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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32497


    標題: In-Hospital Mortality After Spinal Surgery in Hemodialysis Patients: An 11-Year Population-Based Study
    作者: Nyam, Tee-Tau Eric
    Lim, Sher-Wei
    Chung-Han Ho(何宗翰)
    Liao, Jen-Chieh
    Wang, Jhi-Joung
    Chio, Chung-Ching
    Kuo, Jinn-Rung
    Wang, Che-Chuan
    貢獻者: Chi Mei Med Ctr, Dept Neurosurg
    Chi Mei Med Ctr, Dept Med Res
    Min Hwei Coll Hlth Care Management, Dept Nursing
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Southern Taiwan Univ Sci & Technol, Dept Biotechnol
    Southern Taiwan Univ Sci & Technol, Ctr Gen Educ
    關鍵字: Age
    Comorbidity
    End-stage renal disease
    Hemodialysis
    Hospital mortality
    Spinal surgery
    日期: 2019-02
    上傳時間: 2020-07-29 13:47:25 (UTC+8)
    出版者: ELSEVIER SCIENCE INC
    摘要: BACKGROUND: Patients with end-stage renal disease (ESRD) are at an increased risk of surgical mortality. We aimed to investigate the factors associated with in-hospital mortality in patients with ESRD who underwent spinal surgery, which remains to be determined. MATERIAL AND METHODS: An age-and sex-matched cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 2000 and December 2012. Kaplane-Meier curves were plotted with log-rank test to compare the differences between these 2 groups. The Cox proportional hazard model was used to estimate the hazard ratio of in-hospital mortality adjusted with potential confounding. RESULTS: In total, 4109 participants with pre-existing ESRD and 8218 patients without ESRD were included. The in-hospital mortality in ESRD (10.17%) was greater than without ESRD (1.39%). Spinal surgery patients with preexisting ESRD had a 6.78-fold increase in-hospital mortality risk compared with those without ESRD. Spinal surgery patients with ESRD of any age, male or female, and comorbidities experienced a greater incidence of hospital mortality. In patients with ESRD, operations on spinal cords and spinal canal structures had the greatest hospital mortality (14.87%) compared with spinal fusion (3.46%) or excision or destruction of intervertebral disc (3.01%). Kaplane-Meier survival curves showed that patients with ESRD experienced greater hospital mortality than patients without ESRD in all 3 spinal surgery methods (log rank P < 0.0001). CONCLUSIONS: Spinal surgery patients with ESRD have greater in-hospital mortality than patients without ESRD. Age, sex, history of comorbidities, and types of surgical methods were associated with greater in-hospital mortality among patients with ESRD.
    關聯: World Neurosurgery, v.122, pp.E667-E675
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