Patients with appendectomy are at increased risk of herpes zoster: real-world data in Taiwan

Abstract Background It is estimated that 223,900 cases of CDI occur annually in hospitalized patients resulting in 12,800 deaths and $1 billion in attributable costs. Antimicrobial use is a risk factor for CDI and the antimicrobials ordered to treat urinary tract infections have been identified as a factor in both recurrent CDI and community-acquired CDI. This real-world data analysis seeks to explore the relationship between HA-UTI and hospital-onset CDI (HO-CDI). Methods An electronic infection surveillance system was the source of de-identified real-world data from 290 hospitals. Algorithmically-derived measures of healthcare-associated infections (ADM-HAIs), and records of all-cause antimicrobial orders, for all inpatient admissions for the period 10/1/18–9/30/19 were analyzed. All patients who presented with a urine ADM-HAI – suggestive of HA-UTI – and no other healthcare-associated infection (Urine+ patients), were observed for subsequent HO-CDI. Urine+ patients were compared to patients with no HAI of any type, other than CDI (HAI-free patients), and relative risk (RR) was estimated. The analysis was repeated for the subgroup of patients who received an antimicrobial order for any reason during their stay. Results 3,050,525 inpatient admissions were analyzed. 26,634 were identified as Urine+ patients. 188 of those patients subsequently presented with HO-CDI. 2,978,507 were identified as HAI-free patients. 6,238 of those patients presented with HO-CDI. The incidence of HO-CDI was significantly higher in Urine+ patients compared to HAI-free patients (RR=3.37, 95% CL[2.92, 3.89], p< 0.0001). When the analysis was repeated to examine only patients who received antimicrobial orders, Urine+ patients continued to be at higher risk of subsequent HO-CDI compared to HAI-free patients (RR=3.28, 95% CL[2.74,3.92], p< 0.0001). Conclusion The presence of a urine ADM-HAI, suggestive of HA-UTI, was associated with an increased risk of subsequent HO-CDI. This held when only patients with antimicrobial orders were considered. These observations mirror findings from other published studies, however, other factors may have contributed to increased risk for both HA-UTI and HO-CDI. Disclosures Timothy Kelly, MS, MBA, BD (Employee) ChinEn Ai, MPH, BD (Employee) John Murray, MPH, BD (Employee) Yan Xiong, n/a, BD (Becton Dickinson) (Employee) Hanna Jokinen-Gordon, PhD, BD (Employee)

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Increased Risk of Osteoporosis In Depressed Patients: A Real World Data Study Conducted In Italy

Value in Health ◽

10.1016/j.jval.2015.09.2248 ◽

2015 ◽

Vol 18 (7) ◽

pp. A634

Author(s):

F Heiman ◽

R Moretti ◽

V Pegoraro ◽

N Cataldo

Keyword(s):

Real World ◽

Real World Data ◽

World Data ◽

Depressed Patients ◽

Increased Risk

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Association of baseline characteristics and survival in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (CPIs): Real-world evidence.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21625 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21625-e21625

Author(s):

Danielle Crawley ◽

Kerri Beckmann ◽

Saranya Ravindra ◽

Debra Hannah Josephs ◽

James F. Spicer ◽

...

Keyword(s):

Brain Metastases ◽

Real World ◽

Checkpoint Inhibitors ◽

Definitive Treatment ◽

Real World Data ◽

World Data ◽

Risk Of Death ◽

Mutational Status ◽

Increased Risk ◽

Baseline Characteristics

e21625 Background: CPIs including antibodies to programmed death-1 (PD-1) and its ligand anti PD-L1 are associated with superior overall survival (OS) in NSCLC. PDL1 is an imperfect predictive biomarker. We have examined real world data to identify additional factors associated with clinical benefit. Methods: 96 consecutive NSCLC patients (pts) were treated with CPIs at our institution. Multivariate cox proportional hazard regression models were used to examine the associations between OS and baseline characteristics including age, sex, histology, PDL1 status, performance status (PS), steroid use and brain metastases. Results: 93% (89/96) of pts received pembroluzimab, 6 (6%) nivolumab, and 1 (1%) atezoluzimab. All pts had metastatic disease (68% adenocarcinoma). 15% had PS 0, and 70% PS1. 11 of the 96 pts had brain metastases prior to CPI, 4 (37%) had whole brain radiotherapy, 2 (18%) targeted radiotherapy, 2 (18%) resection with radiotherapy and 3 (27%) had no definitive treatment for brain metastases. After multivariate analysis those with PS 1-2 had an increased risk of death (PS = 1 HR 2.74, 95% CI 1.11-6.72; PS = 2 3.61, 95% CI 1.28-10.15) compared with PS 0. Outcomes for pts receiving corticosteroids at the time of initiation of CPI were also inferior (HR 2.29, 95% CI 1.10-4.74) compared to those who were not. Conversely those who had brain metastasis diagnosed prior to commencing CPI had superior OS (HR 0.29 95% CI: 0.11-0.76). No statistically significant association was seen with age, gender, histology, stage at diagnosis, smoking or mutational status. PDL < 50% compared to > 50% was associated with an increased risk of death (HR 1.53 95% CI: 0.90-2.60) though it was not statistically significant. Conclusions: Here we show, using real world data, that PS and use at baseline of oral corticosteroids are associated with inferior OS with CPI treatment for NSCLC, in line with reports from large clinical trials. We show that baseline brain metastases are associated with improved outcomes. This may be explained by survivor bias, in that those who are successfully treated for brain disease, remain PS ≤2 and are able to commence CPI represent a highly selected group.

