Effect of end-stage renal disease on long-term survival after a first-ever mechanical ventilation: a population-based study

doi:10.1186/s13054-015-1071-x

CNU IR > College of Sustainable Environment and Recreation > Dept. of Recreation and Health-Care Management > Periodical Articles > Item 310902800/29747

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Title:	Effect of end-stage renal disease on long-term survival after a first-ever mechanical ventilation: a population-based study
Authors:	Chen, Chin-Ming Lai, Chih-Cheng Cheng, Kuo-Chen Weng, Shih-Feng Liu, Wei-Lun Shen, Hsiu-Nien
Contributors:	休閒保健管理系醫務管理系
Keywords:	intensive-care-unit critically-illpatients chronickidney-disease one-yearmortality replacementtherapy hospitalmortality clinical-features outcomes dialysis failure
Date:	2015-10
Issue Date:	2016-04-19 19:06:45 (UTC+8)
Publisher:	Biomed Central Ltd
Abstract:	Introduction: Patients with end-stage renal disease (ESRDPos) usually have multiple comorbidities and are predisposed to acute organ failure and in-hospital mortality. We assessed the effect of ESRD on the poorly understood long-term mortality risk after a first-ever mechanical ventilation (1-MV) for acute respiratory failure. Methods: The data source was Taiwan's National Health Insurance (NHI) Research Database. All patients given a 1-MV between 1999 and 2008 from one million randomly selected NHI beneficiaries were identified (n = 38,659). Patients with or without ESRD (ESRDNeg) after a 1-MV between 1999 and 2008 were retrospectively compared and followed from the index admission date to death or the end of 2011. ESRDPos patients (n = 1185; mean age: 65.9 years; men: 51.5 %) were individually matched to ESRDNeg patients (ratio: 1: 8) using a propensity score method. The primary outcome was death after a 1-MV. The effect of ESRD on the risk of death after MV was assessed. A Cox proportional hazard regression model was used to assess how ESRD affected the mortality risk after a 1-MV. Results: The baseline characteristics of the two cohorts were balanced, but the incidence of mortality was higher in ESRDPos patients than in ESRDNeg patients (342.30 versus 179.67 per 1000 person-years; P < 0.001; covariate-adjusted hazard ratio: 1.43; 95 % confidence interval: 1.31-1.51). For patients who survived until discharge, ESRD was not associated with long-term (>4 years) mortality. Conclusions: ESRD increased the mortality risk after a 1-MV, but long-term survival seemed similar.
Relation:	Critical Care, v.19, Article ID 354
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles [Dept. of Recreation and Health-Care Management] Periodical Articles

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