The Impact of Dialysis-Requiring Acute Kidney Injury on Long-Term Prognosis of Patients Requiring Prolonged Mechanical Ventilation: Nationwide Population-Based Study

Chia Ter Chao, Chun Cheng Hou, Vin Cent Wu, Hsin Ming Lu, Cheng Yi Wang, Likwang Chen, Tze Wah Kao

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Prolonged mechanical ventilation (PMV) is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. Methods: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI) system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1) patients with end-stage renal diseases (ESRD) before the index admission for PMV onset; (2) patients with dialysis-requiring acute kidney injury (AKI-dialysis) during the hospitalization course; and (3) patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI). We used a random-effects logistic regression model to identify factors associated with mortality. Results: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95% confidence interval [CI]:1.46-1.56), 1.27 (95% CI: 1.23-1.32), and 1.10 (95% CI: 1.08-1.12) for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p

Original languageEnglish
Article numbere50675
JournalPLoS One
Volume7
Issue number12
DOIs
Publication statusPublished - Dec 12 2012

Fingerprint

Dialysis
dialysis
Artificial Respiration
Acute Kidney Injury
prognosis
kidneys
Population
confidence interval
Mortality
Confidence Intervals
Health Expenditures
Health insurance
relative risk
Intensive care units
Hospitalization
Logistic Models
Logistics
health insurance
Hazards
National Health Programs

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

The Impact of Dialysis-Requiring Acute Kidney Injury on Long-Term Prognosis of Patients Requiring Prolonged Mechanical Ventilation : Nationwide Population-Based Study. / Chao, Chia Ter; Hou, Chun Cheng; Wu, Vin Cent; Lu, Hsin Ming; Wang, Cheng Yi; Chen, Likwang; Kao, Tze Wah.

In: PLoS One, Vol. 7, No. 12, e50675, 12.12.2012.

Research output: Contribution to journalArticle

Chao, Chia Ter ; Hou, Chun Cheng ; Wu, Vin Cent ; Lu, Hsin Ming ; Wang, Cheng Yi ; Chen, Likwang ; Kao, Tze Wah. / The Impact of Dialysis-Requiring Acute Kidney Injury on Long-Term Prognosis of Patients Requiring Prolonged Mechanical Ventilation : Nationwide Population-Based Study. In: PLoS One. 2012 ; Vol. 7, No. 12.
@article{027cc1b3488f4f5f936b52e1fbadc795,
title = "The Impact of Dialysis-Requiring Acute Kidney Injury on Long-Term Prognosis of Patients Requiring Prolonged Mechanical Ventilation: Nationwide Population-Based Study",
abstract = "Background: Prolonged mechanical ventilation (PMV) is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. Methods: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI) system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1) patients with end-stage renal diseases (ESRD) before the index admission for PMV onset; (2) patients with dialysis-requiring acute kidney injury (AKI-dialysis) during the hospitalization course; and (3) patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI). We used a random-effects logistic regression model to identify factors associated with mortality. Results: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95{\%} confidence interval [CI]:1.46-1.56), 1.27 (95{\%} CI: 1.23-1.32), and 1.10 (95{\%} CI: 1.08-1.12) for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p",
author = "Chao, {Chia Ter} and Hou, {Chun Cheng} and Wu, {Vin Cent} and Lu, {Hsin Ming} and Wang, {Cheng Yi} and Likwang Chen and Kao, {Tze Wah}",
year = "2012",
month = "12",
day = "12",
doi = "10.1371/journal.pone.0050675",
language = "English",
volume = "7",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - The Impact of Dialysis-Requiring Acute Kidney Injury on Long-Term Prognosis of Patients Requiring Prolonged Mechanical Ventilation

T2 - Nationwide Population-Based Study

AU - Chao, Chia Ter

AU - Hou, Chun Cheng

AU - Wu, Vin Cent

AU - Lu, Hsin Ming

AU - Wang, Cheng Yi

AU - Chen, Likwang

AU - Kao, Tze Wah

PY - 2012/12/12

Y1 - 2012/12/12

N2 - Background: Prolonged mechanical ventilation (PMV) is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. Methods: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI) system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1) patients with end-stage renal diseases (ESRD) before the index admission for PMV onset; (2) patients with dialysis-requiring acute kidney injury (AKI-dialysis) during the hospitalization course; and (3) patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI). We used a random-effects logistic regression model to identify factors associated with mortality. Results: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95% confidence interval [CI]:1.46-1.56), 1.27 (95% CI: 1.23-1.32), and 1.10 (95% CI: 1.08-1.12) for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p

AB - Background: Prolonged mechanical ventilation (PMV) is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. Methods: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI) system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1) patients with end-stage renal diseases (ESRD) before the index admission for PMV onset; (2) patients with dialysis-requiring acute kidney injury (AKI-dialysis) during the hospitalization course; and (3) patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI). We used a random-effects logistic regression model to identify factors associated with mortality. Results: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95% confidence interval [CI]:1.46-1.56), 1.27 (95% CI: 1.23-1.32), and 1.10 (95% CI: 1.08-1.12) for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p

UR - http://www.scopus.com/inward/record.url?scp=84871213518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871213518&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0050675

DO - 10.1371/journal.pone.0050675

M3 - Article

C2 - 23251377

AN - SCOPUS:84871213518

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e50675

ER -