Increased risk for hypothyroidism associated with carbon monoxide poisoning: a nationwide population-based cohort study

Abstract Carbon monoxide poisoning (COP) may cause injuries to the central nervous and endocrine systems, which might increase the risk of developing hypothyroidism. We wanted to evaluate the association between COP and the risk of developing hypothyroidism because epidemiological data on this potential association are limited. We conducted a nationwide population-based cohort study using the Nationwide Poisoning Database and identified 24,328 COP subjects diagnosed between 1999 and 2012. By matching the index date and age, we selected 72,984 non-COP subjects for comparison. Subjects with thyroid diseases and malignancy before 1999 were excluded. We followed up the two groups of subjects until 2013 and compared the risk of developing hypothyroidism. COP subjects had a significantly higher risk for hypothyroidism than non-COP subjects (adjusted hazard ratio [AHR]: 3.8; 95% confidence interval [CI]: 3.2–4.7) after adjusting for age, sex, underlying comorbidities, and monthly income, and the AHR was particular higher in subjects with diabetes mellitus, hyperlipidemia, and mental disorder. The increased risk was highest in the first month after COP (AHR: 41.0; 95% CI: 5.4–310.6), and the impact remained significant even after 4 years. In conclusion, COP was associated with an increased risk for hypothyroidism. Further studies regarding the underlying mechanisms are warranted.

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Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning

Journal of Clinical Medicine ◽

10.3390/jcm7100349 ◽

2018 ◽

Vol 7 (10) ◽

pp. 349 ◽

Cited By ~ 4

Author(s):

Chien-Cheng Huang ◽

Chung-Han Ho ◽

Yi-Chen Chen ◽

Chien-Chin Hsu ◽

Yi-Fong Wang ◽

...

Keyword(s):

Carbon Monoxide ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Carbon Monoxide Poisoning ◽

Population Based ◽

Chronic Obstructive ◽

Monthly Income ◽

Neurological Sequelae ◽

Increased Risk

The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS. The two cohorts had similar sex ratios, but patients who received HBOT were younger (34.8 ± 14.8 vs. 36.1 ± 17.2 years, p < 0.001). Patients who received HBOT had a higher risk for NS (adjusted hazard ratio [AHR]: 1.4; 95% confidence interval [CI]: 1.4–1.5), after adjusting for age, sex, underlying comorbidities (hypertension, diabetes, chronic obstructive pulmonary disease, hyperlipidemia, malignancy, coronary artery disease, congestive heart failure, liver disease, renal disease, connective tissue disease, human immunodeficiency virus [HIV] infection, and alcoholism), monthly income, suicide, drug poisoning, and acute respiratory failure. We observed similar findings when we stratified the patients by age, sex, underlying comorbidities, and monthly income. The increased risk was most prominent in the first 2 weeks (AHR: 2.4; 95% CI: 2.1–2.7) and remained significant up to 6 months later (AHR: 1.6; 95% CI: 1.4–1.7). The risk for NS was higher in patients with COP who received HBOT than in those who did not, even after considering the possible impact of longer observation periods on survivors. Further studies that included the potential confounding factors we did not measure are needed to confirm findings in this study.

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Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

Public Health Nutrition ◽

10.1017/s1368980021001592 ◽

2021 ◽

pp. 1-25

Author(s):

Qionggui Zhou ◽

Xuejiao Liu ◽

Yang Zhao ◽

Pei Qin ◽

Yongcheng Ren ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Normal Weight ◽

Sensitivity Analyses ◽

Hypertension Status ◽

Moderation Effect ◽

Increased Risk ◽

All Cause Mortality ◽

Chinese Cohort ◽

The Impact

Abstract Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort Participants: 17,262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the HRs (95% CI) for mortality in normotensive participants were 1.92 (1.23-3.00), 1.44 (1.01-2.05), 1.14 (0.82-1.58), 0.96 (0.70-1.31), 0.96 (0.65-1.43), 1.32 (0.81-2.14), and 1.32 (0.74-2.35) respectively, and in hypertensive participants were 1.85 (1.08-3.17), 1.67 (1.17-2.39), 1.29 (0.95-1.75), 1.20 (0.91-1.58), 1.10 (0.83-1.46), 1.10 (0.80-1.52), and 0.61 (0.40-0.94) respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity versus normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

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Renin–angiotensin system blocker use and the risk of acute kidney injury after colorectal cancer surgery: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2019-032964 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032964

Author(s):

Charlotte Slagelse ◽

H Gammelager ◽

Lene Hjerrild Iversen ◽

Kathleen D Liu ◽

Henrik T Toft Sørensen ◽

...

