title: Outcomes of chronic dialysis patients admitted to the intensive care unit.
abstract: Admission rates and outcomes of patients who have ESRD and are admitted to an intensive care unit (ICU) are not well defined. We conducted a historical cohort study using a prospective regional ICU database that captured all 11 adult ICUs in Winnipeg, Canada. Between 2000 and 2006, there were 34,965 total admissions to the ICU, 1173 (3.4%) of which were patients with ESRD. The main admission diagnoses among patients with ESRD were cardiac disease (31%), sepsis (15%), and arrest (10%). Compared with other patients in the ICU, those with ESRD were significantly younger but had more diabetes, peripheral arterial disease, and higher APACHE II (Acute Physiology and Chronic Health Evaluation II) scores; mean length of stay in the ICU was similar, however, between these two groups. Restricting the analysis to first admissions to the ICU, unadjusted in-hospital mortality was higher for patients with ESRD (16 versus 11%; P < 0.0001), but this difference did not persist after adjustment for baseline illness severity. In conclusion, although ESRD associates with increased mortality among patients who are admitted to the ICU, this effect is mostly a result of comorbidity.
authors.affiliation: Department of Internal Medicine, University of Manitoba,Winnipeg, Manitoba, R2H 2A6, Canada.
authors.forename: Bradford
authors.initials: B
authors.lastname: Strijack
authors.forename: Julie
authors.initials: J
authors.lastname: Mojica
authors.forename: Manish
authors.initials: M
authors.lastname: Sood
authors.forename: Paul
authors.initials: P
authors.lastname: Komenda
authors.forename: Joe
authors.initials: J
authors.lastname: Bueti
authors.forename: Martina
authors.initials: M
authors.lastname: Reslerova
authors.forename: Dan
authors.initials: D
authors.lastname: Roberts
authors.forename: Claudio
authors.initials: C
authors.lastname: Rigatto
mesh_terms: D018806:APACHE; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D006435:Renal Dialysis; D016896:Treatment Outcome