Persistence and adherence to rivastigmine in patients with dementia: Results from a noninterventional, retrospective study using the National Health Insurance research database of Taiwan

Background: Patients with adhesive capsulitis are evaluated for pain and progressive contracture of the glenohumeral joint. Whether endocrine, immune, or inflammatory processes are involved in its definite pathogenesis is still under debate. Some cross-sectional studies with a small sample size have noted that hyperlipidemia is a possible risk factor for frozen shoulders. Purpose/Hypothesis: The purpose was to conduct a longitudinal population-based study to investigate the risk of adhesive capsulitis among patients with hyperlipidemia. It was hypothesized that patients with hyperlipidemia would have a higher risk of adhesive capsulitis and that the use of statin drugs could reduce the rate. Study Design: Cohort study; Level of evidence, 3. Methods: Using data from the National Health Insurance Research Database (NHIRD) of Taiwan, the authors obtained the records of patients with hyperlipidemia who received a diagnosis between 2004 and 2005 and were followed up until the end of 2010. The control cohort comprised age- and sex-matched patients without hyperlipidemia. Propensity score matching was performed for the other comorbidities. A Cox multivariate proportional hazards model was applied to analyze the risk factors of adhesive capsulitis. The hazard ratio (HR) and adjusted HR were estimated between the study and control cohorts after adjustment for confounders. The effects of statin use on adhesive capsulitis risk were also analyzed. Results: The NHIRD records of 28,748 patients and 114,992 propensity score–matched controls were evaluated. A higher incidence rate of adhesive capsulitis was revealed in the hyperlipidemia cohort, with a crude HR of 1.70 (95% CI, 1.61-1.79; P < .001) and adjusted HR of 1.50 (95% CI, 1.41-1.59; P < .001). Patients with hyperlipidemia who used a statin still had higher crude and adjusted HRs compared with controls. Statin use did not exert protective effects on patients with hyperlipidemia. Conclusion: Patients with hyperlipidemia had a 1.5-fold higher risk of adhesive capsulitis than did healthy controls. Statin use did not provide protection against adhesive capsulitis in patients with hyperlipidemia.

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Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211041226 ◽

2021 ◽

pp. 000348942110412

Author(s):

Ying-Ta Lai ◽

Pin-Zhir Chao ◽

Yu-Kang Chang ◽

Yu-Chun Yen ◽

Yu-Ting Shen ◽

...

Keyword(s):

Health Insurance ◽

Cervical Spine ◽

National Health Insurance ◽

National Health ◽

Vocal Fold ◽

Population Based ◽

Vocal Fold Paralysis ◽

Research Database ◽

Bilateral Vocal Fold Paralysis ◽

Co Morbidity

Objective: Iatrogenic vocal fold paralysis is an important issue in laryngology, yet there are few population-based studies regarding the epidemiology. This study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of iatrogenic unilateral and bilateral vocal fold paralysis (UVFP/BVFP) among the general adult population in Taiwan. Method: This study analyzed patients (20-90 years old) who underwent thyroid, parathyroid, thoracic, cardiac, or anterior cervical spine operations with vocal fold paralysis among adults in Taiwan from January 1, 2007 to December 31, 2013. The codes for vocal fold paralysis were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Claims data in the Taiwan National Health Insurance Research Database were used. Results: The most commonly performed operations which were related to vocal fold paralysis in Taiwan were, in descending order of frequency, thyroid, cervical spine, cardiac, thoracic (esophagectomy), and parathyroid operations. The operations that put laryngeal nerves at risk (ONRs) most commonly associated with a diagnosis of UVFP were, in descending order of frequency, thoracic, thyroid, parathyroid, cardiac, and cervical spine. For both UVFP and BVFP, the most commonly associated age group was 51 to 60. For both UVFP and BVFP, the more commonly associated sex was women. Increased length of stay was associated with a higher incidence of UVFP and BVFP. Charlson medical co-morbidity index (CCI) was not associated with UVFP but BVFP was associated with higher Charlson medical co-morbidity scores. Conclusions: Thyroid operations, age 51 to 60, longer hospital stays are associated with vocal fold paralysis. Overall women are more surgically affected than men. This is the first population-based study of iatrogenic vocal fold paralysis.

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Rates and characteristics of lower limb amputations in Taiwan, 1997

Prosthetics and Orthotics International ◽

10.1080/03093640208726616 ◽

2002 ◽

Vol 26 (1) ◽

pp. 7-14 ◽

Cited By ~ 17

Author(s):

S. Y. Chen ◽

W. C. Chie ◽

C. Lan ◽

M. C. Lin ◽

J. S. Lai ◽

...

