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

研究成果: Article同行評審

2 引文 斯高帕斯(Scopus)

摘要

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.

原文English
文章編號82
期刊Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
23
發行號1
DOIs
出版狀態Published - 2015 十月 28

All Science Journal Classification (ASJC) codes

  • 急診醫學
  • 重症監護和重症監護醫學

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