scholarly journals OP0191 All-cause mortality and cardiovascular death in hydroxychloroquine users in rheumatoid arthritis patients – a population based danish cohort study

2018 ◽  
Author(s):  
K. Soeltoft ◽  
J. Hallas ◽  
M.C.M. Wasko ◽  
A.B. Pedersen ◽  
S.P. Ulrichsen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Cardiovascular Death ◽  
Population Based ◽  
All Cause Mortality ◽  
Danish Cohort

Venous Thromboembolism and Critical Limb Events in Patients with Atrial Fibrillation: A Nationwide Population-Based Cohort Study

Angiology ◽  
2021 ◽  
pp. 000331972110337
Author(s):  
Ming-Shyan Lin ◽  
Chang-Min Chung ◽  
Mei-Yen Chen ◽  
Pao-Hsien Chu ◽  
Shih-Tai Chang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Cardiovascular Death ◽  
Population Based ◽  
Transluminal Angioplasty ◽  
Current Data ◽  
Subdistribution Hazard ◽  
Knee Amputation ◽  
All Cause Mortality

Little is known about whether venous thromboembolism (VTE) causes worse critical limb events in populations with atrial fibrillation (AF). A retrospective cohort study using claims data from Taiwan’s National Health Insurance program between 2001 and 2013 compared AF patients with or without VTE. Outcomes were percutaneous transluminal angioplasty (PTA), amputation, systemic thromboembolism, all-cause mortality, cardiovascular death, ischemic stroke, and acute myocardial infarction. Patients ( n = 316,817) with newly diagnosed AF were analyzed; of those, 2514 (0.79%) had VTE history. After inverse probability of treatment weighting, a history of VTE was significantly associated with higher risks of PTA (3.3 vs 2.2%; subdistribution hazard ratio [SHR] 1.47; 95% confidence interval [CI] 1.17–1.84); above knee amputation (0.7 vs 0.3%; HR 2.15; 95% CI 1.10–4.21); systemic thromboembolism (5.8 vs 3.9%; SHR 1.48; 95% CI 1.21–1.80); all-cause mortality (53 vs 46.4%; HR 1.20, 95% CI 1.12–1.29); and cardiovascular death (34.8 vs 29.4%; HR 1.25, 95% CI 1.14–1.36). In conclusion, VTE might increase the risk of critical lower limb events (PTA and above-knee amputation), systemic thromboembolism, and mortality in the AF population. However, current data cannot confirm a causal relationship between VTE and clinical outcomes in this population.

scholarly journals Mortality in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study and Systematic Review

2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
Greta Charukevič ◽  
Dalia Miltinienė ◽  
Jolanta Dadonienė
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Cohort Study ◽  
General Population ◽  
Mortality Risk ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Population Based ◽  
All Cause Mortality ◽  
Standardized Mortality Ratios

