Gerontology & Geriatric Research

Morbidity and mortality of elderly patients 12 months after starting chronic hemodialysis

International Conference on Geriatrics & Gerontology

July 08-10, 2014 DoubleTree by Hilton Hotel Chicago-North Shore Conference Center, USA

Zorica Dimitrijevic

Accepted Abstracts: J Gerontol Geriat Res

Abstract:

Introduction: We conducted retrospective study in order to investigate the morbidity and mortality 12 months from baseline dialysis date in patients over the age of 70 years. Using proportional hazards models, we examined the association between initial vascular access and comorbidity score and mortality after accounting for number of hospital days in the first years prior to dialysis initiation. Methods: The study period was from 2009 to 2013. During this period, a total of 266 patients over the age of 70 started HD. We excluded patients with acute renal failure, and included patients who were alive and still requiring HD 90 days after dialysis start. The number of patients who met the above criteria was 129. Details of hospitalizations, dialysis access type, and comorbidities were taken from medical records. The Davis comorbidity score was used to classify comorbidities. Patients were divided into those between 70 and 80 years of age (group 1) and those over the age of 80 (group 2). Results: There were 99 patients in group 1 and 30 patients in group 2. The proportion of diabetic patients was slightly higher in group 1 (36.5% vs. 21.7%). Male to female ratio was 1.4:1 in group 1 and 2.3:1 in group 2. In group 1, 44% of patients started dialysis with an AV fistula or graft and 56% with a nontunneled dialysis catheter, as compared with 32%, 68% in group 2. The comorbidity scores were similar in both groups. Seventy five percent of patients in group 1 and 88% in group 2 had 1 or more comorbidities at the start of dialysis. 34.5% of patients in group 1 were diabetic, as compared with 22.3% in group 2. The median number of days spent in hospital in the first year was 11 in group 1 and 9 in group 2. Mortality at 12 months was 27.4% in group 1 and 64.1% in group 2. Conclusion: Our study shows significant difference in survival at first year in the two groups of patients. Starting dialysis with a nontunneled line was a predictor of poor outcome at the first 12 hemodialysis months.

Biography :

Zorica Dimitrijevic has completed her MD and PhD from University of Nis, Serbia and work as a staff physician at Clinic of Nephrology as well as teaching assistant in nephrology at Medical school, University of Nis, Serbia. She has published number of papers in reputed medical journals.