title: Hospital admissions in elderly patients on chronic hemodialysis.
abstract: BACKGROUND
  The purpose of this study was to determine whether number of hospital admissions per patient per year (n/[pt-yr]) and hospital days per patient per year (d/[pt-yr]) differ between elderly and younger patients on chronic hemodialysis (HD).
  
  
  METHODS
  In a retrospective cohort analysis of incident HD patients in one dialysis unit over 15 years, we compared 166 HD patients older than 70 years (77.1 ± 4.7 yrs) at the onset of HD (group A) and 216 patients younger than 70 years both at onset (57.1 ± 7.6 yrs) and at the end of the HD period (group B). Eighty (48.2%) of group A and 141 (65.3%) patients of group B had diabetes mellitus.
  
  
  RESULTS
  No differences were noted in the overall hospitalization rate, presented as mean, {95% Confidence interval} (group A 2.40 {2.04-2.75}, group B 2.03 {1.89-2.16} n[pt-yr]) and days/[pt-year] (group A 33.6 {25.3-41.8}, group B 24.1 {18.9-29.23}). Group A had higher number of hospitalization days (P = 0.012) for surgery or trauma and higher rate (P = 0.045) and days (P = 0.041) of hospitalization for miscellaneous causes, primarily pulmonary disease, or malignancy. Among diabetic patients, group A had only a greater number of hospital days for cardiac disease (P = 0.050). Among patients without diabetes, group A had a higher number for hospital days for surgery or trauma (P = 0.027). All other univariate comparisons were not significant. Multiple linear regression identified comorbidity, quantified by the Charlson index, Caucasian race and poor compliance with the HD schedule as predictors of admission rate and days per year for vascular access issues and comorbidity, poor compliance, and advanced age at onset of HD as predictors of admission for causes other than vascular access related.
  
  
  CONCLUSIONS
  Hospitalizations, which affect quality of life, differ little between elderly and younger patients on HD. Therefore, hospitalizations do not constitute an argument for restricting access to HD to elderly patients.
authors.affiliation: Medicine Service, Raymond G Murphy Veterans Affairs Medical Center and Department of Medicine, University of New Mexico School of Medicine, 1501 San Pedro, SE, Albuquerque, New Mexico 87108, USA.
authors.forename: Yijuan
authors.initials: Y
authors.lastname: Sun
authors.forename: Hussein
authors.initials: H
authors.lastname: Kassam
authors.forename: Muniru
authors.initials: M
authors.lastname: Adeniyi
authors.forename: Milagros
authors.initials: M
authors.lastname: Martinez
authors.forename: Emmanuel I
authors.initials: EI
authors.lastname: Agaba
authors.forename: Aideloje
authors.initials: A
authors.lastname: Onime
authors.forename: Karen S
authors.initials: KS
authors.lastname: Servilla
authors.forename: Dominic S C
authors.initials: DS
authors.lastname: Raj
authors.forename: Glen H
authors.initials: GH
authors.lastname: Murata
authors.forename: Antonios H
authors.initials: AH
authors.lastname: Tzamaloukas
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications; D006331:Heart Diseases / Q000150:complications; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007239:Infections / Q000150:complications; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008659:Metabolic Diseases / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000706:statistics & numerical data; D016491:Peripheral Vascular Diseases / Q000150:complications; D006435:Renal Dialysis / Q000009:adverse effects* / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications; D044465:White People / Q000706:statistics & numerical data