Impact of Healthcare Associated Infections on Survival and Treatment Outcomes Among End Stage Renal Disease Patients on Renal Replacement Therapy

Abbasi, Saad Hanif and Aftab, Raja Ahsan and Lai, Pauline Siew Mei and Lim, Soo Kun and Zainol Abidin, Ruwaida Nur (2021) Impact of Healthcare Associated Infections on Survival and Treatment Outcomes Among End Stage Renal Disease Patients on Renal Replacement Therapy. Frontiers in Pharmacology, 12. p. 707511. ISSN 1663-9812

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Official URL: https://doi.org/10.3389/fphar.2021.707511

Abstract

Background: Due to frequent hospitalizations, complex dialysis procedures and immune compromising effects of end stage renal disease (ESRD), patients on dialysis are more prone to healthcare associated infections (HCAIs). Objective: To study the impact of HCAIs on survival and treatment outcomes among ESRD patients on renal replacement therapy (RRT). Methodology: A multicenter, retrospective study was conducted from June to December 2019 at two public hospitals of Malaysia. ESRD patients with minimum of 6 months on RRT were included, while pregnant patients and patients <18 years were excluded. Multinomial logistic regression was performed to identify risk factors associated with unsuccessful treatment outcomes. Kaplan Meier analysis was performed to study the survival. Results: A total of 670 records were examined, of which 400 patients were included as per the inclusion criteria. The mean survival time of patients without HCAIs [22.7 (95%CI:22.1–23.2)] was higher than the patients with HCAIs [19.9 (95%CI:18.8–20.9)]. Poor survival was seen in patients with >2 comorbidities, >60 years of age, low hemoglobin concentration and high C-reactive protein levels. The most frequent treatment outcome was cured [113 (64.9%)], followed by death [37 (21.3%)] and treatment failure [17 (9.8%)]. Advancing age, and low hemoglobin concentration were independent risk factors associated with death, while recurrent HCAIs, use of central venous catheters, and low serum sodium levels were risk factors for treatment failure. Conclusion: The high burden of HCAIs is a profound challenge faced by patients on RRT, which not only effects the treatment outcomes but also contributes substantially to the poor survival among these patients. © Copyright © 2021 Abbasi, Aftab, Lai, Lim and Zainol Abidin.

Item Type: Article
Uncontrolled Keywords: end stage renal disease (ESRD); healthcare associated infections; hemodialysis (HD); peritoneal dialysis (PD); renal replacement therapy (RRT); treatment outcome
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 21 Sep 2021 04:07
Last Modified: 21 Sep 2021 04:07
URI: http://eprints.um.edu.my/id/eprint/26032

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