Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/28634
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    標題: One-Year Mortality Associations in Hemodialysis Patients after Traumatic Brain Injury-An Eight-Year Population-Based Study
    作者: Liao, Jen-Chieh
    Ho, Chung-Han
    Liang, Fu-Wen
    Wang, Jhi-Joung
    Lin, Kao-Chang
    Chio, Chung-Ching
    Kuo, Jinn-Rung
    貢獻者: 醫務管理系
    關鍵字: INTENSIVE-CARE-UNIT
    STAGE RENAL-DISEASE
    NATIONAL-HEALTH INSURANCE
    CRITICALLY-ILL PATIENTS
    LONG-TERM SURVIVAL
    MAINTENANCE HEMODIALYSIS
    MECHANICAL VENTILATION
    REPLACEMENT THERAPY
    COMORBIDITY INDEX
    PROLONGED STAY
    日期: 2014-04
    上傳時間: 2015-05-06 21:23:18 (UTC+8)
    出版者: Public Library Science
    摘要: Purpose: This study aimed to investigate the one-year mortality associations in hemodialysis patients who underwent neurosurgical intervention after traumatic brain injury (TBI) using a nationwide database in Taiwan. Materials and Methods: An age-and gender-matched longitudinal cohort study of 4416 subjects, 1104 TBI patients with end-stage renal disease (ESRD) and 3312 TBI patients without ESRD, was conducted using the National Health Insurance Research Database in Taiwan between January 2000 and December 2007. The demographic characteristics, length of stay (LOS), length of ICU stay, length of ventilation (LOV), and tracheostomy were collected and analyzed. The co-morbidities of hypertension (HTN), diabetes mellitus (DM), myocardial infarction (MI), stroke, and heart failure (HF) were also evaluated. Results: TBI patients with ESRD presented a shorter LOS, a longer length of ICU stay and LOV, and a higher percentage of comorbidities compared with those without ESRD. TBI patients with ESRD displayed a stable trend of one-year mortality rate, 75.82% to 76.79%, from 2000-2007. For TBI patients with ESRD, the median survival time was 0.86 months, and preexisting stroke was a significant risk factor of mortality (HR: 1.29, 95% C.I.: 1.08-1.55). Pre-existing DM (HR: 1.35, 95% C.I.: 1.12-1.63) and MI (HR: 1.61, 95% C.I.: 1.07-2.42) effect on the mortality in ESRD patients who underwent TBI surgical intervention in the younger (age < 65) and older (age >= 65) population, respectively. In addition, the length of ICU stay and tracheostomy may provide important information to predict the mortality risk. Conclusions: This is the first report indicating an increased risk of one-year mortality among TBI patients with a pre-existing ERSD insult. Comorbidities were more common in TBI patients with ESRD. Physicians should pay more attention to TBI patients with ESRD based on the status of age, comorbidities, length of ICU stay, and tracheostomy to improve their survival.
    關聯: Plos One, v.9 n.4, e93956
    显示于类别:[醫務管理系(所)] 期刊論文

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