FAKTOR-FAKTOR RISIKO STROKE PADA PENYAKIT GINJAL KRONIK STADIUM V YANG MENJALANI HEMODIALISIS

RISK FACTORS OF STROKE IN STAGE V CHRONIC KIDNEY DISEASE WHO UNDERWENT HEMODIALYSISABSTRACTIntroduction: Chronic kidney disease (CKD) and end-stage renal disease are associated with a significantly in- creased risk of stroke. Incidence and mortality of stroke in CKD patients is higher rather than among the general popula- tion. Stroke in hemodialysis patients is also associated with high mortality.Aims: To analyze risk factors that have a relationship with the occurrence of stroke in patients with stage V CKD who underwent hemodialysis in Dr. Kariadi Hospital, Semarang.Method: A case control with retrospective cohort study of patients diagnosed with stage V CKD undergoing hemo- dialysis in Dr. Kariadi Hospital, Semarang, from March 2016 to August 2017. Subject was divided into case group, who experienced stroke, and control group, who did not experience stroke. Bivariate analysis was performed with Chi-square test, multivariate analysis with logistic regression test and rasio Odds.Results: There were 140 subjects with stage V CKD, 70 subjects in each groups. In case group, 85.7% experienced ischemic stroke while the rest hemorrhagic stroke. The duration of hemodialysis was related to the incidence of stroke. In multivariate analysis, patients with diabetes mellitus were more likely to have a stroke by 0.14 times compared to patients who did not have diabetes mellitus, and patients who underwent hemodialysis >12 months, were more likely to have a stroke 4.05 times greater than patients who underwent hemodialysis <12 months.Discussion: There is a relationship between diabetes mellitus and duration of hemodialysis with the occurrence of ischemic stroke, in stage V CKD patients who underwent hemodialysis.Keywords: Chronic kidney disease, hemodialysis, strokeABSTRAKPendahuluan: Penyakit ginjal kronik (PGK) dan penyakit ginjal stadium akhir terkait dengan peningkatan risiko yang signifikan dari stroke. Insiden dan mortalitas stroke pada pasien PGK lebih tinggi dibandingkan populasi umum. Stroke pada pasien dialisis juga dihubungkan dengan mortalitas yang tinggi.Tujuan: Untuk menganalisis faktor-faktor risiko yang memengaruhi terjadinya stroke pada pasien dengan PGK stadium V yang menjalani hemodialisis (HD) di RSUP Dr. Kariadi, Semarang.Metode: Penelitian kasus kontrol dengan pendekatan kohort retrospektif terhadap pasien penyakit ginjal kronik stadium V yang menjalani HD di RSUP Dr. Kariadi, Semarang dari bulan Maret 2016 hingga Agustus 2017. Subjek dibagi ke dalam kelompok kasus, yaitu yang mengalami stroke dan kelompok kontrol yang tidak mengalami stroke. Dilakukan analisis bivariat dengan uji Chi-square dan analisis multivariat dengan uji regresi logistik serta rasio Odds.Hasil: Didapatkan 140 subjek dengan PGK stadium V yang masing-masing kelompok terdiri dari 70 orang. Pada kelompok kasus, sebanyak 85,7% adalah stroke iskemik dan sisanya stroke hemoragik. Lama HD berhubungan dengan kejadian stroke. Pada uji multivariat, subjek yang menderita diabetes melitus (DM) berisiko mengalami stroke sebesar 0,14 kali dibandingkan yang tidak DM dan subjek yang menjalani HD >12 bulan berisiko mengalami stroke 4,05 kali lebih besar dibandingkan yang menjalani HD <12 bulan.Diskusi: Terdapat pengaruh faktor risiko DM dan lama hemodialisis terhadap kejadian stroke iskemik pada pasien PGK stadium V yang menjalani HD.Kata kunci: Hemodialisis, penyakit ginjal kronik, stroke

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FIB-4 Index and Diabetes Mellitus Are Associated with Chronic Kidney Disease in Japanese Patients with Non-Alcoholic Fatty Liver Disease

International Journal of Molecular Sciences ◽

10.3390/ijms21010171 ◽

2019 ◽

Vol 21 (1) ◽

pp. 171 ◽

Cited By ~ 2

Author(s):

Yuya Seko ◽

Kohta Yano ◽

Aya Takahashi ◽

Shinya Okishio ◽

Seita Kataoka ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Multivariate Analysis ◽

