scholarly journals Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Loreto, Peru

2021 ◽  
Author(s):  
Carlos Álvarez-Antonio ◽  
Graciela Meza-Sánchez ◽  
Carlos Calampa ◽  
Wilma Casanova ◽  
Cristiam Carey ◽  
...  
Keyword(s):  
Test Performance ◽  
Herd Immunity ◽  
Age Groups ◽  
Rapid Test ◽  
Prevalence Ratio ◽  
Population Based ◽  
Current Data ◽  
Survey Analysis ◽  
Population Based Study

SummaryBackgroundDetection of SARS-CoV-2 antibodies among people at risk is critical for understanding both the prior transmission of COVID-19 and vulnerability of the population to the continuing transmission and, when done serially, the intensity of ongoing transmission over an interval in a community. In this study, we estimated the seroprevalence of COVID-19 in a representative population-based cohort of Iquitos, one of the regions with the highest mortality rates from COVID-19 in Peru, where a devastating number of cases occurred in March 2020.MethodsWe conducted a population-based study of transmission tested each participant using the COVID-19 IgG/IgM Rapid Test from Orient Gene Biotech and used survey analysis methods to estimate seroprevalence accounting for the sampling design effect and test performance characteristics. Here we report results from the baseline (13 to 18 July 2020) and the first month of follow-up (13 to 18 August 2020) study.FindingsWe enrolled a total of 716 participants and estimated seroprevalence of 70.0% (95% CI: 67.0%–73.4%), a test-re-test positivity of 65% (95% CI: 61.0%–68.3%), and an incidence of new exposures of 1.8% (95% CI: 0.9%–3.2%) data that suggest that transmission is ongoing but is occurring at low levels. We observed significant differences in the seroprevalence between age groups, with participants 18 to 29 years of age having lower seroprevalence than children <12 years of age (Prevalence ratio =0.85 [PR]; 95% CI: 0.73 – 0.98), suggesting that children were not refractory to infection in this setting.InterpretationIquitos demonstrates one of the highest rates of seroprevalence of COVID-19 worldwide. Current data shows a limited case burden in Iquitos for the past seven months and suggests that these levels are sufficient to provide significant but incomplete herd immunity.FundingDirección Regional de Salud de Loreto, DIRESA, Loreto, Peru

scholarly journals SARS-CoV-2 antibody seroprevalence in Lebanon: findings from the first nationwide serosurvey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Abbas Hoballah ◽  
Rana El Haidari ◽  
Ghina Siblany ◽  
Fadi Abdel Sater ◽  
Samir Mansour ◽  
...  
Keyword(s):  
Test Performance ◽  
Point Of Care ◽  
Vaccination Campaign ◽  
Herd Immunity ◽  
Age Groups ◽  
Rapid Test ◽  
Population Based ◽  
P Value ◽  
Cumulative Number ◽  
Population Weight

Abstract Background Lebanon, a small country in the Middle East, remains severely affected by the COVID-19 pandemic. Seroprevalence surveys of anti-SARS-CoV-2 antibodies provide accurate estimates of SARS-CoV-2 infection and hence evaluate the extent of the pandemic. The present study aimed to evaluate the prevalence of SARS-CoV-2 antibodies in Lebanon and to compare the estimated cumulative number of COVID-19 cases with the officially registered number of laboratory-confirmed cases up to January 15, 2021. Methods A nationwide population-based serosurvey study was conducted in Lebanon between December 7, 2020, and January 15, 2021, before the initiation of the national vaccination program. The nCOVID-19 IgG & IgM point-of-care (POCT) rapid test was used to detect the presence of anti-SARS-COV-2 immunoglobulin G (IgG) in the blood. Seroprevalence was estimated after weighting for sex, age, and area of residence and adjusting for the test performance. Results Of the 2058 participants, 329 were positive for IgG SARS-COV-2, resulting in a crude seroprevalence of 16.0% (95% CI 14.4–17.6). The weighed seroprevalence was 15.9% (95% CI of 14.4 and 17.4). After adjusting for test performance, the population weight-adjusted seroprevalence was 18.5% (95% CI 16.8–20.2). This estimate implies that 895,770 individuals of the general population were previously infected by COVID-19 up to January 15, 2021 in Lebanon. The overall estimated number of subjects with previous SARS-CoV-2 infection was three times higher than the officially reported cumulative number of confirmed cases. Seroprevalence was similar across age groups and sexes (p-value > 0.05). However, significant differences were revealed across governorates. Conclusions Our results suggest that the Lebanese population is still susceptible to SARS-CoV-2 infection and far from achieving herd immunity. These findings represent an important contribution to the surveillance of the COVID-19 pandemic in Lebanon and to the understanding of how this virus spreads. Continued surveillance for COVID-19 cases and maintaining effective preventive measures are recommended to control the epidemic spread in conjunction with a national vaccination campaign to achieve the desired level of herd immunity against COVID-19.

