Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study
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. Data derived from the Taiwan National Health Institute Research Database between J...
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| creator | Kuo, Chiu-Huang Hsieh, Tsung-Cheng Wang, Chih-Hsien Chou, Chu-Lin Lai, Yu-Hsien Chen, Yi-Ya Lin, Yu-Li Wu, Sheng-Teng Fang, Te-Chao |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0121705 |
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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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0121705</identifier><identifier>PMID: 25874794</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Arteriosclerosis ; Atherosclerosis ; Cardiovascular Diseases - epidemiology ; Cohort analysis ; Cohort Studies ; Comorbidity ; Complications ; Coronary artery ; Coronary artery disease ; Demographics ; Diabetes ; Dialysis ; Female ; Fractures ; Fractures, Bone - complications ; Fractures, Bone - epidemiology ; Health insurance ; Health risk assessment ; Heart diseases ; Hemodialysis ; Humans ; Long bone ; Male ; Middle Aged ; Morbidity ; Mortality ; Patients ; Proportional Hazards Models ; Renal Dialysis - adverse effects ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - therapy ; Risk Factors ; Sex ratio ; Taiwan - epidemiology</subject><ispartof>PloS one, 2015-04, Vol.10 (4), p.e0121705-e0121705</ispartof><rights>2015 Kuo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Kuo et al 2015 Kuo et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-529a4a8f575113178401faa9b4a8818f4ac0244d7ee80b7b30a5e71a6578c2683</citedby><cites>FETCH-LOGICAL-c526t-529a4a8f575113178401faa9b4a8818f4ac0244d7ee80b7b30a5e71a6578c2683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395346/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395346/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25874794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Moysés, Rosa Maria Affonso</contributor><creatorcontrib>Kuo, Chiu-Huang</creatorcontrib><creatorcontrib>Hsieh, Tsung-Cheng</creatorcontrib><creatorcontrib>Wang, Chih-Hsien</creatorcontrib><creatorcontrib>Chou, Chu-Lin</creatorcontrib><creatorcontrib>Lai, Yu-Hsien</creatorcontrib><creatorcontrib>Chen, Yi-Ya</creatorcontrib><creatorcontrib>Lin, Yu-Li</creatorcontrib><creatorcontrib>Wu, Sheng-Teng</creatorcontrib><creatorcontrib>Fang, Te-Chao</creatorcontrib><title>Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Demographics</subject><subject>Diabetes</subject><subject>Dialysis</subject><subject>Female</subject><subject>Fractures</subject><subject>Fractures, Bone - complications</subject><subject>Fractures, Bone - epidemiology</subject><subject>Health insurance</subject><subject>Health risk assessment</subject><subject>Heart diseases</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Long bone</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Risk Factors</subject><subject>Sex ratio</subject><subject>Taiwan - epidemiology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptUttu1DAQjRCIlsIfILDECy-7-Bo7PCChistKlXiBZ2viOI0XJ15shyqfxF_ivbRqEZJlj8Znjs8cT1W9JHhNmCTvtmGOE_j1Lkx2jQklEotH1TlpGF3VFLPH9-Kz6llKW4wFU3X9tDqjQkkuG35e_dlMJlpItkPRpZ8JhR6NIWbwLi8Ipg5BHmwMyfiyZ2eQCePOOwPZhSkhN5VlXGenjAY7hs6BX5JLaFcAJZlQmttkf80l9gu6cXlAbVGM-ggmz9Gm9wjQdGC7KTTIFC2rEbIZiiQThqIFpTx3y_PqSQ8-2Ren86L68fnT98uvq6tvXzaXH69WRtA6rwRtgIPqhRSEMCIVx6QHaNqSVET1HAymnHfSWoVb2TIMwkoCtZDK0Fqxi-r1kXfnQ9Inl5MmtWSEFi_rgtgcEV2Ard5FN0JcdACnD4kQrzXEYpW3mprOKjC1xZZyBRJKBIo2jSCc9rgpXB9Or83taDtTbIrgH5A-vJncoK_Db81ZIxjfi3l7IoihuJyyHl0y1nuYbJgPunndYKxwgb75B_r_7vgRZcqvp2j7OzEE6_3k3Vbp_eTp0-SVslf3G7kruh019hcRA9vz</recordid><startdate>20150413</startdate><enddate>20150413</enddate><creator>Kuo, Chiu-Huang</creator><creator>Hsieh, Tsung-Cheng</creator><creator>Wang, Chih-Hsien</creator><creator>Chou, Chu-Lin</creator><creator>Lai, Yu-Hsien</creator><creator>Chen, Yi-Ya</creator><creator>Lin, Yu-Li</creator><creator>Wu, Sheng-Teng</creator><creator>Fang, Te-Chao</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150413</creationdate><title>Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study</title><author>Kuo, Chiu-Huang ; Hsieh, Tsung-Cheng ; Wang, Chih-Hsien ; Chou, Chu-Lin ; Lai, Yu-Hsien ; Chen, Yi-Ya ; Lin, Yu-Li ; Wu, Sheng-Teng ; Fang, Te-Chao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-529a4a8f575113178401faa9b4a8818f4ac0244d7ee80b7b30a5e71a6578c2683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Cardiovascular Diseases - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuo, Chiu-Huang</au><au>Hsieh, Tsung-Cheng</au><au>Wang, Chih-Hsien</au><au>Chou, Chu-Lin</au><au>Lai, Yu-Hsien</au><au>Chen, Yi-Ya</au><au>Lin, Yu-Li</au><au>Wu, Sheng-Teng</au><au>Fang, Te-Chao</au><au>Moysés, Rosa Maria Affonso</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-04-13</date><risdate>2015</risdate><volume>10</volume><issue>4</issue><spage>e0121705</spage><epage>e0121705</epage><pages>e0121705-e0121705</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25874794</pmid><doi>10.1371/journal.pone.0121705</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Arteriosclerosis Atherosclerosis Cardiovascular Diseases - epidemiology Cohort analysis Cohort Studies Comorbidity Complications Coronary artery Coronary artery disease Demographics Diabetes Dialysis Female Fractures Fractures, Bone - complications Fractures, Bone - epidemiology Health insurance Health risk assessment Heart diseases Hemodialysis Humans Long bone Male Middle Aged Morbidity Mortality Patients Proportional Hazards Models Renal Dialysis - adverse effects Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - therapy Risk Factors Sex ratio Taiwan - epidemiology |
| title | Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: a nationwide case-matched cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T13%3A51%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Increased%20risks%20of%20mortality%20and%20atherosclerotic%20complications%20in%20incident%20hemodialysis%20patients%20subsequently%20with%20bone%20fractures:%20a%20nationwide%20case-matched%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Kuo,%20Chiu-Huang&rft.date=2015-04-13&rft.volume=10&rft.issue=4&rft.spage=e0121705&rft.epage=e0121705&rft.pages=e0121705-e0121705&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0121705&rft_dat=%3Cproquest_plos_%3E3654902371%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1673122036&rft_id=info:pmid/25874794&rft_doaj_id=oai_doaj_org_article_2cde8ac6e0e248a7a6e0a82995142f09&rfr_iscdi=true |