The following is a summary of ”Trends, Outcomes, and Economic Implications of Peritoneal Dialysis-Associated Peritonitis Hospitalizations: A National Cohort Study,” published in the May 2024 issue of Nephrology by Shah et al.
Researchers conducted a retrospective study examining trends in patient demographics, treatment practices, and in-hospital outcomes over five years to provide an update on the national burden of peritoneal dialysis-associated peritonitis (PDAP).
They used a nationwide all-payer dataset of hospital stays in the US to study primary diagnosis of PDAP(2016 to 2020). They used demographic, clinical, and hospital-level data, especially in-hospital death rates, PD catheter removal, hospital stay length, and healthcare costs. Multivariable logistic regression adjusted for demographic and clinical factors was used to find risk factors linked to adverse outcomes.
The results showed that the yearly PDAP admissions stayed stable, and the costs associated with PDAP were high, over $75,000 per admission. Geographical differences in treatment patterns, with higher rates of catheter removal in western and teaching hospitals compared to northeastern and non-teaching centers. The average cost was nearly $55,000 more in Western states than Midwest states. In 23.2% of cases, the PD catheter was removed. Risk factors for bad outcomes included older age, higher Charlson Comorbidity Index scores, peripheral vascular disease, and the need for vasopressors.
Investigators concluded that PDAP was a major cause of death among patients with PD. Future research should examine how hospital location and teaching status affect PDAP outcomes to improve treatment methods and resource allocation.
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