scholarly journals Associations between thyroid function and mortality: the influence of age

2014 ◽  
Vol 171 (2) ◽  
pp. 183-191 ◽  
Author(s):  
Annenienke C van de Ven ◽  
Romana T Netea-Maier ◽  
Femmie de Vegt ◽  
H Alec Ross ◽  
Fred C G J Sweep ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Age Groups ◽  
Population Based ◽  
Normal Range ◽  
Population Based Study ◽  
Middle Range ◽  
The Relationship ◽  
Subclinical Thyrotoxicosis ◽  
Tsh Levels

ObjectiveThe aim of this study was to investigate the influence of age on the association between thyroid function and mortality.DesignThe Nijmegen Biomedical Study is a population-based study, comprising 5816 randomly selected adults of all age groups without previously known thyroid disease.MethodsTSH, free thyroxine (FT4) and peroxidase antibodies were measured in 2002–2003. The number of deaths were established in 2012 (median follow-up time 9.4 years).ResultsSubclinical thyrotoxicosis was associated with mortality in subjects aged <65 years (hazard ratio (HR) 2.5, 95% CI 1.1–5.7), but not in subjects aged >65 years. As for thyroid function within the normal range: in the 493 participants aged 80 years or older, an FT4 level in the high-normal range (18.5–22 pmol/l) was associated with a higher mortality in comparison with FT4 levels in the middle range (11.5–15.0 pmol/l): HR 1.7 (95% CI 1.0–2.9). In these elderly, TSH levels within the high-normal range (3.0–4.0 mIU/l) were also associated with a higher mortality in comparison with TSH levels within the middle range (1.0–2.0 mIU/l): HR 1.8 (95% CI 1.0–3.1).ConclusionsThe relationship between thyroid function and mortality differs according to age. This finding might (partially) explain the discrepant results of previous studies examining the relationship between thyroid function and mortality in different age groups.

scholarly journals Reduced Risk of Atrial Fibrillation Following Cholecystectomy: A Nationwide Population-Based Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Tung Ching Ho ◽  
Yu-Ching Chen ◽  
Che-Chen Lin ◽  
Hsu-Chih Tai ◽  
Cheng-Yu Wei ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Gallstone Disease ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Population Based Study ◽  
Number Of Patients ◽  
Taiwan National Health Insurance ◽  
Using Data

Background: Gallstone disease (GD) is associated with a high risk of cardiovascular disease. However, it is unknown whether GD contributes to atrial fibrillation (AF). We aimed to investigate the association between GD and AF.Methods: We performed a population-based cohort study using data from the Taiwan National Health Insurance Research Database between 2001 and 2011. A GD cohort of 230,076 patients was compared with a control cohort consisting of an equal number of patients matched for age, sex, cardiovascular and gastrointestinal comorbidities.Results: In total, 5,992 (49.8/10,000 person-years) patients with GD and 5,804 (44.5/10,000 person-years) controls developed AF. GD increased AF risk with a hazard ratio (HR) of 1.20 [95% confidence interval (CI), 1.16–1.25]. In patients with GD but without cholecystectomy, the HR of AF reached 1.57 (95% CI = 1.50–1.63). After cholecystectomy, the HR of AF significantly decreased to 0.85 (95% CI = 0.81–0.90). Among the three age groups with GD (&lt;45, 45–64, and ≥65 years), the adjusted HRs of AF were 1.59 (95% CI = 1.08–2.33), 1.31 (95% CI = 1.18–1.45), and 1.18 (95% CI = 1.13–1.22), respectively. Compared with patients with a CHA2DS2-VASc score equal to 0, the HRs of AF risk among total cohort patients and a score equal to 1, 2, 3, and ≥ 4 were 1.28 (95% CI = 1.15–1.43), 2.26 (95% CI = 2.00–2.56), 3.81 (95% CI = 3.35–4.34), and 5.09 (95% CI = 4.42–5.87), respectively.Conclusion: This population-based longitudinal follow-up study showed that patients with GD had an increased AF risk. Moreover, cholecystectomy was related to reduced AF risk. Cardiovascular checkups may be necessary for patients with GD, especially those who are young and have other typical risk factors.

