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Tytuł pozycji:

Leading Comorbidity associated with 30-day post-anesthetic mortality in geriatric surgical patients in Taiwan: a retrospective study from the health insurance data.

Tytuł :
Leading Comorbidity associated with 30-day post-anesthetic mortality in geriatric surgical patients in Taiwan: a retrospective study from the health insurance data.
Autorzy :
Chu CL; Institute of Biomedical Engineering National Taiwan University, No1, Sec 1, Jen-Ai Rd., Taipei, Taiwan.; Department of Anesthesiology, National Taiwan University Hospital Yun-Lin Branch, No 579, Sec 2, Yun-Lin Rd., Douliu, Yun-Lin, Taiwan.
Chiou HY; School of Public Health, Taipei Medical University, No 250, Wu-Shin Street, Taipei, Taiwan.
Chou WH; Department of Anesthesiology, National Taiwan University Hospital, No 7 Chung-Shan South Road, Taipei, Taiwan, Republic of China.
Chang PY; School of Public Health, Taipei Medical University, No 250, Wu-Shin Street, Taipei, Taiwan.
Huang YY; Institute of Biomedical Engineering National Taiwan University, No1, Sec 1, Jen-Ai Rd., Taipei, Taiwan.
Yeh HM; Department of Anesthesiology, National Taiwan University Hospital, No 7 Chung-Shan South Road, Taipei, Taiwan, Republic of China. .
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Źródło :
BMC geriatrics [BMC Geriatr] 2017 Oct 24; Vol. 17 (1), pp. 245. Date of Electronic Publication: 2017 Oct 24.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: London : BioMed Central, [2001]-
MeSH Terms :
Geriatric Assessment*
Insurance, Health/*statistics & numerical data
Intracranial Hemorrhages/*mortality
Kidney Failure, Chronic/*mortality
Myocardial Infarction/*mortality
Postoperative Complications/*mortality
Aged ; Aged, 80 and over ; Anesthetics ; Comorbidity ; Databases, Factual ; Female ; Humans ; Insurance Claim Review ; International Classification of Diseases ; Logistic Models ; Male ; Retrospective Studies ; Taiwan
References :
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Contributed Indexing :
Keywords: Comorbidity*; Post-anesthesia mortality*
Substance Nomenclature :
0 (Anesthetics)
Entry Date(s) :
Date Created: 20171026 Date Completed: 20180530 Latest Revision: 20181202
Update Code :
20210210
PubMed Central ID :
PMC5654003
DOI :
10.1186/s12877-017-0629-7
PMID :
29065869
Czasopismo naukowe
Background: Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) from Health Insurance Database.
Methods: Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID) 2005 in Taiwan. We use age, sex, type of surgery to calculate propensity score and match death group and survival one with 1:4 ratio (death: survival = 1401: 5823). Multivariate logistic model with stepwise variable selection was employed to investigate the factors affecting death 30 days after anesthesia.
Results: Thirty seven comorbidities can independently predict the post-anesthetic mortality. In our study, the leading comorbidities predict post-anesthetic mortality is chronic renal disease (OR = 2.806), acute myocardial infarction (OR = 4.58), and intracranial hemorrhage (OR = 3.758).
Conclusions: In this study, we present the leading comorbidity contributing to the postoperative mortality in elderly patients in Taiwan from National Health Insurance Database. Chronic renal failure is the leading contributing comorbidity of 30 days mortality after anesthesia in Taiwan which can be explained by the great number of hemodialysis and prolong life span under National Taiwan Health Insurance. Large scale database can offer enormous information which can help to improve quality of medical care.

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