Liver Disease ◽

Kidney Disease ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Ckd Stage ◽

Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). The aim of this retrospective study was to determine the risk factors for progression of CKD in patients with biopsy-proven NAFLD including patatin-like phospholipase domain containing 3 (PNPLA3) polymorphism. A total of 344 patients with biopsy-proven NAFLD were enrolled consecutively in this study. Multivariate analysis identified males (odds ratio (OR) 5.46), age (per 1 year, OR 1.07), and FIB-4 index (≥1.30, OR 3.85) as factors associated with CKD. Of the 154 patients with a baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min, 30 had a deterioration in CKD stage and 15 developed CKD after 3 years. Multivariate analysis identified diabetes mellitus (OR 2.44) as a risk factor for deterioration in CKD stage, while diabetes mellitus (OR 21.54) and baseline eGFR (per 1 mL/min OR 0.88) were risk factors for development of CKD. PNPLA3 did not affect the change in eGFR. In NAFLD patients, a high FIB-4 index was associated with CKD to increases in the index linked to reductions in eGFR. In order to prevent development of CKD, an appropriate therapy focusing on renal function is needed for NAFLD patients, especially those with diabetes.

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Differences in Risk Factors for Diabetic Retinopathy in Type 1 and Type 2 Diabetes Mellitus Patients in North-East Poland

Medicina ◽

10.3390/medicina56040177 ◽

2020 ◽

Vol 56 (4) ◽

pp. 177

Author(s):

Wojciech Matuszewski ◽

Magdalena M. Stefanowicz-Rutkowska ◽

Magdalena Szychlińska ◽

Elżbieta Bandurska-Stankiewicz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Kidney Disease ◽

Study Group

Background and Objective: Nowadays, diabetes is one of the main causes of blindness in the world. Identification and differentiation of risk factors for diabetic retinopathy depending on the type of diabetes gives us the opportunity to fight and prevent this complication. Aim of the research: To assess differences in the risk factors for diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in Warmia and Mazury Region, Poland. Materials and Methods: Risk factors for diabetic retinopathy (DR) were assessed on the basis of an original questionnaire, which included: personal data, clinical history of diabetes and eye disease. Elements of clinical examination: blood pressure, BMI, waist circumference. Indicators of diabetes metabolic control: mean glycemia, glycated hemoglobin (HbA1c), total cholesterol and triglycerides, creatinine, glomerular filtration rate (GFR), albumin–creatinine ratio in urine. Results: The study group included 315 (26%) patients with DM1 and 894 (74%) patients with DM2. Risk factors were estimated on the basis of logistic regression and verified with Student’s t-test. Statistically significant dependencies were found in both groups between the occurrence of diabetic retinopathy and diabetes duration, HbA1c, triglyceride concentrations, indicators of kidney function and cigarette smoking status. In the DM2 group, the development of DR was significantly influenced by the implemented models of diabetic treatment. Conclusions: In the whole study group, the risk of DR was associated with the duration of diabetes, HbA1c, triglyceride concentrations and smoking. In DM1 patients, the risk of DR was associated with diabetic kidney disease in the G1A1/A2 stage of chronic kidney disease, and in DM2 patients with the G2 stage of chronic kidney disease. An important risk factor for DR in DM2 patients was associated with late introduction of insulin therapy.

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Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

IMC Journal of Medical Science ◽

10.3329/imcjms.v11i1.31934 ◽

2017 ◽

Vol 11 (1) ◽

pp. 19-24 ◽

Cited By ~ 1

Author(s):

Muhammad Abdur Rahim ◽

Palash Mitra ◽

Hasna Fahmima Haque ◽

Tasrina Shamnaz Samdani ◽

Shahana Zaman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Kidney Disease ◽

Glycemic Control ◽

Significant Risk ◽

Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

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Prevalence and Risk Factors of Arterio-Venous Fistula Obstruction on Patient with Chronic Kidney Disease

ACI (Acta Cardiologia Indonesiana) ◽

10.22146/jaci.v7i2.3511 ◽

2021 ◽

Vol 7 (2) ◽

pp. 5

Author(s):

Muhamad Taufik Ismail ◽

Hariadi Hariawan ◽

Yulia Wardhani ◽

Metalia Puspitasari ◽

I Putu Aditio Artayasa ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Risk Factor ◽

