Trends and Outcomes of Severe Sepsis in Patients on Maintenance Dialysis. Am J Nephrol 2016;43(2):97-103
Date
03/10/2016Pubmed ID
26959243DOI
10.1159/000444684Scopus ID
2-s2.0-84961223511 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
BACKGROUND: Though the incidence of severe sepsis is rising, there is a lack of contemporary information regarding the epidemiology and outcomes of severe sepsis in those on maintenance dialysis. The objectives of this study were to measure the incidence and outcomes of severe sepsis in those on maintenance dialysis.
METHODS: Using data from Nationwide Inpatient Sample database from 2005 to 2010, we included all hospitalizations of adults with severe sepsis based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Those on maintenance dialysis were identified by ICD-9-CM codes. We calculated incidence of severe sepsis and mortality. We used logistic regression to assess independent effect of maintenance dialysis status on mortality.
RESULTS: Of the estimated 5,000,152 hospitalizations with severe sepsis, 322,734 (6.4%) were on maintenance dialysis. The unadjusted incidence of severe sepsis was 145.4 per 1,000 in those on maintenance dialysis in comparison to 3.5 per 1,000 in the general population. Mortality was higher in those with severe sepsis (30.3 vs. 26.2%; p < 0.001). Maintenance dialysis is an independent predictor of death in those with severe sepsis (OR 1.26; 95% CI 1.23-1.29).
CONCLUSIONS: Hospitalizations with severe sepsis are more prevalent and associated with poor outcomes in those on maintenance dialysis.
Author List
Sakhuja A, Nanchal RS, Gupta S, Amer H, Kumar G, Albright RC, Kashani KBAuthor
Rahul Sudhir Nanchal MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Female
Hospital Mortality
Hospitalization
Humans
Incidence
Kidney Failure, Chronic
Male
Middle Aged
Renal Dialysis
Risk Factors
Sepsis
United States