The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

Mavish S. Chaudry*, Gunnar H. Gislason, Anne Lise Kamper, Marianne Rix, Anders Dahl, Lauge Østergaard, Emil L. Fosbøl, Trine K. Lauridsen, Louise B. Oestergaard, Christian Hassager, Christian Torp-Pedersen, Niels E. Bruun

*Corresponding author for this work

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Abstract

Background: The risk of infective endocarditis (IE) is markedly increased in patients receiving chronic hemodialysis compared with the general population, but outcome data are sparse. The present study investigated causes and risk factors of mortality in a hemodialysis-treated end-stage kidney disease- (ESKD) and a non-ESKD population with staphylococcus (S.) aureus endocarditis. Methods: Hemodialysis-treated ESKD patients with S. aureus endocarditis were identified from Danish National Registries and Non-ESKD patients from The East Danish Database on Endocarditis. For establishing the cause of death The Danish Registry of Cause of Death was used. Independent risk factors of outcome were identified in multivariable Cox regression models. Results: One hundred twenty-one hemodialysis patients and 190 non-ESKD patients with S. aureus endocarditis were included during 1996-2012 and 2002-2012, respectively. The all-cause in-hospital mortality was 22.3% in hemodialysis- and 24.7% in non-ESKD patients. One-year mortality, excluding in-hospital mortality, was 26.4% in hemodialysis patients and 15.2% in non-ESKD patients. The hazard ratio of all-cause mortality in hemodialysis was 2.64 (95% CI 1.70-4.10) at > 70 days after admission compared with non-ESKD. Age (HR 1.03 (95% CI 1.02-1.04)) and diabetes mellitus (HR 2.17 (95% CI 1.54-3.10)) were independent risk factors of all-cause mortality. The hazard ratio of cardiovascular death in hemodialysis was 3.20 (95% CI 1.78-5.77) at > 81 days after admission compared with non-ESKD. Age and diabetes mellitus were independently related to cardiovascular death. Conclusion: All-cause in-hospital mortality rates were similar in hemodialysis and non-ESKD patients with S. aureus endocarditis whereas one-year mortality rates were significantly increased in the hemodialysis population.

Original languageEnglish
Article number216
JournalBMC Nephrology
Volume19
Number of pages10
ISSN1471-2369
DOIs
Publication statusPublished - 3. Sep 2018

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Kidney Diseases
Cause of Death
Hospital Mortality
Registries
Diabetes Mellitus
Population
Proportional Hazards Models
Databases

Keywords

  • Hemodialysis
  • Mortality
  • Staphylococcus aureus endocarditis
  • Renal Dialysis/mortality
  • Endocarditis, Bacterial/diagnosis
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Risk Factors
  • Male
  • Mortality/trends
  • Hospital Mortality/trends
  • Cause of Death/trends
  • Denmark/epidemiology
  • Kidney Failure, Chronic/diagnosis
  • Adult
  • Female
  • Registries
  • Staphylococcal Infections/diagnosis
  • Aged
  • Retrospective Studies
  • Staphylococcus aureus

