Introduction:
Patients with end-stage kidney disease (ESKD) frequently visit the emergency department because of comorbidities and dialysis procedures. This study aimed to compare emergency department visits, post-visit hospitalizations, and in-hospital mortality among patients with end-stage kidney disease and those without chronic kidney disease.
Methods:
Using the National Emergency Care Information System database in South Korea, we analyzed ED visits to regional and local emergency centers from 2019 to 2021. We examined visit causes, hospitalizations, and outcomes. Logistic regression analyses were performed, adjusting for demographic and clinical factors including Korean Triage and Acuity Scale (KTAS).
Results:
This study included 125,392 emergency department visits by patients with ESKD and 19,287,972 non-CKD patients. ESKD patients were older, more likely to be female, be receiving Medical Aid, and more severely ill at the time of emergency department visits. The ESKD group had a higher risk of hospitalization and in-hospital mortality compared to the non-CKD group. The ESKD group had higher rates of ED visits and hospitalizations on weekdays, and higher rates of in-hospital mortality on weekdays and Saturdays. Factors associated with admission and mortality included older age, male sex, transfer from another facility, higher KTAS classification, and longer ED stay. Of those admitted, 25.6% required intensive care, with lower discharge and higher mortality rates compared to ward admissions.
Conclusions:
ESKD patients' ED visits were characterized by high severity, hospitalization rates, and in-hospital mortality. Further research into factors affecting clinical outcomes may improve mortality and morbidity in this population.
I have potential conflict of interest to disclose.
This study was supported by a cooperative research fund from the Korean Society of Nephrology 2023.
I did not use generative AI and AI-assisted technologies in the writing process.