The association between embedded catheter implantation and hospitalization costs for peritoneal dialysis initiation: a retrospective cohort study,Clinical and Experimental Nephrology

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The association between embedded catheter implantation and hospitalization costs for peritoneal dialysis initiation: a retrospective cohort study
Clinical and Experimental Nephrology ( IF 2.2 ) Pub Date : 2023-11-14 , DOI: 10.1007/s10157-023-02416-z
Maki Shinzawa _{1,

2} , Ayumi Matsumoto ₁ , Harumi Kitamura ₁ , Yusuke Sakaguchi ₃ , Atsushi Takahashi ₁ , Isao Matsui ₁ , Masayuki Mizui ₁ , Ryohei Yamamoto _{2,

4} , Yoshitaka Isaka ₁

Affiliation

Background

Compared with the conventional peritoneal dialysis (PD) catheter insertion, embedding PD catheter implantation is one of the procedures for planned PD initiation. However, facilities where embedded PD catheter implantation is available are limited, and the impact of embedded PD catheter implantation on hospitalization cost and length of hospitalization is unknown.

Methods

This retrospective single-center cohort study included 132 patients with PD initiation between 2005 and 2020. The patients were divided into two groups: 64 patients in the embedding group and 68 patients in the conventional insertion group. We created a multivariable generalized linear model (GLM) with the gamma family and log-link function to evaluate the association among catheter embedding, the duration and medical costs of hospitalization for PD initiation. We also evaluated the effect modification between age and catheter embedding.

Results

Catheter embedding (β coefficient − 0.13 [95% confidence interval − 0.21, − 0.05]) and age (per 10 years 0.08 [0.03, 0.14]) were significantly associated with hospitalization costs. Catheter embedding (− 0.21 [− 0.32, − 0.10]) and age (0.11 [0.03, 0.19]) were also identified as factors significantly associated with length of hospitalization. The difference between the embedding group and the conventional insertion group in hospitalization costs for PD initiation (P for interaction = 0.060) and the length of hospitalization (P for interaction = 0.027) was larger in young-to-middle-aged patients than in elderly patients.

Conclusions

Catheter embedding was associated with lower hospitalization cost and shorter length of hospitalization for PD initiation than conventional PD catheter insertion, especially in young-to-middle-aged patients.

中文翻译：

嵌入式导管植入与腹膜透析开始住院费用之间的关联：一项回顾性队列研究

背景

与传统的腹膜透析（PD）导管插入相比，埋置式腹膜透析导管植入是计划腹膜透析启动的程序之一。然而，可进行嵌入式PD导管植入的设施有限，并且嵌入式PD导管植入对住院费用和住院时间的影响尚不清楚。

方法

这项回顾性单中心队列研究纳入了 2005 年至 2020 年间开始进行 PD 的 132 名患者。患者被分为两组：埋入组 64 名患者和常规埋入组 68 名患者。我们创建了一个具有 gamma 系列和对数链接函数的多变量广义线性模型 (GLM)，以评估导管嵌入、PD 启动住院时间和医疗费用之间的关联。我们还评估了年龄和导管埋置之间的影响。

结果

导管埋置（ β系数 − 0.13 [95% 置信区间 − 0.21, − 0.05]）和年龄（每 10 年 0.08 [0.03, 0.14]）与住院费用显着相关。导管埋置（− 0.21 [− 0.32，− 0.10]）和年龄（0.11 [0.03，0.19]）也被认为是与住院时间显着相关的因素。埋置组与传统置入组在PD开始住院费用（交互作用P = 0.060）和住院时间（交互作用P = 0.027）方面，中青年患者的差异大于老年患者患者。