Cite this

Chaudry, Mavish S. ; Gislason, Gunnar H. ; Kamper, Anne Lise ; Rix, Marianne ; Dahl, Anders ; Østergaard, Lauge ; Fosbøl, Emil L. ; Lauridsen, Trine K. ; Oestergaard, Louise B. ; Hassager, Christian ; Torp-Pedersen, Christian ; Bruun, Niels E. / The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis. In: BMC Nephrology. 2018 ; Vol. 19.
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title = "The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis",
abstract = "Background: The risk of infective endocarditis (IE) is markedly increased in patients receiving chronic hemodialysis compared with the general population, but outcome data are sparse. The present study investigated causes and risk factors of mortality in a hemodialysis-treated end-stage kidney disease- (ESKD) and a non-ESKD population with staphylococcus (S.) aureus endocarditis. Methods: Hemodialysis-treated ESKD patients with S. aureus endocarditis were identified from Danish National Registries and Non-ESKD patients from The East Danish Database on Endocarditis. For establishing the cause of death The Danish Registry of Cause of Death was used. Independent risk factors of outcome were identified in multivariable Cox regression models. Results: One hundred twenty-one hemodialysis patients and 190 non-ESKD patients with S. aureus endocarditis were included during 1996-2012 and 2002-2012, respectively. The all-cause in-hospital mortality was 22.3{\%} in hemodialysis- and 24.7{\%} in non-ESKD patients. One-year mortality, excluding in-hospital mortality, was 26.4{\%} in hemodialysis patients and 15.2{\%} in non-ESKD patients. The hazard ratio of all-cause mortality in hemodialysis was 2.64 (95{\%} CI 1.70-4.10) at > 70 days after admission compared with non-ESKD. Age (HR 1.03 (95{\%} CI 1.02-1.04)) and diabetes mellitus (HR 2.17 (95{\%} CI 1.54-3.10)) were independent risk factors of all-cause mortality. The hazard ratio of cardiovascular death in hemodialysis was 3.20 (95{\%} CI 1.78-5.77) at > 81 days after admission compared with non-ESKD. Age and diabetes mellitus were independently related to cardiovascular death. Conclusion: All-cause in-hospital mortality rates were similar in hemodialysis and non-ESKD patients with S. aureus endocarditis whereas one-year mortality rates were significantly increased in the hemodialysis population.",
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author = "Chaudry, {Mavish S.} and Gislason, {Gunnar H.} and Kamper, {Anne Lise} and Marianne Rix and Anders Dahl and Lauge {\O}stergaard and Fosb{\o}l, {Emil L.} and Lauridsen, {Trine K.} and Oestergaard, {Louise B.} and Christian Hassager and Christian Torp-Pedersen and Bruun, {Niels E.}",
year = "2018",
month = "9",
day = "3",
doi = "10.1186/s12882-018-1016-0",
language = "English",
volume = "19",
journal = "B M C Nephrology",
issn = "1471-2369",
publisher = "BioMed Central",

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Chaudry, MS, Gislason, GH, Kamper, AL, Rix, M, Dahl, A, Østergaard, L, Fosbøl, EL, Lauridsen, TK, Oestergaard, LB, Hassager, C, Torp-Pedersen, C & Bruun, NE 2018, 'The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis', BMC Nephrology, vol. 19, 216. https://doi.org/10.1186/s12882-018-1016-0

The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis. / Chaudry, Mavish S.; Gislason, Gunnar H.; Kamper, Anne Lise; Rix, Marianne; Dahl, Anders; Østergaard, Lauge; Fosbøl, Emil L.; Lauridsen, Trine K.; Oestergaard, Louise B.; Hassager, Christian; Torp-Pedersen, Christian; Bruun, Niels E.

In: BMC Nephrology, Vol. 19, 216, 03.09.2018.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

AU - Chaudry, Mavish S.

AU - Gislason, Gunnar H.

AU - Kamper, Anne Lise

AU - Rix, Marianne

AU - Dahl, Anders

AU - Østergaard, Lauge

AU - Fosbøl, Emil L.

AU - Lauridsen, Trine K.

AU - Oestergaard, Louise B.

AU - Hassager, Christian

AU - Torp-Pedersen, Christian

AU - Bruun, Niels E.