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Lower Limb ◽

The United States ◽

Research Database ◽

The United Kingdom ◽

Female Rate ◽

Insurance Programme ◽

National Health Insurance Programme

This study aims to describe the national incidence rate and characteristics of lower limb amputations (LLA) in 1997 from an island-wide database of the national health insurance programme in Taiwan. Some 117,647 discharge records from a sampled database (1 in 20) of the National Health Insurance Research Database were analysed. This study included records (n=171) containing LLA procedures. The LLA procedure rates were obtained by multiplying the number of identified procedures by 20 as the numerator and mid-year total population of Taiwan in 1997 as the denominator. Each procedure was further analysed according to the demographic characteristics of the patients, cause and level of amputation. Summarised gender ratios of LLA procedure rates were obtained by Poisson regression analysis. The crude LLA procedure rate was 18.1 per 100,000 population per year and the crude major LLA procedure rate was 8.8 per 100,000 population per year in Taiwan in 1997. The major cause of LLA procedures was peripheral vascular disease (72%), and the toe was most frequently amputated (48%). The LLA procedure rates, which increased logarithmically with age of patients, were significantly higher in men with a summarised male to female rate ratio of 1.65. The age-standardised LLA procedure rate in Taiwan was lower than that reported in the United States, Finland, the Netherlands, the United Kingdom (Leeds, Middlesborough, and Newcastle), but higher than Spain, Italy, and Japan. The trend of an increasing proportion of PVD-related LLA procedures will prompt the health professionals to develop strategies for LLA prevention.

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Chemical castration decreased the risk of dementia in patients with prostate cancer - from 13368 patients, Taiwan National Health Insurance Research Database

European Urology Supplements ◽

10.1016/s1569-9056(17)30120-3 ◽

2017 ◽

Vol 16 (3) ◽

pp. e86 ◽

Cited By ~ 1

Author(s):

J. Hong ◽

C. Liao ◽

C. Huang ◽

Y. Lu

Keyword(s):

Prostate Cancer ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Research Database ◽

Chemical Castration ◽

Taiwan National Health Insurance

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Long-term use of valproic acid and the prevalence of cancers in bipolar disorder patients in a Taiwanese population: An association analysis using the National Health Insurance Research Database (NHIRD)

Journal of Affective Disorders ◽

10.1016/j.jad.2018.02.047 ◽

2018 ◽

Vol 232 ◽

pp. 103-108 ◽

Cited By ~ 2

Author(s):

Cheng Chia Lin ◽

Tsung-Cheng Hsieh ◽

Lawrence Shih-Hsin Wu

Keyword(s):

Bipolar Disorder ◽

Valproic Acid ◽

Health Insurance ◽

Association Analysis ◽

National Health Insurance ◽

National Health ◽

Research Database ◽

Taiwanese Population

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Risk of infection following colonoscopy and sigmoidoscopy in symptomatic patients

Endoscopy ◽

10.1055/s-0043-107777 ◽

2017 ◽

Vol 49 (08) ◽

pp. 754-764 ◽

Cited By ~ 3

Author(s):

Jiun-Nong Lin ◽

Chang-Bi Wang ◽

Chih-Hui Yang ◽

Chung-Hsu Lai ◽

Hsi-Hsun Lin

Keyword(s):

Health Insurance ◽

Retrospective Study ◽

Confidence Interval ◽

National Health Insurance ◽

Control Group ◽

Research Database ◽

Concordance Index ◽

Risk Of Infection ◽

Increased Risk ◽

Common Infections

Abstract Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients. Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination. Results In all, 112 543 patients who underwent colonoscopy or sigmoidoscopy and 112 543 matched patients who did not undergo these procedures were included. The overall incidence of infection within 30 days after colonoscopy and sigmoidoscopy was 0.37 %, which was significantly higher than that of the control group (0.04 %; P < 0.001). Diverticulitis, peritonitis, and appendicitis were the most common infections. Patients who underwent colonoscopy or sigmoidoscopy had a 9.38-fold risk of infection (95 % confidence interval, 6.81 – 12.93; P < 0.001) compared with the control group. The predicted infection-free rates of the nomogram were closely aligned with the actual infection-free rates, with a bootstrapping concordance index of 0.763. Conclusions Colonoscopy and sigmoidoscopy are associated with an increased risk of infection, which may occur after these procedures. Our nomogram may provide clinicians with an easy tool to evaluate the risk of infection after colonoscopy and sigmoidoscopy in symptomatic patients.