Keyword(s):

Colorectal Cancer ◽

Acute Kidney Injury ◽

Cohort Study ◽

Angiotensin Receptor Blockers ◽

Kidney Injury ◽

Population Based ◽

Adjusted Risk ◽

Increased Risk ◽

The Impact ◽

Postoperative Aki

ObjectivesIt is unknown whether preoperative use of ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) affects the risk of acute kidney injury (AKI) after colorectal cancer (CRC) surgery. We assessed the impact of preoperative ACE-I/ARB use on risk of AKI after CRC surgery.DesignObservational cohort study. Patients were divided into three exposure groups—current, former and non-users—through reimbursed prescriptions within 365 days before the surgery. AKI within 7 days after surgery was defined according to the current Kidney Disease Improving Global Outcome consensus criteria.SettingPopulation-based Danish medical databases.ParticipantsA total of 9932 patients undergoing incident CRC surgery during 2005–2014 in northern Denmark were included through the Danish Colorectal Cancer Group Database.Outcome measureWe computed cumulative incidence proportions (risk) of AKI with 95% CIs for current, former and non-users of ACE-I/ARB, including death as a competing risk. We compared current and former users with non-users by computing adjusted risk ratios (aRRs) using log-binomial regression adjusted for demographics, comorbidities and CRC-related characteristics. We stratified the analyses of ACE-I/ARB users to address any difference in impact within relevant subgroups.ResultsTwenty-one per cent were ACE-I/ARB current users, 6.4% former users and 72.3% non-users. The 7-day postoperative AKI risk for current, former and non-users was 26.4% (95% CI 24.6% to 28.3%), 25.2% (21.9% to 28.6%) and 17.8% (17.0% to 18.7%), respectively. The aRRs of AKI were 1.20 (1.09 to 1.32) and 1.16 (1.01 to 1.34) for current and former users, compared with non-users. The relative risk of AKI in current compared with non-users was consistent in all subgroups, except for higher aRR in patients with a history of hypertension.ConclusionsBeing a current or former user of ACE-I/ARBs is associated with an increased risk of postoperative AKI compared with non-users. Although it may not be a drug effect, users of ACE-I/ARBs should be considered a risk group for postoperative AKI.

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The risk of venous thromboembolism after surgery for esophagogastric malignancy and the impact of chemotherapy: a population-based cohort study

Diseases of the Esophagus ◽

10.1093/dote/doz079 ◽

2019 ◽

Vol 33 (6) ◽

Author(s):

Alfred Adiamah ◽

Lu Ban ◽

Joe West ◽

David J Humes

Keyword(s):

Gastric Cancer ◽

Cohort Study ◽

Venous Thromboembolism ◽

Adjuvant Chemotherapy ◽

Cumulative Incidence ◽

Population Based ◽

Risk Of Death ◽

Increased Risk ◽

Esophagogastric Cancer ◽

The Impact

SUMMARY To define the incidence of postoperative venous thromboembolism (VTE) and effects of chemotherapy in a population undergoing surgery for esophagogastric cancer. This population-based cohort study used linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data from England to identify subjects undergoing esophageal or gastric cancer surgery between 1997 and 2014. Exposures included age, comorbidity, smoking, body mass index, and chemotherapy. Crude rates and adjusted hazard ratios (HRs) were calculated for rate of first postoperative VTE using Cox regression models. The cumulative incidence of VTE at 1 and 6 months was estimated accounting for the competing risk of death from any cause. Of the 2,452 patients identified, 1,012 underwent gastrectomy (41.3%) and 1,440 esophagectomy (58.7%). Risk of VTE was highest in the first month, with absolute VTE rates of 114 per 1,000 person-years (95% CI 59.32–219.10) following gastrectomy and 172.73 per 1,000 person-years (95% CI 111.44–267.74) following esophagectomy. Neoadjuvant and adjuvant chemotherapy was associated with a six-fold increased risk of VTE following gastrectomy, HR 6.19 (95% CI 2.49–15.38). Cumulative incidence estimates of VTE at 6 months following gastrectomy in patients receiving no chemotherapy was 1.90% and esophagectomy 2.21%. However, in those receiving both neoadjuvant and adjuvant chemotherapy, cumulative incidence following gastrectomy was 10.47% and esophagectomy, 3.9%. VTE rates are especially high in the first month following surgery for esophageal and gastric cancer. The cumulative incidence of VTE at 6 months is highest in patients treated with chemotherapy. In this category of patients, targeted VTE prophylaxis may prove beneficial during chemotherapy treatment.

