Inequity in the Hospital Care of Patients with Alcoholism and Medication Addiction

Maylath, E.; Seidel, Jochen

doi:10.1159/000019014

Cited by 4 publications

(2 citation statements)

References 14 publications

(14 reference statements)

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“…A similar higher prevalence of hepatitis in dialysis patients was also reported by other workers [24, 25]. Currently, in our Dialysis Center the prevalence of HCV is 62.5%, while prevalence of dual infections (HCV and HBV) is 2.5% [26]. Thus, most of the reports emerging from Saudi Arabia do suggest a significantly higher prevalence of HCV-positive patients in the dialysis population.…”

Section: Introductionsupporting

confidence: 84%

Effect of Chronic Viral Hepatitis on Graft Survival in Saudi Renal Transplant Patients

Mitwalli¹,

Alam

Al-Wakeel³

et al. 2005

Nephron Clin Pract

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Background: In Saudi Arabia the prevalence of hepatitis C among hemodialysis patients is very high ranging from 60 to 80%. A large number of these dialysis patients go for renal transplant, resulting into a higher prevalence of hepatitis C virus (HCV) infection in renal transplant patients. Yet no current systematic report is available on the influence of hepatitis C status on patient and graft survival. The present study was therefore undertaken to address this objective. Methods: Retrospective analysis of data of 448 renal transplantation subjects was undertaken. The mean follow-up period was 5.85 ± 2.7 (median 5.3) years. The factors associated with renal graft survival were reviewed and these include: age, sex, and type of donor, immunosuppressive medication, episodes of infection, blood pressure, serum creatinine, and status of hepatitis. The primary end-points were renal graft function and patient survival. Logistic regression, COX regression analysis, and Kaplan-Meier survival estimates were used to evaluate the influence of hepatitis C on the above parameters. Results: Among 448 recipients of first kidney transplant patients, 286 (63.8%) were positive for HCV infection. In the HCV-positive group, 204 (71.32%) were males. Kaplan-Meier survival analysis showed a significantly better graft survival for HCV-negative patients than HCV-positive patients (p < 0.001; log-rank test). Logistic regression analysis and COX regression analysis have shown different grades of graft dysfunction were present in HCV-positive patients after adjustment for covariates: age, sex, blood pressure, type of donor, and immunosuppressive medication; the presence of HCV was a major predictor of bad outcome and significantly influenced graft survival (odds ratio = 4.37; 95% Cl = 1.81–4.77). Significant deterioration of liver function was noted in HCV-positive patients at the last follow-up, taking ALT as a marker (ALT level 80.6 ± 5.8 U/l at the last follow-up versus 49.5 ± 32 U/l at baseline p ≤ 0.0001). Sixteen patients had a chronic active course and 1 patient developed biopsy-proven liver cirrhosis and portal hypertension. A serious and significantly greater incidence of fatal chest infections was seen in HCV-positive patients. Although mortality was greater in HCV-positive versus HCV-negative patients (20 vs. 7), the difference did not attain statistical significance (p = 0.23) and none of the patients died as a result of hepatic failure. Conclusion: The presence of HCV infection greatly influenced graft survival in renal transplant patients and a higher proportion of infected patients had renal and hepatic dysfunction. A significant increase in fatal chest infections was noted in HCV-positive patients. Overall mortality was higher in HCV-positive patients, but it was not statistically significant. All measures should be taken to prevent HCV transmission in the dialysis population. Renal transplant recipients with HCV infection need close monitoring for both graft and liver function.

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Section: Introductionsupporting

confidence: 84%

Effect of Chronic Viral Hepatitis on Graft Survival in Saudi Renal Transplant Patients

Mitwalli¹,

Alam

Al-Wakeel³

et al. 2005

Nephron Clin Pract

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“…66% der internistischen Abteilungen mit psychiatrischen Patienten befanden sich in Krankenhäusern ohne psychiatrische Abteilung. Wahrscheinlich werden insbesondere dann alkoholkranke Patienten auf internistischen Stationen und nicht angemessen psychiatrisch behandelt, wenn in keinem ausreichenden Maße psychiatrische Abteilungen in der Wohnortnähe des Patienten zur Verfügung stehen [12].…”

Section: Versorgungssituation Alkoholkranker In Deutschlandunclassified

Zur Relevanz des psychiatrischen Konsils bei alkoholbezogenen Störungen im Allgemeinkrankenhaus

2008

Psychosom Konsiliarpsychiatr

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The ecological relationship between deprivation, social isolation and rates of hospital admission for acute psychiatric care: a comparison of London and New York City

et al. 2006

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Inequity in the Hospital Care of Patients with Alcoholism and Medication Addiction

Cited by 4 publications

References 14 publications

Effect of Chronic Viral Hepatitis on Graft Survival in Saudi Renal Transplant Patients

Effect of Chronic Viral Hepatitis on Graft Survival in Saudi Renal Transplant Patients

Zur Relevanz des psychiatrischen Konsils bei alkoholbezogenen Störungen im Allgemeinkrankenhaus

The ecological relationship between deprivation, social isolation and rates of hospital admission for acute psychiatric care: a comparison of London and New York City

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