Utilization of inpatient care before and after hip fracture: a population-based study

Abstract Background This nationwide population-based study sought to investigate the risk of spine and hip fracture in patients with inflammatory bowel diseases (IBD). Methods Using the 2007–2016 data from the Korean national health insurance claims database, we calculated incidence rate and incidence rate ratios (IRR) of spine and hip fracture in patients with IBD (n = 18,228; 64.1% male, 65.9% ulcerative colitis [UC]) compared with age- and sex- frequency matched subjects in 1:10 ratio (n = 186,871). A Cox regression model was used to evaluate risk of spine and hip fracture. Results The incidence rate and IRR of spine and hip fracture in IBD were 2.88/1000 person-years and 1.21 (95% confidence interval [CI], 1.11–1.31) during the median follow-up of 4.5 years. The risk for spine and hip fracture was significantly higher in UC (IRR 1.39, 95% CI, 1.25- 1.54), whereas it was not significantly higher in Crohn’s disease (IRR 0.85, 95% CI, 0.67- 1.06) than matched controls. In UC, the IRR of spine fracture was 1.41 (95% CI, 1.24–1.58) and the IRR of hip fracture was 1.40 (95% CI, 1.11–1.71). In multivariable analysis using the Cox regression model, the risk of spine and hip fracture increased with age (p trend < 0.001), in female patients (adjusted hazard ratio [aHR], 1.94; 95% CI, 1.50–2.51) and in patients with comorbidities including osteoporosis (aHR 2.86; 95% CI, 2.10–3.89), stroke (aHR 2.74; 95% CI, 1.78–4.21) hypertension (aHR 1.82; 95% CI, 1.38–2.41), diabetes mellitus (aHR 1.67; 95% CI, 1.25–2.24) and dyslipidaemia (aHR 1.36; 95% CI, 1.05–1.78). Conclusion In a population-based study from Korea, we found that the risk for spine and hip fracture increased in patients with IBD, especially in UC patients. Also, this risk increased in patients who are older, female, or have comorbidities.

Download Full-text

Chronic Viral Hepatitis Signifies the Association of Premixed Insulin Analogues with Liver Cancer Risks: A Nationwide Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122097 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2097 ◽

Cited By ~ 1

Author(s):

Chien-Hsieh Chiang ◽

Chia-Sheng Kuo ◽

Wan-Wan Lin ◽

Jun-Han Su ◽

Jin-De Chen ◽

...

Keyword(s):

Viral Hepatitis ◽

Population Based ◽

Insulin Analogues ◽

Chronic Viral Hepatitis ◽

Premixed Insulin ◽

Population Based Study ◽

Before And After ◽

Nested Case Control

This study sought to determine whether chronic hepatitis B or C would modify the association between insulin analogues and hepatocellular carcinoma (HCC) risks. We conducted a nationwide nested case-control study for HCC cases and matched controls from 2003 to 2013 among newly diagnosed type 2 diabetes patients on any antidiabetic agents in Taiwan before and after exclusion of chronic viral hepatitis, respectively. A total of 5832 and 1237 HCC cases were identified before and after exclusion of chronic viral hepatitis, respectively. Incident HCC risks were positively associated with any use of premixed insulin analogues (adjusted odds ratio (OR), 1.27; 95% CI 1.04 to 1.55) among total participants, especially among current users (adjusted OR, 1.45; 95% CI 1.12 to 1.89). However, the association between HCC occurrence and premixed insulin analogues diminished among participants without chronic viral hepatitis (adjusted OR, 1.35; 95% CI 0.92 to 1.98). We also observed a significant multiplicative interaction between chronic viral hepatitis and premixed insulin analogues on HCC risks (P = 0.010). Conclusions: Chronic viral hepatitis signifies the role of premixed insulin analogues in HCC oncogenesis. We recommend a closer liver surveillance among patients prescribed premixed insulin analogues with concomitant chronic viral hepatitis.

Download Full-text

Impact of combination MMRV vaccine on first-dose coverage for measles and varicella: a population-based study

Journal of Public Health ◽

10.1007/s10389-020-01379-9 ◽

2020 ◽

Author(s):

Shannon E. MacDonald ◽

Suzanne Tough ◽

Xiaoyan Guo ◽

James D. Kellner

Keyword(s):

Vaccine Coverage ◽

Varicella Vaccine ◽

Population Based ◽

Combination Vaccine ◽

Population Based Study ◽

Vaccine Introduction ◽

Opt Out ◽

Combination Vaccines ◽

Before And After ◽

To Receive

Abstract Aim Combination vaccines decrease the number of needles required, addressing a common concern of parents. However, some parents are hesitant about combination vaccines and/or want to opt out of certain vaccine components. This study assessed whether introduction of the combination MMRV vaccine influenced coverage levels for measles- and varicella-containing vaccines. Study and methods This was a population-based study of children born in Alberta, Canada between 2006 and 2012. We utilized administrative health data to evaluate coverage for the first dose of measles- and varicella-containing vaccines at the age of 24 months (i.e. between 2008 and 2014) before and after introduction of the combination MMRV vaccine in 2010. Among those who were vaccinated, we assessed whether any children continued to receive separate vaccines after the combination vaccine was introduced. Results Of 308,212 children, 272,345 (88.36%) were vaccinated with measles- and/or varicella-containing vaccines at the age of 24 months. Although coverage for measles-containing vaccines did not change overall between 2008 and 2014, coverage for varicella vaccine increased in the years following the introduction of MMRV. After the combination vaccine introduction, 96.55% of vaccinated children (n = 121,131) received MMRV vaccine. Conclusion Vaccine coverage for varicella increased after the introduction of the combination MMRV vaccine, and there was a narrowing in the gap between MMR and varicella coverage. Very few children received separate vaccines after the introduction of the combination MMRV vaccine. These findings suggest that combination vaccines are acceptable to most parents and increase coverage for varicella in our setting.

Download Full-text