Background and Objectives: Mortality rates among patients with rheumatoid arthritis (RA) have been reported to be higher than in the general population. The long-term prognosis of RA has improved in recent years due to early diagnosis, as well as effective pharmacological treatment, and this may be able to diminish the excess mortality risk. This study was designed to investigate mortality (a) in patients with RA in a retrospectively defined national RA cohort in comparison with the general Lithuanian population, and (b) to conduct a systematic review of the literature from different countries and meta-analysis. Materials and Methods: In this national retrospective cohort study, patients with a first-time diagnosis of RA in the period between 1 January 2013 and 31 December 2017 were identified from the Lithuanian Compulsory Health Insurance Information System database SVEIDRA. All cases were cross-checked with the Health Information Center at the Institute of Hygiene, for the vital status of these patients and date of death if documented. The standardized mortality ratios (SMRs) with 95% confidence intervals (CI) obtained for all-cause mortality in patients with RA adjusted for age, sex, and calendar year were calculated. The search for published studies using the combination of keywords “rheumatoid arthritis AND standardized mortality ratio” was performed in MEDLINE (via PubMed, OVID, and EBSCO), Science Direct, Taylor & Francis, and Springer databases. Studies were selected according to described inclusion and exclusion criteria listed in the paper, and a meta-analysis was conducted. A random-effect meta-analysis model was used to compute the pooled standardized mortality ratios (meta-SMRs). Results: Overall, 4623 patients with newly diagnosed RA during the 2013–2017 period were identified and enrolled in the Lithuanian population-based cohort. The mean age of patients at the time of RA diagnosis was 58.7 (standard deviation (SD) 15.1) years, and 77.1% of the patients were women. The estimated SMR for all-cause mortality was 1.15 (95% CI 1.02, 1.29). The SMR for men (SMR 1.14, 95% CI 0.94, 1.39) was higher than for women (SMR 1.03, 95% CI 0.89, 1.19). A systematic literature search revealed 12 studies meeting the inclusion criteria, starting from 2010 to 2020, representing 50,072 patients. The meta-SMR in patients with RA for all-cause mortality was 1.41 (95% CI 1.29, 1.55). All-cause mortality risk was higher for men (meta-SMR 1.53, 95% CI 1.31, 1.78) than for women (meta-SMR 1.46, 95% CI 1.2, 1.77). Conclusions: In a retrospectively defined population-based national RA cohort, a 15% excess risk of death was observed among patients with RA compared to the general Lithuanian population. Patients with RA have a higher mortality risk than the general population. Published data indicate that the risk of mortality is increased by 41% in patients with RA compared to the general population. Excessive all-cause mortality risk is higher in men than in women. National data showed lower standardized mortality compared to literature data.

Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

2021 ◽  
pp. 1-25
Author(s):  
Qionggui Zhou ◽  
Xuejiao Liu ◽  
Yang Zhao ◽  
Pei Qin ◽  
Yongcheng Ren ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Normal Weight ◽  
Sensitivity Analyses ◽  
Hypertension Status ◽  
Moderation Effect ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Chinese Cohort ◽  
The Impact

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.

scholarly journals SAT0589 RISK FOR PSYCHIATRIC HOSPITALIZATION FOLLOWING A RHEUMA-RELATED HOSPITALIZATION: RESULTS FROM A CZECH NATIONWIDE, COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1253.2-1254
Author(s):  
T. Formánek ◽  
K. Mladá ◽  
M. Husakova
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Psychiatric Hospitalization ◽  
Population Based ◽  
Index Hospitalization ◽  
Increased Risk ◽  
History Of

Background:Cohort studies using nationwide health registers have shown an increased risk for affective and anxiety disorders in people with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) (1-3). Moreover, a nationwide cohort study demonstrated an increased risk for mental disorders in people with rheumatic diseases (4).Objectives:We aimed to investigate the risk for psychiatric hospitalization following a hospitalization for rheumatic disease.Methods:Using data from the Czech nationwide register of all-cause hospitalizations, we obtained 4 971 individuals hospitalized (index hospitalization) between 2004 and 2012 for rheumatic diseases - RA, spondyloarthritis (including AS, psoriatic arthritis and undifferentiated spondyloarthritis), systemic lupus erythematosus and systemic sclerodermia, with no history of psychiatric and rheuma-related hospitalization in the previous 10 years from the index hospitalization. On these individuals, we randomly matched (on age, gender and year of index hospitalization) controls that were hospitalized in the same time period for a non-rheumatic disease and have no history of psychiatric and rheumatic hospitalization in the last 10 years from their index hospitalization, in the ratio of 1:5. We employed conditional logistic regression for assessing the risk for psychiatric hospitalization in the subsequent 3 years from the index hospitalization. To strengthen our results, we repeated the matching step 100 times and run the analysis on each resulting dataset separately, and pooled the results. The findings are expressed as odds ratios (OR) with 95% confidence intervals (95% CI).Results:We identified an elevated risk for psychiatric (OR = 1.34, 95% CI = 1; 1.78) and for affective disorders (OR = 2.19, 95% CI = 1.17; 4.1) in people hospitalized for rheumatic diseases. We did not find a statistically significant association with organic, psychotic and anxiety disorders.Conclusion:There is an increased risk for experiencing a psychiatric disorder in the period of 3 years after a rheuma-related hospitalization.References:[1]Shen C-C, Hu L-Y, Yang AC, Kuo BI-T, Chiang Y-Y, Tsai S-J. Risk of Psychiatric Disorders following Ankylosing Spondylitis: A Nationwide Population-based Retrospective Cohort Study. The Journal of Rheumatology. 2016;43(3).[2]Park J-S, Jang H-D, Hong J-Y, Park Y-S, Han K, Suh S-W, et al. Impact of ankylosing spondylitis on depression: a nationwide cohort study. Scientific Reports. 2019;9(1):6736.[3]Hsu C-C, Chen S-C, Liu C-J, Lu T, Shen C-C, Hu Y-W, et al. Rheumatoid Arthritis and the Risk of Bipolar Disorder: A Nationwide Population-Based Study. PLOS ONE. 2014;9(9).[4]Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent Risk of Hospitalization for Neuropsychiatric Disorders in Patients With Rheumatic Diseases: A Nationwide Study From Sweden. Archives of General Psychiatry. 2008;65(5):501-7.Acknowledgments:Supported by the project (Ministry of Health Czech Republic) for conceptual development of research organization 00023728 (Institute of Rheumatology).Disclosure of Interests:Tomáš Formánek: None declared, Karolina Mladá: None declared, Marketa Husakova Speakers bureau: Novartis

