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Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study

OBJECTIVE: To evaluate the complications, mortality, and medical expenditures after nonurological surgical procedures in patients with chronic kidney disease (CKD). METHODS: Using claims data of Taiwan’s National Health Insurance, we conducted a matched cohort study of 35,643 patients with CKD who u...

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Autores principales: Cherng, Yih-Giun, Chang, Chuen-Chau, Yeh, Chun-Chieh, Hsu, Yung-Ho, Chen, Ta-Liang, Liao, Chien-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690593/
https://www.ncbi.nlm.nih.gov/pubmed/31496825
http://dx.doi.org/10.2147/CLEP.S219140
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author Cherng, Yih-Giun
Chang, Chuen-Chau
Yeh, Chun-Chieh
Hsu, Yung-Ho
Chen, Ta-Liang
Liao, Chien-Chang
author_facet Cherng, Yih-Giun
Chang, Chuen-Chau
Yeh, Chun-Chieh
Hsu, Yung-Ho
Chen, Ta-Liang
Liao, Chien-Chang
author_sort Cherng, Yih-Giun
collection PubMed
description OBJECTIVE: To evaluate the complications, mortality, and medical expenditures after nonurological surgical procedures in patients with chronic kidney disease (CKD). METHODS: Using claims data of Taiwan’s National Health Insurance, we conducted a matched cohort study of 35,643 patients with CKD who underwent nonurological surgeries in 2008–2013. By using a propensity-score matching procedure, 35,643 non-CKD patients were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs) of postoperative complications and in-hospital mortality associated with CKD. RESULTS: The results showed that patients with CKD had higher risks of postoperative septicemia (OR: 1.78, 95% CI: 1.68–1.89), pneumonia (OR: 1.60, 95% CI: 1.48–1.73), stroke (OR: 1.34, 95% CI: 1.24–1.44), and in-hospital mortality (OR: 2.17, 95% CI: 1.90–2.47) compared with non-CKD patients. Longer hospital stays and higher medical expenditures after nonurological surgical procedures were noted in CKD patients. The association between CKD and postoperative adverse events was significant in both sexes, all of the age groups, and the other subgroups. Histories of myocardial infarction, epilepsy, and ages greater than 70 years were factors that were significantly associated with postoperative adverse events. CONCLUSION: Compared with non-CKD patients, surgical patients with CKD exhibited more adverse events, with risks of in-hospital mortality that were approximately 2-fold higher after nonurinary surgery. These findings suggest an urgent need to revise the protocols for postoperative care in this population.
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spelling pubmed-66905932019-09-06 Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study Cherng, Yih-Giun Chang, Chuen-Chau Yeh, Chun-Chieh Hsu, Yung-Ho Chen, Ta-Liang Liao, Chien-Chang Clin Epidemiol Original Research OBJECTIVE: To evaluate the complications, mortality, and medical expenditures after nonurological surgical procedures in patients with chronic kidney disease (CKD). METHODS: Using claims data of Taiwan’s National Health Insurance, we conducted a matched cohort study of 35,643 patients with CKD who underwent nonurological surgeries in 2008–2013. By using a propensity-score matching procedure, 35,643 non-CKD patients were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs) of postoperative complications and in-hospital mortality associated with CKD. RESULTS: The results showed that patients with CKD had higher risks of postoperative septicemia (OR: 1.78, 95% CI: 1.68–1.89), pneumonia (OR: 1.60, 95% CI: 1.48–1.73), stroke (OR: 1.34, 95% CI: 1.24–1.44), and in-hospital mortality (OR: 2.17, 95% CI: 1.90–2.47) compared with non-CKD patients. Longer hospital stays and higher medical expenditures after nonurological surgical procedures were noted in CKD patients. The association between CKD and postoperative adverse events was significant in both sexes, all of the age groups, and the other subgroups. Histories of myocardial infarction, epilepsy, and ages greater than 70 years were factors that were significantly associated with postoperative adverse events. CONCLUSION: Compared with non-CKD patients, surgical patients with CKD exhibited more adverse events, with risks of in-hospital mortality that were approximately 2-fold higher after nonurinary surgery. These findings suggest an urgent need to revise the protocols for postoperative care in this population. Dove 2019-08-08 /pmc/articles/PMC6690593/ /pubmed/31496825 http://dx.doi.org/10.2147/CLEP.S219140 Text en © 2019 Cherng et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Cherng, Yih-Giun
Chang, Chuen-Chau
Yeh, Chun-Chieh
Hsu, Yung-Ho
Chen, Ta-Liang
Liao, Chien-Chang
Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title_full Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title_fullStr Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title_full_unstemmed Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title_short Adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
title_sort adverse outcomes after non urological surgeries in patients with chronic kidney disease: a propensity-score-matched study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690593/
https://www.ncbi.nlm.nih.gov/pubmed/31496825
http://dx.doi.org/10.2147/CLEP.S219140
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