The spectrum of infection-related morbidity in hospitalized haemodialysis patients.

Published

Journal Article

BACKGROUND: Infection is a common cause of mortality and morbidity in haemodialysis patients. Few prospective studies have examined the clinical consequences of infection-related hospitalizations in haemodialysis patients or the risk factors predictive of clinical outcomes. METHODS: The outcomes of all first infection-related hospitalizations of patients enrolled in the HEMO Study were categorized in terms of mortality, requirement for intensive care unit (ICU) stay and length of hospitalization. In addition, the association of hospitalization outcomes with clinical and laboratory parameters was evaluated. RESULTS: Among the 783 first infection-related hospitalizations, 57.7% had a severe outcome (death, ICU stay or hospitalization >/=7 days). The likelihood of a severe outcome increased with patient age (P<0.0001) and with decreased serum albumin (P<0.001). The frequency of a severe outcome varied greatly by infectious disease category (P<0.001), being highest for cardiac infections (95.6%) and infection of unknown source (68.4%), and lowest for urinary tract infections (35.5%) and access-related infections (43.8%). On multivariate analysis, hospitalization outcome was independently associated with patient age, serum albumin and disease category, but not with the randomized Kt/V or flux, gender, race or diabetic status. CONCLUSION: In summary, infection-related hospitalizations are associated with substantial morbidity. Patient age, serum albumin and infectious disease category are independently correlated with the hospitalization outcome, and can be used to estimate the likelihood of serious outcomes at the time of hospital admission.

Full Text

Duke Authors

Cited Authors

  • Allon, M; Radeva, M; Bailey, J; Beddhu, S; Butterly, D; Coyne, DW; Depner, TA; Gassman, JJ; Kaufman, AM; Kaysen, GA; Lewis, JA; Schwab, SJ; HEMO Study Group,

Published Date

  • June 2005

Published In

Volume / Issue

  • 20 / 6

Start / End Page

  • 1180 - 1186

PubMed ID

  • 15769823

Pubmed Central ID

  • 15769823

International Standard Serial Number (ISSN)

  • 0931-0509

Digital Object Identifier (DOI)

  • 10.1093/ndt/gfh729

Language

  • eng

Conference Location

  • England