In-Hospital Mortality After Spinal Surgery in Hemodialysis Patients: An 11-Year Population-Based Study

doi:10.1016/j.wneu.2018.10.119

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Title:	In-Hospital Mortality After Spinal Surgery in Hemodialysis Patients: An 11-Year Population-Based Study
Authors:	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
Contributors:	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
Keywords:	Age Comorbidity End-stage renal disease Hemodialysis Hospital mortality Spinal surgery
Date:	2019-02
Issue Date:	2020-07-29 13:47:25 (UTC+8)
Publisher:	ELSEVIER SCIENCE INC
Abstract:	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.
Relation:	World Neurosurgery, v.122, pp.E667-E675
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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