TIME SPENT IN HOSPITAL: OLDER KIDNEY PATIENTS IN THE LAST 12 MONTHS OF LIFE
Dr AM KHALIL1, Dr LOUISE PURTELL1,2, Ms LAURA AUSTIN1, Ms ILSE BERQUIER1, Dr OSCAR PERRY1, Dr VARSHINI CHANDRASEKAR1, Dr BENJAMIN STRIMAITIS1, Professor ANN BONNER1,3, Dr HELEN HEALY1,4, Dr KIRSTEN HEPBURN1,4
1Kidney Health Service, Metro North Hospital and Health Service, Brisbane, , 2Research Development Unit, Caboolture Hospital, Caboolture, , 3School of Nursing and Midwifery, Griffith University, Southport, , 4Faculty of Medicine, University of Queensland, Herston,
Aim: To understand the hospital utilisation by older people with advanced kidney disease, on dialysis and conservative pathways, known to a kidney supportive care (KSC) service in the last 12 months of life.
Background: People with advanced kidney disease, particularly older people, have high mortality and morbidity, leading to increased time spent in hospital. Few studies have compared time spent in hospital between dialysis and conservative patients within a KSC service in their final year of life.
Methods: Retrospective analysis of people ≥75 years old, who died between February 2017 and March 2024 and reviewed by KSC in the 12 months prior to death. Demographic characteristics, health history, and occasions of hospital healthcare were extracted from medical records. Data were analysed descriptively, and then group differences compared.
Results: Ninety-one people were included, ages ranged from 75 to 93 years at referral, 53 were male (58.2%), 27 were on dialysis and 64 were managed conservatively. The conservative cohort spent fewer days in hospital than those receiving dialysis (22 vs 165; p<0.001), had fewer Emergency Department presentations (3 vs 4; p=0.044), outpatient appointments (7.8 vs 9.7, p=0.1), procedures (0 vs 1, p=0.002) and were less likely to die in hospital (50% vs 70.4%). Patients on haemodialysis spent approximately 45% of their last year in hospital.
Conclusion: Older people receiving conservative management known to KSC spend less time in hospital in their final year of life compared to those on dialysis. Further larger studies are needed to confirm this correlation.
Biography:
Dr Abdul Mueez Khalil is a Senior House Officer at the Royal Brisbane and Women’s Hospital. He is currently on the Basic Physician Training pathway in hopes of pursuing a career in nephrology.