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Risk of Spinal Epidural Abscess Infection in End-Stage Renal Disease: A Population Database Analysis
摘要
BACKGROUND: Studies on the association between end-stage renal disease (ESRD) and spinal epidural abscess (SEA) infection are lacking. The aim of this study was to evaluate whether ESRD patients are at higher risk to develop SEA. METHODS: Claims data from the Bureau of National Health Insurance (NHI) of Taiwan were used for analysis. All incident ESRD patients diagnosed from January 1, 2000 to December 31, 2009 (n = 94,023) were recognized as the study subjects. Randomly selected non-ESRD patients at a 1:1 ratio matched by age and sex through propensity scoring were recruited as the comparison subjects (non-ESRD group, n = 94,023). These subjects were followed until December 31, 2011. The index event was SEA infection. RESULTS: The cumulative incidence rate of SEA was significantly higher in the ESRD patients than in the non-ESRD population (P ＜ 0.001). The incidence rate ratio (IRR) of SEA infection was significantly higher in the ESRD patients (IRR = 6.16; 95% confidence interval [CI] = 3.77-10.06) than in the non- ESRD population, even after stratifying by age and sex. After adjusting for various comorbidities in multivariate Cox proportional hazard regression analysis, the patients with ESRD had 3.33-fold higher risk of a SEA infection (hazard ratio [HR] = 3.33; 95% CI = 2.190-5.055) compared to the non-ESRD population. The ESRD patients with SEA had a significantly higher mortality rate than their non-ESRD counterparts (P = 0.003). The ESRD patients with a history of SEA were at higher risk of mortality than those without SEA (HR = 1.27; 95% CI = 1.05-1.54). CONCLUSION: ESRD patients are at a significantly higher risk of SEA infection than those without ESRD. ESRD patients with history of SEA have a worse long-term survival than those without SEA infection.
延伸閱讀
- 謝宜熹、周崇頌（2002）。Spinal Epidural Abscess as a Possible Complication of Acupuncture: Report of Two Cases。中華民國復健醫學會雜誌，30(2)，123-129。https://doi.org/10.6315/JRMA.200206.0123
- Wang, T. L., Chen, H. Y., & Shen, Y. S. (1993). Spinal Epidural Abscess Presenting as Lower Back Pain: A Case Report and Literature Review. 中華民國復健醫學會雜誌, (21), 161-166. https://www.airitilibrary.com/Article/Detail?DocID=10253009-199312-x-21-161-166-a
- Chen, S. H., Chang, W. N., Lu, C. H., Chuang, Y. C., Lui, C. C., Chen, S. F., Tsai, N. W., Chang, C. C., Chien, C. C., & Huang, C. R. (2011). The Clinical Characteristics, Therapeutic Outcome, and Prognostic Factors of Non-Tuberculous Bacterial Spinal Epidural Abscess in Adults: A Hospital-based Study. Acta Neurologica Taiwanica, 20(2), 107-113. https://doi.org/10.29819/ANT.201106.0005
- Chang, C. Z. (2022). Spinal Epidural Abscess: A District Hospital Basis Study. 南臺灣醫學雜誌, 18(2), 52-60. https://doi.org/10.6726/MJST.202212_18(2).0001
- Tsai, W. K., Chiang, P. K., Chen, M., & Yang, S. (2008). Prevalence and Correlates of Erectile Dysfunction among End-Stage Renal Disorder Patients on Hemodialysis. 臺灣泌尿科醫學會雜誌, 19(1), 35-39. https://www.airitilibrary.com/Article/Detail?DocID=10163220-200803-19-1-35-39-a