Long-Term Incidence of Venous Thromboembolism in Cancer: The Scandinavian Thrombosis and Cancer Cohort

AbstractThe risk of venous thromboembolism (VTE) in patients who survive the first years after a cancer diagnosis after the acute effects of disease and treatment in comparison to a similar background population has been sparsely investigated. The aim of the study was to investigate if incidence rates (IRs) of VTE differed in patients who were alive at least 2 years after a cancer diagnosis without VTE compared with cancer-free references in a population-based cohort study. The study entry was 2 years after a first cancer diagnosis. For each cancer-exposed subject, five reference subjects were identified within the cohort. The IRs were calculated as number of VTEs per 1,000 person years (×10−3 p-y) in total and in distinct cancer types and corresponding reference subjects. Incidence rate ratios (IRRs) were calculated by Poisson's regression. During a mean follow-up of 5.3 years, 110 VTEs occurred among the 7,288 cancer-exposed subjects and 321 VTEs occurred among the 36,297 identified reference subjects. The IR of VTE was higher for cancer-exposed subjects compared with reference subjects, IRs 3.7 × 10−3 p-y, 95% CI: 3.1 to 4.5 and 1.9 × 10−3 p-y, 95% CI: 1.7 to 2.2, respectively. IRs of VTE in most solid cancer types declined to almost the same level as in the reference subjects 2 years after cancer diagnosis, but remained higher in hematological cancers, IRR 4.0, 95% CI: 2.0 to 7.8.

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The Incidence and Timing of Unprovoked Venous Thromboembolism Prior to the Diagnosis of Common Cancers.

Blood ◽

10.1182/blood.v104.11.2582.2582 ◽

2004 ◽

Vol 104 (11) ◽

pp. 2582-2582

Author(s):

Richard White ◽

Ted Wun ◽

Arti Parikh-Patel ◽

Danielle Harvey ◽

Helen Chew

Keyword(s):

Venous Thromboembolism ◽

Cancer Diagnosis ◽

Large Population ◽

Cell Cancer ◽

Population Based ◽

Incidence Rates ◽

Myelogenous Leukemia ◽

Data Set ◽

Discharge Data ◽

Diagnosis Of Cancer

Abstract Background. It is not clear how frequently unprovoked venous thromboembolism (VTE) reflects the presence of an underlying occult malignancy. Objective: To compare the expected and observed incidence of unprovoked VTE during a one year period immediately preceding the diagnosis of common types of cancer Design: Retrospective population-based cohort study using the California Cancer Registry linked with the California Patient Discharge Data Set. Setting: All non-federal hospitals in California. Patients: All cases over the age of 17 that were diagnosed with one of 19 common cancers between Jan. 1993 and Dec. 1995. Measurement. VTE was identified and classified as provoked (after surgery, pregnancy, trauma, medical hospitalization etc.) or unprovoked using an array of validated specific ICD-9-CM codes. VTE cases first diagnosed before the cancer diagnosis of cancer were labeled as having preceding VTE, and VTE cases diagnosed at the time of the cancer diagnosis were labeled as having concurrent VTE cases. Cancer cases with common malignant histologies were identified using the registry. The standardized incidence ratio (SIR) of unprovoked VTE was determined by calculating the expected incidence in the cancer cohorts using the 1995 and 1996 age, race and sex specific incidence rates of unprovoked VTE among California residents. Results. There were 250585 cancer cases; mean age was 66 years, 52% were women, 35% had metastatic or unknown stage cancer at the time of diagnosis; A total of 385 cancer cases had VTE in the preceding year, and 221 of these cases (0.09%) had unprovoked VTE, compared to 216 expected cases, SIR= 1.02 (95% CI= 0.9–1.2, p=NS). 50% of the cases with preceding unprovoked VTE had metastatic or unknown stage cancer (p<0.001). Only cases with lymphoma, renal cell cancer and acute myelogenous leukemia had an SIR significantly greater than 1.0 (SIR range = 2.1–5.3). Among the cases with preceding unprovoked VTE that were later diagnosed with metastatic or unknown stage cancer, there were 30 more VTE cases than expected, SIR = 1.4 (CI = 1.2–1.6), and a significantly greater proportion of these cases were diagnosed with VTE within 91 days of being diagnosed with cancer (p =0.001). 832 (0.33%) cases were diagnosed with VTE during the hospital stay when cancer was diagnosed, and 168 (20%) of the cases were admitted with a principal diagnosis of VTE; 68% of these 832 cases with concurrent VTE had metastatic or unknown stage cancer at the time of diagnosis (p<0.001 vrs entire cohort) Limitations. This was a retrospective study that relied on administrative data to identify cases and outcomes. The extent of any evaluation for cancer that might have occurred among the cases with preceding unprovoked VTE could not be determined. Conclusions: In this large population based cohort of cancer cases, the incidence of unprovoked VTE in the year prior to the diagnosis of cancer was not significantly higher than expected in the general population. Approximately 10% to 15% of the cases diagnosed with preceding unprovoked VTE had features suggesting a causal link between thromboembolism and the undiagnosed cancer. Many patients were diagnosed concurrently with cancer and VTE during the same hospitalization.

