Study On The Relationship Between Fatigue Recovery Time And Prognosis In Maintenance Hemodialysis Patients

Objective:To explore the incidence and influencing factors of fatigue in maintenance hemodialysis(MHD)patients after dialysis,and the relationship between fatigue recovery time and prognosis after dialysis.Materials and Methods:Patients at Dalian Central Hospital from December 1 to 31,2019 were selected in the research.General information,fatigue recovery time after dialysis,laboratory parameters were collected.MHD patients were administered Hamilton Anxiety(HAMA)and Hamilton Depression Scale(HAMD).The follow-up period is 1 year.If the patient died or was hospitalized,record the cause and date,and record the number of hospitalization.SPSS 24.0 software for statistical analysis,P<0.05means significant difference.Results:1.626 effective questionnaires were collected,including 385 males(61.5%)and 241 females(38.5%),with an average age of 56.1±12.9 years old,median dialysis age was 49.0(23.0,96.0)months.2.Fatigue incidence and influencing factors after dialysis:(1)55.5%of patients had fatigue after dialysis,and the median recovery time from fatigue after dialysis was 6.0(3.0,12.0)hours.(2)Influencing factors:Patients were divided into two groups:348/278 cases(with or without fatigue after dialysis).Binary Logistic regression analysis showed that the large ultrafiltration volume(OR=1.333,95%CI 1.117-1.590),high anxiety score(OR=1.179,95%CI 1.087-1.279),high depression score(OR=1.131,95%CI 1.035-1.235)were independent risk factors for fatigue after dialysis.(3)Factors affecting fatigue recovery time after dialysis:Patients were divided into 3 groups of fatigue recovery time:0 hours(278);0-5 hours(144);>5 hours(204).Ordered multiple logistic regression showed that higher anxiety score(P=0.000,OR=0.136,95%CI 0.064-0.207),higher depression score(P=0.000,OR=0.150,95%CI 0.073-0.226),shorter exercise time(P=0.040,OR=-0.246,95%CI-0.412--0.081),could extend the fatigue recovery time.3.The relationship between fatigue recovery time and prognosis after dialysis:44 patients occurred all-cause deaths,accounting for 7%,of which 27 patients had the post-dialysis fatigue,accounting for61.4%.257 patients were hospitalized,accounting for 41%,of which 153 patients had the post-dialysis fatigue,accounting for 59.5%.Kaplan-meier survival analysis based on3 groups of fatigue recovery time after dialysis showed that:Compared with non-dialysis fatigue patients,the hospitalization rate of patients whose recovery time after dialysis was more than 5 hours was significantly higher(P=0.024,χ~2=5.127).But there was not statistically significant in short-term survival rate and the number of hospitalizations(P>0.05).Conclusion:More than half of MHD patients have post-dialysis fatigue,which is more likely to occur in patients with high ultrafiltration,high anxiety and depression scores.Postdialysis fatigue recovery times are associated with psychological scores,and exercise time.Fatigue after dialysis has nothing to do with short-term survival rate and hospitalization rate,but the hospitalization rate of patients with long recovery time after dialysis is high.Therefore,controlling the weight gain between dialysis,paying attention to the patient’s mental health,and encouraging the patient to exercise moderately can reduce the occurrence of fatigue after dialysis,shorten the recovery time of fatigue after dialysis,improve the quality of life of patients,and reduce the rate of rehospitalization.