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Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD.
Clin J Am Soc Nephrol 2015; 10(6):994-1001CJ

Abstract

BACKGROUND AND OBJECTIVES

This study compared the risk of subdural hematoma (SDH) and subsequent mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients with ESRD.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Claims data were obtained from the National Health Insurance Administration Research Database in Taiwan. This retrospective cohort study comprised 10,136 PD patients and 10,136 HD patients with newly diagnosed ESRD from 1998 to 2010. Patients were matched by propensity score and year of dialysis initiation. Incidence rates and hazard ratios of SDH as well as odds ratios of subsequent 30-day deaths from SDH were evaluated from the date of the first dialysis session to the date when SDH was diagnosed, or the date of renal transplantation, death, withdraw from insurance, or the end of the follow-up period (December 31, 2011).

RESULTS

Median (25th percentile, 75th percentile) follow-up times for SDH events were 3.61 years (1.91, 6.33) and 3.33 years (1.83, 5.66) in the HD and PD cohorts, respectively. The overall SDH incidence rate (95% confidence interval [95% CI]) was 61.4% higher in the HD cohort than in the PD cohort (34.7 [95% CI, 31.4 to 35.4] versus 21.5 [95% CI, 20.2 to 22.9] per 10,000 person-years, with an adjusted hazard ratio of 1.62 [95% CI, 1.17 to 2.33]). Approximately 152 of 253 (60%) of SDH events were associated with trauma. Subsequent 30-day SDH-related mortality was not statistically higher in HD patients than in PD patients (29.1% versus 25.3%; adjusted odds ratio, 1.30; 95% CI, 0.70 to 2.41).

CONCLUSIONS

HD patients have a higher risk of developing SDH than PD patients. Both patient groups have a high risk of mortality. Routine education on fall prevention is needed for dialysis patients.

Authors+Show Affiliations

Department of Internal Medicine and Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Divisions of Nephrology and.Neurosurgery.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan;Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan;Divisions of Nephrology and.Divisions of Nephrology and.Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan; and Chang Gung University College of Medicine, Taoyuan, Taiwan.Divisions of Nephrology and.Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; fcsung1008@yahoo.com.Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Department of Neurology, and.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25825482

Citation

Wang, I-Kuan, et al. "Comparison of Subdural Hematoma Risk Between Hemodialysis and Peritoneal Dialysis Patients With ESRD." Clinical Journal of the American Society of Nephrology : CJASN, vol. 10, no. 6, 2015, pp. 994-1001.
Wang IK, Cheng YK, Lin CL, et al. Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD. Clin J Am Soc Nephrol. 2015;10(6):994-1001.
Wang, I. K., Cheng, Y. K., Lin, C. L., Peng, C. L., Chou, C. Y., Chang, C. T., ... Hsu, C. Y. (2015). Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD. Clinical Journal of the American Society of Nephrology : CJASN, 10(6), pp. 994-1001. doi:10.2215/CJN.08140814.
Wang IK, et al. Comparison of Subdural Hematoma Risk Between Hemodialysis and Peritoneal Dialysis Patients With ESRD. Clin J Am Soc Nephrol. 2015 Jun 5;10(6):994-1001. PubMed PMID: 25825482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD. AU - Wang,I-Kuan, AU - Cheng,Yu-Kai, AU - Lin,Cheng-Li, AU - Peng,Chiao-Ling, AU - Chou,Che-Yi, AU - Chang,Chiz-Tzung, AU - Yen,Tzung-Hai, AU - Huang,Chiu-Ching, AU - Sung,Fung-Chang, AU - Hsu,Chung Y, Y1 - 2015/03/30/ PY - 2014/08/16/received PY - 2015/02/02/accepted PY - 2015/4/1/entrez PY - 2015/4/1/pubmed PY - 2016/3/10/medline KW - ESRD KW - hemodialysis KW - mortality KW - peritoneal dialysis KW - subdural hematoma SP - 994 EP - 1001 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 10 IS - 6 N2 - BACKGROUND AND OBJECTIVES: This study compared the risk of subdural hematoma (SDH) and subsequent mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Claims data were obtained from the National Health Insurance Administration Research Database in Taiwan. This retrospective cohort study comprised 10,136 PD patients and 10,136 HD patients with newly diagnosed ESRD from 1998 to 2010. Patients were matched by propensity score and year of dialysis initiation. Incidence rates and hazard ratios of SDH as well as odds ratios of subsequent 30-day deaths from SDH were evaluated from the date of the first dialysis session to the date when SDH was diagnosed, or the date of renal transplantation, death, withdraw from insurance, or the end of the follow-up period (December 31, 2011). RESULTS: Median (25th percentile, 75th percentile) follow-up times for SDH events were 3.61 years (1.91, 6.33) and 3.33 years (1.83, 5.66) in the HD and PD cohorts, respectively. The overall SDH incidence rate (95% confidence interval [95% CI]) was 61.4% higher in the HD cohort than in the PD cohort (34.7 [95% CI, 31.4 to 35.4] versus 21.5 [95% CI, 20.2 to 22.9] per 10,000 person-years, with an adjusted hazard ratio of 1.62 [95% CI, 1.17 to 2.33]). Approximately 152 of 253 (60%) of SDH events were associated with trauma. Subsequent 30-day SDH-related mortality was not statistically higher in HD patients than in PD patients (29.1% versus 25.3%; adjusted odds ratio, 1.30; 95% CI, 0.70 to 2.41). CONCLUSIONS: HD patients have a higher risk of developing SDH than PD patients. Both patient groups have a high risk of mortality. Routine education on fall prevention is needed for dialysis patients. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/25825482/Comparison_of_Subdural_Hematoma_Risk_between_Hemodialysis_and_Peritoneal_Dialysis_Patients_with_ESRD_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=25825482 DB - PRIME DP - Unbound Medicine ER -