Predicting catheter removal in peritoneal dialysis peritonitis patients visiting the emergency department: a multivariable logistic regression and decision tree analysis

Peritonitis is a debilitating complication of peritoneal dialysis (PD). Identifying high-risk patients requiring PD catheter removal based on early information in the emergency room (ER) is critical. This cross-sectional study included 518 PD patients who visited the ER in the Chang Gung Memorial Hospital, Chia-Yi branch between 2002 and 2018. Among the 518 PD patients, 31 (6%) required PD catheter removed during the visit. Decision tree analysis, incorporating five key factors (neutrophil count, CRP, age, sodium, and albumin), identified 16 terminal nodes (TNs), with four higher risk groups (> 20%): lower neutrophils with lower CRP and younger age (TN1), lower neutrophils with higher CRP (TN4), higher neutrophils with moderate age and lower albumin (TN14), and high neutrophils with older age (TN16). Decision tree analysis effectively predicts the optimal timing for catheter removal in PD peritonitis patients. Clinically, this approach helps reduce mortality resulting from delayed catheter removal.