Increased risk of all‐cause mortality associated with domperidone use in Parkinson's patients: a population‐based cohort study in the UK

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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Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study

Acta Endocrinologica ◽

10.1530/eje-16-0576 ◽

2017 ◽

Vol 176 (1) ◽

pp. 1-9 ◽

Cited By ~ 19

Author(s):

Olaf M Dekkers ◽

Erzsébet Horváth-Puhó ◽

Suzanne C Cannegieter ◽

Jan P Vandenbroucke ◽

Henrik Toft Sørensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Ischemic Stroke ◽

Cardiovascular Events ◽

Population Based ◽

Arterial Embolism ◽

Registration System ◽

Increased Risk ◽

All Cause Mortality

Objective Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. Design It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. Results The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40–4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33–1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58–8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30–8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. Conclusions We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism.

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Associations Between Anemia, Cognitive Impairment, and All-Cause Mortality in Oldest-Old Adults: A Prospective Population-Based Cohort Study

Frontiers in Medicine ◽

10.3389/fmed.2021.613426 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jia Wangping ◽

Han Ke ◽

Wang Shengshu ◽

Song Yang ◽

Yang Shanshan ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Impairment ◽

Mortality Risk ◽

Proportional Hazards ◽

Oldest Old ◽

Population Based ◽

Cox Proportional Hazards ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality

Objective: To evaluate the combined effects of anemia and cognitive function on the risk of all-cause mortality in oldest-old individuals.Design: Prospective population-based cohort study.Setting and Participants: We included 1,212 oldest-old individuals (men, 416; mean age, 93.3 years).Methods: Blood tests, physical examinations, and health questionnaire surveys were conducted in 2012 were used for baseline data. Mortality was assessed in the subsequent 2014 and 2018 survey waves. Cox proportional hazards models were used to evaluate anemia, cognitive impairment, and mortality risk. We used restricted cubic splines to analyze and visualize the association between hemoglobin (Hb) levels and mortality risk.Results: A total of 801 (66.1%) deaths were identified during the 6-year follow-up. We noted a significant association between anemia and mortality (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14–1.54) after adjusting for confounding variables. We also observed a dose-response relationship between the severity of anemia and mortality (P < 0.001). In the restricted cubic spline models, Hb levels had a reverse J-shaped association with mortality risk (HR 0.88, 95% CI 0.84–0.93 per 10 g/L-increase in Hb levels below 130 g/L). The reverse J-shaped association persisted in individuals without cognitive impairment (HR 0.88, 95% CI 0.79–0.98 per 10 g/L-increase in Hb levels below 110 g/L). For people with cognitive impairment, Hb levels were inversely associated with mortality risk (HR 0.83, 95% CI 0.78–0.89 per 10 g/L-increase in Hb levels below 150 g/L). People with anemia and cognitive impairment had the highest risk of mortality (HR 2.60, 95% CI 2.06–3.27).Conclusion: Our results indicate that anemia is associated with an increased risk of mortality in oldest-old people. Cognitive impairment modifies the association between Hb levels and mortality.

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Outcomes of an Inpatient Dialysis Start in Patients With Kidney Graft Failure: A Population-Based Multicentre Cohort Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120985376 ◽

2021 ◽

Vol 8 ◽

pp. 205435812098537

Author(s):

Kyla L. Naylor ◽

Gregory A. Knoll ◽

Eric McArthur ◽

Amit X. Garg ◽

Ngan N. Lam ◽

...

Keyword(s):

