en
Scientific article
English

Quality of care and survival of haemodialysed patients in western Switzerland

Published inNephrology, dialysis, transplantation, vol. 23, no. 6, p. 1975-1981
Publication date2008
Abstract

BACKGROUND: Many factors affect survival in haemodialysis (HD) patients. Our aim was to study whether quality of clinical care may affect survival in this population, when adjusted for demographic characteristics and co-morbidities. METHODS: We studied survival in 553 patients treated by chronic HD during March 2001 in 21 dialysis facilities in western Switzerland. Indicators of quality of care were established for anaemia control, calcium and phosphate product, serum albumin, pre-dialysis blood pressure (BP), type of vascular access and dialysis adequacy (spKt/V) and their baseline values were related to 3-year survival. The modified Charlson co-morbidity index (including age) and transplantation status were also considered as a predictor of survival. RESULTS: Three-year survival was obtained for 96% of the patients; 39% (211/541) of these patients had died. The 3-year survival was 50, 62 and 69%, respectively, in patients who had 0-2, 3 and >or=4 fulfilled indicators of quality of care (test for linear trend, P < 0.001). In a Cox multivariate analysis model, the absence of transplantation, a higher modified Charlson's score, decreased fulfilment of indicators of good clinical care and low pre-dialysis systolic BP were independent predictors of death. CONCLUSION: Good clinical care improves survival in HD patients, even after adjustment for availability of transplantation and co-morbidities.

Keywords
  • Age Factors
  • Aged
  • Aged 80 and over
  • Analysis of Variance
  • Cause of Death
  • Female
  • Humans
  • Kaplan-Meiers Estimate
  • Kidney Failure Chronic/diagnosis/mortality/therapy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Quality Indicators Health Care
  • Quality of Health Care
  • Renal Dialysis/methods/mortality
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Statistics Nonparametric
  • Survival Analysis
  • Switzerland/epidemiology
  • Treatment Outcome
Citation (ISO format)
SAUDAN, Patrick et al. Quality of care and survival of haemodialysed patients in western Switzerland. In: Nephrology, dialysis, transplantation, 2008, vol. 23, n° 6, p. 1975–1981. doi: 10.1093/ndt/gfm915
Main files (1)
Article (Accepted version)
accessLevelRestricted
Identifiers
ISSN of the journal1460-2385
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