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Second primary malignancies in ruxolitinib-treated myelofibrosis: real-world evidence from 219 consecutive patients

Blood Advances ◽

10.1182/bloodadvances.2019000646 ◽

2019 ◽

Vol 3 (21) ◽

pp. 3196-3200 ◽

Cited By ~ 4

Author(s):

Margherita Maffioli ◽

Toni Giorgino ◽

Barbara Mora ◽

Alessandra Iurlo ◽

Elena Elli ◽

...

Keyword(s):

Real World ◽

Second Primary ◽

Real World Data ◽

World Data ◽

Real World Evidence ◽

Increased Risk ◽

Key Points ◽

Second Primary Malignancies

Key Points We present real-world data on all ruxolitinib-treated myelofibrosis patients in a 10-million-resident region, with a follow-up of 2 years. We found no evidence of an increased risk of developing lymphomas.

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Children with appendectomy have increased risk of future sepsis: Real‐world data in Taiwan

International Journal of Clinical Practice ◽

10.1111/ijcp.14912 ◽

2021 ◽

Author(s):

Tzu‐Han Liao ◽

Cheng‐Li Lin ◽

Chien‐Heng Lin ◽

Meng‐Che Wu ◽

James Cheng‐Chung Wei

Keyword(s):

Real World ◽

Real World Data ◽

World Data ◽

Increased Risk

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Antipsychotics during pregnancy and increased risk of congenital malformation in offspring: toward a systematic use of real-world data

The Lancet Regional Health - Europe ◽

10.1016/j.lanepe.2021.100257 ◽

2021 ◽

Vol 11 ◽

pp. 100257

Author(s):

Guillaume Fond ◽

Damien Etchecopar-Etchart ◽

Julie Blanc ◽

Laurent Boyer

Keyword(s):

Congenital Malformation ◽

Real World ◽

Real World Data ◽

World Data ◽

Increased Risk

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Predicting time to relapse in patients with schizophrenia according to patients’ relapse history: a historical cohort study using real-world data in Sweden

BMC Psychiatry ◽

10.1186/s12888-021-03634-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kristian Tore Jørgensen ◽

Martin Bøg ◽

Madhu Kabra ◽

Jacob Simonsen ◽

Michael Adair ◽

...

Keyword(s):

Disease Progression ◽

Real World ◽

Real World Data ◽

Historical Cohort ◽

World Data ◽

Drug Register ◽

Increased Risk ◽

History Of ◽

The Individual ◽

Time To Relapse

Abstract Background For patients with schizophrenia, relapse is a recurring feature of disease progression, often resulting in substantial negative impacts for the individual. Although a patient’s relapse history (specifically the number of prior relapses) has been identified as a strong risk factor for future relapse, this relationship has not yet been meticulously quantified. The objective of this study was to use real-world data from Sweden to quantify the relationship of time to relapse in schizophrenia with a patient’s history of prior relapses. Methods Data from the Swedish National Patient Register and Swedish Prescribed Drug Register were used to study relapse in patients with schizophrenia with a first diagnosis recorded from 2006–2015, using proxy definitions of relapse. The primary proxy defined relapse as a psychiatric hospitalisation of ≥7 days’ duration. Hazard ratios (HRs) were calculated for risk of each subsequent relapse, and Aalen-Johansen estimators were used to estimate time to next relapse. Results 2,994 patients were included, and 5,820 relapse episodes were identified using the primary proxy. As the number of previous relapses increased, there was a general trend of decreasing estimated time between relapses. Within 1.52 years of follow-up, 50% of patients with no history of relapse were estimated to have suffered their first relapse episode. 50% of patients with one prior relapse were estimated to have a second relapse within 1.23 years (HR: 1.84 [1.71–1.99]) and time to next relapse further decreased to 0.89 years (HR: 2.77 [2.53–3.03]) and 0.22 years (HR: 18.65 [15.42–22.56]) for 50% of patients with two or ten prior relapses, respectively. Supplementary analyses using different inclusion/exclusion criteria for the study population and redefined proxies of relapse reflected the pattern observed with the primary analyses of a higher number of prior relapses linked with increased risk of/reduced estimated time to the next relapse. Conclusions The results suggested a trend of accelerating disease progression in schizophrenia, each relapse episode predisposing an individual to the next within a shorter time period. These results emphasise the importance of providing early, effective, and tolerable treatments that better meet a patient’s individual needs.

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