Delirium in hemodialysis predicts mortality: a single-center, long-term observational study

Norio Yasui-Furukori,1 Natsumi Tarakita,1 Waka Uematsu,2 Hisao Saito,2 Kazuhiko Nakamura,1 Chikara Ohyama,3 Norio Sugawara4 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, 3Department of...

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Autores principales:	Yasui-Furukori N, Tarakita N, Uematsu W, Saito H, Nakamura K, Ohyama C, Sugawara N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	cohort delirium hemodialysis mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/c189c7750e1b48b1b7ece05d88f1efb0
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spelling	oai:doaj.org-article:c189c7750e1b48b1b7ece05d88f1efb02021-12-02T05:07:47ZDelirium in hemodialysis predicts mortality: a single-center, long-term observational study1178-2021https://doaj.org/article/c189c7750e1b48b1b7ece05d88f1efb02017-12-01T00:00:00Zhttps://www.dovepress.com/delirium-in-hemodialysis-predicts-mortality-a-single-center-long-term--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Norio Yasui-Furukori,1 Natsumi Tarakita,1 Waka Uematsu,2 Hisao Saito,2 Kazuhiko Nakamura,1 Chikara Ohyama,3 Norio Sugawara4 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, 3Department of Urology, Graduate School of Medicine, Hirosaki University, Hirosaki, 4Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan Objectives: Delirium signifies underlying brain dysfunction; however, its clinical significance in hemodialysis remains unclear. In this study, we sought to determine whether the occurrence of delirium during hemodialysis was associated with higher mortality.Patients and methods: This was a retrospective, 10-year cohort study. This study was performed at the urology department located within a hospital in Oyokyo, Hirosaki. We analyzed 338 of 751 patients who underwent hemodialysis. Psychiatrists diagnosed patients with delirium according to the corresponding DSM-IV-TR criteria. Cox proportional hazard regression, which was adjusted for patient age at the time of hemodialysis initiation, sex, and the presence of diabetes mellitus, was performed. Hazard ratios (HRs) and their 95% CIs were also reported.Results: In total, 286 patients without psychiatric diseases and 52 patients with delirium were evaluated. Eighty percent of patients with delirium died within 1 year of hemodialysis initiation, while only 22% of patients without delirium died within the same time period (P<0.01). Kaplan–Meier plots demonstrated the existence of associations between delirium and all-cause mortality (global log-rank P<0.001), cardiovascular disease-related mortality (global log-rank P<0.001), and infection-related mortality (global log-rank P<0.001). Moreover, Cox proportional hazard regression showed that delirium was associated with all-cause mortality (HR=1.96, 95% CI: 1.32–2.90), cardiovascular disease-related mortality (HR=2.65, 95% CI: 1.31–5.35), and infection-related mortality (HR=3.30, 95% CI: 1.34–8.10).Conclusion: Delirium is an independent predictor of death in patients undergoing hemodialysis. Keywords: delirium, hemodialysis, mortality, observational study, disturbance of consciousnessYasui-Furukori NTarakita NUematsu WSaito HNakamura KOhyama CSugawara NDove Medical PressarticlecohortdeliriumhemodialysismortalityNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 3011-3016 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	cohort delirium hemodialysis mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	cohort delirium hemodialysis mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Yasui-Furukori N Tarakita N Uematsu W Saito H Nakamura K Ohyama C Sugawara N Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
description	Norio Yasui-Furukori,1 Natsumi Tarakita,1 Waka Uematsu,2 Hisao Saito,2 Kazuhiko Nakamura,1 Chikara Ohyama,3 Norio Sugawara4 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, 3Department of Urology, Graduate School of Medicine, Hirosaki University, Hirosaki, 4Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan Objectives: Delirium signifies underlying brain dysfunction; however, its clinical significance in hemodialysis remains unclear. In this study, we sought to determine whether the occurrence of delirium during hemodialysis was associated with higher mortality.Patients and methods: This was a retrospective, 10-year cohort study. This study was performed at the urology department located within a hospital in Oyokyo, Hirosaki. We analyzed 338 of 751 patients who underwent hemodialysis. Psychiatrists diagnosed patients with delirium according to the corresponding DSM-IV-TR criteria. Cox proportional hazard regression, which was adjusted for patient age at the time of hemodialysis initiation, sex, and the presence of diabetes mellitus, was performed. Hazard ratios (HRs) and their 95% CIs were also reported.Results: In total, 286 patients without psychiatric diseases and 52 patients with delirium were evaluated. Eighty percent of patients with delirium died within 1 year of hemodialysis initiation, while only 22% of patients without delirium died within the same time period (P<0.01). Kaplan–Meier plots demonstrated the existence of associations between delirium and all-cause mortality (global log-rank P<0.001), cardiovascular disease-related mortality (global log-rank P<0.001), and infection-related mortality (global log-rank P<0.001). Moreover, Cox proportional hazard regression showed that delirium was associated with all-cause mortality (HR=1.96, 95% CI: 1.32–2.90), cardiovascular disease-related mortality (HR=2.65, 95% CI: 1.31–5.35), and infection-related mortality (HR=3.30, 95% CI: 1.34–8.10).Conclusion: Delirium is an independent predictor of death in patients undergoing hemodialysis. Keywords: delirium, hemodialysis, mortality, observational study, disturbance of consciousness
format	article
author	Yasui-Furukori N Tarakita N Uematsu W Saito H Nakamura K Ohyama C Sugawara N
author_facet	Yasui-Furukori N Tarakita N Uematsu W Saito H Nakamura K Ohyama C Sugawara N
author_sort	Yasui-Furukori N
title	Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
title_short	Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
title_full	Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
title_fullStr	Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
title_full_unstemmed	Delirium in hemodialysis predicts mortality: a single-center, long-term observational study
title_sort	delirium in hemodialysis predicts mortality: a single-center, long-term observational study
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c189c7750e1b48b1b7ece05d88f1efb0
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_version_	1718400617134686208

Delirium in hemodialysis predicts mortality: a single-center, long-term observational study

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