Correlation between a Bedridden Status and the Long-term Outcome in Hemodialysis Patients after Intracerebral Hemorrhaging
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- Yamashita Ayuko
- Division of Blood Purification, Nagasaki University Hospital, Japan Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Kitamura Mineaki
- Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Tateishi Yohei
- Department of Neurology and Strokology, Nagasaki University Hospital, Japan
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- Torigoe Kenta
- Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Muta Kumiko
- Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Mochizuki Yasushi
- Division of Blood Purification, Nagasaki University Hospital, Japan Deparment of Urology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Izumo Tsuyoshi
- Department of Neurosurgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Matsuo Takayuki
- Department of Neurosurgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Tsujino Akira
- Department of Neurology and Strokology, Nagasaki University Hospital, Japan
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- Sakai Hideki
- Deparment of Urology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Mukae Hiroshi
- Department of Respiratory Medicine, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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- Nishino Tomoya
- Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Japan
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Abstract
<p>Objective The quality of life and activities of daily living (ADL) are generally poor among dialysis patients after intracerebral hemorrhaging, and their precise clinical course remains unclear. In addition, the association between the severity of cerebral hemorrhaging and the long-term prognosis in these patients has not been fully elucidated. This study aimed to evaluate the subsequent prognosis of hemodialysis patients who survived the acute phase of intracerebral hemorrhaging. </p><p>Methods We included hemodialysis patients who were admitted to Nagasaki University Hospital between 2007 and 2015 for intracerebral hemorrhaging treatment. After excluding cases of in-hospital death, survivors were classified using the 5-point modified Rankin Scale (mRS), which specifically measures the ADL in patients with cerebrovascular diseases. The patients were followed up at the medical facilities to which they were transferred in the same medical zone until 2017. </p><p>Results Out of 91 patients with cerebral hemorrhaging (65±11 years old, 66% men, hemodialysis duration 108±91 months), 62 survived until discharge. Twenty-one patients died during observation, largely due to infectious diseases, such as sepsis and pneumonia (n=16, 76%). Compared to patients with mRS 0-4 (n=31), those with mRS 5 (n=31) showed a significantly poorer prognosis. The hazard ratio adjusted for age and antiplatelets was 13.7 (95% confidence interval: 3.88-63.7, p<0.001). </p><p>Conclusion Hemodialysis patients with intracerebral hemorrhaging who were bedridden showed poor outcomes. The major causes of death were infections. Therefore, these patients should be carefully monitored for infections in order to improve their prognosis. </p>
Journal
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- Internal Medicine
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Internal Medicine 61 (8), 1133-1138, 2022-04-15
The Japanese Society of Internal Medicine