scholarly journals Incidence and Survival of Multiple Myeloma; A Population-Based Study on 10 961 Patients Diagnosed 1982-2017

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4380-4380 ◽  
Author(s):  
Øystein Langseth ◽  
Tor Åge Myklebust ◽  
Tom Børge Johannesen ◽  
Øyvind Hjertner ◽  
Anders Waage
Keyword(s):  
Multiple Myeloma ◽  
Age Groups ◽  
Relative Survival ◽  
Population Based ◽  
New Drugs ◽  
Steady Increase ◽  
Age Group ◽  
Calendar Period ◽  
Population Based Study

Background: Several population-based studies on multiple myeloma (MM) have shown an improvement in relative survival (RS) for patients aged 65 years or younger at the time of diagnosis. In patients aged 75 years or older, the improvement in long-term RS is absent in most reports or much less pronounced. To our knowledge, only 2 studies based on the Surveillance, Epidemiology and End Results (SEER) database have demonstrated a significant increase in RS for this age-group. (Pulte et al. 2011, Costa et al. 2017) We performed a population-based study on Norwegian MM-patients to provide up-to-date estimates on changes in relative survival during the past 3 decades. Methods: The Cancer Registry of Norway (CRN) was established in 1951 and provides high-quality nationwide cancer statistics. For MM, the reported completeness of case-ascertainment is above 95%. Incidence data and all reported cases of MM diagnosed between January 1, 1982 and December 31, 2017 were retrieved from the CRN (n=10 961). Nationwide drug consumption statistics for drugs used in myeloma treatment were retrieved from the Norwegian Drug Wholesales Statistics and the Norwegian Prescriptions Database, Norwegian Institute of Public Health. Follow-up ended December 31, 2017. The time of MM-diagnosis was divided into 7 categories: 1982-1987, 1988-1992 (melphalan-prednisone), 1993-1997(early high-dose melphalan with autologous stem-cell transplant (HDM-ASCT)), 1998-2002 (introduction of thalidomide), 2003-2007 (early thalidomide upfront, introduction of bortezomib), 2008-2012 (thalidomide and bortezomib upfront, introduction of lenalidomide), 2013-2017 (lenalidomide upfront, early pomalidomide, daratumumab, panobinostat and carfilzomib). Age at diagnosis was divided into 3 categories; <65 years, 65-79 years and 80 years or older. We estimated relative survival ratios (RSR) with 95% confidence intervals 5 and 10 years after the time of diagnosis by the Ederer-II method. The analysis was stratified by age-group and calendar period of diagnosis. Cohort analysis was applied to calendar periods with complete follow-up, and period analysis was applied where complete-follow up was not available (2013-2017 and 10-year estimates for 2008-2012). Non-overlapping confidence intervals were considered statistically significant. Results: The age-standardized incidence rate was stable until approximately year 2000, followed by an increasing tendency reaching 8.4 cases per 100 000 persons in 2017. Figure 1. Patients diagnosed before the age of 65 had a steady increase in both 5 and 10-year RSR across all calendar periods. For patients aged 65-79 years, the 5- and 10-year RSR's were stable at approximately 0.3 and 0.1, respectively, until the calendar period 1998-2002. In the following years, an improvement in both 5- and 10-year RSR was observed. The 5-year RSR improved significantly from 0.31 (95% CI; 0.27-0.35) in the first calendar period to 0.43 (95% CI;0.39- 0.47) during 2008-2012. The predicted 5-year RSR for 2013-2017 was 0.48 (95% CI; 0.44-0.52). There were also signs of improved 10-year RSR, predicted to 0.23 (95% CI; 0.18-0.27) during 2013-2017 compared to 0.11 (95% CI; 0.08-0.14) during 1982-1987. The 5-year RSR for patients aged 80+ years was 0.11 (95% CI; 0.01-0.17) during 1982-1987 and the 10-year RSR was 0.03 (95% CI; 0.01-0.11). In the following 4 calendar periods the RSR-estimates fluctuated before a rising tendency during the last 2 periods. The 5-year RSR improved significantly to 0.26 (95% CI; 0.20-0.32) during 2008-2012 and further rising to a predicted value of 0.32 (95% CI; 0.25-0.38) during 2013-2017. Figure 2. Additionally, complete annual prescription statistics for the oral agents thalidomide, lenalidomide and pomalidomide were obtained. Conclusions: We provide real-world observations on changes in RS in a population-based cohort of 10 961 MM-patients. We demonstrate an improvement in 5-year relative survival across all age-groups, including patients aged 80 years or older. For patients <65 years, there was a steady increase in RS since 1982 and we see no obvious impact of the implementation of HDM-ASCT. For the other age-groups, the improvement in RS coincides with the introduction of new drugs. The increase in incidence since 2000 may be due to increased testing for M-protein. We can point to the introduction of new drugs and increased incidence of indolent cases as possible reasons for increasing RS. Disclosures No relevant conflicts of interest to declare.