Cohort Study ◽

Cumulative Incidence ◽

Graft Failure ◽

Population Based ◽

Hospital Inpatient ◽

Kidney Graft ◽

Kidney Transplant Recipients ◽

Increased Risk ◽

Significant Difference ◽

All Cause Mortality

Background: The frequency and outcomes of starting maintenance dialysis in the hospital as an inpatient in kidney transplant recipients with graft failure are poorly understood. Objective: To determine the frequency of inpatient dialysis starts in patients with kidney graft failure and examine whether dialysis start status (hospital inpatient vs outpatient setting) is associated with all-cause mortality and kidney re-transplantation. Design: Population-based cohort study. Setting: We used linked administrative healthcare databases from Ontario, Canada. Patients: We included 1164 patients with kidney graft failure from 1994 to 2016. Measurements: All-cause mortality and kidney re-transplantation. Methods: The cumulative incidence function was used to calculate the cumulative incidence of all-cause mortality and kidney re-transplantation, accounting for competing risks. Subdistribution hazard ratios from the Fine and Gray model were used to examine the relationship between inpatient dialysis starts (vs outpatient dialysis start [reference]) and the dependent variables (ie, mortality or re-transplant). Results: We included 1164 patients with kidney graft failure. More than half (55.8%) of patients with kidney graft failure, initiated dialysis as an inpatient. Compared with outpatient dialysis starters, inpatient dialysis starters had a significantly higher cumulative incidence of mortality and a significantly lower incidence of kidney re-transplantation ( P < .001). The 10-year cumulative incidence of mortality was 51.9% (95% confidence interval [CI]: 47.4, 56.9%) (inpatient) and 35.3% (95% CI: 31.1, 40.1%) (outpatient). After adjusting for clinical characteristics, we found inpatient dialysis starters had a significantly increased hazard of mortality in the first year after graft failure (hazard ratio: 2.18 [95% CI: 1.43, 3.33]) but at 1+ years there was no significant difference between groups. Limitations: Possibility of residual confounding and unable to determine inpatient dialysis starts that were unavoidable. Conclusions: In this study we identified that most patients with kidney graft failure had inpatient dialysis starts, which was associated with an increased risk of mortality. Further research is needed to better understand the reasons for an inpatient dialysis start in this patient population.

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Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England

BMJ ◽

10.1136/bmj.n628 ◽

2021 ◽

pp. n628 ◽

Cited By ~ 1

Author(s):

Harriet Forbes ◽

Caroline E Morton ◽

Seb Bacon ◽

Helen I McDonald ◽

Caroline Minassian ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Hospital Admissions ◽

Absolute Risk ◽

Population Based ◽

Intensive Care Admission ◽

Risk Of Death ◽

Hazard Ratios ◽

Increased Risk ◽

The Uk

Abstract Objective To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic. Design Population based cohort study, on behalf of NHS England. Setting Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020). Participants Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020. Main outcome measures Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household. Results Among 9 334 392 adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10 000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10 000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10 000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10 000 in the number of hospital admissions. Conclusions In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.

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Complications and mortality in patients with schizophrenia and diabetes: Population-based cohort study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.143925 ◽

2015 ◽

Vol 207 (5) ◽

pp. 450-457 ◽

Cited By ~ 9

Author(s):

Chi-Shin Wu ◽

Mei-Shu Lai ◽

Susan Shur-Fen Gau

Keyword(s):

Cohort Study ◽

Microvascular Complications ◽

Population Based ◽

Macrovascular Complications ◽

Research Database ◽

Long Term Outcome ◽

Increased Risk ◽

All Cause Mortality ◽

Patients With Diabetes ◽

Complications And Mortality

BackgroundThe long-term outcome of patients with both diabetes and schizophrenia remains unclear.AimsTo explore whether having schizophrenia increases the risk of advanced complications and mortality in people with diabetes.MethodThis is a population-based matched cohort study using Taiwan's National Health Insurance Research Database. A total of 11 247 participants with diabetes and schizophrenia and 11 247 participants with diabetes but not schizophrenia were enrolled. We used Cox proportional hazard models to determine the effect of schizophrenia on macrovascular and microvascular complications, and all-cause mortality.ResultsThe adjusted hazard ratios were 1.49 (95% CI 1.32–1.68) for macrovascular complications, 1.05 (95% CI 0.91–1.21) for microvascular complications and 3.68 (95% CI 3.21–4.22) for all-cause mortality in patients with diabetes and schizophrenia compared with those patients with diabetes but not schizophrenia.ConclusionsPatients with both diabetes and schizophrenia had an increased risk of macrovascular complications and all-cause mortality but did not have statistically significant elevated risk of microvascular complications.

