title: Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina.
abstract: In order to evaluate the factors that contributed to missed dialysis sessions and increased hospitalizations of hemodialysis patients after Hurricane Katrina, we contacted 386 patients from 9 New Orleans hemodialysis units. Data were collected through structured telephone interviews on socio-demographics, dialysis factors, and evacuation characteristics. Overall, 44% of patients reported missing at least one and almost 17% reported missing 3 or more dialysis sessions. The likelihood of missing 3 or more sessions was greater for those whose dialysis vintage was less than 2 years compared to those for whom it was 5 or more years, who had 38 or fewer billed dialysis sessions compared to those who had 39 or more in the 3 months before the storm, who lived alone before the storm, who were unaware of their dialysis facility's emergency plans, who did not evacuate prior to hurricane landfall, and who were placed in a shelter. The adjusted odds ratio of hospitalization among patients who missed 3 or more compared to those who did not miss any dialysis sessions was 2.16 (95% CI: 1.05-4.43). These findings suggest that when preparing for future disasters more emphasis needs to be placed on patient awareness and early execution of emergency plans.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Los Angeles, USA; Department of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Amanda H
authors.initials: AH
authors.lastname: Anderson
authors.affiliation: Department of Medicine, Section of Nephrology, Ochsner Health System, New Orleans, Los Angeles, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Cohen
authors.affiliation: Department of Medicine, United States Renal Data System Rehabilitation/Quality of Life Special Studies Center, Emory University, Atlanta, Georgia, USA.
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Kutner
authors.affiliation: Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Kopp
authors.affiliation: Division of Renal Disease and Hypertension, Department of Medicine, George Washington University, Washington, DC, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Los Angeles, USA; Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York, USA. Electronic address: paul.muntner@mssm.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000368:Aged; D055867:Cyclonic Storms; D004189:Disaster Planning / Q000592:standards*; D004190:Disasters; D005260:Female; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D055820:New Orleans; D010353:Patient Education as Topic; D006435:Renal Dialysis; D011795:Surveys and Questionnaires