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One-year mortality of chronic kidney disease patients following spinal cord injury: A 14-year population-based study.
World Neurosurg. 2017 Jun 08;:
Authors: Yu SC, Kuo JR, Shiue YL, Yu ZX, Ho CH, Wu CC, Wang JJ, Chu CC, Lim SW
Abstract
OBJECTIVE: Chronic kidney disease (CKD) has become a global public health burden because of its increasing incidence, high risk of progression to end-stage renal disease (ESRD), and poor prognosis. We aimed to investigate the 1-year mortality rate of spinal cord injury (SCI) patients with CKD and ESRD, and compare it with that of SCI patients without CKD by conducting a large Taiwanese population dataset.
METHODS: In this 14-year retrospective cohort study, the study group (SCI with CKD group, N=3315) and comparison group (SCI without CKD group, N=6630) were matched at a 1:2 ratio with propensity score matching by age, sex, comorbidities, length of intensive care unit (ICU) stay, and length of stay. The 1-year mortality rate and the relative risks of mortality were calculated. Mortality rates stratified by age, sex, and comorbidities were also analyzed.
RESULTS: The SCI with CKD group had a significantly shorter survival period (10.13 vs 10.97 months), higher 1-year mortality rate (17.65% vs 8.54%) and higher risk of mortality than the comparison group (adjusted hazard ratio [HR], 2.25). Furthermore, CKD with ESRD had a 7.71-fold higher risk of mortality than SCI patients without CKD for ages<50 years. The presence of comorbidities was a risk factor for mortality among SCI patients with CKD or ESRD in contrast to SCI patients without CKD.
CONCLUSIONS: SCI patients with CKD, especially those with ESRD, have a higher risk of mortality than non-CKD patients. Therefore, CKD patients should have carefully monitoring for the development of 1-year mortality after SCI, especially for ESRD.
PMID: 28602927 [PubMed - as supplied by publisher]
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