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Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0103078 ◽

2014 ◽

Vol 9 (8) ◽

pp. e103078 ◽

Cited By ~ 58

Author(s):

Kuang-Hsi Chang ◽

Mei-Yin Chang ◽

Chih-Hsin Muo ◽

Trong-Neng Wu ◽

Chiu-Ying Chen ◽

...

Keyword(s):

Carbon Monoxide ◽

Cohort Study ◽

Nitrogen Dioxide ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Increased Risk

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Use of gastric acid–suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0249050 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0249050

Author(s):

Hsiu-Chen Lin ◽

Kuan-Tzu Huang ◽

Hsiu-Li Lin ◽

Yow-Sheng Uang ◽

Yi Ho ◽

...

Keyword(s):

Cohort Study ◽

Gastric Acid ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Gastrointestinal Disease ◽

Asian Population ◽

Population Based ◽

Increased Risk ◽

The Impact ◽

Upper Gastrointestinal

Background Prescriptions for gastric acid–suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. However, little data exist regarding their association with dementia in the Asian population. The objective of this study was thus to investigate the impact of the use of PPIs and H2RAs on the risk of dementia in an Asian population with upper gastrointestinal disease (UGID). Methods We conducted a population-based retrospective cohort study with a 10-year follow-up using data from 2000 to 2015 derived from Taiwan’s Longitudinal Health Insurance Database. We included 6711 patients with UGID receiving gastric acid–suppressive agents, 6711 patients with UGID not receiving agents, and 6711 patients without UGID or treatment thereof, all at least 20 years of age. Groups were matched for age, sex, and index date. The association between gastric acid–suppressive agent use and dementia was analyzed using a Cox proportional hazards regression model adjusted for potential confounders. Results The adjusted hazard ratio (aHR) of dementia for patients with UGID receiving gastric acid–suppressive agents compared with patients with UGID without gastric acid–suppressive agents was 1.470 (95% confidence interval [CI] 1.267–1.705, p < 0.001). Both PPIs and H2RAs increase the risk of dementia (PPIs: aHR 1.886 [95% CI 1.377–2.582], p < 0.001; H2RAs: aHR 1.357 [95% CI 1.098–1.678], p < 0.01), with PPIs exhibiting significantly greater risk (aHR 1.456 [95% CI 1.022–2.075], p < 0.05). Conclusions Our results demonstrate an increased risk of dementia in patients with UGID receiving gastric acid–suppressive agents, including PPIs and H2RAs, and the use of PPIs was associated with a significantly greater risk than H2RA use.

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Atopic Dermatitis and Infertility: A Nationwide Retrospective Cohort Study

Dermatology ◽

10.1159/000515600 ◽

2021 ◽

pp. 1-7

Author(s):

Amir Horev ◽

Guy Shalom ◽

Adi Y. Weintraub ◽

Tamar Freud ◽

Arnon D. Cohen

Keyword(s):

Atopic Dermatitis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Large Scale ◽

Epidemiological Data ◽

Healthcare Services ◽

Control Group ◽

Potential Association ◽

The Impact

Background: Given that common pathophysiological factors play a role in atopic dermatitis (AD) and infertility, we assumed that the 2 conditions might demonstrate an epidemiological association. Large-scale epidemiological data on this topic are lacking. Objectives: The aim of this work was to evaluate the potential association between AD and infertility in a broad community-based population. Methods: A nationwide retrospective cohort study was conducted, analyzing the association between AD and infertility. We compared AD patients diagnosed by a dermatologist between 2002 and 2018 and a matched control group. The study population was subdivided according to age into adults (age ≥18 years) and children (age <18 years), and was further subdivided according to AD severity, classified as either mild or moderate-to-severe according to AD-related drug use and healthcare services utilization. Results: The study included 127,150 patients with AD and 127,071 comparison enrollees. AD was associated with a higher prevalence of infertility than that of the control group (1.4 and 1.1%, respectively). The prevalence of infertility, per 1,000 patient-years, was increased in patients with AD compared to that of the control group (2.17 and 1.7, respectively). Multivariate analysis for infertility demonstrated that AD was a key risk factor for infertility in both males and females with mild AD and moderate-to-severe AD. Conclusion: A significant association between AD and infertility was observed. This association suggests that infertility may be an additional manifestation of AD. Further studies are warranted to evaluate the impact of AD management in the setting of infertility and vice versa.

