Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury

Hsin Hung Chen, Chien Chin Hsu, Shih Feng Weng, Hung Jung Lin, Jhi Joung Wang, How-Ran Guo, Shih Bin Su, Chien Cheng Huang, Jiann Hwa Chen

Research output: Contribution to journalArticle

Abstract

Background: Hemodialysis (HD) treatment for end-stage renal disease (ESRD) (HD+ESRD) may increase the risk of intracranial hemorrhage (ICH) after a head injury (HI) for which heparin is used. However, the results of noncontrast head computed tomography (CT) in such patients are not always clear. We aimed to evaluate the effect of HD on the risk of ICH in ESRD patients and in controls without ESRD with HD (HD-ESRD), and to determine whether to lower the threshold of head CT in HD+ESRD patients after HI. Methods: In this nationwide population-based study using Taiwan's National Health Insurance Research Database, we enrolled 6938 HD+ESRD HI patients for the case group and 13,876 randomly selected HD-ESRD HI patients for the control group. Measures of the post-HI association between HD+ESRD and ICH determined using conditional logistic regression. Results: Five hundred sixty-eight (2.74 %) patients had post-HI ICH: 185 in the HD+ESRD group (2.67 % of cases) and 383 were from the HD-ESRD group (2.76 % of controls). Conditional logistic regression analysis revealed that after adjusting for age, gender, diabetes, hypertension, congestive heart failure, stroke, cancer, and liver disease, HD+ESRD patients had no higher odds of ICH (adjusted odds ratio [AOR]: 0.91; 95 % confidence interval [CI]: 0.75-1.11) than did HD-ESRD patients. In the subgroup analysis of immediate ICH, HD+ESRD patients had lower odds than did HD-ESRD patients (AOR: 0.73; 95 % CI: 0.56-0.94). Conclusions: HD+ESRD did not increase the post-HI risk of ICH. Therefore, it may not be necessary to lower the threshold of head CT in HD+ESRD patients.

Original languageEnglish
Article number82
JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume23
Issue number1
DOIs
Publication statusPublished - 2015 Oct 28

Fingerprint

Intracranial Hemorrhages
Craniocerebral Trauma
Chronic Kidney Failure
Renal Dialysis
Head
Tomography
Logistic Models
Odds Ratio
Confidence Intervals
Control Groups
National Health Programs
Liver Neoplasms
Taiwan

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Chen, Hsin Hung ; Hsu, Chien Chin ; Weng, Shih Feng ; Lin, Hung Jung ; Wang, Jhi Joung ; Guo, How-Ran ; Su, Shih Bin ; Huang, Chien Cheng ; Chen, Jiann Hwa. / Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury. In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2015 ; Vol. 23, No. 1.
@article{212f1972ef934dfe879926c40c7664c7,
title = "Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury",
abstract = "Background: Hemodialysis (HD) treatment for end-stage renal disease (ESRD) (HD+ESRD) may increase the risk of intracranial hemorrhage (ICH) after a head injury (HI) for which heparin is used. However, the results of noncontrast head computed tomography (CT) in such patients are not always clear. We aimed to evaluate the effect of HD on the risk of ICH in ESRD patients and in controls without ESRD with HD (HD-ESRD), and to determine whether to lower the threshold of head CT in HD+ESRD patients after HI. Methods: In this nationwide population-based study using Taiwan's National Health Insurance Research Database, we enrolled 6938 HD+ESRD HI patients for the case group and 13,876 randomly selected HD-ESRD HI patients for the control group. Measures of the post-HI association between HD+ESRD and ICH determined using conditional logistic regression. Results: Five hundred sixty-eight (2.74 {\%}) patients had post-HI ICH: 185 in the HD+ESRD group (2.67 {\%} of cases) and 383 were from the HD-ESRD group (2.76 {\%} of controls). Conditional logistic regression analysis revealed that after adjusting for age, gender, diabetes, hypertension, congestive heart failure, stroke, cancer, and liver disease, HD+ESRD patients had no higher odds of ICH (adjusted odds ratio [AOR]: 0.91; 95 {\%} confidence interval [CI]: 0.75-1.11) than did HD-ESRD patients. In the subgroup analysis of immediate ICH, HD+ESRD patients had lower odds than did HD-ESRD patients (AOR: 0.73; 95 {\%} CI: 0.56-0.94). Conclusions: HD+ESRD did not increase the post-HI risk of ICH. Therefore, it may not be necessary to lower the threshold of head CT in HD+ESRD patients.",
author = "Chen, {Hsin Hung} and Hsu, {Chien Chin} and Weng, {Shih Feng} and Lin, {Hung Jung} and Wang, {Jhi Joung} and How-Ran Guo and Su, {Shih Bin} and Huang, {Chien Cheng} and Chen, {Jiann Hwa}",
year = "2015",
month = "10",
day = "28",
doi = "10.1186/s13049-015-0168-1",
language = "English",
volume = "23",
journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",
issn = "1757-7241",
publisher = "BioMed Central",
number = "1",

}

Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury. / Chen, Hsin Hung; Hsu, Chien Chin; Weng, Shih Feng; Lin, Hung Jung; Wang, Jhi Joung; Guo, How-Ran; Su, Shih Bin; Huang, Chien Cheng; Chen, Jiann Hwa.

