| Summary: | 碩士 === 國立中山大學 === 醫務管理研究所 === 98 === Background: The prevalence of patients with end stage renal disease (ESRD) in Taiwan has risen to the first in the world in recent years. Non-traumatic lower extremity lesion is a common disease of diabetic and ESRD patients. Many studies have found that the prevalence of non-traumatic lower extremity lesion in diabetic patients with ESRD is higher than normal diabetic patients. Prevention the incidence of lower extremity lesions in patients with ESRD may prevent patients from further amputation.
Objectives: This study explored the prevalence of ESRD with Non-traumatic lower extremity lesion. We focused on demography status, comorbidities, dialysis therapies and utilization of health care to define the risk factors of disease.
Methods: This study conducted secondary data analysis with administrative data from Bureau of National Health Insurance (HV_CD data) for four years (2000, 2002, 2004 and 2006). In total, there were 57021, 75711, 76750, and 86902 for years 2000, 2002, 2004, and 2006, respectively. To attain the research purposes, descriptive analyses and logistic regression were performed.
Result: The prevalence of ESRD with non-traumatic lower extremity lesion for the four years were 1.30%, 1.44%, 2.71% and 2.45%, respectively. ESRD patients with and without non-traumatic lower extremity lesion were significant difference between comorbidities (OR for the four years were 2.06, 1.98, 1.86 and 1.83), dialysis therapies (hemodialysis / peritoneal dialysis, OR for the four years were 17.1, 16.79, 15.12 and 9.23) and duration of dialysis (1-5 years / 5 years and more, OR was 1.39 in 2002).There were significant differences in regions of hospital organizations (compared with the north, OR were 0.67 in the center in 2000, 1.47 in the east in 2002 and 0.87 in the center in 2006), class of hospital organizations (compared with Academic Medical Centers, OR were 1.40 in Regional Hospitals, 1.50 in District Hospitals and 0.36 in Physician Clinics in 2000, 0.18 in Physician Clinics in 2002, 0.76 in Regional Hospitals, 0.78 in District Hospitals and 0.23 in Physician Clinics in 2004, 0.66 in Regional Hospitals, 0.75 in District Hospitals and 0.26 in Physician Clinics in 2006 ) and outpatient visits ( positive correlation in all years except 2000).
Conclusion: The risk factors of suffering non-traumatic lower extremity lesion in ESRD patients are comorbidities, dialysis therapies and duration of dialysis. In the part of regions of hospital organizations, the east region has higher and the center region has lower probability of suffering the disease, comparing with the north region. Academic Medical Centers has the highest probability to find ESRD patients with non-traumatic lower extremity lesion. We also found the numbers of outpatient visits were increasing with the disease. Based on the results, we highly suggest that caregivers from dialysis units have to pay great attention in taking care of the ESRD patients with non-traumatic lower extremity lesion to prevent from the further amputation.
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