Admission After Intervention: When and Why
Hospitalization of end-stage renal disease (ESRD) is a major morbidity to the patient and cost to the payer. Forty-eight percent decline has been noted in admissions related to vascular access in 2009 compared to 1994, and the number one reason for hospitalization in ESRD patients now is infection-related admissions. Interventionists are routinely performing these procedures at outpatient vascular access centers providing limiting disruptions in dialysis care. Invasive procedures have associated complications and require that the operator has in-depth knowledge of rescue when required and use inpatient admission if indicated. Procedure sedation analgesia (PSA) plays an integral role in managing invasive procedures and has risks that should be weighed prior to each encounter. Comprehensive intraoperative care and on occasion’s inpatient observation is warranted after a complication is witnessed. This chapter reviews the conditions that warrant the patient to be operated inpatient or placed in observation after the procedure.
KeywordsAccess Center Metastatic Infection Phlegmasia Cerulea Dolens Native Kidney Biopsy Tunnel Dialysis Catheter
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