論文

査読有り 国際誌
2018年11月

In-Hospital Outcomes of Patients With Advanced Chronic Kidney Disease, Dialysis, and Kidney Transplant Undergoing Spinal Fusion: Analysis of a Nationwide Database.

Clinical spine surgery
  • Hiroyuki Yoshihara
  • ,
  • Daisuke Yoneoka

31
9
開始ページ
400
終了ページ
405
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/BSD.0000000000000692

STUDY DESIGN: A retrospective analysis of population-based national hospital discharge data collected for the nationwide inpatient sample (NIS). OBJECTIVES: To examine the in-hospital outcomes of patients with advanced chronic kidney disease (CKD), dialysis, and kidney transplant undergoing spinal fusion on a national level. SUMMARY OF BACKGROUND DATA: Patients with advanced CKD have been living longer with the support and improvement of medical treatment, dialysis, and organ transplant. Some of those patients undergo spinal fusion surgery. However, there is limited information regarding the outcomes of patients with advanced CKD, dialysis, and kidney transplant, undergoing spinal fusion. METHODS: Clinical data were derived from the US Nationwide Inpatient Sample (NIS) between 2000 and 2009. Patients who underwent spinal fusion were identified and divided into 4 groups: those with advanced CKD, dialysis, and kidney transplant, and those without advanced CKD. Data regarding, patient-system and health care system-related characteristics, comorbidities, in-hospital complications, and mortality were retrieved and analyzed. In-hospital outcomes were compared between the groups and analyzed with the use of multivariate logistic regression. RESULTS: Among the all groups, overall in-hospital complications rate was the highest (42.0%) for patients with advanced CKD and in-hospital mortality rate was the highest (5.2%) for those with dialysis, undergoing spinal fusion. Patients with dialysis had 8.7 and 9.5 times higher risk of in-hospital mortality compared with those with kidney transplant and those without advanced CKD. CONCLUSIONS: Patients with advanced CKD, dialysis, and kidney transplant had significant higher rates and risks of in-hospital morbidity or mortality than those without advanced CKD, undergoing spinal fusion. Particularly, patients with dialysis undergoing spinal fusion need to be informed with high mortality risk.

リンク情報
DOI
https://doi.org/10.1097/BSD.0000000000000692
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30024446

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