Abstract:

Objective To investigate the main cause of pre-hospital ambulance use and its day-of-week pattern of distribution according to hemodialysis schedule in a cohort of maintenance hemodialysis (MHD) patients in Beijing. Methods A cohort of 572 MHD patients that called pre-hospital ambulance in Beijing between July 2019 and June 2020 were retrospectively analyzed. There were 349 males (61.0%) and 223 females (39.0%), the mean age was (67.1±13.0) years, and the median dialysis age was 5 (2,9) years. Patient characteristics, main cause of pre-hospital ambulance calls and day-of-week distribution patterns of pre-hospital ambulance calls were collected. Results The most common reason for pre-hospital emergency calls in 572 patients with MHD was heart failure (89 cases, 15.6%), followed by sudden death (77 cases, 13.5%) and cerebrovascular disease (58 cases, 10.1%). The highest incidence of prehospital ambulance utilization and sudden death in MHD patients occurred on the days following the longest dialysis interval (Mondays and Tuesdays). Pre-hospital emergency calls for heart failure occurred more often at the end of the longest dialysis intervals, on Sundays and Mondays. The risk of cerebrovascular disease had no association with dialysis schedules. Conclusion Heart failure, sudden death and cerebrovascular disease are the main causes of pre-hospital ambulance calls in MHD patients. Long dialysis intervals may lead to an increased risk of pre-hospital ambulance use in MHD patients.

Key words: maintenance hemodialysis, pre hospital first aid, long dialysis interval