scholarly journals 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Jack McHugh ◽  
Talha Khawaja ◽  
Larry M Baddour ◽  
Larry M Baddour ◽  
Juan Crestanello ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Population Based ◽  
Cardiac Valve ◽  
Valve Repair ◽  
Population Based Study ◽  
Increased Risk ◽  
One Year

Abstract Background Bloodstream infections (BSIs) confer an increased risk of infective endocarditis (IE) in patients with a prosthetic cardiac valve. This relationship is less well established in patients undergoing valve repair. We conducted a retrospective population-based study to determine the incidence of BSIs following valve repair and identify risk factors associated with the development of IE. Methods The Rochester Epidemiology Project (REP) data linkage system was used to identify all persons who underwent valve repair in a 7-county region in Southeastern Minnesota between January 1, 2010 and December 31, 2018. Medical records were screened for the development of a BSI from time of procedure until May 15, 2020. Patients were classified as having BSI only, BSI with IE at outset, or BSI with subsequent development of new IE. IE at outset was defined as cases where IE was diagnosed at the time of initial positive blood culture. Results A total of 387 patients underwent valve repair surgery. A total of 31 (8%) patients subsequently developed a BSI, 4% within one year of surgery. Seventeen patients underwent mitral repair with annuloplasty, 9 underwent tricuspid annuloplasty, and 5 had concurrent repairs. Median time to the development of BSI was 338 days. Of the 31 patients with BSI, 4 (13%) had BSI with IE at outset. No patients developed IE subsequent to BSI, Enterococcus spp. was responsible for 3 cases of IE, and MSSA for 1. All cases occurred within one year of surgery. Given the low incidence, statistical analysis of associated risk factors for IE was not feasible. All patients with BSI and IE at outset, however, died by the end of the study period, versus 11/27 in the BSI only group. Conclusion Incidence of BSIs was higher in patients undergoing cardiac valve repair than in the general population. The incidence of IE with a BSI was 13%, which is lower than what has been previously published. It is notable that all cases of IE occurred within one year of surgery. Recognizing that endothelialization of device surfaces occurs, it is tempting to speculate that the risk of IE may be time dependent and may decline over time. Subsequent investigation of this theory is underway. Disclosures Larry M. Baddour, MD, Boston Scientific (Consultant)

scholarly journals Bloodstream Infection Following Cardiac Valve Repair: A Population-Based Study

2021 ◽  
Vol 8 (11) ◽  
Author(s):  
Jack W McHugh ◽  
Khawaja M Talha ◽  
Larry M Baddour ◽  
Karen M Fischer ◽  
Juan Crestanello ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Population Based ◽  
Case Control ◽  
Cardiac Valve ◽  
Control Analysis ◽  
Valve Repair ◽  
Population Based Study ◽  
Crude Incidence ◽  
Increased Risk ◽  
Case Control Analysis

Abstract Background The aim of this study was to determine the incidence, epidemiology, and associated risk factors of bloodstream infection (BSI) in patients who had previously undergone cardiac valve repair. Methods A population-based study that included 7 counties in southeastern Minnesota using the expanded Rochester Epidemiology Project (e-REP) for adults (≥18 years) who underwent valve repair between 1 January 2010 and 31 December 2018 was conducted. Electronic health records were screened for development of BSI and infective endocarditis (IE) from the date of valve repair through 30 July 2020. A 1:4 nested case-control analysis was performed to determine an association, if any, of male sex, Charlson comorbidity index (CCI), and county of residence with BSI. Results A total of 335 patients underwent valve repair, of whom 28 (8.3%) developed an index case of BSI, with 14 episodes occurring within 1 year of surgery. The median age of patients with BSI was 70 years, and 79% were male. The crude incidence of BSI was 1671 cases per 100000 person-years and Escherichia coli was the most common pathogen. Case-control analysis demonstrated a significant correlation between CCI and incidence of BSI (P < .001). Only 4 (14.3%) patients developed IE concurrent with the onset of BSI, and no patients developed IE subsequent to BSI. Conclusions The crude incidence of BSI following valve repair was higher in our e-REP cohort than previous population-based studies, and half of the BSI cases occurred within 1 year of surgery. Patients with a higher CCI at baseline were at increased risk of subsequent BSI.

