Association between Hydroxychloroquine and bacterial pneumonia in rheumatic patients: A population‐based propensity score matching cohort study

Objectives: The main purpose of this retrospective cohort study was to provide an evaluation of Ankylosing spondylitis (AS) patients' fibromyalgia risk in different age and sex subgroups by analyzing large study samples.Methods: Datasets from the National Taiwan Insurance Research Database (NHIRD) were retrieved in this retrospective cohort study. This study was approved by the Institutional Review Board of Chung Shan Medical University (IRB permit number CS15134). Within the Longitudinal Health Insurance Database (LHID), and the subset of NHIRD, we identified AS patients to explore the risk of further fibromyalgia. The exposure cohort included patients with newly-diagnosed AS (ICD-9-CM:720.0) during 2000–2013. After 1:4 age-sex matching and 1:2 propensity score matching, and adjusting potential confounders, individuals without AS were identified as a comparison cohort. The adjusted hazard ratio of subsequent development of fibromyalgia in people with AS was evaluated. Further stratification analyses of different ages and genders were then undertaken to validate the results.Results: In total, 17 088 individuals were included in the present study, including 5,696 patients with AS and 11,392 individuals without AS. Respective incidence rates (per 1,000 person-months) of fibromyalgia was 0.52 (95% CI, 0.46–0.59) in the AS cohort and 0.39 (95% CI, 0.35–0.44) in the non-AS cohort. Compared with the non-AS cohort, aHR of developing fibromyalgia was 1.32 (95% CI, 1.12–1.55) in people with AS. This association was consistent in both statistical models of 1:4 age–sex matching and 1:2 propensity score matching.Conclusion: Patients with AS were associated with a higher risk of fibromyalgia, especially those over 65 years old. In managing patients with AS, clinicians should be aware of this association, which could impact diagnosis, disease activity evaluation, and treatment.

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Predictive role of HER2-status on the effectiveness of endocrine adjuvant treatment in postmenopausal breast cancer patients: a population-based cohort study

Breast Cancer Research and Treatment ◽

10.1007/s10549-020-06022-5 ◽

2020 ◽

Author(s):

Aglaia Schiza ◽

Davide Mauri ◽

Irma Fredriksson ◽

Anna-Karin Wennstig ◽

Antonios Valachis

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Endocrine Therapy ◽

Population Based ◽

Her2 Status ◽

Her2 Positive ◽

Study Results

Abstract Purpose There are conflicting results on the potential role of HER2-status on the efficacy of aromatase inhibitors (AIs) and tamoxifen (TAM) in patients with hormone receptor (HR)-positive breast cancer (BC). The purpose of this population-based cohort study was to investigate the potential benefit of AIs compared to TAM as adjuvant therapy in postmenopausal BC patients by HER2-status in the era of modern therapy with HER2-blockade. Methods A population-based cohort study was performed including all postmenopausal women diagnosed with HR-positive BC without distant metastasis between 2007 and 2012 in three healthcare regions in Sweden. We analyzed the breast cancer-specific survival (BCSS) and overall survival (OS) in two distinct cohorts (HER2-negative, HER2-positive) based on the type of endocrine therapy (ET) used. A propensity score matching was performed separately in the HER2-negative and HER2-positive cohorts, respectively. Results After propensity score matching, 4368 patients with HER2-negative and 214 patients with HER2-positive BC were available for analysis. In the HER2-negative cohort, an improved BCSS [Hazard Ratio (HR): 0.51; 95% confidence interval (CI): 0.34–0.77, p value < 0.001] and a trend toward improved OS (HR: 0.66; 95% CI: 0.41–1.08, p value = 0.093) in favor of AI-based therapy was observed. In the HER2-positive cohort, no statistically significant difference between AI-based ET and TAM was found in terms of either BCSS or OS, although the direction of HR was similar as in the HER2-negative cohort (HR for BCSS: 0.84; 95% CI: 0.14–5.04, p = 0.849; HR for OS: 0.62; 95% CI: 0.10–3.38, p = 0.345). Conclusion Our study results, based on propensity-matched cohorts, did not support any predictive value of HER2-status on endocrine therapy in postmenopausal BC patients. AI-based ET remains the treatment of choice for postmenopausal BC patients with HR-positive disease in the modern era of HER2-directed therapy irrespective of HER2-status.

