| アブストラクト | AIM: We aimed to estimate the burden of end-stage renal disease (ESRD) among patients admitted to intensive care units (ICUs), by comparing hospital outcomes between patients with and without ESRD. METHODS: Using the Japanese Diagnosis Procedure Combination database, we identified patients aged 20 years or older who were admitted to ICUs for >/=3 days (2 nights) in 2011. We created a matched cohort of patients with and without ESRD for hospital, age, sex, main diagnosis category, and ICU admission type (medical or surgical) at a maximum ratio of 1:3. For these matched patients, we compared patient characteristics, treatment regimens at ICU admission, and hospital outcomes. We also performed a multivariable logistic regression analysis for the associations between ESRD and 28-day (counting from ICU admission) and in-hospital mortality. RESULTS: Among the 164 423 eligible patients, 7998 (4.9%) had ESRD, from which 5228 ESRD and 12 274 non-ESRD patients were matched for the aforementioned factors. Compared to non-ESRD patients, ESRD patients were on more intensive treatment regimens, including mechanical ventilation, vasoactive drugs, and blood transfusion. Patients with ESRD showed significantly higher ICU, 28-day, and in-hospital mortality and longer lengths of stay in the ICU and hospital (28-day mortality: 11.7% vs. 8.3%; P < 0.001, in-hospital mortality: 21.1% vs. 12.0%; P < 0.001). After adjusting for confounding factors, ESRD was independently associated with 28-day mortality (adjusted odds ratio: 1.36, 95% confidence interval [CI]: 1.22-1.52) and in-hospital mortality (adjusted odds ratio: 1.85, 95% CI: 1.69-2.02). CONCLUSION: This study involving the Japanese national inpatient database, with a matched-pair cohort design, suggested that ESRD is an important burden in the critical care setting. |
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| ジャーナル名 | Nephrology (Carlton, Vic.) |
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| 投稿日 | 2016/06/02 |
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| 投稿者 | Iwagami, Masao; Yasunaga, Hideo; Matsui, Hiroki; Horiguchi, Hiromasa; Fushimi, Kiyohide; Noiri, Eisei; Nangaku, Masaomi; Doi, Kent |
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| 組織名 | Department of Hemodialysis and Apheresis, The University of Tokyo Hospital,;Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, Tokyo, Japan.;Department of Health Informatics and Policy, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.;Department of Nephrology and Endocrinology, The University of Tokyo Hospital,;Department of Emergency and Critical Care Medicine, The University of Tokyo;Hospital, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27248702/ |
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