Abstract 1158: Sudden Death in Children with Cardiomyopathy: Long Term Follow-Up from a National Population-Based Study of Childhood Cardiomyopathy

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tara Bharucha ◽  
Andrew M Davis ◽  
Christian Turner ◽  
Robert Justo ◽  
Terry Robertson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Sudden Death ◽  
Systolic Dysfunction ◽  
Population Based ◽  
Z Score ◽  
Icd Implantation ◽  
Population Based Study ◽  
Increased Risk

Introduction Better data regarding the incidence and risk factors for sudden cardiac death (SCD) in children with cardiomyopathy (CM) is critical in defining appropriate primary prevention strategies. Methods The National Australian Childhood Cardiomyopathy Study is a prospective cohort study, including all children in Australia with primary CM diagnosed at 0 – 10 years of age, between 1987–1997. SCD was defined as sudden and unexpected death in children who were not hospitalized and not in congestive heart failure at the time of death. Nine subjects with sudden death as presenting symptom were excluded. Indexed echocardiographic measurements at latest follow-up were compared between subjects with SCD and survivors. Results Study criteria were met by 291 children. Mean duration of follow-up was 9.2 years. The incidence of sudden death relative to each CM type, for all cases and as a proportion of deaths, is shown in the Table : Incidence of SCD by CM type. SCD incidence was significantly associated with CM type, for all cases ( p = 0.006) and when only those subjects who died were considered ( p = 0.005), with LVNC and RCM having up to 4 times the risk of other CM types. Children with familial DCM had a significantly higher rate of SCD than subjects with non-familial CM (12% vs 3%; p = 0.028), however, familial CM was not a risk factor in other CM types. DCM SCD subjects had larger LVEDd Z score than survivors (median 5.53 vs 1.16; p <0.0001) and lower FS Z score (median −9.23 vs −0.51; p = 0.0025). HCM SCD subjects had thicker LVPW dimension Z scores than survivors (median 4.63 vs 1.18; p = 0.007). Twelve subjects (2 DCM, 8 HCM and 2 LVNC) underwent ICD implantation (8/12 for primary prevention). Conclusions: This population based study defines new risk factors for sudden death in children with CM. RCM is well known to have a high incidence of SCD. In addition, children with LVNC and those with DCM who have severe dilatation, systolic dysfunction or familial DCM are at increased risk of sudden death.

scholarly journals Endogenous sex hormone levels in men are not associated with risk of venous thromboembolism: the Tromsø study

2009 ◽  
Vol 160 (5) ◽  
pp. 833-838 ◽  
Author(s):  
Johan Svartberg ◽  
Sigrid K Brækkan ◽  
Gail A Laughlin ◽  
John-Bjarne Hansen
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Free Testosterone ◽  
Population Based ◽  
Sex Hormone ◽  
Population Based Study ◽  
Hormone Levels ◽  
Increased Risk ◽  
The Impact

ObjectivesLow testosterone levels in men have been associated with cardiovascular risk factors and atherosclerosis and lately also an increased risk of both cardiovascular disease (CVD) and all-cause mortality. As arterial CVDs and venous thromboembolism (VTE) have been shown to share common risk factors, the purpose of the present study was to determine the impact of endogenous sex hormone levels on the incidence of VTE in a cohort of men.DesignA prospective, population-based study.MethodsSex hormone measurements were available in 1350 men, aged 50–84, participating in the Tromsø study in 1994–1995. First, lifetime VTE-events during the follow-up were registered up to September 1 2007.ResultsThere were 63 incident VTE-events (4.5 per 1000 person-years) during a mean of 10.4 years of follow-up. Age was significantly associated with increased risk of VTE; men 70 years or older had a 2.5-fold higher risk of VTE (HR 2.47, 95% CI 1.19–5.12), compared with those between 50 and 60 years of age. In age-adjusted analyses, endogenous sex hormones levels were not associated with risk of VTE; for each s.d. increase, hazards ratios (95% CI) were 1.06 (0.83–1.35) for total testosterone, 1.02 (0.79–1.33) for free testosterone, and 1.27 (0.94–1.71) for ln-estradiol. In dichotomized analyses comparing men in the lowest total and free testosterone quartile with men in the higher quartiles, hypoandrogenemia was not associated with risk of VTE.ConclusionsIn this population-based study of middle-aged and older men, endogenous sex hormone levels were not associated with 10-year risk of VTE.

