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Titolo:
PREVALENCE, RECOGNITION, AND IMPLICATIONS OF MENTAL IMPAIRMENT AMONG HEMODIALYSIS-PATIENTS
Autore:
SEHGAL AR; GREY SF; DEOREO PB; WHITEHOUSE PJ;
Indirizzi:
METROHLTH MED CTR,DIV NEPHROL,2500 METROHLTH DR CLEVELAND OH 44109 CASE WESTERN RESERVE UNIV,DEPT MED CLEVELAND OH 44106 CASE WESTERN RESERVE UNIV,DEPT EPIDEMIOL & BIOSTAT CLEVELAND OH 44106 CASE WESTERN RESERVE UNIV,CTR BIOMED ETH CLEVELAND OH 44106 UNIV HOSP CLEVELAND,DIV NEPHROL CLEVELAND OH 44106 CTR DIALYSIS CTR CLEVELAND OH 00000 CASE WESTERN RESERVE UNIV,UNIV HOSP CLEVELAND,ALZHEIMER CTR CLEVELANDOH 44106
Titolo Testata:
American journal of kidney diseases
fascicolo: 1, volume: 30, anno: 1997,
pagine: 41 - 49
SICI:
0272-6386(1997)30:1<41:PRAIOM>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
STAGE RENAL-DISEASE; COGNITIVE FUNCTION; ALZHEIMERS-DISEASE; ADVANCE DIRECTIVES; DIALYSIS PATIENTS; CARE; POPULATION; PROGRAM; QUALITY; STATE;
Keywords:
HEMODIALYSIS; MENTAL IMPAIRMENT; MINI MENTAL STATUS EXAM; PROTEIN NUTRITION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
49
Recensione:
Indirizzi per estratti:
Citazione:
A.R. Sehgal et al., "PREVALENCE, RECOGNITION, AND IMPLICATIONS OF MENTAL IMPAIRMENT AMONG HEMODIALYSIS-PATIENTS", American journal of kidney diseases, 30(1), 1997, pp. 41-49

Abstract

The increasing age and co-morbidity of dialysis patients may be associated with an increase in the prevalence of Alzheimer's disease, stroke, and other causes of mental impairment. We sought to determine the prevalence, recognition, and implications of mental impairment among chronic hemodialysis patients. We administered the Mini Mental Status Exam (MMSE) to 336 randomly selected patients from three dialysis units. To determine recognition of mental impairment by health care providers, we compared MMSE scores with mental status assessments obtained from each patient's dialysis technician and medical record. To determine the clinical implications of mental impairment, we prospectively obtained Kt/V, albumin, protein catabolic rate, blood pressure, and hematocrit values. To determine the resource implications of mental impairment, we assessed staff time required to care for each patient as well ashospitalizations. We found that 22% of subjects had mild mental impairment (MMSE 18 to 23) and that 8% had moderate-severe mental impairment (MMSE 0 to 17). The sensitivity of technician and medical record mental status assessments were 57% and 15%, respectively. After adjustingfor demographic and medical variables, low MMSE score was independently associated with low protein catabolic rate (odds ratio, 1.5; P = 0.02), increased technician time caring for patient after dialysis (oddsratio, 1.5; P = 0.005), and increased hospital days (odds ratio, 1.4;P = 0.03). In conclusion, there is a high prevalence of unrecognized mental impairment among hemodialysis patients that has adverse implications for protein nutritional status, staff time, and hospitalization. We recommend that clinicians routinely screen for mental impairment and target impaired patients for interventions to improve mental statusand associated adverse outcomes. (C) 1997 by the National Kidney Foundation, Inc.

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Documento generato il 21/09/20 alle ore 09:45:00