Kidney Disease ◽

Doppler Ultrasound ◽

Duplex Ultrasound ◽

Smoking Habits ◽

Av Fistula ◽

Venous Fistula

Prevalence and Risk Factors of Arterio-Venous Fistula Obstruction on Patient with Chronic Kidney Disease Ismail MT1, Hariawan H1, Wardhani Y2, Puspitasari M2, Artayasa IPA1, Ramadhan G1, Tarigan T1, Triatmaja R1 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, 55284, Indonesia 2Department of Internal Medicine Faculty of Medicine Universitas Gadjah Mada-RSUP Dr. Sardjito Yogyakarta Indonesia ABSTRACT Aim: AV fistula obstruction has become one of the main vascular access complications in patients undergoing haemodialysis. This complications have significant impacts on the morbidity and mortality of dialysis patients while also leading to higher medical costs. Clinical monitoring has been routinely used for early detection of AV fistula stenosis and obstruction, however screening with Doppler ultrasound is still not a routine recommendation. This study aims to know prevalence and risk factors of AV Fistula obstruction detected by Duplex ultrasound examination. Methods: This study was a hospital-based descriptive analytic study with cross sectional design conducted at the haemodialysis center of National General Hospital Dr. Sardjito, Yogyakarta, Indonesia. Patient demographic and clinical risk factor were recorded using direct interview. AV fistula obstruction were assessed using Duplex ultrasound by professional sonographer. Results: Seventy four (74) patients are using AV fistula as entry access for hemodialysis in RSUP dr. Sardjito. It is consist of 39 male (53%) and 35 Female (47%). The mean age of patients is 50 years old. Surveillance using Doppler ultrasound found 20 patients (27%) have stenotic AV Fistula. Smoking habits (OR 5.37, 95% CI, 1.760 - 16.431, p=0.002) and diabetes mellitus (OR 5.00, 95% CI, 1.631 – 15.503, p=0.004) increase risk for having stenotic AV fistula. Only 4 patient (20 %) of all 20 patient with stenotic AV fistula were symptomatic, and needed for further vascular intervention Conclusion: Prevalence of AV fistula obstruction detected by Doppler ultrasound was 27% of all AV fistula patient with only 5% had symptomatic AV fistula failure. Smoking habits and diabetes mellitus are important risk factor for AV fistula obstruction. Asymptomatic AV fistula obstruction often goes undetected by clinical monitoring that can increase of risk of symptomatic AV fistula obstruction in the future. The further study is needed to determine level recommendation of routine AV fistula surveillance with Doppler Ultrasound. Key words: AV Fistula obstruction, CKD, Doppler ultrasound surveillance, Risk factors, Prevalence

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Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus

Diabetes Mellitus ◽

10.14341/2072-0351-822 ◽

2013 ◽

Vol 16 (3) ◽

pp. 90-96

Author(s):

Irina Mikhailovna Kutyrina ◽

Tatiana Evgen'evna Rudenko ◽

Svetlana Alekseevna Savel'eva ◽

Mikhail Yur'evich Shvetsov ◽

Marina Vladimirovna Shestakova

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiorenal Syndrome ◽

Left Ventricular ◽

Diabetic Patients ◽

Related Factors ◽

Myocardial Remodelling ◽

History Of

AIM: Combination of cardiovascular and renal disease is currently viewed as a unified cardiorenal syndrome (CRS). The aim of our study was to assess the CRS prevalence and risk factors associated with left ventricular hypertrophy (LVH) in patients with pre-dialysis stages of chronic kidney disease (CKD) of various etiology. MATERIALS AND METHODS: We enrolled 172 patients with CKD to participate in this study. First group consisted of 83 patients with nondiabetic CKD at 2nd through 4th stage (mean age 46-15 years, 51% male and 29% female). Mean glomerular filtration rate (GFR) was 37.2 ml/min (33.9-41.4 with 95% CI); creatinine plasma clearance was 2.9 mg/dl (2.6-3.2). Second group consisted of 89 patients with type 2 diabetes mellitus (T2DM) and CKD at 1st?2nd stage (40% male and 60% female) with albuminuria (mean age 57.3-7.1 years). Duration of diabetes in this sampling was 10.4-7.1 years. All patients underwent standard clinical examination, supplemented with echocardiography to evaluate the influence of general and CKD-related risk factors for LVH. RESULTS: LVH was diagnosed in 37.3% of non-diabetic patients with CKD at 2nd through 4th stage. Aside from classic cardiovascular riskfactors (including age, gender, arterial hypertension, family history of cardiovascular diseases, hypercholesterolemia), we observed theimpact of kidney-related factors (anemia, plasma creatinine, disturbance of calcium-phosphorus metabolism). CKD progression wasassociated with elevation in the incidence of concentric and eccentric LVH). Patients with T2DM were diagnosed with LVH in 36% ofcases. Increased myocardial mass correlated with plasma levels of uric acid, HbA1c, obesity and albuminuria. There was also a firmassociation between diabetic nephropathy, left ventricular myocardial remodelling and a history of cardiovascular events. CONCLUSION: In patients with diabetes mellitus and CKD cardiorenal syndrome develops at pre-dialysis stages due to both classic and kidney-related cardiovascular risk factors.

