Association of age with risk of major depression among patients with chronic kidney disease over midlife: a nationwide cohort study in Taiwan

2018 ◽  
Vol 31 (08) ◽  
pp. 1171-1179 ◽  
Author(s):  
Shih-Feng Chen ◽  
Yu-Huei Chien ◽  
Pau-Chung Chen ◽  
I-Jen Wang
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Major Depression ◽  
Kidney Disease ◽  
Comparison Group ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
The Impact

ABSTRACTBackground:The impact of age on the development of depression among patients with chronic kidney disease (CKD) at stages before dialysis is not well known. We aimed to explore the incidence of major depression among predialysis CKD patients of successively older ages through midlife.Methods:We conducted a retrospective cohort study using the longitudinal health insurance database 2005 in Taiwan. This study investigated 17,889 predialysis CKD patients who were further categorized into study (i.e. middle and old-aged) groups and comparison group aged 18–44. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was applied for coding diseases.Results:The group aged 75 and over had the lowest (hazard ratio [HR] 0.47; 95% confidence interval [CI] 0.32–0.69) risk of developing major depression, followed by the group aged 65–74 (HR 0.67; 95% CI 0.49–0.92), using the comparison group as reference. The adjusted survival curves showed significant differences in cumulative major depression-free survival between different age groups. We observed that the risk of major depression development decreases with higher age. Females were at a higher risk of major depression than males among predialyasis CKD patients.Conclusions:The incidence of major depression declines with higher age in predialysis CKD patients over midlife. Among all age groups, patients aged 75 and over have the lowest risk of developing major depression. A female preponderance in major depression development is present. We suggest that depression prevention and therapy should be integrated into the standard care for predialysis CKD patients, especially for those young and female.

scholarly journals Prevalence of Chronic Kidney Disease, Thrombotic Cardiovascular Events, and Use of Oral P2Y12 Inhibitors among Veterans

2018 ◽  
Vol 47 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Manisha Singh ◽  
Deepa Raghavan ◽  
James S. Williams ◽  
Bradley C. Martin ◽  
Teresa J. Hudson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Patient Population ◽  
International Classification Of Diseases ◽  
Period Prevalence ◽  
P2y12 Inhibitors ◽  
Classification Of Diseases ◽  
Pharmacy Data ◽  
Cost Differences

Background: Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescription trend for P2Y12i remains unclear. Methods: Using national VA corporate warehouse data, we used International Classification of Diseases-9 codes to identify Veterans with CKD, dialysis-dependent CKD, and CV events. VA pharmacy data were used to count P2Y12i prescriptions for the federal fiscal years (FY) 2011 through 2015. Results: The period prevalence of Veterans with CKD was 378,233 (6.1%). The point prevalence of CKD increased by 49% from 132,979 (2.30%) in FY11 to 213,444 (3.42%) in FY15. The period prevalence of Veterans with dialysis-dependent CKD was 150,298 (2.4%). In all, 128,703 (56.7%) CV events occurred in Veterans with CKD. Veterans with CKD were given 50.1% of prescriptions for clopidogrel, 49.3% for prasugrel, and 60.4% for ticagrelor. In this patient population, year-to-year increases in P2Y12i prescriptions were observed with a dramatic increase in ticagrelor prescriptions. Conclusion: CKD is common among Veterans and its true prevalence is likely being underestimated. The prevalence of dialysis-dependent CKD is higher among Veterans than the non-Veteran US population. CV events are widely co-prevalent and these patients are commonly prescribed P2Y12i. The recent increase in ticagrelor prescriptions in this patient population and large cost differences between the 3 P2Y12i underline the need for future studies to identify the preferred P2Y12i for these patients.

Increased prevalence of psychosis in patients who get admitted with atrial fibrillation with worse outcomes

2017 ◽  
Vol 41 (S1) ◽  
pp. S575-S576
Author(s):  
Z. Mansuri ◽  
S. Patel ◽  
P. Patel ◽  
O. Jayeola ◽  
A. Das ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
International Classification Of Diseases ◽  
Trend Test ◽  
Classification Of Diseases ◽  
Competing Interest ◽  
Armitage Trend Test ◽  
The Impact

