors. Kidney Int. 1995 Mar; 47(3):884-90. https://doi.org/10.1038/ki.1995.132

Syed Wamique Yusuf. Chronic congestive heart failure. 2017.

Parfrey PS, Harnett JD, Griffiths SM, Gault MH, Barré PE. Congestive heart failure in dialysis patients. Arch Intern Med. 1988 Jul; 148(7):1519-25. https://doi.org/10.1001/archinte.1988.00380070037010

Wang AYM, Sanderson JE. Current perspectives on diagnosis of heart failure in long-term dialysis patients. Am J Kidney Dis. 2011 Feb; 57(2):308-319. https://doi.org/10.1053/j.ajkd.2010.07.019

Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circulation: Heart Failure. 2013 May; 6(3):606-19. https://doi.org/10.1161/hhf.0b013e318291329a

Writing Group M, Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. Heart Disease and Stroke Statistics-2016 Update: A Report from the American Heart Association. Circulation. 2016 Jan; 133(4):e38-360. https://doi.org/10.1161/CIR.0000000000000366

Gerber Y, Weston SA, Redfield MM, Chamberlain MA, Manemann SM, Jiang R, et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA intern Med. 2015 Jun; 175(6): 996-1004. https://doi.org/10.1001/jamainternmed.2015.0924

Sarnak MJ. Cardiovascular complications in chronic kidney disease. Ame J Kidney Dis. 2003 Jun; 41(5):11-7. https://doi.org/10.1016/s0272-6386(03)00372-x

Cheung AK, Sarnak MJ, Yan G, Berkoben M, Heyka R, Kaufman A, et al. Cardiac diseases in maintenance hemodialysis patients: results of the HEMO Study. Kidney Int. 2004 Jun 30; 65(6):2380-9. https://doi.org/10.1111/j.1523-1755.2004.00657.x

Hutchinson, TA, Thomas DC, MacGibbon B. Predicting survival in adults with end-stage renal disease: an age equivalence index. Ann Intern Med. 1982 Apr; 96(4):417-423. https://doi.org/10.7326/0003-4819-96-4-417

Soucie JM, McClellan WM. Early death in dialysis patients: risk factors and impact on incidence and mortality rates. J Am Soc Nephrol. 1996 Oct; 7(10):2169-75. https://doi.org/10.1681/asn.v7102169

US RENAL DATA SYSTEM: USRDS 1991 Anual Report. Bethesda, The National Institute of Diabetes and Digestive and Kidney Diseases, 1991.

Trespalacios FC, Taylor AJ, Agodoa LY, Bakris GL, Abbott KC. Heart failure as a cause for hospitalization in chronic dialysis patients. Ame J kidney Dis. 2003 Jun;41(6):1267-77. https://doi.org/10.1016/s0272-6386(03)00359-7

CANADIAN ORGAN REPLACEMENT REGISTER: 1991 Annual Report. Hospital Medical Records Institute. Don Mils, Ontario, Apr 1993.

Dialysis in the Kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl. 2017; 28(4):949-57.

McCullough PA, Chan CT, Weinhandl ED, Burkart JM, Bakris GL. Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease. A J Kidney Dis. 2016 Nov;68(5S1):S5-S14. https://doi.org/10.1053/j.ajkd.2016.05.025

Rostand SG, Sanders C, Kirk KA, Rutsky EA, Fraser RG. Myocardial calcification and cardiac dysfunction in chronic renal failure. Am J Med. 1988; 85(5):651-7. https://doi.org/10.1016/s0002-9343(88)80237-7

Goodkin DA, Bragg-Gresham JL, Koenig KG, Wolfe RA, Akiba T, Andreucci VE, et al. Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Am Soc Nephrol. 2003 Dec; 14(12):3270-7. https://doi.org/10.1097/01.asn.0000100127.54107.57

Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am J Kidney Dis. 1998 Nov;32(5):853-906. https://doi.org/10.1016/s0272-6386(98)70145-3

Sharabas I, Siddiqi N. Cardiovascular disease risk profiles comparison among dialysis patients. Saudi J Kidney Dis Transpl. Jul-Aug 2016; 27(4):692-700. https://doi.org/10.4103/1319-2442.185225

Higgins TL, McGee WT, Steingrub JS, Rapoport J, Lemeshow S, Teres D. Early indicators of prolonged intensive care unit stay: Impact of illness severity, physician staffing, and pre–intensive care unit length of stay. Crit Care Med. 2003 Jan;31(1):45-51. https://doi.org/10.1097/00003246-200301000-00007

Lee DS, Schull MJ, Alter DA, Austin PC, Laupacis A, Chong A, et al. Early Deaths in Heart Failure Patients Discharged from the Emergency Department: A Population-based Analysis. Circulation. 2009;120(18): S748-S749. [Accessed 2021 Jul 06]. Available from: https://www.ahajournals.org/doi/abs/10.1161/circ.120.suppl_18.S748-c

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul; 37(27):2129-2200. https://doi.org/10.1093/eurheartj/ehw128

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Copyright (c) 2018 Marwan Albeshri et al.

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