RISK-FACTORS FOR HOSPITAL UTILIZATION IN CHRONIC DIALYSIS PATIENTS

It is not known if the risk factors for hospital utilization are simil ar to the risk factors for mortality in chronic dialysis patients. The risk factors associated with hospital days per year of patient risk w ere identified in a subset of patients in Network 6 (the states of Nor th Carolina, South Carolina, and Georgia) who began dialysis in 1989. The demographic characteristics of this cohort of 1572 patients includ ed a mean (+/- SD) age of 57.4 +/- 15.0 yr; 63.7% of the patients were African American, 52.4.% were female, and 33.0% had diabetes mellitus as the primary cause of ESRD. The median number of hospital days per year of patient risk was 8.8, with 25th and 75th quartiles of 3.9 and 20.1, respectively. By using multiple regression analysis, the stronge st predictors of the number of hospital days per year of patient risk included low serum albumin level (P = 0.0001), decreased activity leve l (P = 0.0006), diabetes mellitus as the primary cause of ESRD (P = 0. 002), peripheral vascular disease (P = 0.004), white race (P = 0.01), increasing age (P = 0.03), the absence of hypertension (P = 0.03), and the presence of angina (P = 0.03), smoking (P = 0.03), and congestive heart failure (P = 0.045). These risk factors are similar to those re ported for an increased risk of mortality in dialysis patients and som e of them, such as smoking, are modifiable and may be amenable to inte rventional strategies.