Original Article

A retrospective cohort study on unscheduled admissions among patients with end stage renal disease (ESRD) receiving maintenance renal replacement therapy (RRT) and its mortality outcome

Authors: Zher Lin Go, Hon Shen P’ng, Wai Seng Cheong.

ABSTRACT

Background: While international data exists on hospitalisation and its associated mortality among endstage renal disease (ESRD) population on maintenance renal replacement therapy (RRT), local data is not known. The objective of this single centre retrospective observational study is to determine the burden of hospital admission and readmission among the ESRD population and the mortality outcome after hospitalisation.

Methods: We obtained our study data from the HSNI Batu Pahat nephrology service inpatient database, patients’ medical records and Jabatan Pendaftaran Negara (JPN) registry of death.

Results: There were 195 index admissions identified from January to June 2016. We found that hospital readmission rate was high at 19.5% within 30 days, 34.4% within 60 days, and 44.6% within 90 days of discharge. Commonest reason of admission was fluid overload (20.7%). Overload was also the commonest reason of readmissions within 30 and 60 days (28.9% and 23.8% respectively), whereas vascular access related issues were the commonest reason of readmission within 90 days of discharge (21.8%). The 90-day mortality rate after index admission was also high at around 18%. The commonest cause of mortality was Infection and Sepsis (42.9%), followed by Acute Coronary Syndrome (22.9%).

Conclusions: This study demonstrated the heavy burden of hospitalisation and high mortality rate among ESRD populations. Further larger researches are welcomed to look into the factors associated and the problems faced, in order to improve not only individual morbidity and mortality outcomes, but also on hospitalisation cost and healthcare resources.

Keywords: ESRD on RRT, Hospital Admission, Readmission, Mortality after Hospital Admissions, Reasons of Admission, Reasons of Readmission, Reasons of Mortality.

Citation: IeJSME 2018 12(3): 12-20

DOI: https://doi.org/10.56026/imu.12.3.12