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Incidences and risk factors of severe infections in young adults with schizophrenia: A nationwide register-based cohort study in Denmark

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.219 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S313-S313

Author(s):

M. Pankiewicz-Dulacz ◽

E. Stenager ◽

M. Chen

Keyword(s):

Risk Factors ◽

Young Adults ◽

Cohort Study ◽

Population Based ◽

Incidence Rates ◽

Gastrointestinal Infections ◽

Background Population ◽

Co Morbidity ◽

Severe Infections ◽

Rate Ratios

IntroductionPatients with schizophrenia deal with many risk factors that make them more susceptible to infections. However, knowledge about incidence and the nature of infections among people with schizophrenia is scarce.AimsTo investigate the occurrence and risk factors for severe infections in schizophrenia patients.Objectives– to determine incidence rates of infections among young adults with schizophrenia;– to define risk factors for infections.MethodPopulation-based nationwide cohort study with selection of all individuals born in Denmark between 1975–1990 and follow-up period from 1995–2013 was conducted. Data from the Danish Psychiatric Central Register and the Danish National Hospital Registry were used. A Poisson regression was chosen to estimate incidence rate ratios of infections and to explore the associations of different risk factors like sex, age, substance abuse and medical co-morbidity with the rates of infections.Preliminary results922,564 individuals born between 1975–1990 were included in the study. Overall, 3520 women and 5479 men were identified with schizophrenia. In percentages, 36% with schizophrenia had infectious diseases compared to 25% of background population. Some of severe infections like HIV (0.23% vs 0.05%), sepsis (0.72% vs 0.27%), hepatitis (1.4% vs 0.22%) skin infections (12% vs 6.2%)and tuberculosis (0.12% vs 0.06%) were highly increased in persons with schizophrenia, whereas smaller differences were found regarding CNS infections (0.5% vs 0.4%) and gastrointestinal infections (8.7% vs 6.2%).ConclusionsThe preliminary data results suggest, that individuals with schizophrenia have higher prevalence of all types of severe infectious compared to the background population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

Thrombosis and Haemostasis ◽

10.1160/th13-09-0793 ◽

2014 ◽

Vol 112 (08) ◽

pp. 255-263 ◽

Cited By ~ 80

Author(s):

Alexander T. Cohen ◽

Luke Bamber ◽

Stephan Rietbrock ◽

Carlos Martinez

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

The Elderly ◽

Population Based ◽

Incidence Rates ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Recurrence Rates ◽

Recurrent Vte ◽

Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

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Abstract MP33: Heart Failure Following Cancer Therapy in Patients with Hematological Malignancies Aged 18 Years and Under: A Linked Health Data Analysis (1996-2009)

Circulation ◽

10.1161/circ.133.suppl_1.mp33 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Narelle M Berry ◽

Shahid Ullah ◽

Vincent L Versace ◽

Alexandra L McCarthy ◽

John J Atherton ◽

...

