Hospital case volume and clinical outcomes in critically ill patients with acute kidney injury treated with dialysis

被引：5

作者：

Chimunda, Timothy ^{[1
]}

Silver, Samuel A. ^{[2
]}

Kuwornu, John Paul ^{[3
]}

Li, Lihua ^{[3
]}

Nash, Danielle M. ^{[3
]}

Dixon, Stephanie N. ^{[3
]}

Adhikari, Neill K. J. ^{[4
]}

Acedillo, Rey R. ^{[2
]}

Harel, Ziv ^{[3
,5
,6
]}

Kitchlu, Abhijat ^{[5
]}

Garg, Amit X. ^{[3
,7
]}

Bell, Chaim M. ^{[3
,8
]}

Sood, Manish M. ^{[3
,9
]}

Kim, Joseph S. ^{[3
,10
]}

Wald, Ron ^{[3
,5
,6
]}

机构：

[1] Univ Melbourne, Rural Sch Med, Univ Monash, Div Crit Care,Bendigo Hlth, Bendigo, Australia

[2] Queens Univ, Div Nephrol, Kingston, ON, Canada

[3] Inst Clin Evaluat Sci, Toronto, ON, Canada

[4] Univ Toronto, Interdept Div Crit Care Med, Sunnybrook Hlth Sci Hosp, Dept Crit Care Med, Toronto, ON, Canada

[5] Univ Toronto, St Michaels Hosp, Div Nephrol, Toronto, ON, Canada

[6] St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[7] Western Univ, London Hlth Sci Hosp, Div Nephrol, London, ON, Canada

[8] Univ Toronto, Sinai Hlth Syst, Dept Med, Toronto, ON, Canada

[9] Univ Ottawa, Ottawa Hosp, Div Nephrol, Ottawa, ON, Canada

[10] Univ Toronto, Univ Hlth Network, Div Nephrol, Toronto, ON, Canada

来源：

JOURNAL OF CRITICAL CARE | 2018年 / 48卷

基金：

加拿大健康研究院;

关键词：

Centre volume outcomes; Dialysis dependence; Critically ill; AKI; MORTALITY; ASSOCIATION;

D O I：

10.1016/j.jcrc.2018.08.024

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Purpose: To determine whether patients with severe acute kidney injury who receive dialysis (AKI-D) experience better outcomes at centres that care for more patients with AKI-D. Materials and methods: Linked administrative datasets where used to perform a retrospective cohort study of all critically ill patients in Ontario, Canada, who had a first episode of AKI-D between 2002 and 2011. Centre volume for a given year. was designated by calculating the mean number of patients treated with acute dialysis at that centre during that year and the one preceding it. Patients treated at that centre were then assigned to a centre volume quartile for that year. Results: We identified 19,658 critically ill patients with AKI-D treated at 54 Ontario hospitals. Mortality and dialysis dependence at 90-days were 46% and 31%, respectively. Centre volume was not associated with mortality at 90 days (with quartile 1 as the reference, adjusted odds ratio (a0R) 1.16 (95% CI, 0.87 - 1.54) in quartile 2, aOR 1.17 (95% CI, 0.91 - 1.50) in quartile 3, and aOR 1.06 (95% CI, 0.81 - 1.41) in quartile 4). Conclusions: There are no Centre volume survival associations in the management of AKI-D despite high mortality and dependence rate. (C) 2018 Published by Elsevier Inc.

引用

页码：276 / 282

页数：7

共 28 条

[1]

Does It Matter Where You Are Hospitalized for Inflammatory Bowel Disease? A Nationwide Analysis of Hospital Volume [J].