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Clinical outcomes among hemodialysis patients with atrial fibrillation: a Korean nationwide population-based study
- Title
- Clinical outcomes among hemodialysis patients with atrial fibrillation: a Korean nationwide population-based study
- Authors
- Kang, Yeunmi; Choi, Hyung Yun; Kwon, Young Eun; Shin, Ji Hyeon; Won, Eun Mi; Yang, Ki Hwa; Oh, Hyung Jung; Ryu, Dong-Ryeol
- Ewha Authors
- 류동열
- SCOPUS Author ID
- 류동열
- Issue Date
- 2021
- Journal Title
- KIDNEY RESEARCH AND CLINICAL PRACTICE
- ISSN
- 2211-9132
2211-9140
- Citation
- KIDNEY RESEARCH AND CLINICAL PRACTICE vol. 40, no. 1, pp. 99 - 108
- Keywords
- Atrial fibrillation; Hemodialysis; Hemorrhagic stroke; Hospitalization; Ischemic stroke; Mortality; Warfarin
- Publisher
- KOREAN SOC NEPHROLOGY
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Background: The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. Methods: In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. Results: Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222-1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225-1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050-2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075-2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. Conclusion: This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.
- DOI
- 10.23876/j.krcp.20.022
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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