K HARRISON1, N COOK2, K CHERRY2, J BAKKER2, D POWER2, J SNIDER2
1Latrobe Regional Hospital, Traralgon West, Victoria; 2Austin Health, Heidelberg, Victoria
Aim: To provide a snapshot of patients aged 75 years and over dialysing through a single metropolitan centre in regards to quality of life, dialysis duration, hospitalisation and deaths.
Background: Commencing dialysis in elderly patients remains controversial. Elderly patients have the highest incidence of dialysis commencement, raising questions of the appropriateness of this in relation to patient survival, quality of life and cost.
Method: After ethics approval, data was retrospectively collected from patient files and pre-existing databases for patients aged 75 years and above receiving dialysis between 1/1/2014 and 31/12/2014. SF-36 questionnaires and Karnofsky scores were performed where patients consented.
Results: 123 patients were included. 89.4% received satellite dialysis. 88.6% of patients lived in their own homes and most were independently mobile. 34.6% drove themselves to dialysis and 39% utilised non-emergency ambulance. Patients who died had a higher proportion of cardiac disease (p=0.013), diabetes (p=0.036) and lower limb ischaemia (p<0.0001). Patients who died during the study period had a higher number of co-morbid conditions compared to those still living (p<0.0001). 31 patients died. Median dialysis duration was 4.74 years (IQR 2.11-7.27). Median hospitalisation was 3 days (IQR 0-13), higher in those deceased compared to those living, median 21 days and 0 days respectively. 23 patients completed the SF36 questionnaire with a broad range of responses.
Conclusions: Most patients were sufficiently independent to be considered to have quality of life. Patients who died were more likely to have a greater number of co-morbidities and to be hospitalised. This is consistent with other observational studies.