Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study.
BACKGROUND:Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. METHODS:Data derived from the Taiwan National Health Institute Research...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4395346?pdf=render |
| _version_ | 1819265636843388928 |
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| author | Chiu-Huang Kuo Tsung-Cheng Hsieh Chih-Hsien Wang Chu-Lin Chou Yu-Hsien Lai Yi-Ya Chen Yu-Li Lin Sheng-Teng Wu Te-Chao Fang |
| author_facet | Chiu-Huang Kuo Tsung-Cheng Hsieh Chih-Hsien Wang Chu-Lin Chou Yu-Hsien Lai Yi-Ya Chen Yu-Li Lin Sheng-Teng Wu Te-Chao Fang |
| author_sort | Chiu-Huang Kuo |
| collection | DOAJ |
| description | BACKGROUND:Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. METHODS:Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. RESULTS:After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p < 0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p < 0.001), stroke (HR = 1.19, p < 0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p < 0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. CONCLUSIONS:The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications. |
| first_indexed | 2024-12-23T20:48:32Z |
| format | Article |
| id | doaj.art-2cde8ac6e0e248a7a6e0a82995142f09 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-23T20:48:32Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2cde8ac6e0e248a7a6e0a82995142f092022-12-21T17:31:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01104e012170510.1371/journal.pone.0121705Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study.Chiu-Huang KuoTsung-Cheng HsiehChih-Hsien WangChu-Lin ChouYu-Hsien LaiYi-Ya ChenYu-Li LinSheng-Teng WuTe-Chao FangBACKGROUND:Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. METHODS:Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. RESULTS:After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p < 0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p < 0.001), stroke (HR = 1.19, p < 0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p < 0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. CONCLUSIONS:The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications.http://europepmc.org/articles/PMC4395346?pdf=render |
| spellingShingle | Chiu-Huang Kuo Tsung-Cheng Hsieh Chih-Hsien Wang Chu-Lin Chou Yu-Hsien Lai Yi-Ya Chen Yu-Li Lin Sheng-Teng Wu Te-Chao Fang Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. PLoS ONE |
| title | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. |
| title_full | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. |
| title_fullStr | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. |
| title_full_unstemmed | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. |
| title_short | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study. |
| title_sort | increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures a nationwide case matched cohort study |
| url | http://europepmc.org/articles/PMC4395346?pdf=render |
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