{"title":"COVID-19 大流行期间日本医科大学附属医院血液透析患者治疗条件的变化。","authors":"Naoko Shimoda, Yukinao Sakai, Takuya Nishino, Sayuri Kawasaki, Akio Hirama, Tetsuya Kashiwagi, Masato Iwabu","doi":"10.1272/jnms.JNMS.2024_91-207","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic.</p><p><strong>Methods: </strong>We analyzed data from the Diagnosis Procedure Combination (DPC) system. Data for inpatients receiving dialysis during collection periods A (before the COVID-19 pandemic) and B (after the start of the COVID-19 pandemic) were extracted and compared. The numbers of inpatients and new patients, the number of patients admitted (by department), duration of stay, mortality, place of residence, surgical procedures, and DPC classification were compared.</p><p><strong>Results: </strong>There were no significant differences between periods in patient age, duration of hospital stay, number of new patients, number of ambulance transports, number of deaths, body mass index, comorbidities, laboratory variables before the first dialysis after hospitalization, or patient area of residence. Although differences were observed among the departments, the numbers of emergency dialysis inpatients and maintenance dialysis inpatients increased. The number of surgeries also increased overall, particularly for maintenance dialysis patients (p = 0.0273). The percentage of DPC III patients was significantly higher in period B (p = 0.0368).</p><p><strong>Conclusions: </strong>The number of surgeries performed on maintenance dialysis patients and the overall DPC III rate significantly increased after the start of the COVID-19 pandemic at our hospital, suggesting that COVID-19 worsened the condition of maintenance dialysis patients and prolonged hospital stays.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"172-179"},"PeriodicalIF":1.2000,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Changes in Treatment Conditions for Patients Receiving Hemodialysis at Nippon Medical School Hospital during the COVID-19 Pandemic.\",\"authors\":\"Naoko Shimoda, Yukinao Sakai, Takuya Nishino, Sayuri Kawasaki, Akio Hirama, Tetsuya Kashiwagi, Masato Iwabu\",\"doi\":\"10.1272/jnms.JNMS.2024_91-207\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic.</p><p><strong>Methods: </strong>We analyzed data from the Diagnosis Procedure Combination (DPC) system. Data for inpatients receiving dialysis during collection periods A (before the COVID-19 pandemic) and B (after the start of the COVID-19 pandemic) were extracted and compared. The numbers of inpatients and new patients, the number of patients admitted (by department), duration of stay, mortality, place of residence, surgical procedures, and DPC classification were compared.</p><p><strong>Results: </strong>There were no significant differences between periods in patient age, duration of hospital stay, number of new patients, number of ambulance transports, number of deaths, body mass index, comorbidities, laboratory variables before the first dialysis after hospitalization, or patient area of residence. Although differences were observed among the departments, the numbers of emergency dialysis inpatients and maintenance dialysis inpatients increased. The number of surgeries also increased overall, particularly for maintenance dialysis patients (p = 0.0273). The percentage of DPC III patients was significantly higher in period B (p = 0.0368).</p><p><strong>Conclusions: </strong>The number of surgeries performed on maintenance dialysis patients and the overall DPC III rate significantly increased after the start of the COVID-19 pandemic at our hospital, suggesting that COVID-19 worsened the condition of maintenance dialysis patients and prolonged hospital stays.</p>\",\"PeriodicalId\":56076,\"journal\":{\"name\":\"Journal of Nippon Medical School\",\"volume\":\" \",\"pages\":\"172-179\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nippon Medical School\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1272/jnms.JNMS.2024_91-207\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nippon Medical School","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1272/jnms.JNMS.2024_91-207","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:COVID-19 大流行对血液透析患者产生了巨大影响。本研究调查了大流行开始后我院血液透析治疗的变化:我们分析了诊断程序组合(DPC)系统中的数据。我们提取并比较了 A 收集期(COVID-19 大流行之前)和 B 收集期(COVID-19 大流行开始之后)接受透析的住院患者数据。比较了住院病人和新病人的数量、入院病人的数量(按科室)、住院时间、死亡率、居住地、手术程序和 DPC 分类:不同时期的患者在年龄、住院时间、新患者人数、救护车转运次数、死亡人数、体重指数、合并症、住院后首次透析前的实验室变量或患者居住地等方面均无明显差异。虽然各部门之间存在差异,但急诊透析住院病人和维持性透析住院病人的数量都有所增加。手术数量总体上也有所增加,尤其是维持性透析患者(P = 0.0273)。B 阶段的 DPC III 患者比例明显更高(P=0.0368):结论:我院在 COVID-19 大流行开始后,为维持性透析患者实施的手术次数和 DPC III 的总体比例显著增加,这表明 COVID-19 使维持性透析患者的病情恶化,并延长了住院时间。
Changes in Treatment Conditions for Patients Receiving Hemodialysis at Nippon Medical School Hospital during the COVID-19 Pandemic.
Background: The COVID-19 pandemic has had an enormous impact on hemodialysis patients. This study investigated changes in hemodialysis treatment at our hospital after the start of the pandemic.
Methods: We analyzed data from the Diagnosis Procedure Combination (DPC) system. Data for inpatients receiving dialysis during collection periods A (before the COVID-19 pandemic) and B (after the start of the COVID-19 pandemic) were extracted and compared. The numbers of inpatients and new patients, the number of patients admitted (by department), duration of stay, mortality, place of residence, surgical procedures, and DPC classification were compared.
Results: There were no significant differences between periods in patient age, duration of hospital stay, number of new patients, number of ambulance transports, number of deaths, body mass index, comorbidities, laboratory variables before the first dialysis after hospitalization, or patient area of residence. Although differences were observed among the departments, the numbers of emergency dialysis inpatients and maintenance dialysis inpatients increased. The number of surgeries also increased overall, particularly for maintenance dialysis patients (p = 0.0273). The percentage of DPC III patients was significantly higher in period B (p = 0.0368).
Conclusions: The number of surgeries performed on maintenance dialysis patients and the overall DPC III rate significantly increased after the start of the COVID-19 pandemic at our hospital, suggesting that COVID-19 worsened the condition of maintenance dialysis patients and prolonged hospital stays.
期刊介绍:
The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.