Hospitalization rate and outcomes in patients with left ventricular dysfunction receiving hemodialysis

Abstract

Introduction

Left ventricular dysfunction (LVD) is characterized as left ventricular ejection fraction (EF) below half of the systolic capacity of the left ventricle. Patients on hemodialysis have higher risk of developing LVD than the general population. Our aim was to assess hospitalization rate and outcomes in hemodialysis patients with LVD.

Patients and methods

All patients ≥18 years old, who started hemodialysis therapy at King Abdulaziz University Hospital between January 2011 and December 2011, were identified using medical records of hemodialysis unit. Patients were then divided into three groups, according to their EF results prior to the initiation of hemodialysis, as patients with EF <40%, EF between 40% and 49%, and EF ≥50%. Patients were then followed for 5 years by reviewing their hospital records to assess their outcomes, hospital admissions, and length of hospital stay.

Results

Analysis included 333 patients. Patients with EF <40% were 40, 36 patients with EF 40%–49%, and 257 patients had an EF >50%. Patients with EF <50% were significantly older than patients with EF >50% (P=0.002). Diabetes mellitus and hypertension were more prevalent in patients with EF <40% and EF 40%–49% when compared with patients with EF >50% (P<0.001, P=0.002). The average length of stay between the three groups was significantly different (P=0.007). Intensive care unit admissions were significantly different when comparing the three groups (P=0.013) and was found to be an independent risk factor for mortality in our patients. Half of the patients with EF <40% and 44% of patients with EF of 40%–49% died compared with only 27% of patients with EF >50% (P=0.002). However, Kaplan–Meier analysis showed no significant difference in the survival time among the three groups (P=0.845).

Conclusion

Mortality and morbidity increased in patients with LVD on hemodialysis compared with patients with normal EF.

Keywords:

• LVD
• hemodialysis
• mortality
• hospitalization

Acknowledgments

We would like to thank Basma Salah Bamakhrama, Noor Jamal Baamer, Deema Siraj Abid, Eman Ghazi Darwish, and Wafaa Mohammed Alelyani for their help in data collection.

Disclosure

The authors report no conflicts of interest in this work.