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Risk of empyema in patients with end-stage renal disease: a nationwide propensity-matched cohort study.
QJM. 2017 Jul 01; 110(7):425-430.QJM

Abstract

Background

Empyema is a rare but important complication among patients with end-stage renal disease (ESRD). However, a nationwide, propensity-matched cohort study has never been performed.

Methods

We conducted a retrospective cohort study using data from the National Health Insurance Research Database of Taiwan. The ESRD group consisted of 82 765 patients diagnosed between 2000 and 2008. The comparison group consisted of individuals without kidney disease selected at a 1:1 ratio matched by propensity score estimated with age, gender, year of diagnosis and comorbidities. The occurrence of empyema was monitored until the end of 2011. The hazard ratios (HRs) of empyema were estimated using the Cox proportional hazards model.

Results

The incidence of empyema was 2.76-fold higher in the ESRD group than in the comparison group (23.7 vs. 8.19/10 000 person-years, P <0.001), with an adjusted HR of 3.01 [95% confidence interval (CI) = 2.67-3.39]. There was no difference of the incidence of empyema between hemodialysis (HD) and peritoneal dialysis (PD) (adjusted HR = 0.96, 95% CI = 0.75-1.23). In addition, 30-day mortality rate since empyema diagnosis was significantly higher in ESRD group than the comparison group (15.9% vs. 10.9%), with an adjusted OR of 1.69 (95% CI = 1.17-2.44).

Conclusion

The risk of empyema was significantly higher in patients with ESRD than in those without kidney disease. The occurrence of empyema was without difference in patients undergoing HD compared to those undergoing PD. The 30-day mortality rate since empyema diagnosis was also significantly higher in patients with ESRD.

Authors+Show Affiliations

Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. Department of Health Services Administration, China Medical University, Taichung, Taiwan. Mahidol University Faculty of Public Health, Bangkok, Thailand.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28062748

Citation

Shen, T-C, et al. "Risk of Empyema in Patients With End-stage Renal Disease: a Nationwide Propensity-matched Cohort Study." QJM : Monthly Journal of the Association of Physicians, vol. 110, no. 7, 2017, pp. 425-430.
Shen TC, Chen CH, Wang IK, et al. Risk of empyema in patients with end-stage renal disease: a nationwide propensity-matched cohort study. QJM. 2017;110(7):425-430.
Shen, T. C., Chen, C. H., Wang, I. K., Lin, C. L., Tu, C. Y., Hsia, T. C., Shih, C. M., Hsu, W. H., & Sung, F. C. (2017). Risk of empyema in patients with end-stage renal disease: a nationwide propensity-matched cohort study. QJM : Monthly Journal of the Association of Physicians, 110(7), 425-430. https://doi.org/10.1093/qjmed/hcx004
Shen TC, et al. Risk of Empyema in Patients With End-stage Renal Disease: a Nationwide Propensity-matched Cohort Study. QJM. 2017 Jul 1;110(7):425-430. PubMed PMID: 28062748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of empyema in patients with end-stage renal disease: a nationwide propensity-matched cohort study. AU - Shen,T-C, AU - Chen,C-H, AU - Wang,I-K, AU - Lin,C-L, AU - Tu,C-Y, AU - Hsia,T-C, AU - Shih,C-M, AU - Hsu,W-H, AU - Sung,F-C, PY - 2016/09/17/received PY - 2017/1/8/pubmed PY - 2018/5/23/medline PY - 2017/1/8/entrez SP - 425 EP - 430 JF - QJM : monthly journal of the Association of Physicians JO - QJM VL - 110 IS - 7 N2 - Background: Empyema is a rare but important complication among patients with end-stage renal disease (ESRD). However, a nationwide, propensity-matched cohort study has never been performed. Methods: We conducted a retrospective cohort study using data from the National Health Insurance Research Database of Taiwan. The ESRD group consisted of 82 765 patients diagnosed between 2000 and 2008. The comparison group consisted of individuals without kidney disease selected at a 1:1 ratio matched by propensity score estimated with age, gender, year of diagnosis and comorbidities. The occurrence of empyema was monitored until the end of 2011. The hazard ratios (HRs) of empyema were estimated using the Cox proportional hazards model. Results: The incidence of empyema was 2.76-fold higher in the ESRD group than in the comparison group (23.7 vs. 8.19/10 000 person-years, P <0.001), with an adjusted HR of 3.01 [95% confidence interval (CI) = 2.67-3.39]. There was no difference of the incidence of empyema between hemodialysis (HD) and peritoneal dialysis (PD) (adjusted HR = 0.96, 95% CI = 0.75-1.23). In addition, 30-day mortality rate since empyema diagnosis was significantly higher in ESRD group than the comparison group (15.9% vs. 10.9%), with an adjusted OR of 1.69 (95% CI = 1.17-2.44). Conclusion: The risk of empyema was significantly higher in patients with ESRD than in those without kidney disease. The occurrence of empyema was without difference in patients undergoing HD compared to those undergoing PD. The 30-day mortality rate since empyema diagnosis was also significantly higher in patients with ESRD. SN - 1460-2393 UR - https://www.unboundmedicine.com/medline/citation/28062748/Risk_of_empyema_in_patients_with_end_stage_renal_disease:_a_nationwide_propensity_matched_cohort_study_ L2 - https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/hcx004 DB - PRIME DP - Unbound Medicine ER -