Back to Journals » Neuropsychiatric Disease and Treatment » Volume 13

Delirium in hemodialysis predicts mortality: a single-center, long-term observational study

Authors Yasui-Furukori N, Tarakita N, Uematsu W, Saito H, Nakamura K, Ohyama C, Sugawara N

Received 22 September 2017

Accepted for publication 15 November 2017

Published 14 December 2017 Volume 2017:13 Pages 3011—3016

DOI https://doi.org/10.2147/NDT.S152355

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Taro Kishi


Norio Yasui-Furukori,1 Natsumi Tarakita,1 Waka Uematsu,2 Hisao Saito,2 Kazuhiko Nakamura,1 Chikara Ohyama,3 Norio Sugawara4

1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 2Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, 3Department of Urology, Graduate School of Medicine, Hirosaki University, Hirosaki, 4Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan

Objectives: Delirium signifies underlying brain dysfunction; however, its clinical significance in hemodialysis remains unclear. In this study, we sought to determine whether the occurrence of delirium during hemodialysis was associated with higher mortality.
Patients and methods: This was a retrospective, 10-year cohort study. This study was performed at the urology department located within a hospital in Oyokyo, Hirosaki. We analyzed 338 of 751 patients who underwent hemodialysis. Psychiatrists diagnosed patients with delirium according to the corresponding DSM-IV-TR criteria. Cox proportional hazard regression, which was adjusted for patient age at the time of hemodialysis initiation, sex, and the presence of diabetes mellitus, was performed. Hazard ratios (HRs) and their 95% CIs were also reported.
Results: In total, 286 patients without psychiatric diseases and 52 patients with delirium were evaluated. Eighty percent of patients with delirium died within 1 year of hemodialysis initiation, while only 22% of patients without delirium died within the same time period (P<0.01). Kaplan–Meier plots demonstrated the existence of associations between delirium and all-cause mortality (global log-rank P<0.001), cardiovascular disease-related mortality (global log-rank P<0.001), and infection-related mortality (global log-rank P<0.001). Moreover, Cox proportional hazard regression showed that delirium was associated with all-cause mortality (HR=1.96, 95% CI: 1.32–2.90), cardiovascular disease-related mortality (HR=2.65, 95% CI: 1.31–5.35), and infection-related mortality (HR=3.30, 95% CI: 1.34–8.10).
Conclusion: Delirium is an independent predictor of death in patients undergoing hemodialysis.

Keywords: delirium, hemodialysis, mortality, observational study, disturbance of consciousness

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]