title: Subdural hematoma in patients with end-stage renal disease receiving hemodialysis.
abstract: OBJECTIVE
  Hemodialysis (HD) may increase the risk of acute subdural hematoma (SDH) with high fatality, but the extent of this disease in non-western populations is unclear. The incidence of and fatality from SDH in patients with end-stage renal disease (ESRD) on HD were examined for an Asian population.
  
  
  METHODS
  A cohort of 4709 newly diagnosed ESRD patients on HD from 1998 to 2010 and a control cohort of 18 663 subjects without any kidney disease were identified from a universal insurance claims database in Taiwan. The incidence and hazard of SDH for the two cohorts and 30-day mortality from SDH were measured by the end of 2010.
  
  
  RESULTS
  The incidence of SDH was 4.47-fold higher in the HD cohort than in the control cohort (56.3 vs. 12.6 per 10 000 person-years) with an adjusted hazard ratio (HR) of 3.81 (95% CI 2.77-5.25). HD patients with SDH had a high odds of 30-day mortality with an adjusted odds ratio of 6.34 (95% CI 2.37-16.9).
  
  
  CONCLUSIONS
  ESRD patients with HD were demonstrated to be at high risk of subsequent SDH and to have a high mortality risk from SDH. Proper care for HD patients is necessary to prevent the devastating disorder.
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Department of Internal Medicine, China Medical University College of Medicine, Taichung, Taiwan; Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: I-K
authors.initials: IK
authors.lastname: Wang
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Wu
authors.forename: H-L
authors.initials: HL
authors.lastname: Kuo
authors.forename: S-Y
authors.initials: SY
authors.lastname: Lin
authors.forename: C-T
authors.initials: CT
authors.lastname: Chang
authors.forename: T-H
authors.initials: TH
authors.lastname: Yen
authors.forename: F-R
authors.initials: FR
authors.lastname: Chuang
authors.forename: Y-K
authors.initials: YK
authors.lastname: Cheng
authors.forename: C-C
authors.initials: CC
authors.lastname: Huang
authors.forename: F-C
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006408:Hematoma, Subdural / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000401:mortality; D013624:Taiwan / Q000453:epidemiology
keywords: cohort study; end-stage renal disease; hemodialysis; subdural hematoma