透析前慢性肾脏病患者患肺炎的风险：台湾一项基于人群的队列研究
Risk of contracting pneumonia among patients with predialysis chronic kidney disease: a population-based cohort study in Taiwan.
作者信息
Lai Shih-Wei, Lin Cheng-Li, Liao Kuan-Fu
机构信息
College of Medicine, China Medical University, Taichung 404, Taiwan - Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan.
College of Medicine, China Medical University, Taichung 404, Taiwan - Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
出版信息
Biomedicine (Taipei). 2017 Sep;7(3):20. doi: 10.1051/bmdcn/2017070320. Epub 2017 Aug 25.
OBJECTIVES
The objective of the study was to investigate the association between predialysis chronic kidney disease and contracting pneumonia in Taiwan.
METHODS
We employed a population-based, retrospective cohort design using the database of the Taiwan National Health Insurance (NHI) Program. There were 18807 subjects aged 20-84 years who were newly diagnosed with predialysis chronic kidney disease between 2000 to 2012 as the predialysis chronic kidney disease group and 18807 randomly selected subjects without chronic kidney disease as the non-chronic kidney disease group. The predialysis chronic kidney disease and non-chronic kidney disease groups were matched according to sex, age, comorbidities, and the year of index date. The incidence of contracting pneumonia among both groups at the end of 2013 was calculated. The multivariable Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for contracting pneumonia being associated with predialysis chronic kidney disease.
RESULTS
The overall incidence of contracting pneumonia was 1.47-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (24.6 vs. 16.7 per 1, 000 person-years, 95% CI 1.40, 1.55). After adjusting for co-variables, the HR of contracting pneumonia became 1.52 for subjects with predialysis chronic kidney disease (95% CI 1.43, 1.60) compared to subjects without chronic kidney disease. With even further analysis, in the absence of any comorbidity, the adjusted HR of contracting pneumonia was 1.53 for subjects with predialysis chronic kidney disease alone (95% CI 1.32, 1.76).
CONCLUSIONS
Patients with predialysis chronic kidney disease have a 1.52-fold increased risk of contracting pneumonia as compared to those with non-chronic kidney disease. Even in the absence of any comorbidity, a greater than average risk of contracting pneumonia remains present.
目的
本研究的目的是调查台湾透析前慢性肾脏病与患肺炎之间的关联。
方法
我们采用基于人群的回顾性队列设计，使用台湾全民健康保险（NHI）计划的数据库。有18807名年龄在20 - 84岁之间的受试者在2000年至2012年期间新诊断为透析前慢性肾脏病，作为透析前慢性肾脏病组，另有18807名随机选择的无慢性肾脏病的受试者作为非慢性肾脏病组。透析前慢性肾脏病组和非慢性肾脏病组根据性别、年龄、合并症和索引日期年份进行匹配。计算两组在2013年底患肺炎的发病率。使用多变量Cox比例风险回归模型计算与透析前慢性肾脏病相关的患肺炎的风险比（HR）和95%置信区间（CI）。
结果
透析前慢性肾脏病组患肺炎的总体发病率比非慢性肾脏病组高1.47倍（每1000人年分别为24.6例和16.7例，95% CI 1.40, 1.55）。在调整协变量后，与无慢性肾脏病的受试者相比，透析前慢性肾脏病受试者患肺炎的HR为1.52（95% CI 1.43, 1.60）。进一步分析发现，在无任何合并症的情况下，仅患有透析前慢性肾脏病的受试者患肺炎的调整后HR为1.53（95% CI 1.32, 1.76）。
结论
与非慢性肾脏病患者相比，透析前慢性肾脏病患者患肺炎的风险增加了1.52倍。即使在无任何合并症的情况下，患肺炎的风险仍高于平均水平。
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