Abstract: SA-PO464
Trends, Outcomes, and Economic Implications of Peritoneal Dialysis-Associated Peritonitis: A National Cohort Study
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Vashisth, Shagun, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- Raker, Christina A., Rhode Island Hospital, Providence, Rhode Island, United States
- Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background
Peritoneal dialysis-associated peritonitis (PDAP) is a serious complication of peritoneal dialysis, associated with significant morbidity, modality transition, and mortality. We provide an update on the national burden of this significant complication in the US, highlighting trends in demographics, treatment practices, and in-hospital outcomes of PDAP from 2016 to 2020.
Methods
Utilizing a national all-payer dataset of hospitalizations in the US, we conducted a retrospective cohort study of adult hospitalizations with a primary diagnosis of PDAP from 2016 to 2020. We analyzed demographic, clinical, and hospital-level data, evaluating in-hospital mortality, PD catheter removal, length of stay, and healthcare spending. Multivariable logistic regression adjusted for demographic and clinical covariates was employed to identify risk factors associated with adverse outcomes.
Results
This study included 17,335 PDAP hospitalizations from 2016 to 2020. In-hospital mortality was observed in 3.29% of cases and 23.2% of episodes resulted in removal of the PD catheter. Healthcare expenditures associated with PDAP totaled over $75,000 per admission. Additionally, geographic variations in treatment patterns were present, with treatment at western and teaching hospitals associated with increased rates of catheter removal relative to northeastern and non-teaching centers and a mean cost of nearly $55,000 more in Western states compared to Midwest states. Risk factors associated with adverse outcomes are represented in Table 1.
Conclusion
PDAP is a major cause of mortality among PD patients, and there is a vital need for future studies to examine the impact of hospital location and teaching status on PDAP outcomes, which can inform treatment practices and resource allocation.