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Presentation and outcomes of chronic kidney disease patients with COVID-19

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2021-0071 ◽

2021 ◽

Author(s):

Carolina Gonçalves Branco ◽

Inês Duarte ◽

Joana Gameiro ◽

Cláudia Costa ◽

Filipe Marques ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Multivariate Analysis ◽

Kidney Disease ◽

Clinical Presentation ◽

Tertiary Care ◽

Kidney Injury ◽

Older Age ◽

Global Health Issue ◽

Independent Risk Factors

Abstract Introduction: COVID-19 is currently a global health issue and an important cause of mortality. Chronic kidney disease (CKD) is one of the risk factors for infection, morbidity and mortality by SARS-CoV-2. In our study, we aimed to evaluate the clinical presentation and outcomes of CKD patients with COVID-19, as well as identify predictors of mortality. Methods: This was a retrospective study of CKD patients admitted in a tertiary-care Portuguese hospital between March and August of 2020. Variables were submitted to univariate and multivariate analysis to determine factors predictive of in-hospital mortality. Results: 130 CKD patients were analyzed (median age 73.9 years, male 60.0%). Hypertension (81.5%), cardiovascular disease (36.2%), and diabetes (54.6%) were frequent conditions. Cough, dyspnea, fever and respiratory failure were also common. Almost 60% had anemia, 50% hypoalbuminemia, 13.8% hyperlactacidemia and 17% acidemia. Mean serum ferritin was 1531 µg/L, mean CRP 8.3 mg/dL and mean LDH 336.9 U/L. Most patients were treated with lopinavir/ritonavir, hydroxychloroquine or corticosteroids and only 2 with remdesivir. Eighty percent had acute kidney injury and 16.2% required intensive care unit admission. The 34 patients who died were older and more likely to have heart failure. They had higher neutrophils/lymphocytes ratio, ferritin, lactate, and LDH levels. Multivariate analysis identified an association between older age [OR 1.1 (CI 1.01-1.24), p=0.027], higher ferritin [OR 1.0 (CI 1.00-1.00), p=0.009] and higher LDH levels [OR 1.0 (CI 1.00-1.01), p=0.014] and mortality. Conclusion: In our cohort of CKD patients with COVID-19, older age, higher ferritin, and higher LDH levels were independent risk factors for mortality.

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Chronic Kidney Disease and Associated Risk Factors Assessment among Diabetes Mellitus Patients at A Tertiary Hospital, Northwest Ethiopia

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v28i6.3 ◽

1970 ◽

Vol 28 (6) ◽

Author(s):

Shewaneh Damtie ◽

Belete Biadgo ◽

Habtamu Wondifraw Baynes ◽

Sintayehu Ambachew ◽

Tadele Melak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Systolic Blood Pressure ◽

Older Age ◽

Diabetic Patients ◽

Study Participants

BACKGROUND: The prevalence of chronic kidney disease, particularly in diabetic patients, is increasing rapidly throughout the world. Nowadays, many individuals in developing nations are suffering from diabetes which is one of the primary risk factors of chronic kidney disease.METHODS: Institution based cross-sectional study was conducted at the University of Gondar Hospital from February to April 2016. A total of 229 study participants were selected using systematic random sampling technique. Urine sample was collected for albumin determination by dipstick. The Simplified Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Binary logistic regression model was used to identify risk factors.RESULTS: Of the total 229 study participants, 50.2% were females and the mean age was 47±15.7 years. Among study participants, the prevalence of chronic kidney disease (CKD) was found to be 21.8% (95% CI: 16% - 27%). Of all study participants, 9(3.9%) had renal impairment (eGFR < 60 ml/min/ 1.73 m2) and 46 (20.1%) had albuminuria. Older age (AOR: 5.239, 95% CI: 2.255-12.175), systolic blood pressure ≥140mmHg (AOR: 3.633, 95% CI: 1.597-8.265), type 2 diabetes mellitus (AOR: 3.751, 95% CI: 1.507-9.336) and longer duration of diabetes (AOR: 3.380, 95% CI: 1.393-8.197) were independent risk factors of CKD.CONCLUSIONS: The study identified high prevalence (21.8%) of CKD among diabetic adults. CKD was significantly associated with older age, systolic blood pressure, type 2 DM and longer duration of DM. Thus, DM patients should be diagnosed for chronic kidney disease and then managed accordingly.

