Hospitalization and Day of the Week: Comparing Peritoneal Dialysis, Home Hemodialysis, and In-Center Hemodialysis
Bibliographic record
Abstract
Background: Studies have shown that there are daily variations in mortality for patients receiving in-center hemodialysis (HD) but not home HD, peritoneal dialysis or more frequent in-center HD. Less is known about daily variations in hospitalization according to dialysis modality. Methods: We analyzed all chronic dialysis patients in Canada (excluding Manitoba and Quebec) from 1 Jan 2005 to 31 Dec 2014 using the Canadian Organ Replacement Register (CORR). Dialysis modalities were defined (using CORR) as peritoneal dialysis, conventional HD or frequent HD (nocturnal or short daily) and HD modalities were furthered categorized as home versus in-center. All switches between modalities after dialysis initiation were included provided the duration of the switch was >30 days. The absolute number of hospitalizations for each day of the week was reported for each treatment type and differences in the distribution of hospitalizations were compared using the Chi-Square test. Results: The cohort consisted of 36,334 individuals. Median age was 67 and 61% were of male sex. A total of 81% of patients were receiving hemodialysis at dialysis initiation and the cause of end-stage kidney disease was secondary to diabetes in 37%. Overall, there were 119,466 hospitalizations over the observation period. The cumulative number of hospitalizations was highest for conventional in-center HD (92,707) and lowest for conventional home HD (701). Day of the week admissions for each treatment type are noted in Table 1 (P<0.001). Hospitalizations were least frequent on saturday and sunday for all groups. The proportion of admissions was highest on monday or tuesday for conventional HD (regardless of location) and frequent in-center HD. In contrast, frequent home HD had a higher proportion of admissions on wednesday. Conclusions: There are daily variations in hospitalization comparing dialysis modalities. Future planned analyses will evalute whether there are adjusted differences in day of the week hospitalization across modalities accounting for differences in patient characteristics. - Treatment Group Total Sunday Monday Tuesday Wednesday Thursday Friday Saturday Conventional In-Center HDa 92707 8971 (10) 15496 (17) 16138 (18) 14643 (16) 14108 (15) 13508 (16) 9843 (11) Frequent In-Center HD 1426 137 (10) 262 (18) 228 (16) 211 (15) 219 (15) 201 (14) 168 (12) Conventional Home HD 701 60 (9) 137 (20) 129 (18) 115 (16) 93 (13) 95 (14) 72 (10) Frequent Home HD 1439 149 (10) 213 (15) 231 (16) 273 (19) 230 (16) 191 (13) 152 (11) Peritoneal Dialysis 23193 2562 (11) 3684 (16) 3800 (16) 3727 (16) 3533 (15) 3473 (15) 2414 (10) aHemodialysis Day of the week hospitalization for each dialysis treatment type (N, %)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".