Patient survival is associated with hematocrit (HCT) level.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:190A 1997
Using the Medicare payment database, four annual cohorts of hemodialysis patients were analyzed, comparing overall survival with mean hematocrit groupings.
For all years taken together (1990-1993), patients with mean hematocrit 30- 33% appeared to have the best survival rates, with relative risk of death increasing by approximately 10% for mean hematocrit 27-30%, and by 40% for mean hematocrit < 27%. For patients with mean hematocrit 33-36%, relative risks for death in 1990, 1991, and 1992 were not significantly different from the 30-33% group. However, in the most recent 1993 cohort studied, the highest (33-36%) hematocrit group had an 8% lower death rate than the 30-33% group. Important factors contributing to the 1993 data could include improved dialysis delivery and blood pressure control, both possibly unrelated to hematocrit levels. The number of patients in the 33-36% hematocrit groups was substantially smaller in each year. Cause of death was not provided.
This is important information and may help to change HCFA policy regarding erythropoietin reimbursement. These findings correlate well with data from the same author in which higher hematocrit levels were found to be associated with lower risk for hospitalization. (Rick L. Latos, M.D., Wheeling, WV)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area : Anemia/Erythropoietin/Iron
CRF: Problem Areas : Outcomes (Morbidity, Mortality)