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Risk of mortality and complications in patients with schizophrenia and diabetes mellitus: population-based cohort study

The British Journal of Psychiatry ◽

10.1192/bjp.2020.248 ◽

2021 ◽

pp. 1-8

Author(s):

Joe Kwun Nam Chan ◽

Corine Sau Man Wong ◽

Philip Chi Fai Or ◽

Eric Yu Hai Chen ◽

Wing Chung Chang

Keyword(s):

Cohort Study ◽

Complication Rate ◽

Population Based ◽

Incident Diabetes ◽

Diabetes Diagnosis ◽

Risk Of Mortality ◽

Increased Risk ◽

Metabolic Complication ◽

All Cause Mortality ◽

Patients With Diabetes

Background Schizophrenia patients have markedly elevated prevalence of diabetes compared with the general population. However, risk of mortality and diabetes-related complications among schizophrenia patients with co-occurring diabetes is understudied. Aims We investigated whether schizophrenia increased the risk of overall mortality, complications and post-complication mortality in people with diabetes. Method This population-based, propensity-score matched (1:10) cohort study identified 6991 patients with incident diabetes and pre-existing schizophrenia and 68 682 patients with incident diabetes only between 2001 and 2016 in Hong Kong using a medical record database of public healthcare services. Association between schizophrenia and all-cause mortality was examined with a Cox proportional hazards model. Effect of schizophrenia on first-year complication occurrence following diabetes diagnosis and post-complication mortality rates were evaluated. Results Schizophrenia was associated with increased all-cause mortality (adjusted hazards ratio [aHR] 1.11, 95% CI 1.05–1.18), particularly among men and older age groups. Schizophrenia patients with diabetes had higher metabolic complication rate (aHR 1.99, 95% CI 1.63–2.42), lower microvascular complication rate (aHR 0.75, 95% CI 0.65–0.86) and comparable macrovascular complication rate (aHR 0.93, 95% CI 0.85–1.03), relative to patients with diabetes only. Among patients with diabetes complications, schizophrenia was associated with elevated all-cause mortality after macrovascular (aHR 1.19, 95% CI 1.04–1.37) and microvascular (aHR 1.33, 95% CI 1.08–1.64) complications. Gender-stratified analyses revealed that a significant effect of schizophrenia on heightened post-complication mortality was observed in men only. Conclusions Schizophrenia patients with co-occurring diabetes are at increased risk of excess mortality, including post-complication mortality. Further research identifying effective interventions is warranted to optimise diabetes-related outcomes in this vulnerable population.

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Risk of mortality associated with concomitant antidepressant and benzodiazepine therapy among patients with depression: a population-based cohort study

BMC Medicine ◽

10.1186/s12916-020-01854-w ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Han Eol Jeong ◽

Ha-Lim Jeon ◽

In-Sun Oh ◽

Woo Jung Kim ◽

Ju-Young Shin

Keyword(s):

Cohort Study ◽

Population Based ◽

Cox Proportional Hazards ◽

Study Cohort ◽

Therapeutic Effects ◽

Healthcare Database ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

Baseline Characteristics

Abstract Background With antidepressants (ADs) having minimal therapeutic effects during the initial weeks of treatment, benzodiazepines (BZDs) are concomitantly used to alleviate depressive symptoms of insomnia or anxiety. However, with mortality risks associated with this concomitant use yet to be examined, it remains unclear as to whether this concomitant therapy offers any benefits in treating depression. Methods We conducted a population-based cohort study using South Korea’s nationwide healthcare database from 2002 to 2017. Of 2.6 million patients with depression, we identified 612,729 patients with incident depression and newly prescribed ADs or BZDs, by excluding those with a record of diagnosis or prescription within the 2 years prior to their incident diagnosis. We classified our study cohort into two discrete groups depending on the type of AD treatment received within 6 months of incident diagnosis—AD monotherapy and AD plus BZD (AD+BZD) therapy. We matched our study cohort in a 1:1 ratio using propensity scores to balance baseline characteristics and obtain comparability among groups. The primary outcome was all-cause mortality, and patients were followed until the earliest of outcome occurrence or end of the study period. We conducted multivariable Cox proportional hazards regression analysis to estimate adjusted hazards ratios (HRs) with 95% confidence intervals (CIs) for the risk of mortality associated with AD+BZD therapy versus AD monotherapy. Results The propensity score-matched cohort had 519,780 patients with 259,890 patients in each group, where all baseline characteristics were well-balanced between the two groups. Compared to AD monotherapy, AD+BZD therapy was associated with an increased risk of all-cause mortality (adjusted HR, 1.04; 95% CI, 1.02 to 1.06). Conclusions Concomitantly initiating BZDs with ADs was associated with a moderately increased risk of mortality. Clinicians should therefore exercise caution when deciding to co-prescribe BZDs with ADs in treating depression, as associated risks were observed.