ObjectiveTo determine trends and impact on outcomes of atrial fibrillation (AF) in patients with pre-existing psychosis.BackgroundWhile post-AF psychosis has been extensively studied, contemporary studies including temporal trends on the impact of pre-AF psychosis on AF and post-AF outcomes are largely lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from the healthcare cost and utilization project (HCUP) from year's 2002–2012. We identified AF and psychosis as primary and secondary diagnosis respectively using validated international classification of diseases, 9th revision, and Clinical Modification (ICD-9-CM) codes, and used Cochrane–Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 3.887.827AF hospital admissions from 2002–2012 of which 1.76% had psychosis. Proportion of hospitalizations with psychosis increased from 5.23% to 14.28% (P trend < 0.001). Utilization of atrial-cardioversion was lower in patients with psychosis (0.76%v vs. 5.79%, P < 0.001). In-hospital mortality was higher in patients with Psychosis (aOR 1.206; 95%CI 1.003–1.449; P < 0.001) and discharge to specialty care was significantly higher (aOR 4.173; 95%CI 3.934–4.427; P < 0.001). The median length of hospitalization (3.13 vs. 2.14 days; P < 0.001) and median cost of hospitalization (16.457 vs. 13.172; P < 0.001) was also higher in hospitalizations with psychosis.ConclusionsOur study displayed an increasing proportion of patients with Psychosis admitted due to AF with higher mortality and extremely higher morbidity post-AF, and significantly less utilization of atrial-cardioversion. There is a need to explore reasons behind this disparity to improve post-AF outcomes in this vulnerable population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study

2020 ◽  
Author(s):  
Frederikke Vestergaard Nielsen ◽  
Mette Rønn Nielsen ◽  
Ida Lund Lorenzen ◽  
Jesper Amstrup ◽  
Torben Anders Kløjgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
International Classification Of Diseases ◽  
Rank Test ◽  
Test Results ◽  
Historical Cohort ◽  
Specific Diagnosis ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Icd 10

Abstract Background The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality. Methods A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10 th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. Results We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were ‘unspecified disease’ (Z039), constituting 47.0 % (n 35,279). In children 0-9 years old, ‘febrile convulsions’ was the most frequent non-specific diagnosis used in 54.3 % (n 1,602). Overall, 1- and 30-day mortality was 2.2 % (n 1,205) and 6.0 % (n 3,258). The highest mortality was in the diagnostic group ‘suspected cardiovascular disease’ (Z035) and ‘unspecified disease’ (Z039) with 1-day mortality 2.6 % (n 43) and 2.4 % (n 589), and 30 day mortality of 6.32 % (n 104) and 8.1 % (n 1,975). Conclusion Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.

scholarly journals Association Between Diagnosis Code Expansion and Changes in 30‐Day Risk‐Adjusted Outcomes for Cardiovascular Diseases

2021 ◽  
Author(s):  
Lauren Gilstrap ◽  
Rishi K. Wadhera ◽  
Andrea M. Austin ◽  
Stephen Kearing ◽  
Karen E. Joynt Maddox ◽  
...  
Keyword(s):  
Logistic Regression ◽  
International Classification Of Diseases ◽  
Fee For Service ◽  
Readmission Rates ◽  
Difference In Differences ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Changes In Risk ◽  
The Impact

BACKGROUND In January 2011, Centers for Medicare and Medicaid Services expanded the number of inpatient diagnosis codes from 9 to 25, which may influence comorbidity counts and risk‐adjusted outcome rates for studies spanning January 2011. This study examines the association between (1) limiting versus not limiting diagnosis codes after 2011, (2) using inpatient‐only versus inpatient and outpatient data, and (3) using logistic regression versus the Centers for Medicare and Medicaid Services risk‐standardized methodology and changes in risk‐adjusted outcomes. METHODS AND RESULTS Using 100% Medicare inpatient and outpatient files between January 2009 and December 2013, we created 2 cohorts of fee‐for‐service beneficiaries aged ≥65 years. The acute myocardial infarction cohort and the heart failure cohort had 578 728 and 1 595 069 hospitalizations, respectively. We calculate comorbidities using (1) inpatient‐only limited diagnoses, (2) inpatient‐only unlimited diagnoses, (3) inpatient and outpatient limited diagnoses, and (4) inpatient and outpatient unlimited diagnoses. Across both cohorts, International Classification of Diseases, Ninth Revision ( ICD‐9 ) diagnoses and hierarchical condition categories increased after 2011. When outpatient data were included, there were no significant differences in risk‐adjusted readmission rates using logistic regression or the Centers for Medicare and Medicaid Services risk standardization. A difference‐in‐differences analysis of risk‐adjusted readmission trends before versus after 2011 found that no significant differences between limited and unlimited models for either cohort. CONCLUSIONS For studies that span 2011, researchers should consider limiting the number of inpatient diagnosis codes to 9 and/or including outpatient data to minimize the impact of the code expansion on comorbidity counts. However, the 2011 code expansion does not appear to significantly affect risk‐adjusted readmission rate estimates using either logistic or risk‐standardization models or when using or excluding outpatient data.

