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外文期刊>Journal of Korean medical science.
>The Influence of Renal Dialysis on All-Cause Mortality in Older Patients with Hip Fracture: a Korean Nationwide Cohort Study
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The Influence of Renal Dialysis on All-Cause Mortality in Older Patients with Hip Fracture: a Korean Nationwide Cohort Study
BACKGROUND:The purpose of this study was to analyze the all-cause mortality rate over time after elderly hip fracture in end-stage renal disease (ESRD) patients with dialysis, using a Korean nationwide claims database.METHODS:This retrospective nationwide study identified subjects from the Korean National Health Insurance Service-Senior cohort (NHIS-Senior). The NHIS-Senior (total of 588,147 participants) was constructed by 10% random sampling and was designed to represent the elderly living in Korea. Subjects were patients aged 65-99 years who underwent surgical treatment for femoral neck fractures or intertrochanteric fractures. A generalized estimating equation model with Poisson distribution and logarithmic link function was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) to measure associations between renal dialysis and cumulative mortality in various time frames.RESULTS:The total number of patients included in this study was 16,818. These patients were divided into two groups: 116 (0.69%) in the dialysis group and 16,702 (99.31%) in the no-dialysis group. The mean length of hospital stay was 43.87 ± 48.45 days in the dialysis group and 36.29 ± 37.49 days in the no-dialysis group (P = 0.095). The effect of renal dialysis on all-cause mortality was 2.29-fold (aRR; 95% CI, 1.29-4.06; P = 0.005) within 30 days and 1.72-fold (aRR; 95% CI, 1.34-2.21; P 0.001) within 1-year after hip fracture compared to the no-dialysis group. And, the effect of renal dialysis of in-hospital mortality was 2.72-fold (aRR; 95% CI, 1.71-4.33; P 0.001) compared to the no-dialysis group.CONCLUSION:Elderly patients who underwent dialysis have very high mortality rates after hip fracture. Therefore, it is considered that postoperative care through multidisciplinary management and understanding of pathophysiology for the ESRD patients is necessary.? 2020 The Korean Academy of Medical Sciences.
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机译：背景：本研究的目的是通过韩国全国主义索赔数据库分析老年人肾脏疾病（ESRD）患者的老年髋关节骨折（ESRD）患者后的全因死亡率。来自韩国国家健康保险服务 - 高级队列（Nhis-Senior）。 NHIS-Senu（总共588,147名参与者）由10％的随机抽样构建，旨在代表韩国的老人。受试者是65-99岁的患者接受股骨颈骨折或股骨间骨折的手术治疗。具有泊松分布和对数链路函数的广义估计方程模型用于估计调整后的风险比（ARR）和95％置信区间（CIs）来测量各种时间段中的肾透析和累积死亡率之间的关联。结果：总数本研究中包含的患者16,818。将这些患者分为两组：在透析组中，在透析组中116（0.69％），No-idanysis基团中的16,702（99.31％）。透析组中，住院住院的平均长度为43.87±48.45天，无透析组中36.29±37.49天（P = 0.095）。肾透析对所有原因死亡率的影响为2.29倍（ARR; 95％CI，1.29-4.06; p = 0.005），1.72倍（ARR; 95％CI，1.34-21; P <0.001 ）与无透析组相比，臀部骨折后的1年内。而且，与无透析组相比，肾脏透析的肾透析的影响为2.72倍（ARR; 95％CI，1.71-4.33; P <0.001）。结论：透析的老年患者具有很高的死亡率臀部骨折后的速率。因此，需要通过多学科管理和对ESRD患者的病理生理学的术后护理是必要的。 2020韩国医学科学院。
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