The impact of the COVID-19 pandemic on home dialysis modality use in Canada
Notice bibliographique
Résumé
Background: During the COVID-19 pandemic, nephrology societies recommended that individuals receiving facility-based hemodialysis transition to home modalities where possible. We aimed to understand if more people transitioned from facility-based hemodialysis to home dialysis modalities in Canada during the COVID-19 pandemic compared to historical trends. We also compared home dialysis failure (transition to facility-based hemodialysis) rates, reasons for failure on home dialysis, and risk factors for failure on home dialysis. Methods: Using administrative data from the Canadian Organ Replacement Registry (CORR), we performed an interrupted time-series analysis comparing monthly trends in transition to and failures on home dialysis during the pre-pandemic period (Jan. 1, 2016 – Dec. 31, 2019) to the pandemic period (Apr. 1, 2020 – Sept. 30, 2021). All individuals who spent any time on hemodialysis during the study period were included in the study cohort. Transitions and failures were each defined as moves of 30 days or greater. Logistic regression models were used to examine predictors of home dialysis failures between time periods. Results: 31,596 and 22,607 individuals were prevalent on facility-based hemodialysis during the pre-pandemic and pandemic periods, respectively. Transitions to home dialysis increased during the pandemic (trend change = 0.00006, p=0.03). Home dialysis failures within our cohort increased (trend change = 0.000357, p=0.045) but facility-based initiations did not change during the pandemic as compared to pre-pandemic. In our cohort, there were more home dialysis failures due to peritonitis (9.2% vs 7.3%; p = 0.0423) and resource-related reasons (5.8% vs 2.7%; p <0.0001), and fewer failures due to dialysis recipient/family burnout (4.3% vs 5.9%; p=0.0307) during the pandemic period. Conclusion: Transitions to home dialysis increased in response to COVID-19 related risks. Whether the increase in home dialysis failures was attributable to excess transitions from facility-based hemodialysis or other pandemic-related factors remains unresolved. Exploratory findings from this study may help healthcare providers expand criteria, education, and resources for home dialysis and prepare for changes in dialysis care to reduce home dialysis failure such as assisted home dialysis
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».