scholarly journals The Impact of Cardiovascular Disease and Chronic Kidney Disease on Life Expectancy and Direct Medical Cost in a 10-Year Diabetes Cohort Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (8) ◽  
pp. 1750-1758
Author(s):  
Eric Yuk Fai Wan ◽  
Weng Yee Chin ◽  
Esther Yee Tak Yu ◽  
Ian Chi Kei Wong ◽  
Esther Wai Yin Chan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Life Expectancy ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
The Impact

scholarly journals Gout and the risk of advanced chronic kidney disease in the UK health system: a national cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031550 ◽  
Author(s):  
Austin G Stack ◽  
Michelle Elizabeth Johnson ◽  
Betina Blak ◽  
Alyssa Klein ◽  
Lewis Carpenter ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
International Classification Of Diseases ◽  
Secondary Outcome ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Advanced Chronic Kidney Disease ◽  
National Cohort

ObjectiveEvaluate the association between gout and risk of advanced chronic kidney disease (CKD).DesignRetrospective matched cohort study.SettingUK Clinical Practice Research Datalink.ParticipantsThe analysis included data for 68 897 patients with gout and 554 964 matched patients without gout. Patients were aged ≥18 years, registered at UK practices, had ≥12 months of clinical data and had data linked with Hospital Episode Statistics. Patients were excluded for history of advanced CKD, juvenile gout, cancer, HIV, tumour lysis syndrome, Lesch-Nyhan syndrome or familial Mediterranean fever.Primary and secondary outcome measuresAdvanced CKD was defined as first occurrence of: (1) dialysis, kidney transplant, diagnosis of end-stage kidney disease (ESKD) or stage 5 CKD (diagnostic codes in Read system or International Classification of Diseases, Tenth Revision); (2) estimated glomerular filtration rate (eGFR) <10 mL/min/1.73 m²; (3) doubling of serum creatinine from baseline and (4) death associated with CKD.ResultsAdvanced CKD incidence was higher for patients with gout (8.54 per 1000 patient-years; 95% CI 8.26 to 8.83) versus without gout (4.08; 95% CI 4.00 to 4.16). Gout was associated with higher advanced CKD risk in both unadjusted analysis (HR, 2.00; 95% CI 1.92 to 2.07) and after adjustment (HR, 1.29; 95% CI 1.23 to 1.35). Association was strongest for ESKD (HR, 2.13; 95% CI 1.73 to 2.61) and was present for eGFR <10 mL/min/1.73 m² (HR, 1.45; 95% CI 1.30 to 1.61) and serum creatinine doubling (HR, 1.13; 95% CI 1.08 to 1.19) but not CKD-associated death (HR, 1.14; 95% CI 0.99 to 1.31). Association of gout with advanced CKD was replicated in propensity-score matched analysis (HR, 1.23; 95% CI 1.17 to 1.29) and analysis limited to patients with incident gout (HR, 1.28; 95% CI 1.22 to 1.35).ConclusionsGout is associated with elevated risk of CKD progression. Future studies should investigate whether controlling gout is protective and reduces CKD risk.

Incidence of Football Injuries and Complaints in Different Age Groups and Skill-Level Groups

2000 ◽  
Vol 28 (5_suppl) ◽  
pp. 51-57 ◽  
Author(s):  
Lars Peterson ◽  
Astrid Junge ◽  
Jiri Chomiak ◽  
Toni Graf-Baumann ◽  
Jiri Dvorak
Keyword(s):  
Continuing Education ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Fair Play ◽  
Skill Levels ◽  
Subsequent Performance ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Over Time

In this study, the incidence of football injuries and complaints as related to different age groups and skill levels was studied over the period of 1 year. All injuries and complaints as well as the amount of time players spent in training and games were recorded. All injured players were examined weekly by physicians, and all injuries were assessed according to the International Classification of Diseases (ICD-10), which describes them in terms of injury type and location, the treatment required, and the duration of subsequent performance limitations. A total of 264 players of different age groups and skill levels was observed for 1 year. Five hundred fifty-eight injuries were documented. Two hundred sixteen players had one or more injuries. Only 48 players (18%) had no injury. The average number of injuries per player per year was 2.1. Injuries were classified as mild (52%), moderate (33%), or severe (15%). Almost 50% of all injuries were contact injuries; half of all the contact injuries were associated with foul play. The majority of injuries were strains and sprains involving the ankle, knee, and lumbar spine. Nearly all players (91%) suffered from complaints related to football. Only 23 players reported no injuries and no complaints. Prevention programs, fair play, and continuing education in techniques and skills may reduce the incidence of injuries over time.

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