Keyword(s):

Heart Failure ◽

Cancer Diagnosis ◽

Mortality Risk ◽

Hematological Malignancies ◽

Causal Link ◽

Health Data ◽

Innovative Strategies ◽

Hematological Cancers ◽

Patients With Heart Failure ◽

After Cancer

Introduction: The causal link between chemotherapy treatments and subsequent cardiotoxicity is well established, particularly for children with hematological malignancies. Little information exists on the characteristics and outcomes for patients with heart failure (HF) after chemotherapy. This study aimed to describe the characteristics, survival and mortality of patients who received chemotherapy for hematological cancer (leukemias, lymphomas and related disorders) before 18 years old and subsequently developed HF compared to those who did not. Methods: Linked health data (1996-2009) from the Queensland Cancer Registry, Death Registry and Hospital Administration records for HF and chemotherapy admissions were reviewed. From all breast and hematological cancers patients (n=73,158), 15,987 received chemotherapy, including 819 patients aged ≤18 years at time of cancer diagnosis. Patients were categorized as those with an index HF admission (occurred after cancer diagnosis) and those without an index HF admission (non HF). Results: Of the 819 patients, 3.7% (n=30) had an index HF admission. Median age of HF patients at time of cancer diagnosis was 5 years (IQR 3-12) compared to 7 years (IQR 3-14) in the non HF group (p=0.503). Median follow up from cancer diagnosis was 2.5 years in the HF group compared to 5.42 years in the non HF group (p<0.01). Of those who developed HF, 70% (n=21) had the index admission within 12 months of their cancer diagnosis. Of those with HF, 53.3% (n=16) died (all cause) compared to 14.6% (n=115) with no HF. On adjustment for age, sex and chemotherapy admissions, HF patients had an almost 5 fold increased mortality risk compared to non HF patients (HR 4.91 [95% CI, 2.88-8.36]) (Figure 1). Conclusions: This study demonstrated that in children with hematological cancers the onset of HF occurred soon after chemotherapy and mortality risk is almost 5 times that of children who do not develop HF. Innovative strategies are still needed for the prevention and management of cardiotoxicity in this population.

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Incidence of atrial fibrillation in different major cancer subtypes: a Nationwide population-based 12 year follow up study

BMC Cancer ◽

10.1186/s12885-019-6314-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Christina Boegh Jakobsen ◽

Morten Lamberts ◽

Nicholas Carlson ◽

Morten Lock-Hansen ◽

Christian Torp-Pedersen ◽

...

Keyword(s):

Atrial Fibrillation ◽

General Population ◽

The Elderly ◽

Population Based ◽

Incidence Rates ◽

Cancer Subtypes ◽

History Of ◽

The Difference ◽

Rate Ratios ◽

New Onset

Abstract Background The prevalence of both atrial fibrillation (AF) and malignancies are increasing in the elderly, but incidences of new onset AF in different cancer subtypes are not well described.The objectives of this study were therefore to determine the incidence of AF in different cancer subtypes and to examine the association of cancer and future AF. Methods Using national databases, the Danish general population was followed from 2000 until 2012. Every individual aged > 18 years and with no history of cancer or AF prior to study start was included. Incidence rates of new onset AF were identified and incidence rate ratios (IRRs) of AF in cancer patients were calculated in an adjusted Poisson regression model. Results A total of 4,324,545 individuals were included in the study. Cancer was diagnosed in 316,040 patients. The median age of the cancer population was 67.0 year and 51.5% were females. Incidences of AF were increased in all subtypes of cancer. For overall cancer, the incidence was 17.4 per 1000 person years (PY) vs 3.7 per 1000 PY in the general population and the difference increased with age. The covariate adjusted IRR for AF in overall cancer was 1.46 (95% confidence interval (CI) 1.44–1.48). The strength of the association declined with time from cancer diagnosis (IRR0-90days = 3.41 (3.29–3.54), (IRR-180 days-1 year = 1.57 (CI 1.50–1.64) and (IRR2–5 years = 1.12 (CI 1.09–1.15). Conclusions In this nationwide cohort study we observed that all major cancer subtypes were associated with an increased incidence of AF. Further, cancer and AF might be independently associated.

