for nine patients. One patient died 3 weeks after operation and the other has been operated on 9 months before this study had been finished.We considered an improvement of over 2 grades on the rating scale as a very good result, of 2 grades as a good result and 1 point as moderate. In case of a bilateral thalamotomy the better result of the two operations has been considered for the ultimate result. Eight patients have been interviewed on their opinion of the operation result, and this has been compared with the outcome of the rating scales. The other three patients died some years ago.
Objective To assess employment status in new end-stage renal disease (ESRD) patients at the start of dialysis and after 1 year, and to determine whether demographic and clinical variables and physical and psychosocial functioning at the start of dialysis are risk factors for loss of employment after 1 year of dialysis. Design Prospective follow-up study in which 38 of 48 Dutch dialysis centers participate. Patients 659 patients who had started on dialysis and who were between 18 and 65 years old were included. Patients were re-examined after 12 months. Main Outcome Measures Demographic data, physical and psychosocial functioning with the Short-Form Health Survey (SF-36), and data on employment status were obtained using questionnaires. Nephrologists provided the clinical data. Results At the start of dialysis, 35% of patients were employed, in contrast to 61% of the general Dutch population. Within 1 year, the proportion of employed patients decreased from 31% to 25% of hemodialysis patients, and from 48% to 40% of peritoneal dialysis patients. In patients who were working at the start of dialysis, independent risk factors for loss of work within 1 year were impaired physical and psychosocial functioning [odds ratio physical: 3.4, 95% confidence interval (%CI), 1.0 – 11.2; odds ratio psychosocial: 4.2, 95% CI, 1.2 – 14.2]. Conclusions As the percentage of employed patients at the start of dialysis is about half the expected percent-age, loss of work is an important issue in both predialysis and dialysis patients. Improvements in physical and psychosocial functioning are potentially preventive of loss of work in patients who are employed when they start dialysis.
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