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Inflammatory bowel disease as a risk factor for periodontitis under Taiwanese National Health Insurance Research database

Journal of Dental Sciences ◽

10.1016/j.jds.2018.03.004 ◽

2018 ◽

Vol 13 (3) ◽

pp. 242-247 ◽

Cited By ~ 4

Author(s):

Hui-Chieh Yu ◽

Tsung-Po Chen ◽

Yu-Chao Chang

Keyword(s):

Inflammatory Bowel Disease ◽

Risk Factor ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Bowel Disease ◽

Research Database ◽

Inflammatory Bowel

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Consensus on Control of Risky Nonvariceal Upper Gastrointestinal Bleeding in Taiwan with National Health Insurance

BioMed Research International ◽

10.1155/2014/563707 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Bor-Shyang Sheu ◽

Chun-Ying Wu ◽

Ming-Shiang Wu ◽

Cheng-Tang Chiu ◽

Chun-Che Lin ◽

...

Keyword(s):

Health Insurance ◽

High Risk ◽

Gastrointestinal Bleeding ◽

National Health Insurance ◽

National Health ◽

Upper Gastrointestinal Bleeding ◽

Ulcer Bleeding ◽

Chronic Obstructive ◽

Research Database ◽

Upper Gastrointestinal

Background and Aims. To compose upper gastrointestinal bleeding (UGIB) consensus from a nationwide scale to improve the control of UGIB, especially for the high-risk comorbidity group.Methods. The steering committee defined the consensus scope to cover preendoscopy, endoscopy, postendoscopy, and overview from Taiwan National Health Insurance Research Database (NHIRD) assessments for UGIB. The expert group comprised thirty-two Taiwan experts of UGIB to conduct the consensus conference by a modified Delphi process through two separate iterations to modify the draft statements and to vote anonymously to reach consensus with an agreement ≥80% for each statement and to set the recommendation grade.Results. The consensus included 17 statements to highlight that patients with comorbidities, including liver cirrhosis, end-stage renal disease, probable chronic obstructive pulmonary disease, and diabetes, are at high risk of peptic ulcer bleeding and rebleeding. Special considerations are recommended for such risky patients, including raising hematocrit to 30% in uremia or acute myocardial infarction, aggressive acid secretory control in high Rockall scores, monitoring delayed rebleeding in uremia or cirrhosis, considering cycloxygenase-2 inhibitors plus PPI for pain control, and early resumption of antiplatelets plus PPI in coronary artery disease or stroke.Conclusions. The consensus comprises recommendations to improve care of UGIB, especially for high-risk comorbidities.

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Thiazide diuretics and the risk of hip fracture after stroke: a population-based propensity-matched cohort study using Taiwan’s National Health Insurance Research Database

BMJ Open ◽

10.1136/bmjopen-2017-016992 ◽

2017 ◽

Vol 7 (9) ◽

pp. e016992 ◽

Cited By ~ 8

Author(s):

Shu-Man Lin ◽

Shih-Hsien Yang ◽

Hung-Yu Cheng ◽

Chung-Chao Liang ◽

Huei-Kai Huang

Keyword(s):

Cohort Study ◽

Health Insurance ◽

Hip Fracture ◽

National Health Insurance ◽

National Health ◽

Population Based ◽

Research Database ◽

Matched Cohort ◽

Matched Cohort Study

ObjectivesThis study aimed to investigate the association between thiazide use and the risk of hip fracture after stroke.SettingA population-based, propensity-matched cohort study was conducted on the basis of Taiwan’s National Health Insurance Research Database.ParticipantsPatients with newly diagnosed ischaemic stroke between 2000 and 2011 were included. After propensity score matching, 7470 patients were included, of whom 3735 received thiazides and 3735 did not.Outcome measuresHRs for developing hip fractures within 2 years after stroke were calculated using Cox proportional hazards regression model with adjustments for sociodemographic and coexisting medical conditions.ResultsOverall, patients using thiazides after stroke had a lower risk of hip fracture than those not using thiazides (8.5 vs 13.9 per 1000 person-years, adjusted HR=0.64, 95% CI 0.46 to 0.89, p=0.007). Further sensitivity analysis based on the duration of thiazide use revealed that the risk of hip fracture tended to decrease as the duration of exposure of thiazides increased. However, the effect was significant only in patients with long-term use of thiazides (using thiazides for >365 days within 2 years after stroke), with a 59% reduction in the risk of hip fracture when compared with patients not using thiazide (adjusted HR=0.41, 95% CI 0.22 to 0.79, p=0.008).ConclusionsThe long-term use of thiazides is associated with a decreased risk of hip fracture after stroke.

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