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Poisoning substances taken by young people: a population-based cohort study

British Journal of General Practice ◽

10.3399/bjgp18x698897 ◽

2018 ◽

Vol 68 (675) ◽

pp. e703-e710 ◽

Cited By ~ 6

Author(s):

Edward G Tyrrell ◽

Denise Kendrick ◽

Kapil Sayal ◽

Elizabeth Orton

Keyword(s):

Cohort Study ◽

Young People ◽

Population Based ◽

Incidence Rates ◽

Practice Research ◽

Mortality Data ◽

Clinical Practice Research Datalink ◽

Self Harm ◽

Harm Prevention ◽

Rate Ratios

BackgroundGlobally, poisonings account for most medically-attended self-harm. Recent data on poisoning substances are lacking, but are needed to inform self-harm prevention.AimTo assess poisoning substance patterns and trends among 10–24-year-olds across EnglandDesign and settingOpen cohort study of 1 736 527 young people, using linked Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics mortality data, from 1998 to 2014.MethodPoisoning substances were identified by ICD-10 or Read Codes. Incidence rates and adjusted incidence rate ratios (aIRR) were calculated for poisoning substances by age, sex, index of multiple deprivation, and calendar year.ResultsIn total, 40 333 poisoning episodes were identified, with 57.8% specifying the substances involved. The most common substances were paracetamol (39.8%), alcohol (32.7%), non-steroidal anti-inflammatory drugs (NSAIDs) (11.6%), antidepressants (10.2%), and opioids (7.6%). Poisoning rates were highest at ages 16–18 years for females and 19–24 years for males. Opioid poisonings increased fivefold from 1998–2014 (females: aIRR 5.30, 95% confidence interval (CI) = 4.08 to 6.89; males: aIRR 5.11, 95% CI = 3.37 to 7.76), antidepressant poisonings three-to fourfold (females: aIRR 3.91, 95% CI = 3.18 to 4.80, males: aIRR 2.70, 95% CI = 2.04 to 3.58), aspirin/NSAID poisonings threefold (females: aIRR 2.84, 95% CI = 2.40 to 3.36, males: aIRR 2.76, 95% CI = 2.05 to 3.72) and paracetamol poisonings threefold in females (aIRR 2.87, 95% CI = 2.58 to 3.20). Across all substances poisoning incidence was higher in more disadvantaged groups, with the strongest gradient for opioid poisonings among males (aIRR 3.46, 95% CI = 2.24 to 5.36).ConclusionIt is important that GPs raise awareness with families of the substances young people use to self-harm, especially the common use of over-the-counter medications. Quantities of medication prescribed to young people at risk of self-harm and their families should be limited, particularly analgesics and antidepressants.

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Non-infectious comorbidity in patients with multiple sclerosis: A national cohort study in Sweden

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217320947761 ◽

2020 ◽

Vol 6 (3) ◽

pp. 205521732094776

Author(s):

Anna Castelo-Branco ◽

Flaminia Chiesa ◽

Camilla E Bengtsson ◽

Sally Lee ◽

Neil N Minton ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cohort Study ◽

Improve Patient Care ◽

Bowel Dysfunction ◽

Population Based ◽

Incidence Rates ◽

Swedish Population ◽

Comorbidity Burden ◽

National Cohort ◽

Rate Ratios

Background Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts. Objective To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex. Methods In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years) and 61,828 matched MS-free individuals were identified between 1 January 2008 and 31 December 2016, using national registers. Incidence rates (IRs) and incidence rate ratios (IRRs) with 95% CI were calculated for each outcome. Results IRs of cardiovascular disease (CVD) were higher among MS patients than MS-free individuals, (major adverse CVD: IRR 1.42; 95% CI 1.12–1.82; hemorrhagic/ischemic stroke: 1.46; 1.05–2.02; transient ischemic attack: 1.65; 1.09–2.50; heart failure: 1.55; 1.15–2.10); venous thromboembolism: 1.42; 1.14–1.77). MS patients also had higher risks of several non-CVDs such as autoimmune conditions (IRR 3.83; 3.01–4.87), bowel dysfunction (2.16; 1.86–2.50), depression (2.38; 2.11–2.68), and fractures (1.32; 1.19–1.47), as well as being hospitalized and to suffer from CVD-related deaths ((1.91; 1.00–3.65), particularly in females (3.57; 1.58–8.06)). Conclusion MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.

