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Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients.
Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits.
Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09–1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97 – 3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95–3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70 ; 95% CI: 2.13-3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45-3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests.
Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.
Keywords
end-stage renal disease, emergency medicine, national characteristics, resource utilization
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CURRENT STATUS: Published
View the published article at BMC Emergency Medicine.
Version 3
Posted 08 Dec, 2020
No community comments so far
Review #2 received
Received 07 Jan, 2021
Review #1 received
Received 13 Dec, 2020
Reviewer #2 agreed
On 04 Dec, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Editor assigned
On 25 Nov, 2020
Submission checks complete
On 25 Nov, 2020
Editor invited
On 25 Nov, 2020
No comments provided
Editorial decision: Major revision
On 12 Nov, 2020
Review #1 received
Received 11 Nov, 2020
Reviewer #2 agreed
On 08 Nov, 2020
Review #2 received
Received 08 Nov, 2020
Reviewers invited
Invitations sent on 03 Nov, 2020
Reviewer #1 agreed
On 03 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 01 Nov, 2020
Editor invited
On 01 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 05 Oct, 2020
Review #1 received
Received 04 Oct, 2020
Reviewer #2 agreed
On 29 Sep, 2020
Review #2 received
Received 29 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Reviewers invited
Invitations sent on 16 Sep, 2020
Editor assigned
On 14 Sep, 2020
Submission checks complete
On 10 Sep, 2020
Editor invited
On 09 Sep, 2020
First submitted
On 31 Aug, 2020
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Subject Areas
Critical Care & Emergency Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Emergency Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Emergency Medicine.
Version 3
Posted 08 Dec, 2020
No community comments so far
Review #2 received
Received 07 Jan, 2021
Review #1 received
Received 13 Dec, 2020
Reviewer #2 agreed
On 04 Dec, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Editor assigned
On 25 Nov, 2020
Submission checks complete
On 25 Nov, 2020
Editor invited
On 25 Nov, 2020
No comments provided
Editorial decision: Major revision
On 12 Nov, 2020
Review #1 received
Received 11 Nov, 2020
Reviewer #2 agreed
On 08 Nov, 2020
Review #2 received
Received 08 Nov, 2020
Reviewers invited
Invitations sent on 03 Nov, 2020
Reviewer #1 agreed
On 03 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 01 Nov, 2020
Editor invited
On 01 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 05 Oct, 2020
Review #1 received
Received 04 Oct, 2020
Reviewer #2 agreed
On 29 Sep, 2020
Review #2 received
Received 29 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Reviewers invited
Invitations sent on 16 Sep, 2020
Editor assigned
On 14 Sep, 2020
Submission checks complete
On 10 Sep, 2020
Editor invited
On 09 Sep, 2020
First submitted
On 31 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Emergency Medicine.
Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients.
Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits.
Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09–1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97 – 3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95–3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70 ; 95% CI: 2.13-3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45-3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests.
Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.
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