PY - 2018/9/3

Y1 - 2018/9/3

N2 - Background: The risk of infective endocarditis (IE) is markedly increased in patients receiving chronic hemodialysis compared with the general population, but outcome data are sparse. The present study investigated causes and risk factors of mortality in a hemodialysis-treated end-stage kidney disease- (ESKD) and a non-ESKD population with staphylococcus (S.) aureus endocarditis. Methods: Hemodialysis-treated ESKD patients with S. aureus endocarditis were identified from Danish National Registries and Non-ESKD patients from The East Danish Database on Endocarditis. For establishing the cause of death The Danish Registry of Cause of Death was used. Independent risk factors of outcome were identified in multivariable Cox regression models. Results: One hundred twenty-one hemodialysis patients and 190 non-ESKD patients with S. aureus endocarditis were included during 1996-2012 and 2002-2012, respectively. The all-cause in-hospital mortality was 22.3% in hemodialysis- and 24.7% in non-ESKD patients. One-year mortality, excluding in-hospital mortality, was 26.4% in hemodialysis patients and 15.2% in non-ESKD patients. The hazard ratio of all-cause mortality in hemodialysis was 2.64 (95% CI 1.70-4.10) at > 70 days after admission compared with non-ESKD. Age (HR 1.03 (95% CI 1.02-1.04)) and diabetes mellitus (HR 2.17 (95% CI 1.54-3.10)) were independent risk factors of all-cause mortality. The hazard ratio of cardiovascular death in hemodialysis was 3.20 (95% CI 1.78-5.77) at > 81 days after admission compared with non-ESKD. Age and diabetes mellitus were independently related to cardiovascular death. Conclusion: All-cause in-hospital mortality rates were similar in hemodialysis and non-ESKD patients with S. aureus endocarditis whereas one-year mortality rates were significantly increased in the hemodialysis population.

AB - Background: The risk of infective endocarditis (IE) is markedly increased in patients receiving chronic hemodialysis compared with the general population, but outcome data are sparse. The present study investigated causes and risk factors of mortality in a hemodialysis-treated end-stage kidney disease- (ESKD) and a non-ESKD population with staphylococcus (S.) aureus endocarditis. Methods: Hemodialysis-treated ESKD patients with S. aureus endocarditis were identified from Danish National Registries and Non-ESKD patients from The East Danish Database on Endocarditis. For establishing the cause of death The Danish Registry of Cause of Death was used. Independent risk factors of outcome were identified in multivariable Cox regression models. Results: One hundred twenty-one hemodialysis patients and 190 non-ESKD patients with S. aureus endocarditis were included during 1996-2012 and 2002-2012, respectively. The all-cause in-hospital mortality was 22.3% in hemodialysis- and 24.7% in non-ESKD patients. One-year mortality, excluding in-hospital mortality, was 26.4% in hemodialysis patients and 15.2% in non-ESKD patients. The hazard ratio of all-cause mortality in hemodialysis was 2.64 (95% CI 1.70-4.10) at > 70 days after admission compared with non-ESKD. Age (HR 1.03 (95% CI 1.02-1.04)) and diabetes mellitus (HR 2.17 (95% CI 1.54-3.10)) were independent risk factors of all-cause mortality. The hazard ratio of cardiovascular death in hemodialysis was 3.20 (95% CI 1.78-5.77) at > 81 days after admission compared with non-ESKD. Age and diabetes mellitus were independently related to cardiovascular death. Conclusion: All-cause in-hospital mortality rates were similar in hemodialysis and non-ESKD patients with S. aureus endocarditis whereas one-year mortality rates were significantly increased in the hemodialysis population.

KW - Hemodialysis

KW - Mortality

KW - Staphylococcus aureus endocarditis

KW - Renal Dialysis/mortality

KW - Endocarditis, Bacterial/diagnosis

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Risk Factors

KW - Male

KW - Mortality/trends

KW - Hospital Mortality/trends

KW - Cause of Death/trends

KW - Denmark/epidemiology

KW - Kidney Failure, Chronic/diagnosis

KW - Adult

KW - Female

KW - Registries

KW - Staphylococcal Infections/diagnosis

KW - Aged

KW - Retrospective Studies

KW - Staphylococcus aureus

U2 - 10.1186/s12882-018-1016-0

DO - 10.1186/s12882-018-1016-0

M3 - Journal article

C2 - 30176809

AN - SCOPUS:85052753937

VL - 19

JO - B M C Nephrology

JF - B M C Nephrology

SN - 1471-2369

M1 - 216

ER -