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Trends of venous thromboembolism risk before and after diagnosis of gout: a general population-based study

Rheumatology ◽

10.1093/rheumatology/kez398 ◽

2019 ◽

Vol 59 (5) ◽

pp. 1099-1107 ◽

Cited By ~ 5

Author(s):

Lingyi Li ◽

Natalie McCormick ◽

Eric C Sayre ◽

John M Esdaile ◽

Diane Lacaille ◽

...

Keyword(s):

Venous Thromboembolism ◽

General Population ◽

Population Based ◽

Incidence Rates ◽

Vein Thrombosis ◽

Hazard Ratios ◽

Thrombosis Risk ◽

Before And After ◽

Health Database ◽

Deep Vein

Abstract Objective To estimate the overall risk and the temporal trend of venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE) before and after gout diagnosis in an incident gout cohort compared with the general population. Methods We conducted a matched cohort study using a province-wide population-based administrative health database in Canada. We calculated incidence rates (IRs) and multivariable adjusted hazard ratios (HRs) for the risk of VTE, DVT and PE before and after gout diagnosis. Results Among 130 708 incident individuals with gout (64% male, mean age 59 years), 2071 developed VTE, 1377 developed DVT and 1012 developed PE. IRs per 1000 person-years for gout were 2.63, 1.74 and 1.28 compared with 2.03, 1.28 and 1.06 for non-gout, respectively. The fully adjusted HRs (95% CI) for VTE, DVT and PE were 1.22 (1.13, 1.32), 1.28 (1.17, 1.41) and 1.16 (1.05, 1.29). For the pre-gout period, the fully adjusted HRs (95% CI) were 1.51 (1.38, 1.64), 1.55 (1.40, 1.72) and 1.47 (1.31, 1.66) for VTE, DVT and PE. During the third, second and first years preceding gout, the fully adjusted HRs for VTE were 1.44, 1.56 and 1.62. During the first, second, third, fourth and fifth years after gout, the fully adjusted HRs were 1.63, 1.29, 1.33, 1.28 and 1.22. Similar trends were also seen for DVT and PE. Conclusion Increased risks of VTE, DVT and PE were found both before and after gout diagnosis. The risk increased gradually before gout, peaking in the year prior to diagnosis, and then progressively declined. Gout-associated inflammation may contribute to venous thrombosis risk.

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Genitourinary disease risks among 5-year ovarian cancer survivors in a population-based cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.10073 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 10073-10073

Author(s):

Mia Hashibe ◽

Yuji Chen ◽

Brenna Blackburn ◽

Yuan Wan ◽

Kerry G. Rowe ◽

...

Keyword(s):

Ovarian Cancer ◽

Renal Failure ◽

Acute Renal Failure ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Population Based ◽