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MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and cancer: an old debate revisited

Acta Endocrinologica ◽

10.1530/eje-16-0178 ◽

2016 ◽

Vol 175 (4) ◽

pp. R147-R156 ◽

Cited By ~ 39

Author(s):

Cesar Luiz Boguszewski ◽

John Ayuk

Keyword(s):

Patient Outcomes ◽

Epidemiological Data ◽

Cross Sectional ◽

Endocrine Disease ◽

Potential Association ◽

Increased Risk ◽

Incidence And Mortality ◽

Prostate Cancers ◽

Study Designs ◽

The Impact

Based on experimental and animal models, epidemiological data from non-acromegaly populations, and longitudinal and cross-sectional cohorts of patients with acromegaly, a potential association between acromegaly and cancer has long been hypothesized, in particular colorectal cancer, and, to a lesser extent, breast, thyroid and prostate cancers. The exact mechanisms underlying this potential association have not been fully elucidated. Results from studies examining cancer incidence and mortality in acromegaly have been inconsistent, with some demonstrating increased risk, whereas others show no increase. This article reviews the existing data relating to cancer risk and mortality in acromegaly, exploring the limitations of study designs and the impact of changes in disease control and patient outcomes over time.

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Autoimmune Connective Tissue Disease Following Carbon Monoxide Poisoning: A Nationwide Population-Based Cohort Study

Clinical Epidemiology ◽

10.2147/clep.s266396 ◽

2020 ◽

Vol Volume 12 ◽

pp. 1287-1298

Author(s):

Chien-Cheng Huang ◽

Chung-Han Ho ◽

Yi-Chen Chen ◽

Chien-Chin Hsu ◽

Hung-Jung Lin ◽

...

Keyword(s):

Carbon Monoxide ◽

Cohort Study ◽

Connective Tissue ◽

Connective Tissue Disease ◽

Carbon Monoxide Poisoning ◽

Population Based

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Microscopic Colitis and Risk Of Cancer—AA Population-Based Cohort Study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa156 ◽

2020 ◽

Cited By ~ 1

Author(s):

David Bergman ◽

Hamed Khalili ◽

Bjorn Roelstraete ◽

Jonas F Ludvigsson

Keyword(s):

Cohort Study ◽

Reference Group ◽

Large Population ◽

Population Based ◽

Microscopic Colitis ◽

First Year ◽

Increased Risk ◽

Risk Of Cancer ◽

The Impact

Abstract Background and Aims The association between microscopic colitis [MC] and cancer risk is unclear. Large, population-based studies are lacking. Methods We conducted a nationwide cohort study of 11 758 patients with incident MC [diagnosed 1990–2016 in Sweden], 50 828 matched reference individuals, and 11 614 siblings to MC patients. Data were obtained through Sweden´s pathology departments and from the Swedish Cancer Register. Adjusted hazard ratios [aHRs] were calculated using Cox proportional hazards models. Results At the end of follow-up [mean: 6.7 years], 1239 [10.5%] of MC patients had received a cancer diagnosis, compared with 4815 [9.5%] of reference individuals (aHR 1.08 [95% confidence interval1.02–1.16]). The risk of cancer was highest during the first year of follow up. The absolute excess risks for cancer at 5, 10, and 20 years after MC diagnosis were + 1.0% (95% confidence interval [CI] 0.4%-1.6%), +1.5% [0.4%-2.6%], and + 3.7% [-2.3–9.6%], respectively, equivalent to one extra cancer event in every 55 individuals with MC followed for 10 years. MC was associated with an increased risk of lymphoma (aHR 1.43 [1.06–1.92]) and lung cancer (aHR 1.32 [1.04–1.68]) but with decreased risks of colorectal (aHR 0.52 [0.40–0.66]) and gastrointestinal cancers (aHR 0.72 [0.60–0.85]). We found no association with breast or bladder cancer. Using siblings as reference group to minimise the impact of shared genetic and early environmental factors, patients with MC were still at an increased risk of cancer (HR 1.20 [1.06–1.36]). Conclusions This nationwide cohort study demonstrated an 8% increased risk of cancer in MC patients. The risk was highest during the first year of follow-up.

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