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TO020ASSESSMENT AND MANAGEMENT OF RISK FACTORS IN PEOPLE WITH CHRONIC KIDNEY DISEASE AND DIABETES MELLITUS MULTIMORBIDITY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw146.05 ◽

2016 ◽

Vol 31 (suppl_1) ◽

pp. i69-i69

Author(s):

Natalie Shur ◽

Rupert Major ◽

Dimitris Papamargaritis ◽

David Webb ◽

Kamlesh Khunti ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Management Of Risk

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Abstract 503: Chronic Kidney Disease is a Risk for Abdominal Aortic Aneurysm but Diabetes Mellitus is a Protective Factor in Japanese

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.503 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Hidemi Takeuchi ◽

Haruhito Uchida ◽

Michihiro Okuyama ◽

Ryoko Umebayashi ◽

Yuki Kakio ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Abdominal Aortic Aneurysm ◽

Kidney Disease ◽

Aortic Aneurysm ◽

Protective Factor ◽

Multivariate Logistic Regression Analysis ◽

Asian Population ◽

Abdominal Aortic

Objective: Abdominal aortic aneurysm (AAA) is the most common aortic aneurysm. Chronic kidney disease (CKD) and diabetes mellitus (DM) are considered as risk factors for cardiovascular diseases. However, the association between CKD and AAA remains unknown. Although DM has been reported to exert protective effect on the incidence and development of AAA in western population, such protective role of DM was not explored in the Asian population. The purpose of this study was to determine the relationship of CKD and DM and the presence of AAA. We performed a cross-sectional retrospective case-control study in Asian population. Methods and Results: We enrolled 261 patients with AAA (AAA+) and age-and-sex matched 261 patients without AAA (AAA-) at two hospitals between 2008 and 2014, and examined the association between the risk factors and the presence of AAA. Furthermore, to investigate AAA prevalencein each group, we enrolled 1126 patients with CKD and 400 patients with DM. The presence of CKD in patients with AAA+ was significantly higher than that in patients with AAA- (AAA+; 65 %, AAA-; 52 %, P = 0.004). The presence of DM in patients with AAA+ was significantly lower than that in patients with AAA- (AAA+; 17 %, AAA-; 35 %, P < 0.001). A multivariate logistic regression analysis demonstrated that hypertension, ischemic heart disease and CKD were independent determinants, whereas, DM was the only independent protective factor, for the presence of AAA. The prevalence of AAA in patients with CKD 65 years old and above was 5.1 %, whereas, that in patients with DM 65 years old and above was only 0.6 %. Conclusion: CKD is a positively associated with the presence of AAA. In contrast, DM is a negatively associated with the presence of AAA.

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Risk Factors for Infection Following Total Wrist Arthroplasty and Arthrodesis: An Analysis of 6641 Patients

Hand ◽

10.1177/1558944719890036 ◽

2019 ◽

pp. 155894471989003

Author(s):

Alyssa D. Althoff ◽

Russell A. Reeves ◽

Sophia A. Traven ◽

Harris S. Slone ◽

D. Nicole Deal ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Postoperative Infection ◽

Disease Risk ◽

International Classification Of Diseases ◽

Posttraumatic Arthritis ◽

Nationally Representative ◽

Wrist Arthroplasty

Background: Infection following wrist arthroplasty (WA) or wrist fusion (WF) is an uncommon but difficult complication often resulting in explantation and prolonged courses of antibiotics. The purposes of this study are to: (1) characterize the demographic trends of individuals undergoing WA and WF; (2) determine the incidence of postoperative infection; and (3) identify risk factors for postoperative infection. Methods: The PearlDiver database was used to query 100% Medicare Standard Analytic files from 2005 to 2014. Patients undergoing WA or radiocarpal WF were identified using Current Procedural Terminology (CPT) codes. Diagnosis for infection within 1 year of operative intervention was assessed by International Classification of Diseases, Ninth Revision codes or CPT codes related to infection. Multivariable logistic regression analyses were performed to evaluate the risk factors for postoperative infection. Results: Of the 6641 patients included, 1137 (17.1%) underwent arthroplasty and 5504 (82.9%) underwent arthrodesis. Within 1 year of the index procedure, 3.5% had a diagnosis of, or procedure for, postoperative infection (WA: n = 40 of 1137; WF: n = 192 of 5504). Risk factors for infection following WA include age >85, tobacco use, depression, diabetes mellitus, and chronic kidney disease. Risk factors following radiocarpal WF include male sex, age >85, body mass index <19 kg/m2, depression, diabetes mellitus, and chronic kidney disease. Posttraumatic origin of wrist arthritis was a risk factor for infection following both WA and WF. Conclusions: Infection following WA and WF is relatively uncommon in a nationally representative Medicare database cohort. Risk factors common to both WA and WF include age >85, depression, diabetes mellitus, chronic kidney disease, and posttraumatic arthritis.

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