scholarly journals Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study

2015 ◽  
Vol 18 (6) ◽  
pp. 806-811 ◽  
Author(s):  
Yoshie Yokoyama ◽  
Terumi Oda ◽  
Noriyo Nagai ◽  
Masako Sugimoto ◽  
Kenji Mizukami
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Child Maltreatment ◽  
Personal Information ◽  
Population Based ◽  
Multiple Births ◽  
Population Based Study ◽  
Factors Associated ◽  
Increased Risk ◽  
The Relationship

Background: The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Methods: Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. Results: After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Conclusion: Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

Risk factors associated with bloodstream infections in end-stage renal disease patients: a population-based study

2018 ◽  
Vol 50 (11-12) ◽  
pp. 831-836 ◽  
Author(s):  
Gabrielle Dagasso ◽  
Joslyn Conley ◽  
Elizabeth Parfitt ◽  
Kelsey Pasquill ◽  
Lisa Steele ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Bloodstream Infections ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals The risk and trend of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a general population-based study

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 188-195
Author(s):  
Lingyi Li ◽  
Na Lu ◽  
Ana Michelle Avina-Galindo ◽  
Yufei Zheng ◽  
Diane Lacaille ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
General Population ◽  
Population Based ◽  
Case Definition ◽  
Population Based Study ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein

Abstract Objectives To estimate the overall risk of venous thromboembolism (VTE), pulmonary embolism (PE) and deep vein thrombosis (DVT) among patients newly diagnosed with RA compared with the general population without RA; and to estimate the risk trends of VTE, PE and DVT after RA diagnosis up to 5 years compared with the general population. Methods Using previously validated RA case definition, we conducted a matched cohort study using the population-based administrative health database from the province of British Columbia, Canada. We calculated incidence rates (IRs) and fully adjusted hazard ratios (HRs) for the risk of VTE, DVT and PE after RA index date. Results Among 39 142 incident RA patients (66% female, mean age 60), 1432, 543 and 1068 developed VTE, PE and DVT, respectively. IRs for the RA cohort were 3.79, 1.43 and 2.82 per 1000 person-years vs 2.70, 1.03 and 1.94 per 1000 person-years for the non-RA cohort. After adjusting for VTE risk factors, the HRs (95% CI) were 1.28 (1.20, 1.36), 1.25 (1.13, 1.39) and 1.30 (1.21, 1.40) for VTE, PE and DVT, respectively. The fully adjusted HRs for VTE during the first five years after RA diagnosis were 1.60, 1.47, 1.40, 1.30 and 1.28, respectively. A similar trend was shown in PE. Conclusion This population-based study demonstrates that RA patients have an increased risk of VTE, PE and DVT after diagnosis compared with the general population. This risk is independent of traditional VTE risk factors and is highest during the first year after RA diagnosis, then progressively declined.

scholarly journals Here one year, gone the next? Investigating persistence of frequent emergency department attendance: a retrospective study in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027700 ◽  
Author(s):  
Luise Lago ◽  
Victoria Westley-Wise ◽  
Judy Mullan ◽  
Kelly Lambert ◽  
Rebekah Zingel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intervention Studies ◽  
Population Based ◽  
Geographic Region ◽  
Population Based Study ◽  
Logistic Regression Models ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Adults And Children ◽  
One Year

