Quality of care and survival of haemodialysed patients in western Switzerland.
Details
State: Public
Version: Final published version
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_961BE375A0D8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Quality of care and survival of haemodialysed patients in western Switzerland.
Journal
Nephrology, Dialysis, Transplantation
Working group(s)
Western Switzerland Dialysis Study Group
Contributor(s)
Fellay G., Descombes E., Martin PY., Levy M., Freudiger H., Brunisholz M., Robert D., Giovanini M., Uldry PY., Vogel G., Haldimann B., Blanc E., Evequoz P., Schmid M., Scherrer P., Burnier M., Teta D., Halabi G., Guignard JP., von Albertini B., Hudry MT., Gautier T., Halabi G., Glueck Z.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Publication state
Published
Issued date
2008
Volume
23
Number
6
Pages
1975-1981
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
BACKGROUND: Many factors affect survival in haemodialysis (HD) patients. Our aim was to study whether quality of clinical care may affect survival in this population, when adjusted for demographic characteristics and co-morbidities.
METHODS: We studied survival in 553 patients treated by chronic HD during March 2001 in 21 dialysis facilities in western Switzerland. Indicators of quality of care were established for anaemia control, calcium and phosphate product, serum albumin, pre-dialysis blood pressure (BP), type of vascular access and dialysis adequacy (spKt/V) and their baseline values were related to 3-year survival. The modified Charlson co-morbidity index (including age) and transplantation status were also considered as a predictor of survival.
RESULTS: Three-year survival was obtained for 96% of the patients; 39% (211/541) of these patients had died. The 3-year survival was 50, 62 and 69%, respectively, in patients who had 0-2, 3 and >or=4 fulfilled indicators of quality of care (test for linear trend, P < 0.001). In a Cox multivariate analysis model, the absence of transplantation, a higher modified Charlson's score, decreased fulfilment of indicators of good clinical care and low pre-dialysis systolic BP were independent predictors of death.
CONCLUSION: Good clinical care improves survival in HD patients, even after adjustment for availability of transplantation and co-morbidities.
METHODS: We studied survival in 553 patients treated by chronic HD during March 2001 in 21 dialysis facilities in western Switzerland. Indicators of quality of care were established for anaemia control, calcium and phosphate product, serum albumin, pre-dialysis blood pressure (BP), type of vascular access and dialysis adequacy (spKt/V) and their baseline values were related to 3-year survival. The modified Charlson co-morbidity index (including age) and transplantation status were also considered as a predictor of survival.
RESULTS: Three-year survival was obtained for 96% of the patients; 39% (211/541) of these patients had died. The 3-year survival was 50, 62 and 69%, respectively, in patients who had 0-2, 3 and >or=4 fulfilled indicators of quality of care (test for linear trend, P < 0.001). In a Cox multivariate analysis model, the absence of transplantation, a higher modified Charlson's score, decreased fulfilment of indicators of good clinical care and low pre-dialysis systolic BP were independent predictors of death.
CONCLUSION: Good clinical care improves survival in HD patients, even after adjustment for availability of transplantation and co-morbidities.
Keywords
Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Cause of Death, Female, Humans, Kaplan-Meier Estimate, Kidney Failure, Chronic/diagnosis, Kidney Failure, Chronic/mortality, Male, Middle Aged, Multivariate Analysis, Quality Indicators, Health Care, Quality of Health Care, Renal Dialysis/methods, Renal Dialysis/mortality, Retrospective Studies, Risk Assessment, Severity of Illness Index, Sex Factors, Statistics, Nonparametric, Survival Analysis, Switzerland/epidemiology, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
14/10/2009 10:24
Last modification date
14/02/2022 7:56
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