新增老年血液透析患者反复住院和死亡危险因素分析

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Abstract Objective To explore the risk factors of repeated hospitalization in the first year after starting dialysis and its correlation with long-term death in new elderly hemodialysis patients. Methods From July 2013 to June 2018, 166 patients aged ≥60 years old who started dialysis treatment in the hemodialysis room of the Affiliated Hospital of Southwest Medical University were screened out. According to the frequency of hospitalization in the first year after the start of regular dialysis, the patients were divided into non-hospitalization group (57 cases), hospitalization for 1-2 times (71 cases), hospitalization for 3 times or more (38 cases). The laboratory data, complications, all-cause mortality, etc. of patients in the three groups before starting dialysis were compared, and the orderly logistic regression model and COX regression model were respectively used to explore the hospitalization frequency and risk factors of death of the patients. Results A total of 242 hospitalizations were made in 166 patients in the first year after the start of dialysis, with 58 deaths due to all causes by June 2019. The main causes of hospitalization were infectious diseases, cardiovascular events and complications related to vascular access. The main causes of death were cardiovascular events, severe infections and cerebrovascular accidents. Multivariate logistic regression analysis showed that old age, low immunoreactive parathyroid hormone (iPTH), high B natriuretic peptide (BNP), low albumin and low hemoglobin were associated with increased hospitalization risk (P ＜ 0.05), and COX regression analysis showed that hospitalization frequency, low iPTH, high BNP and low albumin were risk factors for death of patients in the first year after the start of dialysis (P ＜ 0.05). Conclusion Low iPTH, low proteinemia and high BNP before dialysis are risk factors for hospitalization and long-term death of patients.

Key words： Maintenance hemo-dialysis Elderly patients Hospitalization Death Risk factors

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	GENG Lei1 WU Weihua1 HUANG Chaoyue1 LIU Jian1
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GENG Lei1 WU Weihua1 HUANG Chaoyue1 LIU Jian1,2. Analysis of risk factors for repeated hospitalization and death in newly increased elderly hemodialysis patients[J]. 中国医药导报, 2020, 17(8): 134-138.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I8/134

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