In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol. 23, No. 1, 82, 28.10.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury

AU - Chen, Hsin Hung

AU - Hsu, Chien Chin

AU - Weng, Shih Feng

AU - Lin, Hung Jung

AU - Wang, Jhi Joung

AU - Guo, How-Ran

AU - Su, Shih Bin

AU - Huang, Chien Cheng

AU - Chen, Jiann Hwa

PY - 2015/10/28

Y1 - 2015/10/28

N2 - Background: Hemodialysis (HD) treatment for end-stage renal disease (ESRD) (HD+ESRD) may increase the risk of intracranial hemorrhage (ICH) after a head injury (HI) for which heparin is used. However, the results of noncontrast head computed tomography (CT) in such patients are not always clear. We aimed to evaluate the effect of HD on the risk of ICH in ESRD patients and in controls without ESRD with HD (HD-ESRD), and to determine whether to lower the threshold of head CT in HD+ESRD patients after HI. Methods: In this nationwide population-based study using Taiwan's National Health Insurance Research Database, we enrolled 6938 HD+ESRD HI patients for the case group and 13,876 randomly selected HD-ESRD HI patients for the control group. Measures of the post-HI association between HD+ESRD and ICH determined using conditional logistic regression. Results: Five hundred sixty-eight (2.74 %) patients had post-HI ICH: 185 in the HD+ESRD group (2.67 % of cases) and 383 were from the HD-ESRD group (2.76 % of controls). Conditional logistic regression analysis revealed that after adjusting for age, gender, diabetes, hypertension, congestive heart failure, stroke, cancer, and liver disease, HD+ESRD patients had no higher odds of ICH (adjusted odds ratio [AOR]: 0.91; 95 % confidence interval [CI]: 0.75-1.11) than did HD-ESRD patients. In the subgroup analysis of immediate ICH, HD+ESRD patients had lower odds than did HD-ESRD patients (AOR: 0.73; 95 % CI: 0.56-0.94). Conclusions: HD+ESRD did not increase the post-HI risk of ICH. Therefore, it may not be necessary to lower the threshold of head CT in HD+ESRD patients.

AB - Background: Hemodialysis (HD) treatment for end-stage renal disease (ESRD) (HD+ESRD) may increase the risk of intracranial hemorrhage (ICH) after a head injury (HI) for which heparin is used. However, the results of noncontrast head computed tomography (CT) in such patients are not always clear. We aimed to evaluate the effect of HD on the risk of ICH in ESRD patients and in controls without ESRD with HD (HD-ESRD), and to determine whether to lower the threshold of head CT in HD+ESRD patients after HI. Methods: In this nationwide population-based study using Taiwan's National Health Insurance Research Database, we enrolled 6938 HD+ESRD HI patients for the case group and 13,876 randomly selected HD-ESRD HI patients for the control group. Measures of the post-HI association between HD+ESRD and ICH determined using conditional logistic regression. Results: Five hundred sixty-eight (2.74 %) patients had post-HI ICH: 185 in the HD+ESRD group (2.67 % of cases) and 383 were from the HD-ESRD group (2.76 % of controls). Conditional logistic regression analysis revealed that after adjusting for age, gender, diabetes, hypertension, congestive heart failure, stroke, cancer, and liver disease, HD+ESRD patients had no higher odds of ICH (adjusted odds ratio [AOR]: 0.91; 95 % confidence interval [CI]: 0.75-1.11) than did HD-ESRD patients. In the subgroup analysis of immediate ICH, HD+ESRD patients had lower odds than did HD-ESRD patients (AOR: 0.73; 95 % CI: 0.56-0.94). Conclusions: HD+ESRD did not increase the post-HI risk of ICH. Therefore, it may not be necessary to lower the threshold of head CT in HD+ESRD patients.

UR - http://www.scopus.com/inward/record.url?scp=84945539423&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945539423&partnerID=8YFLogxK

U2 - 10.1186/s13049-015-0168-1

DO - 10.1186/s13049-015-0168-1

M3 - Article

VL - 23

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

SN - 1757-7241

IS - 1

M1 - 82

ER -