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Incidence of cardiometabolic diseases in people living with and without HIV in the UK: a population-based matched cohort study

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab420 ◽

2021 ◽

Author(s):

Tiffany E Gooden ◽

Mike Gardner ◽

Jingya Wang ◽

Kate Jolly ◽

Deirdre A Lane ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Population Based ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Increased Risk ◽

All Cause Mortality ◽

Hiv Negative

Abstract Background Evidence on the risk of cardiovascular disease (CVD) and CVD risk factors in people with HIV (PWH) is limited. We aimed to identify the risk of composite CVD, individual CVD events and common risk factors. Methods This was a nationwide population-based cohort study comparing adult (≥18y) PWH with HIV-negative individuals matched on age, sex, ethnicity and location. The primary outcome was composite CVD comprising stroke, myocardial infarction (MI), peripheral vascular disease (PVD), ischaemic heart disease and heart failure. The secondary outcomes were individual CVD events, hypertension, diabetes, chronic kidney disease (CKD) and all-cause mortality. Cox proportional hazard regression models were used to examine the risk of each outcome. Results We identified 9233 PWH and 35721 HIV-negative individuals. An increased risk was found for composite CVD (adjusted hazard ratio [aHR] 1.50, 95% CI 1.28-1.77), stroke (aHR 1.42, 95% CI 1.08-1.86), ischaemic heart disease (aHR 1.55, 95% CI 1.24-1.94), hypertension (aHR 1.37, 95% CI 1.23-1.53), type 2 diabetes (aHR 1.28, 95% CI 1.09-1.50), CKD (aHR 2.42, 95% CI 1.98-2.94) and all-cause mortality (aHR 2.84, 95% CI (2.48-3.25). Conclusions PWH have a heightened risk for CVD and common CVD risk factors, reinforcing the importance for regular screening for such conditions.

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Heart Rate and Heart Rate Variability Changes Are Not Related to Future Cardiovascular Disease and Death in People With and Without Dysglycemia: A Downfall of Risk Markers? The Whitehall II Cohort Study

10.2337/figshare.13526351.v1 ◽

2021 ◽

Author(s):

Christian S Hansen ◽

Marit E Jørgensen ◽

Marek Malik ◽

Daniel R Witte ◽

Eric J Brunner ◽

...

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Cohort Study ◽

Population Based ◽

Increased Risk ◽

All Cause Mortality ◽

Future Events ◽

Design And Methods

Objective Higher resting heart rate (rHR) and lower heart rate variability (HRV) are associated with increased risk of cardiovascular disease (CVD) and all-cause mortality in people with and without diabetes It is unknown whether temporal changes in rHR and HRV may contribute to this risk. We investigated associations between 5-year changes in rHR and HRV and risk of future CVD and death, taking into account participants’ baseline glycemic state. Research design and Methods In this prospective population-based cohort study we investigated 4,611 CVD-free civil servants (mean age 60, SD=5.9 years, 70% men). rHR and/or 6 indices of HRV were measured. Associations of 5-year change in 5-minute rHR and HRV with fatal- and non-fatal CVD and all-cause mortality or the composite of the two were assessed with adjustments for relevant confounders. Effect modification by glycemic state was tested. Results At baseline, 63% of participants were normoglycemic, 29% had prediabetes and 8% had diabetes. During a median (IQR) follow-up of 11.9 (11.4;12.3) years, 298 participants (6.5%) experienced a CVD event and 279 (6.1%) died from non-CVD related causes. We found no association between 5-year changes in rHR and HRV and future events. Only baseline rHR was associated with all-cause mortality. A 10 beats per minute higher baseline level showed a 11.4% higher rate of all-cause mortality (95%CI:1.0;22.9%, P=0.032). Glycemic state did not modify associations. Conclusion Changes in rHR and HRV and possibly also baseline values of these measures are not associated with future CVD or mortality in people with or without dysglycemia.

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