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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
Chin-Ming Chen; Chih-Cheng Lai; Kuo-Chen Cheng; Shih-Feng Weng; Wei-Lun Liu; Hsiu-Nien Shen; Chen, Chin-Ming; Lai, Chih-Cheng; Cheng, Kuo-Chen; Weng, Shih-Feng; Liu, Wei-Lun; Shen, Hsiu-Nien
- Abstract
<bold>Introduction: </bold>Patients with end-stage renal disease (ESRD(Pos)) 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.<bold>Methods: </bold>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 (ESRD(Neg)) 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. ESRD(Pos) patients (n = 1185; mean age: 65.9 years; men: 51.5 %) were individually matched to ESRD(Neg) 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.<bold>Results: </bold>The baseline characteristics of the two cohorts were balanced, but the incidence of mortality was higher in ESRD(Pos) patients than in ESRD(Neg) 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.<bold>Conclusions: </bold>ESRD increased the mortality risk after a 1-MV, but long-term survival seemed similar.
- Subjects
TAIWAN; ADULT respiratory distress syndrome treatment; MORTALITY risk factors; ARTIFICIAL respiration; CHRONIC kidney failure; HEMODIALYSIS; LONGITUDINAL method; COMORBIDITY; RETROSPECTIVE studies
- Publication
Critical Care, 2015, Vol 19, Issue 1, p1
- ISSN
1364-8535
- Publication type
journal article
- DOI
10.1186/s13054-015-1071-x