Results
Patient Characteristics
Table 1 compares demographic and health status characteristics of patients who did and did not receive early dialysis. Of the total 13,836 study patients, 8,256 (60%) received early dialysis on Saturday (October 27), Sunday (October 28), or Monday (October 29) in 209 of 229 (92%) dialysis facilities in the study area. Patients who received early dialysis were more likely to be older (P < 0.001) and white (P < 0.001) and less likely to be dual eligible for Medicare and Medicaid (P < 0.001).
ED Visits, Hospitalizations, and Mortality
Unadjusted analyses show that patients with early dialysis had lower odds of ED visits (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.63–0.89; P = 0.001) and hospitalization (OR, 0.77; 95% CI, 0.65–0.92; P = 0.004) than patients without early dialysis (Table 2). Patients with early dialysis had similar odds of 30-day mortality compared with patients without early dialysis (OR, 0.80; 95% CI, 0.58–1.09; P = 0.2; Table 2).
In adjusted analyses controlling for patient characteristics, early dialysis continued to be associated with decreased odds of ED visits (OR, 0.80; 95% CI, 0.67–0.96; P = 0.01) and hospitalizations (OR, 0.79; 95% CI, 0.66–0.94; P = 0.01) in the week of the storm (Table 2). Early dialysis was also found to be significantly associated with reduced odds of 30-day mortality (OR, 0.72; 95% CI, 0.52–0.997; P = 0.048; Table 2).
Patient Characteristics Associated With Adverse Outcomes
As shown in Table 2, dual-eligible patients had increased odds for an ED visit and hospitalization, while being nonwhite was associated with decreased odds of both adverse outcomes. Cardiovascular comorbid conditions in the month prior to the storm were associated with increased odds of hospitalization and 30-day mortality. Hospitalization or ED visit in the month prior to the storm was associated with increased odds of hospitalization, ED visits, and 30-day mortality. In addition, being nonwhite and younger was associated with decreased odds of 30-day mortality.