No relation between biomarkers at age 47–49 and aortic diameter after 14–19 years of follow-up – a population-based study

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 291-295 ◽  
Author(s):  
Soumia Taimour ◽  
Moncef Zarrouk ◽  
Jan Holst ◽  
Olle Melander ◽  
Gunar Engström ◽  
...  
Keyword(s):  
Population Based ◽  
Aortic Diameter ◽  
Aortic Dilatation ◽  
Population Based Study ◽  
Reactive Protein ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Old Men

Abstract. Background: Biomarkers reflecting diverse pathophysiological pathways may play an important role in the pathogenesis of abdominal aortic aneurysm (aortic diameter ≥30 mm, AAA), levels of many biomarkers are elevated and correlated to aortic diameter among 65-year-old men undergoing ultrasound (US) screening for AAA. Probands and methods: To evaluate potential relationships between biomarkers and aortic dilatation after long-term follow-up, levels of C-reactive protein (CRP), proneurotensin (PNT), copeptin (CPT), lipoprotein-associated phospholipase 2 (Lp-PLA2), cystatin C (Cyst C), midregional proatrial natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM) were measured in 117 subjects (114 [97 %] men) aged 47–49 in a prospective population-based cohort study, and related to aortic diameter at US examination of the aorta after 14–19 years of follow-up. Results: Biomarker levels at baseline did not correlate with aortic diameter after 14–19 years of follow up (CRP [r = 0.153], PNT [r = 0.070], CPT [r = –.156], Lp-PLA2 [r = .024], Cyst C [r = –.015], MR-proANP [r = 0.014], MR-proADM [r = –.117]). Adjusting for age and smoking at baseline in a linear regression model did not reveal any significant correlations. Conclusions: Tested biomarker levels at age 47–49 were not associated with aortic diameter at ultrasound examination after 14–19 years of follow-up. If there are relationships between these biomarkers and aortic dilatation, they are not relevant until closer to AAA diagnosis.

scholarly journals Association of Tooth Scaling with Acute Myocardial Infarction and Analysis of the Corresponding Medical Expenditure: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7613
Author(s):  
Yi-Wei Kao ◽  
Ben-Chang Shia ◽  
Huei-Chen Chiang ◽  
Mingchih Chen ◽  
Szu-Yuan Wu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Periodontal Diseases ◽  
Population Based ◽  
Medical Expenditure ◽  
Control Group ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Scaling Group

Accumulating evidence has shown a significant correlation between periodontal diseases and systemic diseases. In this study, we investigated the association between the frequency of tooth scaling and acute myocardial infarction (AMI). Here, a group of 7164 participants who underwent tooth scaling was compared with another group of 7164 participants without tooth scaling through propensity score matching to assess AMI risk by Cox’s proportional hazard regression. The results show that the hazard ratio of AMI from the tooth scaling group was 0.543 (0.441, 0.670) and the average expenses of AMI in the follow up period was USD 265.76, while the average expenses of AMI in follow up period for control group was USD 292.47. The tooth scaling group was further divided into two subgroups, namely A and B, to check the influence of tooth scaling frequency on AMI risk. We observed that (1) the incidence rate of AMI in the group without any tooth scaling was 3.5%, which is significantly higher than the incidence of 1.9% in the group with tooth scaling; (2) the tooth scaling group had lower total medical expenditures than those of the other group because of the high medical expenditure associated with AMI; and (3) participants who underwent tooth scaling had a lower AMI risk than those who never underwent tooth scaling had. Therefore, the results of this study demonstrate the importance of preventive medicine.

scholarly journals Lymphoproliferative malignancies in patients with neurofibromatosis 1