scholarly journals Gender- and age-related differences of statin use on incident dementia in patients with rheumatoid arthritis: a Nationwide population-based cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsung-Kun Lin ◽  
Jing-Yang Huang ◽  
Lung-Fa Pan ◽  
Gwo-Ping Jong
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Subgroup Analysis ◽  
Cox Regression ◽  
Population Based ◽  
Age Related ◽  
Hazard Ratios ◽  
Incident Dementia ◽  
Gender And Age ◽  
New Onset

Abstract Background Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA. Methods We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003–2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted. Results Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97–1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients. Conclusion No association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40–60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.

scholarly journals Association between glaucoma surgery and all-cause and cause-specific mortality among elderly patients with glaucoma: a nationwide population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Yeop Lee ◽  
Hun Lee ◽  
Ji Sung Lee ◽  
Sol Ah Han ◽  
Yoon Jeon Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Cox Regression ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Population Based ◽  
Angle Closure ◽  
Charlson Comorbidity Index Score ◽  
All Cause Mortality ◽  
Specific Mortality

AbstractThis population-based, retrospective cohort study aimed to evaluate the association between glaucoma surgery and all-cause and cause-specific mortality among Korean elderly patients with glaucoma. A total of 16210 elderly patients (aged ≥ 60 years) diagnosed with glaucoma between 2003 and 2012 were included, and their insurance data were analyzed. The participants were categorized into a glaucoma surgery cohort (n = 487), which included individuals who had diagnostic codes for open angle glaucoma (OAG) or angle closure glaucoma (ACG) and codes for glaucoma surgery, and a glaucoma diagnosis cohort (n = 15,723), which included patients who had codes for OAG and ACG but not for glaucoma surgery. Sociodemographic factors, Charlson Comorbidity Index score, and ocular comorbidities were included as covariates. Cox regression models were used to assess the association between glaucoma surgery and mortality. The incidence of all-cause mortality was 34.76/1,000 person-years and 27.88/1,000 person-years in the glaucoma surgery and diagnosis groups, respectively. The adjusted hazard ratio (HR) for all-cause mortality associated with glaucoma surgery was 1.31 (95% confidence interval [CI], 1.05–1.62, P = 0.014). The adjusted HR for mortality due to a neurologic cause was significant (HR = 2.66, 95% CI 1.18–6.00, P = 0.018). The adjusted HRs for mortality due to cancer (HR = 2.03, 95% CI 1.07–3.83, P = 0.029) and accident or trauma (HR = 4.00, 95% CI 1.55–10.34, P = 0.004) associated with glaucoma surgery for ACG were significant as well. Glaucoma surgery was associated with an increase of mortality in elderly patients with glaucoma. In particular, the risk of mortality associated with glaucoma surgery due to neurologic causes was significant.

scholarly journals A.07 Characterizing the epidemiology of epilepsy in Saskatchewan, Canada

