• World Neurosurg · Sep 2017

    One-year mortality of chronic kidney disease patients following spinal cord injury: A 14-year population-based study.

    • Shou-Chun Yu, Jinn-Rung Kuo, Yow-Ling Shiue, Zong-Xing Yu, Chung-Han Ho, Chia-Chun Wu, Jhi-Joung Wang, Chin-Chen Chu, and Sher-Wei Lim.
    • Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Medical Research, Chi Mei Medical Center, Chiali Branch, Tainan, Taiwan.
    • World Neurosurg. 2017 Sep 1; 105: 462-469.

    ObjectiveChronic kidney disease (CKD) has become a global public health burden because of its increasing incidence, high risk of progression to end-stage renal disease (ESRD), and poor prognosis. We aimed to investigate the 1-year mortality of patients with spinal cord injury (SCI) with CKD and ESRD, and compare it with that of patients with SCI without CKD by reviewing a large Taiwanese population data set.MethodsIn this 14-year retrospective cohort study, the study group (SCI with CKD group, n = 3315) and comparison group (SCI without CKD group, n = 6630) were matched at a 1:2 ratio with propensity score matching by age, sex, comorbidities, length of intensive care unit stay, and length of stay. The 1-year mortality and the relative risks of mortality were calculated. Mortality stratified by age, sex, and comorbidities was also analyzed.ResultsThe SCI with CKD group had a significantly shorter survival period (10.13 vs. 10.97 months), higher 1-year mortality (17.65% vs. 8.54%), and higher risk of mortality than did the comparison group (adjusted hazard ratio, 2.25). Furthermore, patients with CKD with ESRD had a 7.71-fold higher risk of mortality than did patients with SCI without CKD for ages <50 years. The presence of comorbidities was a risk factor for mortality among patients with SCI CKD or ESRD in contrast to patients with SCI without CKD.ConclusionsPatients with SCI with CKD, especially those with ESRD, have a higher risk of mortality than do patients who do not have CKD. Therefore, patients with CKD should have carefully monitoring for the development of 1-year mortality after SCI, especially for ESRD.Copyright © 2017 Elsevier Inc. All rights reserved.

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