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christina Bergqvist ◽  
François Hemery ◽  
Arnaud Jannic ◽  
Salah Ferkal ◽  
Pierre Wolkenstein
Keyword(s):  
General Population ◽  
Medical History ◽  
Hodgkin Lymphoma ◽  
Incidence Rate ◽  
Population Based ◽  
Neurofibromatosis 1 ◽  
Population Based Study ◽  
Non Hodgkin Lymphoma ◽  
History Of

AbstractNeurofibromatosis 1 (NF1) is an inherited, autosomal-dominant, tumor predisposition syndrome with a birth incidence as high as 1:2000. A patient with NF1 is four to five times more likely to develop a malignancy as compared to the general population. The number of epidemiologic studies on lymphoproliferative malignancies in patients with NF1 is limited. The aim of this study was to determine the incidence rate of lymphoproliferative malignancies (lymphoma and leukemia) in NF1 patients followed in our referral center for neurofibromatoses. We used the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We performed a keyword search on clinical notes generated between Jan/01/2014 and May/11/2020 for patients aged 18 years or older. A total of 1507 patients with confirmed NF1 patients aged 18 years and above were identified (mean age 39.2 years; 57% women). The total number of person-years in follow-up was 57,736 (men, 24,327 years; women, 33,409 years). Mean length of follow-up was 38.3 years (median, 36 years). A total of 13 patients had a medical history of either lymphoma or leukemia, yielding an overall incidence rate of 22.5 per 100,000 (0.000225, 95% confidence interval (CI) 0.000223–0.000227). This incidence is similar to that of the general population in France (standardized incidence ratio 1.07, 95% CI 0.60–1.79). Four patients had a medical history leukemia and 9 patients had a medical history of lymphoma of which 7 had non-Hodgkin lymphoma, and 2 had Hodgkin lymphoma. Our results show that adults with NF1 do not have an increased tendency to develop lymphoproliferative malignancies, in contrast to the general increased risk of malignancy. While our results are consistent with the recent population-based study in Finland, they are in contrast with the larger population-based study in England whereby NF1 individuals were found to be 3 times more likely to develop both non-Hodgkin lymphoma and lymphocytic leukemia. Large-scale epidemiological studies based on nationwide data sets are thus needed to confirm our findings.

scholarly journals Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hossein Farhadnejad ◽  
Karim Parastouei ◽  
Hosein Rostami ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Metabolic Syndrome ◽  
Positive Association ◽  
Population Based ◽  
Population Based Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Confounding Variables ◽  
Adjusted Model ◽  
Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

scholarly journals Polypill eligibility and equivalent intake in a Swiss population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julien Castioni ◽  
Nazanin Abolhassani ◽  
Peter Vollenweider ◽  
Gérard Waeber ◽  
Pedro Marques-Vidal
Keyword(s):  
Enzyme Inhibitor ◽  
Large Fraction ◽  
Population Based ◽  
Cvd Risk ◽  
Population Based Study ◽  
Current Smoking ◽  
Swiss Population ◽  
Men Elderly ◽  
Multivariable Adjustment

AbstractThe polypill has been advocated for cardiovascular disease (CVD) management. The fraction of the population who could benefit from the polypill in Switzerland is unknown. Assess (1) the prevalence of subjects (a) eligible for the polypill and (b) already taking a polypill equivalent; and (2) the determinants of polypill intake in the first (2009–2012) and second follow-ups (2014–2017) of a population-based prospective study conducted in Lausanne, Switzerland. The first and the second follow-ups included 5038 and 4596 participants aged 40–80 years, respectively. Polypill eligibility was defined as having a high CVD risk as assessed by an absolute CVD risk ≥ 5% with the SCORE equation for Switzerland and/or presenting with CVD. Four polypill equivalents were defined: statin + any antihypertensive with (A) or without (B) aspirin; statin + calcium channel blocker (CCB) (C); and statin + CCB + angiotensin-converting enzyme inhibitor (D). The prevalence of polypill eligibility was 20.6% (95% CI 19.5–21.8) and 27.7% (26.5–29.1) in the first and second follow-up, respectively. However, only around one-third of the eligible 29.5% (95% CI 26.7–32.3) and 30.4% (27.9–33.0) respectively, already took the polypill equivalents. All polypill equivalents were more prevalent among men, elderly and in presence of CVD. After multivariable adjustment, in both periods, male gender was associated with taking polypill equivalent A (OR: 1.93; 95% CI 1.45–2.55 and OR: 1.67; 95% CI 1.27–2.19, respectively) and polypill equivalent B (OR: 1.52; 95% CI 1.17–1.96 and OR: 1.41; 95% CI 1.07–1.85, respectively). Similarly, in both periods, age over 70 years, compared to middle-age, was associated with taking polypill equivalent A (OR: 11.71; CI 6.74–20.33 and OR: 9.56; CI 4.13–22.13, respectively) and equivalent B (OR: 13.22; CI 7.27–24.07 and OR: 20.63; CI 6.51–56.36, respectively). Former or current smoking was also associated with a higher likelihood of taking polypill equivalent A in both periods. A large fraction of the population is eligible for the polypill, but only one-third of them actually benefits from an equivalent, and this proportion did not change over time.

