Relationship between hospital volume and hemorrhagic complication after percutaneous renal biopsy: results from the Japanese diagnosis procedure combination database

Hiroyuki Yamamoto, Hideki Hashimoto, Mitsuhiro Nakamura, Hiromasa Horiguchi, Hideo Yasunaga

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although hemorrhagic complications are major complications of percutaneous renal biopsy (PRB), the relationship between procedure volume and morbidity remains unclear for PRB. The present study investigated the impact of hospital volume on the occurrence of hemorrhagic complications after PRB. Methods: Using large claims-based data in the diagnosis procedure combination database in Japan, we identified inpatients with renal disorders who underwent PRB within 4 days after admission during July to December 2007 to 2010. We assessed patient age, sex, clinical syndromes, hemorrhagic complications and diagnoses, and annual hospital volume of PRB divided into quintiles. Multivariate logistic regression analyses fitted with a generalized estimation equation were performed accounting for within-hospital clustering. Results: A total of 15,191 patients were identified from 942 hospitals. The overall proportion of hemorrhagic complications was 2.1 %, including diagnoses of hemorrhagic events (1.6 %), red blood cell transfusion (0.5 %), and requiring angiography or endovascular procedure (0.1 %). In-hospital deaths attributable to the complications occurred in 0.06 % of the patients. Patients with rapidly progressive nephritic syndrome (odds ratio 3.41, 95 % confidence interval 2.22–5.25) had significantly higher incidence than those with chronic nephritic syndrome. No significant association was observed between hospital volume and hemorrhagic complications, with odds ratios for the low-intermediate, intermediate, intermediate-high, and high-volume groups relative to the low-volume group of 0.74 (0.43–1.26), 1.19 (0.74–1.92), 1.16 (0.67–2.00), and 1.35 (0.78–2.34), respectively. Conclusions: No significant relationship was observed between hemorrhagic complication incidence and hospital volume regarding PRB.

Original languageEnglish
Pages (from-to)271-277
Number of pages7
JournalClinical and Experimental Nephrology
Volume19
Issue number2
DOIs
Publication statusPublished - 2015 Apr 1
Externally publishedYes

Fingerprint

Databases
Kidney
Biopsy
Odds Ratio
Erythrocyte Transfusion
Endovascular Procedures
Incidence
Cluster Analysis
Inpatients
Angiography
Japan
Logistic Models
Regression Analysis
Confidence Intervals
Morbidity

Keywords

  • Hemorrhagic complications
  • Hospital volume
  • Renal biopsy
  • Risk factor
  • Volume–outcome relationship

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Relationship between hospital volume and hemorrhagic complication after percutaneous renal biopsy : results from the Japanese diagnosis procedure combination database. / Yamamoto, Hiroyuki; Hashimoto, Hideki; Nakamura, Mitsuhiro; Horiguchi, Hiromasa; Yasunaga, Hideo.

In: Clinical and Experimental Nephrology, Vol. 19, No. 2, 01.04.2015, p. 271-277.

Research output: Contribution to journalArticle

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abstract = "Background: Although hemorrhagic complications are major complications of percutaneous renal biopsy (PRB), the relationship between procedure volume and morbidity remains unclear for PRB. The present study investigated the impact of hospital volume on the occurrence of hemorrhagic complications after PRB. Methods: Using large claims-based data in the diagnosis procedure combination database in Japan, we identified inpatients with renal disorders who underwent PRB within 4 days after admission during July to December 2007 to 2010. We assessed patient age, sex, clinical syndromes, hemorrhagic complications and diagnoses, and annual hospital volume of PRB divided into quintiles. Multivariate logistic regression analyses fitted with a generalized estimation equation were performed accounting for within-hospital clustering. Results: A total of 15,191 patients were identified from 942 hospitals. The overall proportion of hemorrhagic complications was 2.1 {\%}, including diagnoses of hemorrhagic events (1.6 {\%}), red blood cell transfusion (0.5 {\%}), and requiring angiography or endovascular procedure (0.1 {\%}). In-hospital deaths attributable to the complications occurred in 0.06 {\%} of the patients. Patients with rapidly progressive nephritic syndrome (odds ratio 3.41, 95 {\%} confidence interval 2.22–5.25) had significantly higher incidence than those with chronic nephritic syndrome. No significant association was observed between hospital volume and hemorrhagic complications, with odds ratios for the low-intermediate, intermediate, intermediate-high, and high-volume groups relative to the low-volume group of 0.74 (0.43–1.26), 1.19 (0.74–1.92), 1.16 (0.67–2.00), and 1.35 (0.78–2.34), respectively. Conclusions: No significant relationship was observed between hemorrhagic complication incidence and hospital volume regarding PRB.",
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AU - Yamamoto, Hiroyuki

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AU - Yasunaga, Hideo

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KW - Hemorrhagic complications

KW - Hospital volume

KW - Renal biopsy

KW - Risk factor

KW - Volume–outcome relationship

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