We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Association of dialysis with in‐hospital disability progression and mortality in community‐onset stroke.
- Authors
Usui, Tomoko; Hanafusa, Norio; Yasunaga, Hideo; Nangaku, Masaomi
- Abstract
Aim: End‐stage renal disease is associated with increased risk of cerebrovascular disease, but the effect on post‐stroke clinical outcomes has not been thoroughly investigated. Methods: Using the Japanese Diagnosis Procedure Combination database, which includes administrative claims and discharge abstract data, we examined the association between risk factors including dialysis therapy and in‐hospital disability progression or mortality in patients with community‐onset stroke. We extracted data of patients aged ≥ 20 years old who were admitted to the hospital within 3 days after onset of stroke between July 2010 and March 2013. The disability level was divided into modified Rankin Scale (mRS) 0–1, 2–3, 4–5, and 6 (death). Disability progression was defined as an increase in disability level. Odds ratios for in‐hospital disability progression and mortality were calculated using logistic regression models. Results: Of 435 403 patients, 7562 (1.7%) received dialysis therapy. The median length of stay was 21 and 20 days for patients with and without dialysis, respectively. During the hospital stay, disability progressed in 100 402 (23.1%) patients and 45 919 (10.5%) died. Patients on dialysis had a higher prevalence of disability progression (26.8%) and mortality (13.1%) compared to those without dialysis (23.0% and 10.5%, respectively). Dialysis was associated with an increased risk of in‐hospital disability progression (odds ratio, 1.56; 95% confidence interval, 1.47–1.66) and mortality (odds ratio 1.70; 95% confidence interval, 1.57–1.84). These risks were comparable among subtypes of stroke. Conclusions: Dialysis was associated with an increased risk of in‐hospital disability progression and mortality among patients with community‐onset stroke, regardless of stroke subtype. Summary at a Glance: This large study of stroke outcomes in Japanese patients demonstrates that dialysis patients have worse disability outcomes and greater mortality, and this effect was seen across all stroke subtypes. It suggests that diabetes may not have an additional incremental effect upon outcomes.
- Subjects
CEREBROVASCULAR disease; CHRONIC kidney failure; STROKE; DISABILITIES; MORTALITY; HEMODIALYSIS patients
- Publication
Nephrology, 2019, Vol 24, Issue 7, p737
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.13242