scholarly journals OP0248 PREMATURE MORTALITY BURDEN FOR SYSTEMIC SCLEROSIS: NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 156.1-156
Author(s):  
E. Yen ◽  
D. Singh ◽  
M. Wu ◽  
R. Singh
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Disease Burden ◽  
Age Groups ◽  
Premature Mortality ◽  
Population Based ◽  
Age Group ◽  
Population Based Study ◽  
Mortality Burden ◽  
Over Time

Background:Premature mortality is an important way to quantify disease burden. Patients with systemic sclerosis (SSc) can die prematurely of disease, however, the premature mortality burden of SSc is unknown. The years of potential life lost (YPLL), in addition to age-standardized mortality rate (ASMR) in younger ages, can be used as measures of premature death.Objectives:To evaluate the premature mortality burden of SSc by calculating: 1) the proportions of SSc deaths as compared to deaths from all other causes (non-SSc) by age groups over time, 2) ASMR for SSc relative to non-SSc-ASMR by age groups over time, and 3) the YPLL for SSc relative to other autoimmune diseases.Methods:This is a population-based study using a national mortality database of all United States residents from 1968 through 2015, with SSc recorded as the underlying cause of death in 46,798 deaths. First, we calculated the proportions of deaths for SSc and non-SSc by age groups for each of 48 years and performed joinpoint regression trend analysis1to estimate annual percent change (APC) and average APC (AAPC) in the proportion of deaths by age. Second, we calculated ASMR for SSc and non-SSc causes and ratio of SSc-ASMR to non-SSc-ASMR by age groups for each of 48 years, and performed joinpoint analysis to estimate APC and AAPC for these measures (SSc-ASMR, non-SSc-ASMR, and SSc-ASMR/non-SSc-ASMR ratio) by age. Third, to calculate YPLL, each decedent’s age at death from a specific disease was subtracted from an arbitrary age limit of 75 years for years 2000 to 2015. The years of life lost were then added together to yield the total YPLL for each of 13 preselected autoimmune diseases.Results:23.4% of all SSc deaths as compared to 13.5% of non-SSc deaths occurred at <45 years age in 1968 (p<0.001, Chi-square test). In this age group, the proportion of annual deaths decreased more for SSc than for non-SSc causes: from 23.4% in 1968 to 5.7% in 2015 at an AAPC of -2.2% (95% CI, -2.4% to -2.0%) for SSc, and from 13.5% to 6.9% at an AAPC of -1.5% (95% CI, -1.9% to -1.1%) for non-SSc. Thus, in 2015, the proportion of SSc and non-SSc deaths at <45 year age was no longer significantly different. Consistently, SSc-ASMR decreased from 1.0 (95% CI, 0.8 to 1.2) in 1968 to 0.4 (95% CI, 0.3 to 0.5) per million persons in 2015, a cumulative decrease of 60% at an AAPC of -1.9% (95% CI, -2.5% to -1.2%) in <45 years old. The ratio of SSc-ASMR to non-SSc-ASMR also decreased in this age group (cumulative -20%, AAPC -0.3%). In <45 years old, the YPLL for SSc was 65.2 thousand years as compared to 43.2 thousand years for rheumatoid arthritis, 18.1 thousand years for dermatomyositis,146.8 thousand years for myocarditis, and 241 thousand years for type 1 diabetes.Conclusion:Mortality at younger ages (<45 years) has decreased at a higher pace for SSc than from all other causes in the United States over a 48-year period. However, SSc accounted for more years of potential life lost than rheumatoid arthritis and dermatomyositis combined. These data warrant further studies on SSc disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in treatment, identify high-risk populations, and set research priorities and funding.References:[1]Yen EY….Singh RR. Ann Int Med 2017;167:777-785.Disclosure of Interests:None declared

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