Delirium is independently associated with early mortality in elderly patients starting hemodialysis
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ORIGINAL ARTICLE
Delirium is independently associated with early mortality in elderly patients starting hemodialysis Yohei Arai1,2 · Shingo Shioji3 · Hiroyuki Tanaka3 · Isao Kondo1 · Emi Sakamoto1 · Minami Suzuki1 · Daisuke Katagiri1 · Manami Tada1 · Fumihiko Hinoshita1 Received: 9 December 2019 / Accepted: 21 July 2020 © Japanese Society of Nephrology 2020
Abstract Background Delirium is an independent predictor of death in patients undergoing dialysis for end-stage renal disease (ESRD). However, it is unknown whether delirium during hospitalization at the start of hemodialysis (HD) in elderly populations is associated with early mortality. Methods We conducted a retrospective cohort study to investigate the association between delirium and early mortality in the elderly after starting HD. The cohort consisted of patients ≥ 75 years who started dialysis for ESRD at the National Center for Global Health and Medicine from 2010 to 2017 and at Yokosuka Kyosai Hospital from 2007 to 2011. Delirium was defined as patients who showed new symptoms of transient confused thinking and reduced awareness of their environment and were prescribed antipsychotic medications. The primary outcome was death within 1 year. Data were analyzed using Cox proportional hazard models with adjustments for baseline characteristics. A multinomial logistic regression was used to identify the determinants of patients developing delirium. Results We enrolled 259 patients (males, 60%); 33 patients were diagnosed with delirium. The primary outcome was observed in 19 patients with delirium (58%) and 24 patients without delirium (11%) (p 7 mL/min/1.73 m2, BUN > 100 mg/dL, systolic blood pressure
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