ObjectivesPatients are presenting to emergency departments (EDs) with increasing complexity at rates beyond population growth and ageing. Intervention studies target patients with 12 months or less of frequent attendance. However, these interventions are not well targeted since most patients do not remain frequent attenders. This paper quantifies temporary and ongoing frequent attendance and contrasts risk factors for each group.DesignRetrospective population-based study using 10 years of longitudinal data.SettingAn Australian geographic region that includes metropolitan and rural EDs.Participants332 100 residents visited any ED during the study period.Main outcome measureFrequent attendance was defined as seven or more visits to any ED in the region within a 12-month period. Temporary frequent attendance was defined as meeting this threshold only once, and ongoing more than once. Risk factors for temporary and ongoing frequent attenders were identified using logistic regression models for adults and children.ResultsOf 8577 frequent attenders, 80.1% were temporary and 19.9% ongoing (12.9% repeat, 7.1% persistent). Among adults, ongoing were more likely than temporary frequent attenders to be young to middle aged (aged 25–64 years), and less likely to be from a high socioeconomic area or be admitted. Ongoing frequent attenders had higher rates of non-injury presentations, in particular substance-related (OR=2.5, 99% CI 1.1 to 5.6) and psychiatric illness (OR=2.9, 99% CI 1.8 to 4.6). In comparison, children who were ongoing were more likely than temporary frequent attenders to be aged 5–15 years, and were not more likely to be admitted (OR=2.7, 99% CI 0.7 to 10.9).ConclusionsFuture intervention studies should distinguish between temporary and ongoing frequent attenders, develop specific interventions for each group and include rigorous evaluation.

The incidence of other malignancies before and after sarcoma diagnosis: A population-based study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11076-11076
Author(s):  
Winette T.A. Van Der Graaf ◽  
Husson Olga ◽  
Willem J. van Houdt ◽  
Ingrid M.E. Desar ◽  
Vincent K.Y. Ho
Keyword(s):  
Risk Factors ◽  
Unknown Origin ◽  
Population Based ◽  
Population Based Study ◽  
Netherlands Cancer Registry ◽  
Increased Risk ◽  
Hematological Cancers ◽  
Before And After ◽  
Second Tumors ◽  
Associated Risk Factors

11076 Background: Sarcomas encompass a group of rare and heterogeneous mesenchymal malignancies with mostly unknown origin. Both exogenous risk factors, in particular radiotherapy, as well as genetic risk factors have been described. Second tumors next to sarcomas suggest associated risk factors. In the current study, we investigate the incidence of sarcomas and other malignancies by using population-based data from the Netherlands Cancer Registry. Methods: In 29,638 patients diagnosed with sarcoma between 1989 and 2015, with a median age of 59 years, we quantified the risk of other malignancies after sarcoma diagnosis using standardized incidence ratios (SIRs). In assessing associations with malignancies before sarcoma diagnosis, we focussed on previous radiotherapy. Skin carcinomas, with the exception of melanomas, were excluded. Results: In total, 3,381 (11.4%) sarcoma patients, median age 71years, had a previous malignancy (at a median age of 66 years). The most frequent sarcomas associated with prior tumors were angiosarcoma (34.5%) and gastrointestinal stromal tumours (20.6%). In the angiosarcoma group, 78.6% of patients had received prior radiotherapy for their previous tumors. Subsequent tumors (diagnosed in patients with median age of 69.5 years) after sarcoma diagnoses were detected in 2,523 patients with median age of 63 years (SIR 1.13; 95%CI: 1.09–1.18). Risks appear notably elevated for breast cancer (SIR 1.19; 95%CI: 1.06–1.34), lung cancer (SIR 1.15; 95%CI: 1.04–1.27), cancers of the urinary tract system (SIR 1.33; 95%CI: 1.14–1.53) and hematological cancers (SIR 1.31; 95%CI: 1.13–1.51). Median time until diagnosis of subsequent cancer was 52.7 months. Conclusions: Sarcoma patients have a markedly increased risk on another malignancy, either before or after the sarcoma diagnosis. Further research into genetic and exogenous risk factors may help to explain the associations.

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