General Population Cohort ◽

Disease Risks ◽

After Cancer

10073 Background: In the US, there are approximately 235,200 ovarian cancer survivors today. Five-year survival for ovarian cancer has increased from 36% for women who were diagnosed in 1975-1977 to 46% for women diagnosed between 2005-2011. Long term follow-up studies among ovarian cancer survivors are uncommon and late effects have not been well characterized in a population-based cohort. Although genitourinary complications during treatment are well known, long term impacts need to be investigated. Methods: A total of 602 first primary invasive ovarian cancer cases diagnosed between 1996-2012 who survived for > 5 years were identified in the Utah Population Database and compared to a general population cohort of women. Genitourinary disease diagnoses were identified through ICD codes from hospital electronic medical records and statewide ambulatory surgery and inpatient data. Cox regression models were used to estimate hazard ratios for disease risks by time since cancer diagnosis with adjustments on matching factors, baseline BMI, baseline Charlson Comorbidity Index (CCI), and race. Results: The overall risk of genitourinary diseases for ovarian cancer patients in comparison to the general population cohort was 1.51 (95%CI = 1.30-1.74) 5-10 years after cancer diagnosis. Approximately 54.6% of ovarian cancer survivors were diagnosed with a genitourinary disease 5-10 years after cancer diagnosis. The most common genitourinary diseases among the ovarian cancer survivors were urinary tract infections (10.1%), acute renal failure (5.5%), and chronic kidney disease (4.4%). The greatest risks were observed for hydronephrosis (HR = 10.65, 95%CI = 3.68-30.80), pelvic peritoneal adhesions (HR = 5.81, 95%CI = 1.11-30.39), cystitis and urethritis (HR = 2.67, 95%CI = 1.21-6.38), and acute renal failure (HR = 2.30, 95%CI = 1.36-3.88). Conclusions: Ovarian cancer survivors experience increased risks of various genitourinary diseases in the 5-10 year period following cancer diagnosis. Understanding the multimorbidity trajectory among ovarian cancer survivors is of vital importance to improve their clinical care after cancer diagnosis and allow for increased attention to these potential late effects.

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Risk and Prognosis of Bacteremia and Fungemia among Peritoneal Dialysis Patients: A Population-Based Cohort Study

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00197 ◽

2016 ◽

Vol 36 (6) ◽

pp. 647-654 ◽

Cited By ~ 4

Author(s):

Lars Skov Dalgaard ◽

Mette Nørgaard ◽

Johan Vestergaard Povlsen ◽

Bente Jespersen ◽

Søren Jensen-Fangel ◽

...

Keyword(s):

Escherichia Coli ◽

Cohort Study ◽

Peritoneal Dialysis ◽

Population Based ◽

Incidence Rates ◽

Dialysis Patients ◽

Comparison Cohort ◽

Causative Agents ◽

Rate Ratios ◽

Population Controls

Background The incidence of bacteremia and fungemia (BAF) is largely unknown in end-stage renal disease (ESRD) patients initiating peritoneal dialysis (PD). Objective The main objective was to estimate and compare incidence rates of first episodes of BAF in incident PD patients and a comparison cohort. A secondary objective was to compare causative agents and 30-day post-BAF mortality between PD patients and the comparison cohort. Methods Design: Observational cohort study. Setting: Central and North Denmark regions. Participants: patients who initiated PD during 1995 – 2010. For each patient we sampled up to 10 controls from the general population matched on age, sex, and municipality. Main outcome Data on positive blood cultures were retrieved from electronic microbiology databases covering the 2 regions. We calculated incidence rates (IRs) of first-time BAF for PD patients and population controls. Incidence-rate ratios (IRRs) were calculated to compare these rates. Thirty-day mortality was estimated by Kaplan-Meier analysis. Results Among 1,024 PD patients and 10,215 population controls, we identified 75 and 282 episodes of BAF, respectively. Incidence rates of BAF were 4.7 (95% confidence interval [CI], 3.8 – 5.9) per 100 person-years of follow-up (PYFU) in PD patients and 0.5 (95% CI, 0.4 – 0.5) per 100 PYFU in population controls (IRR = 10.4; 95% CI, 8.1 – 13.5). In PD patients, the most frequent microorganisms were Escherichia coli (18.7%) and Staphylococcus aureus (13.3%). Escherichia coli (27.3%) also ranked first among population controls. Thirty-day mortality following BAF was 20.8% (95% CI, 12.6 – 31.0) and 20.7% (95% CI, 16.3 – 25.9) among PD patients and population controls, respectively. Conclusions Peritoneal dialysis patients are at markedly higher risk of BAF than population controls. Causative agents and the 30-day post-BAF mortality were similar in the 2 cohorts.

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