Factors influencing the symptom-to-contact time in patients with peritoneal dialysis-associated peritonitis: a multi-center retrospective study.

Abstract

Background: Delays in seeking medical attention cause delays in the initiation of antibiotic therapy, prolonging the duration of illness in patients with peritoneal dialysis-associated peritonitis (PDAP). However, there is limited information on the factors that cause delays in seeking initial medical attention after the onset of symptoms. This study aims to investigate the situation and factors influencing delayed consultation in PDAP patients.

Methods: Retrospective review of clinical and epidemiological data of all adult patients with peritoneal dialysis-associated peritonitis in three hospitals in Xiamen, China, who developed peritonitis between January 2022 and November 2024. Data were analysed with descriptive and inferential statistics (i.e. correlation and multiple logistic regression) using the Statistical Package for the Social Sciences version 27.

Results: A total of 134 patients were included in the current study, of whom 77 (57.5%) had symptom-to-contact time (SC time) ≦ 24 h. Cloudy effluent was the most common presenting symptom (73.9%), while 67.9% had abdominal pain and 53% had both. Univariate analysis showed that there was a statistically significant difference between groups in residence (χ2 = 10.059, P = 0.002), PD modality (χ2 = 7.151, P = 0.007), fever (χ2 = 10.631, P = 0.001), abdominal pain (χ2 = 13.206, P < 0.001), cloudy effluent (χ2 = 8.002, P = 0.005), and diarrhea (χ2 = 4.953, P = 0.026). Univariate logistic regression analysis demonstrated that Residence(OR = 2.54, 95% CI:1.09-5.94, p = 0.032)、PD modality(OR = 0.06, 95% CI:0.01-0.87, p = 0.039)、Abdominal pain(OR = 4.60, 95% CI:1.87-11.32, p = 0.001)、Fever(OR = 4.34, 95% CI:1.24-15.17, p = 0.022)、Diarrhea(OR = 0.26, 95% CI:0.07-0.94, p = 0.040)are factors affecting the SC time in patients with peritoneal dialysis-associated peritonitis.

Conclusion: A substantial proportion of PDAP patients experienced delayed consultation. Specifically, residence, PD modality, abdominal pain, fever, and diarrhea were the influencing factors for delayed consultation in PDAP patients. Targeted interventions in managing PDAP patients are therefore important to promote timely consultations, particularly in rural areas, by improving patient awareness and education. They should also enhance the accessibility of healthcare services and provide clear guidance on when to seek medical attention.

Trial registration: Not applicable.