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Association of comorbidities with COVID-19 infection rate and severity: nationwide cohort study with propensity score matching

10.1101/2021.09.22.21263946 ◽

2021 ◽

Author(s):

Jiyong Kim ◽

Seong Hun Park ◽

Jong Moon Kim

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Infection Rate ◽

Severe Infection ◽

Population Based ◽

The Disabled ◽

Severe Group ◽

Korean National Health Insurance ◽

The Government

OBJECTIVE: To describe the association of comorbidities with coronavirus infection-19 (COVID-19) infection rates and severity of infection through Korean nationwide medical system. DESIGN: Nationwide population-based retrospective cohort study. SETTING: Korean national health insurance claims database between January 1, 2020, and May 30, 2020. PARTICIPANTS: Patients with positive COVID-19 test and 12 folded controls matched by age, sex and region. MAIN OUTCOMES MEASURES: Outcomes were confirmation of the comorbidities affecting the infection rate and the severity of COVID-19. Patients and outcomes were propensity score matching of factors which may affect COVID-19 infection rate and severity was performed. COVID-19 infections were confirmed through laboratory testing. Severe infection was defined as those who underwent tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, or died. RESULTS: A total of 8070 individuals with positive covid-19 test and 12015 controls were identified. In people aged 60 or older, in those insured with Medicaid, and in the disabled, the proportion corresponding to the severe group of patients showed a tendency to increase. The infection rate of COVID-19 was highest in pulmonary disease (adjusted odds ratio 1.88, 95% confidence interval 1.70 to 2.03), and hyperlipidemia (0.73, 0.67 to 0.80) had a lower infection rate. Disease severity was highest in kidney disease (5.59, 2.48 to 12.63), and lower in hyperlipidemia (0.78, 0.60 to 1.00). CONCLUSIONS: There is less bias as the government pays for all tests and treatments related to COVID-19 included in the data used in this study. Using propensity matching to reduce statistical bias, we found that most comorbidities increased the infection rate and severity of COVID-19, whereas hyperlipidemia reduced the rate and severity of infection. These results can be utilized to effectively manage COVID-19 infections.

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A commentary on “Evaluation of delayed bleeding risks associated with partial hepatectomy: A nationwide population-based propensity score matching study” (Int J Surg 2021; 90:105980)

International Journal of Surgery ◽

10.1016/j.ijsu.2021.106041 ◽

2021 ◽

pp. 106041

Author(s):

Yi Fu ◽

Shixi Wu

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Partial Hepatectomy ◽

Population Based ◽

Delayed Bleeding

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The volume–outcome relationship in laparoscopic cholecystectomy: a population-based study using propensity score matching

Surgical Endoscopy ◽

10.1007/s00464-013-2867-x ◽

2013 ◽

Vol 27 (9) ◽

pp. 3139-3145 ◽

Cited By ~ 14

Author(s):

Hon-Yi Shi ◽

King-Teh Lee ◽

Chong-Chi Chiu ◽

Hao-Hsien Lee

Keyword(s):

Laparoscopic Cholecystectomy ◽

Propensity Score ◽

Propensity Score Matching ◽

Population Based ◽

Population Based Study ◽

Outcome Relationship ◽

Volume Outcome

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Dialyzer Classification and Mortality in Hemodialysis Patients: A 3-Year Nationwide Cohort Study

Frontiers in Medicine ◽

10.3389/fmed.2021.740461 ◽

2021 ◽

Vol 8 ◽

Author(s):

Masanori Abe ◽

Ikuto Masakane ◽

Atsushi Wada ◽

Shigeru Nakai ◽

Kosaku Nitta ◽

...

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Subgroup Analysis ◽

Hemodialysis Patients ◽

Type I ◽

High Flux ◽

Type Iv ◽

Japanese Classification ◽

Type V

Background: Dialyzers are classified as low-flux, high-flux, and protein-leaking membrane dialyzers internationally and as types I, II, III, IV, and V based on β2-microglobulin clearance rate in Japan. Type I dialyzers correspond to low-flux membrane dialyzers, types II and III to high-flux membrane dialyzers, and types IV and V to protein-leaking membrane dialyzers. Here we aimed to clarify the association of dialyzer type with mortality.Methods: This nationwide retrospective cohort study analyzed data from the Japanese Society for Dialysis Therapy Renal Data Registry from 2010 to 2013. We enrolled 238,321 patients on hemodialysis who were divided into low-flux, high-flux, and protein-leaking groups in the international classification and into type I to V groups in the Japanese classification. We assessed the associations of each group with 3-year all-cause mortality using Cox proportional hazards models and performed propensity score matching analysis.Results: By the end of 2013, 55,308 prevalent dialysis patients (23.2%) had died. In the international classification subgroup analysis, the hazard ratio (95% confidence interval) was significantly higher in the low-flux group [1.12 (1.03–1.22), P = 0.009] and significantly lower in the protein-leaking group [0.95 (0.92–0.98), P = 0.006] compared with the high-flux group after adjustment for all confounders. In the Japanese classification subgroup analysis, the hazard ratios were significantly higher for types I [1.10 (1.02–1.19), P = 0.015] and II [1.10 (1.02–1.39), P = 0.014] but significantly lower for type V [0.91 (0.88–0.94), P < 0.0001] compared with type IV after adjustment for all confounders. These significant findings persisted after propensity score matching under both classifications.Conclusions: Hemodialysis using protein-leaking dialyzers might reduce mortality rates. Furthermore, type V dialyzers are superior to type IV dialyzers in hemodialysis patients.

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