Dialysis dating sites
The NHIRD is a large database derived from this system and includes a number of datasets, such as the Inpatients Expenditures Dataset, the Catastrophic Illness Dataset, and the Accident Dataset.
The system uses International Classification of Disease Clinical Modification, 9th revision (ICD-9-CM) codes to classify diseases.
Because the population is aging, the prevention and management of hip fractures have become some of the most important public health issues worldwide.
In addition, end-stage renal disease (ESRD) is another growing public health issue among the aging population.
The list of patients with a first fragility-related hip fractures was cross-linked to the Catastrophic Illness Dataset to identify patients who had undergone regular maintenance dialysis on the day of admission for their hip fractures (Catastrophic Illness Dataset disease category code 4; ICD-9-CM diagnosis codes 585.05, 403.01, 403.11, 403.91, 404.02, 404.03, 404.12, 404.13, 404.92, and 404.93).
To exclude patients with acute renal failure who required emergency dialysis for resuscitation during the acute stage of fracture treatment, only patients who had been undergoing regular maintenance dialysis for 1 year or longer were included in the study.
Data were extracted from the NHIRD database in Taiwan, which includes health information collected since 1995, when the Taiwan National Health Insurance, a single-payer health insurance system, was launched by the government.
Ninety-nine percent of Taiwan's population is enrolled in this insurance system.
Mortality events were 155, 188, 464, and 103 in the dialysis group, and 314, 382, 1505, and 284 in the non-dialysis group, with adjusted hazard ratios (associated 95% confidence intervals) of 2.58 (2.13–3.13), 2.95 (2.48–3.51), 2.84 (2.55–3.15), and 2.39 (1.94–2.93) at 0 to 3 months, 3 months to 1 year, 1 to 6 years, and 6 to 10 years after the fracture, respectively.
Hip fractures in older people requiring dialysis are associated with high mortality.
Our study primarily aimed to evaluate the specific burden of dialysis on the mortality rate following hip fracture.
Each dialysis hip fracture patient was age- and sex-matched to 5 randomly selected non-dialysis patients who had sustained a hip fracture during the same year.
Complete matching was not possible for 27 patients because we could not find 5 patients of the same age in the non-dialysis population; therefore, these patients were matched to non-dialysis peers with an age difference of up to 3 years.