https://scholars.lib.ntu.edu.tw/handle/123456789/531528
標題: | Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study | 作者: | CHIEH-KAI CHAN Chi, Chun-Yi TAI-SHUAN LAI TAO-MIN HUANG NAI-KUAN CHOU Huang, Yi-Ping Prowle, John R. VIN-CENT WU YUNG-MING CHEN |
公開日期: | 十二月-2020 | 出版社: | Nature Research | 卷: | 10 | 期: | 1 | 起(迄)頁: | 20572 | 來源出版物: | Scientific Reports | 摘要: | Acute kidney injury (AKI) is a frequent complication of traumatic injury; however, long-term outcomes such as mortality and end-stage kidney disease (ESKD) have been rarely reported in this important patient population. We compared the long-term outcome of vehicle-traumatic and non-traumatic AKI requiring renal replacement therapy (AKI-RRT). This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Vehicle-trauma patients who were suffered from vehicle accidents developing AKI-RRT during hospitalization were identified, and matching non-traumatic AKI-RRT patients were identified between 2000 and 2010. The incidences of ESKD, 30-day, and long-term mortality were evaluated, and clinical and demographic associations with these outcomes were identified using Cox proportional hazards regression models. 546 vehicle-traumatic AKI-RRT patients, median age 47.6?years (interquartile range: 29.0–64.3) and 76.4% male, were identified. Compared to non-traumatic AKI-RRT, vehicle-traumatic AKI-RRT patients had longer length of stay in hospital [median (IQR):15 (5–34) days vs. 6 (3–11) days; p < 0.001). After propensity matching with non-traumatic AKI-RRT cases with similar demographic and clinical characteristics. Vehicle-traumatic AKI-RRT patients had lower rates of long-term mortality (adjusted hazard ratio (HR), 0.473; 95% CI, 0.392–0.571; p < 0.001), but similar rates of ESKD (HR, 1.166; 95% CI, 0.829–1.638; p = 0.377) and short-term risk of death (HR, 1.134; 95% CI, 0.894–1.438; p = 0.301) as non-traumatic AKI-RRT patients. In competing risk models that focused on ESKD, vehicle-traumatic AKI-RRT patients were associated with lower ESKD rates (HR, 0.552; 95% CI, 0.325–0.937; p = 0.028) than non-traumatic AKI-RRT patients. Despite severe injuries, vehicle-traumatic AKI-RRT patients had better long-term survival than non-traumatic AKI-RRT patients, but a similar risk of ESKD. Our results provide a better understanding of long-term outcomes after vehicle-traumatic AKI-RRT. ? 2020, The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85096594262&doi=10.1038%2fs41598-020-77556-3&partnerID=40&md5=9c7665ce4491165aa4fcde3c97c46723 https://scholars.lib.ntu.edu.tw/handle/123456789/531528 |
ISSN: | 2045-2322 | DOI: | 10.1038/s41598-020-77556-3 | SDG/關鍵字: | acute kidney failure; adult; cohort analysis; female; human; incidence; injury; intensive care unit; male; middle aged; mortality; procedures; proportional hazards model; renal replacement therapy; retrospective study; Taiwan; Acute Kidney Injury; Adult; Cohort Studies; Female; Humans; Incidence; Intensive Care Units; Male; Middle Aged; Proportional Hazards Models; Renal Replacement Therapy; Retrospective Studies; Taiwan; Wounds and Injuries |
顯示於: | 醫學系 |
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