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Erschienen in: Journal of Bone and Mineral Metabolism 5/2020

12.05.2020 | Original Article

Long-term excess mortality after hip fracture in hemodialysis patients: a nationwide cohort study in Japan

verfasst von: Minako Wakasugi, Junichiro James Kazama, Atsushi Wada, Takayuki Hamano, Ikuto Masakane, Ichiei Narita

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 5/2020

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Abstract

Introduction

Fracture dialysis patients have a higher risk of 1-year mortality compared with non-fracture dialysis patients. However, it is unclear whether excess mortality persists for more than a year.

Materials and methods

We conducted a nationwide cohort study in 162,360 hemodialysis patients in Japan. Study outcomes were 5-year all-cause mortality and cause-specific mortality. Cox proportional hazards regression was used to examine the association between hip fracture and mortality in two cohorts: the full cohort, which included potential confounders as covariates in multivariable-adjusted regression models, and the propensity score-matched cohort.

Results

Crude mortality rates for fracture patients were double those of non-fracture patients and persisted during the 5-year period. The association between hip fracture and mortality was significant even after adjusting for premorbid conditions (hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.13–1.32). Similar findings were observed in the propensity score-matched cohort of 2410 patients (HR 1.20, 95% CI 1.05–1.36). While cause-specific mortality rates for all categories, with the exception of sudden deaths, were higher for fracture patients relative to non-fracture patients in the full unmatched cohort, only the mortality rate for heart disease was significantly higher for fracture patients relative to non-fracture patients in the propensity score-matched cohort.

Conclusion

Excess mortality persisted for many years after hip fracture in hemodialysis patients, and was still present after adjusting for several premorbid conditions and propensity score matching.
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Metadaten
Titel
Long-term excess mortality after hip fracture in hemodialysis patients: a nationwide cohort study in Japan
verfasst von
Minako Wakasugi
Junichiro James Kazama
Atsushi Wada
Takayuki Hamano
Ikuto Masakane
Ichiei Narita
Publikationsdatum
12.05.2020
Verlag
Springer Singapore
Erschienen in
Journal of Bone and Mineral Metabolism / Ausgabe 5/2020
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-020-01110-4

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