Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD
| Autor: | I-Kuan Wang, Tzung-Hai Yen, Fung-Chang Sung, Yu-Kai Cheng, Che-Yi Chou, Chiao-Ling Peng, Cheng-Li Lin, Chiu-Ching Huang, Chiz-Tzung Chang, Chung Y. Hsu |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Databases Factual Epidemiology medicine.medical_treatment Taiwan macromolecular substances Kaplan-Meier Estimate Critical Care and Intensive Care Medicine Risk Assessment Peritoneal dialysis Renal Dialysis Risk Factors Internal medicine medicine Risk of mortality Odds Ratio Humans Propensity Score Dialysis Aged Proportional Hazards Models Retrospective Studies Transplantation business.industry Incidence Hazard ratio Retrospective cohort study Original Articles Middle Aged Surgery Hematoma Subdural Logistic Models Treatment Outcome Nephrology Cohort Kidney Failure Chronic Female Hemodialysis business Peritoneal Dialysis |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN. 10(6) |
| ISSN: | 1555-905X |
| Popis: | Background and objectives This study compared the risk of subdural hematoma (SDH) and subsequent mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients with ESRD. Design, setting, participants, & measurements Claims data were obtained from the National Health Insurance Administration Research Database in Taiwan. This retrospective cohort study comprised 10,136 PD patients and 10,136 HD patients with newly diagnosed ESRD from 1998 to 2010. Patients were matched by propensity score and year of dialysis initiation. Incidence rates and hazard ratios of SDH as well as odds ratios of subsequent 30-day deaths from SDH were evaluated from the date of the first dialysis session to the date when SDH was diagnosed, or the date of renal transplantation, death, withdraw from insurance, or the end of the follow-up period (December 31, 2011). Results Median (25th percentile, 75th percentile) follow-up times for SDH events were 3.61 years (1.91, 6.33) and 3.33 years (1.83, 5.66) in the HD and PD cohorts, respectively. The overall SDH incidence rate (95% confidence interval [95% CI]) was 61.4% higher in the HD cohort than in the PD cohort (34.7 [95% CI, 31.4 to 35.4] versus 21.5 [95% CI, 20.2 to 22.9] per 10,000 person-years, with an adjusted hazard ratio of 1.62 [95% CI, 1.17 to 2.33]). Approximately 152 of 253 (60%) of SDH events were associated with trauma. Subsequent 30-day SDH-related mortality was not statistically higher in HD patients than in PD patients (29.1% versus 25.3%; adjusted odds ratio, 1.30; 95% CI, 0.70 to 2.41). Conclusions HD patients have a higher risk of developing SDH than PD patients. Both patient groups have a high risk of mortality. Routine education on fall prevention is needed for dialysis patients. |
| Databáze: | OpenAIRE |
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