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High Risk of Peritonsillar Abscess in End-Stage Renal Disease Patients: A Nationwide Real-World Cohort Study

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  • Geng-He Chang

    (Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Ang Lu

    (Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Yao-Hsu Yang

    (Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Department of Traditional Chinese Medicine, Chiayi Branch of Chang-Gung Memorial Hospital, Chiayi 613, Taiwan
    School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Chia-Yen Liu

    (Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Pey-Jium Chang

    (Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Chuan-Pin Lee

    (Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Yao-Te Tsai

    (Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Cheng-Ming Hsu

    (Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Ching-Yuan Wu

    (Department of Traditional Chinese Medicine, Chiayi Branch of Chang-Gung Memorial Hospital, Chiayi 613, Taiwan
    School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Wei-Tai Shih

    (Department of Traditional Chinese Medicine, Chiayi Branch of Chang-Gung Memorial Hospital, Chiayi 613, Taiwan
    School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Ming-Shao Tsai

    (Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

Abstract

Background: Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However, no relevant research has focused on the ESRD–PTA relationship. This study explored PTA in ESRD patients and their prognosis. Methods: We identified 157,026 patients diagnosed as having ESRD over January 1997 to December 2013 from Taiwan’s National Health Insurance Research Database (NHIRD). Each patient with ESRD (hereafter, patients) was matched with one control without chronic kidney disease (CKD; hereafter, controls) by sex, age, urbanization level, and income. Next, PTA incidence until death or the end of 2013 was compared between the two groups, and the relative risk of PTA was analyzed using a multiple logistic regression model. Results: The patients had a significantly higher PTA incidence than did the controls (incidence rate ratio: 2.02, 95% confidence interval [CI]: 1.40–2.91, p < 0.001). The Kaplan–Meier analysis revealed that the patients had a higher cumulative incidence of PTA than did the controls ( p < 0.001). In Cox regression analysis, the patients had nearly twofold higher PTA risk (adjusted hazard ratio [HR]: 1.98, 95% CI: 1.37–2.86, p < 0.001). The between-group differences in the PTA-related hospital stay length (8.1 ± 10.3 days in patients and 5.7 ± 4.6 days in controls, p = 0.09), consequent deep-neck infection complication (4.2% in patients and 6.3% in controls, p = 0.682), and mortality (0.0% in both groups) were nonsignificant. Conclusions: Although ESRD does not predict a poor prognosis of PTA, it is an independent PTA risk factor.

Suggested Citation

  • Geng-He Chang & Ang Lu & Yao-Hsu Yang & Chia-Yen Liu & Pey-Jium Chang & Chuan-Pin Lee & Yao-Te Tsai & Cheng-Ming Hsu & Ching-Yuan Wu & Wei-Tai Shih & Ming-Shao Tsai, 2021. "High Risk of Peritonsillar Abscess in End-Stage Renal Disease Patients: A Nationwide Real-World Cohort Study," IJERPH, MDPI, vol. 18(13), pages 1-10, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:13:p:6775-:d:581057
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    References listed on IDEAS

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    1. Chi-Shin Wu & Mei-Shu Lai & Susan Shur-Fen Gau & Sheng-Chang Wang & Hui-Ju Tsai, 2014. "Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
    2. Ming-Shao Tsai & Geng-He Chang & Wei-Ming Chen & Chia-Yen Liu & Meng-Hung Lin & Pey-Jium Chang & Tsung-Yu Huang & Yao-Te Tsai & Ching-Yuan Wu & Cheng-Ming Hsu & Yao-Hsu Yang, 2019. "The Association Between Decompensated Liver Cirrhosis and Deep Neck Infection: Real-World Evidence," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
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