Emergency department visits for patients with end-stage kidney disease in Korea: registry data from the National Emergency Department Information System 2019-2021.

Abstract

Background: Patients with end-stage kidney disease (ESKD) frequently visit the emergency department (ED) due to complications from comorbidities and dialysis. This study aimed to investigate the clinical outcomes and patterns of ED visits, hospitalizations, and in-hospital mortality among ED visits by ESKD patients in South Korea.

Methods: This study utilized data from the National Emergency Department Information System from 2019 to 2021. ED visits were analyzed for ESKD patients and compared with non-chronic kidney disease (non-CKD) patients. Logistic regression analyses were conducted to assess factors associated with hospitalization and mortality, adjusting for demographics, insurance, and clinical characteristics, including the Korean Triage and Acuity Scale (KTAS).

Results: The study included 125,392 ED visits from ESKD patients and 19,287,972 from non-CKD patients. ED visits by ESKD patients had significantly higher hospitalization (66.7%) and in-hospital mortality (9.4%) rates compared to those by non-CKD patients (21.0% and 5.1%, respectively). ESKD patients were older, more frequently female, and more likely to receive medical aid. Factors strongly associated with higher hospitalization and mortality rates included advanced age, male sex, transfer from another facility, higher KTAS scores, and prolonged ED stays. Common causes of ED visits in ESKD patients included vascular device complications, digestive system disorders, pneumonia, pulmonary edema, and fluid or electrolyte imbalances.

Conclusion: ED visits by patients with ESKD were characterized by high severity, hospitalization rates, and in-hospital mortality. Further research on factors affecting clinical outcomes may improve mortality and morbidity in this population.