2018 ◽  
Vol 45 (s2) ◽  
pp. S11-S11
Author(s):  
L Hernandez Ronquillo ◽  
L Thorpe ◽  
P Pahwa ◽  
J Tellez Zenteno
Keyword(s):  
Cohort Study ◽  
Age Groups ◽  
Population Based ◽  
Secular Trends ◽  
Health Administrative Data ◽  
Time Period ◽  
Canadian Population ◽  
Incidence And Mortality ◽  
All Cause Mortality ◽  
Icd Codes

Background: There is no available estimate of the incidence and mortality of epilepsy in all age groups in the Canadian population. This study aimed to measure the incidence, prevalence, mortality and the secular trends for epilepsy in Saskatchewan between 2005 and 2010. Methods: A population-based cohort study was established from Saskatchewan’s provincial health administrative data. The population was followed until termination of coverage, death, or 31 December 2010. Individuals with epilepsy were identified based on ICD codes algorithms from 2005 to 2010. Results: The age-standardized incidence of epilepsy was 62 per 100,000 person-year. The age-standardized incidence rate of epilepsy in self-declared Registered Indians was 122 per 100,000 person-year. There was a significant decrease in the incidence of epilepsy for all groups over the study period. The age-standardized prevalence of epilepsy was 9 per 1,000 people. There was a significant increase in the prevalence of epilepsy over this time period. The adjusted mortality rate was 0.023 per 1000 person-year, and the all-cause Standardized Mortality Ration for epilepsy was 2.45. The SMR remained constant over the six-year period of the study. Conclusions: This study is the first in Canada to measure the incidence and all-cause mortality of epilepsy in all age groups.

scholarly journals 1738. Incidence and Outcomes of Hospitalization with Invasive Fungal Infection Among Solid-Organ Transplant Recipients: A Population-Based Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S636-S636
Author(s):  
Kyla L Naylor ◽  
Alexandra Ouédraogo ◽  
Sarah E Bota ◽  
Shahid Husain ◽  
J Michael Paterson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Graft Failure ◽  
Organ Transplant ◽  
Population Based ◽  
Solid Organ Transplant ◽  
Cumulative Probability ◽  
Solid Organ ◽  
Transplant Recipients ◽  
All Cause Mortality

Abstract Background Invasive fungal infection (IFI) in solid-organ transplant (SOT) recipients is associated with significant morbidity and mortality. The long-term probability of post-transplant IFI is poorly understood. Methods We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada to determine the incidence rate, 1-, 5- and 10-year cumulative probability of IFI-related hospitalization, and 1-year post-IFI all-cause mortality in SOT recipients from 2002 to 2016. We also examined post-IFI death-censored graft failure in renal transplant patients. Results We included 9326 SOT recipients (median follow-up 5.35 years). Overall, the incidence of IFI was 8.3 per 1000 person-years (95% confidence interval [CI]: 7.5–9.1). The 1-year cumulative probability of IFI was 7.4% (95% CI: 5.8–9.3%), 5.4% (95% CI: 3.6–8.1%), 1.8% (95% CI: 1.3–2.5%), 1.2% (95% CI: 0.5–3.2%), and 1.1% (95% CI: 0.9–1.4%) for lung, heart, liver, kidney-pancreas, and kidney-only transplant recipients, respectively. Lung transplant recipients had both the highest incidence rate and the highest 10-year probability of IFI: 43.0 per 1,000 person-years (95% CI: 36.8–50.0) and 26.4% (95% CI: 22.4–30.9%), respectively. Lung transplantation was also associated with the highest 1-year cumulative probability of post-IFI all-cause mortality (40.2%,95% CI: 33.1–48.3%). Among kidney transplant recipients, the 1-year probability of death-censored graft failure after IFI was 9.8% (95% CI: 6.0–15.8%). Conclusion The 1-year cumulative probability of IFI varies widely among SOT recipients. Lung transplantation was associated with the highest incidence of IFI with considerable 1-year all-cause mortality. The findings of this study considerably improved our understanding of the long-term probability of post-transplant IFI. Disclosures All authors: No reported disclosures.

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