演題情報

学会・委員会企画

開催回
第59回・2014年・神戸
 

Adverse outcome after stroke in patients with renal dialysis: a nationwide matched retrospective cohort study

演題番号 : GI-10-1-1

Chien-Chang Liao:1、Chun-Chuan Shih:2

1:School of Medicine, Taipei Medical University, Taipei, Taiwan、2:School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan

 

Background: The increased risk of stroke in patients with renal dialysis was reported in previous studies. However, little was known about the influence of renal dialysis on the outcomes after stroke. The purpose of this study is to investigate the post-stroke adverse events in patients with renal dialysis.
Methods: With the use of reimbursement claims from the Taiwan National Health Insurance system, we performed a nationwide cohort study and identified 6659 stroke patients with pre-stroke renal dialysis. Matching procedure with propensity score was used to selected appropriate 6659 non-dialysis stroke patients. Outcomes of post-stroke complications, mortality, and consumption of medical resources associated with pre-stroke renal dialysis were evaluated in the multivariate logistic regressions with estimating adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Results: After the matching with propensity score, there was no significant difference in age, sex, urbanization, coexisting medical conditions, and types of stroke between stroke patients with and without renal dialysis. Compared with stroke patients without renal dialysis, stroke patients with renal dialysis had increased risks of post-stroke in-hospital mortality (OR=2.95, 95% CI=2.51-3.46). Pre-stroke renal dialysis was also associated with post-stroke gastrointestinal bleeding (OR=1.74, 95% CI=1.40-2.17), epilepsy (OR=1.56, 95% CI=1.08-2.26), pneumonia (OR=1.40, 95% CI=1.22-1.61), increased medical expenditure (OR=1.54, 95% CI=1.41-1.69), and admission to intensive care unit (OR=1.73, 95% CI=1.58-1.90).
Discussion: This study was limited to unavailable information of detailed sociodemographics, biochemical measures, and stroke severity.
Conclusion: Increased complications and mortality after stroke were investigated in patients with renal dialysis.

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