A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia

Objective: It is currently unknown whether there are differences in patients' characteristics and hemodialysis (HD) outcomes between patients who undergo emergent HD in the emergency department (ED) and non-ED setting (i.e. ward, intensive care unit (ICU) or HD unit). Therefore, this study a...

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Main Author:	Rosedee, Noor Aida
Format:	Thesis
Language:	English
Published:	2020
Subjects:	R Medicine
Online Access:	http://eprints.usm.my/60459/1/NOOR%20AIDA%20ROSEDEE-E.pdf
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id	my-usm-ep.60459
record_format	uketd_dc
spelling	my-usm-ep.604592024-05-05T08:00:03Z A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia 2020 Rosedee, Noor Aida R Medicine RA440-440.87 Study and teaching. Research RC648-665 Diseases of the endocrine glands. Clinical endocrinology Objective: It is currently unknown whether there are differences in patients' characteristics and hemodialysis (HD) outcomes between patients who undergo emergent HD in the emergency department (ED) and non-ED setting (i.e. ward, intensive care unit (ICU) or HD unit). Therefore, this study aims to compare the clinical and non-clinical characteristics and HD outcomes between patients who underwent emergent HD at ED (“ED group”) and non-ED (“non-ED group”) settings. Methods: This is a retrospective observational study among patients admitted through the ED of a tertiary teaching hospital in Malaysia and underwent acute HD within 24 hours of admission between January 2016 till December 2017. Results: A total of 177 patients were included in the study. The bivariable analysis found that the ED group had a significantly higher proportion of new cases (i.e. no known history of HD), fluid overload cases, and refractory fluid overload indication as compared to the non-ED group. It was also found that the ED group had a higher proportion of those requiring mechanical ventilation and 60-day mortality. Hierarchical regression found that HD locations play a significant role in determining HD outcomes in terms of 60-days mortality and ICU stays. Those who underwent HD at non-ED have 0.263 (95%CI=0.096, 0.723) times lower odds of 60-day mortality but 2.946 (95%CI=1.051, 8.258) times higher odds of staying in ICU. Conclusion: There were significant differences in patients’ characteristics and HD outcomes between patients underwent HD in ED and non-ED settings. Emergent HD location may influence 60-day mortality and ICU stays. As the current study is insufficient to confidently justify the use of HD in ED settings as compared to the non-ED setting, a randomized controlled trial is needed. 2020 Thesis http://eprints.usm.my/60459/ http://eprints.usm.my/60459/1/NOOR%20AIDA%20ROSEDEE-E.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine R Medicine R Medicine
spellingShingle	R Medicine R Medicine R Medicine Rosedee, Noor Aida A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
description	Objective: It is currently unknown whether there are differences in patients' characteristics and hemodialysis (HD) outcomes between patients who undergo emergent HD in the emergency department (ED) and non-ED setting (i.e. ward, intensive care unit (ICU) or HD unit). Therefore, this study aims to compare the clinical and non-clinical characteristics and HD outcomes between patients who underwent emergent HD at ED (“ED group”) and non-ED (“non-ED group”) settings. Methods: This is a retrospective observational study among patients admitted through the ED of a tertiary teaching hospital in Malaysia and underwent acute HD within 24 hours of admission between January 2016 till December 2017. Results: A total of 177 patients were included in the study. The bivariable analysis found that the ED group had a significantly higher proportion of new cases (i.e. no known history of HD), fluid overload cases, and refractory fluid overload indication as compared to the non-ED group. It was also found that the ED group had a higher proportion of those requiring mechanical ventilation and 60-day mortality. Hierarchical regression found that HD locations play a significant role in determining HD outcomes in terms of 60-days mortality and ICU stays. Those who underwent HD at non-ED have 0.263 (95%CI=0.096, 0.723) times lower odds of 60-day mortality but 2.946 (95%CI=1.051, 8.258) times higher odds of staying in ICU. Conclusion: There were significant differences in patients’ characteristics and HD outcomes between patients underwent HD in ED and non-ED settings. Emergent HD location may influence 60-day mortality and ICU stays. As the current study is insufficient to confidently justify the use of HD in ED settings as compared to the non-ED setting, a randomized controlled trial is needed.
format	Thesis
qualification_level	Master's degree
author	Rosedee, Noor Aida
author_facet	Rosedee, Noor Aida
author_sort	Rosedee, Noor Aida
title	A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
title_short	A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
title_full	A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
title_fullStr	A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
title_full_unstemmed	A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia
title_sort	study on patients requiring emergency hemodialysis in hospital universiti sains malaysia
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2020
url	http://eprints.usm.my/60459/1/NOOR%20AIDA%20ROSEDEE-E.pdf
_version_	1804888941643431936

A study on patients requiring emergency hemodialysis in Hospital Universiti Sains Malaysia

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