Mortality and risk of cardiac complications among immediate survivors of accidental electric shock: a Danish nationwide cohort study

ObjectiveExposure to electric shock has been associated with an increased risk of developing delayed cardiac arrhythmias and cardiac diseases. We examined whether electric shock patients have an increased risk of developing cardiac disease, cardiac arrhythmias or death compared with the general Danish population.DesignMatched cohort study.SettingA nationwide study in Denmark from 1994 to 2011.ParticipantsWe identified 11 462 Danish patients who visited an emergency ward or were admitted to a hospital due to electric shock from 1994 to 2011. Each patient was matched for age and sex with five random controls from the Danish population.Main outcome measuresMortality, cardiac procedures and cardiac diseases following electric shock.ResultsA total of 7390 electric shock patients were seen at an emergency ward and 4072 electric shock patients were admitted to a hospital. The median patient age was 28.6 years (Q1–Q3, 21.3–37.7) for the emergency ward patients and 26.4 years (Q1–Q3, 18.3–37.4) for admitted patients. In both groups, most patients were male (74.0% and 76.8%). Few of the electric shock patients had a record of cardiovascular disease at baseline (364/11 462, 3.2%). The 5-year cumulative incidence of death was 0.47% (95% CI 0.29% to 0.65%) for emergency ward patients and 1.04% (95% CI 0.71% to 1.37%) for admitted patients. No difference in 5-year survival was observed compared with matched controls (emergency ward, p=0.10; admitted patients, p=0.80). Fewer than four patients received a pacemaker within 30 days.ConclusionsThis nationwide study did not demonstrate an increase in mortality among patients seen at hospitals after accidental electric shock compared with a background population. Cardiac procedures and diseases following electric shock were very rare. We suggest that nearly all patients can be discharged safely from the emergency room after electric shock without further observation.

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Multimorbidity and mortality

Journal of Comorbidity ◽

10.1177/2235042x18804063 ◽

2018 ◽

Vol 8 (1) ◽

pp. 2235042X1880406 ◽

Cited By ~ 18

Author(s):

TG Willadsen ◽

V Siersma ◽

DR Nicolaisdóttir ◽

R Køster-Rasmussen ◽

DE Jarbøl ◽

...

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Prospective Cohort Study ◽

High Mortality ◽

Mortality Risk ◽

Prospective Cohort ◽

Excess Mortality ◽

Sensory Organs ◽

Danish Population ◽

Increased Risk

Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed. Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of one to five diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3.986.209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least 2 of 10 diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, ORs) and ratio of ORs (ROR) were used to study mortality and excess mortality. Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination was the musculoskeletal–cardiovascular (0.4%), which had double the mortality (OR, 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR, 0.97). The neurological–cancer combination had the highest mortality (OR, 6.35), was less prevalent (0.07%), and had no excess mortality (ROR, 0.94). Cardiovascular–lung was moderately prevalent (0.2%), had high mortality (OR, 5.75), and had excess mortality (ROR, 1.18). Endocrine–kidney had high excess mortality (ROR, 1.81) and cancer–mental had low excess mortality (ROR, 0.66). Mortality increased with the number of groups. Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, that is, were additive rather than synergistic.

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Increased risk of antidepressant use in childhood cancer survivors: A Danish population-based cohort study

European Journal of Cancer ◽

10.1016/j.ejca.2015.01.001 ◽

2015 ◽

Vol 51 (5) ◽

pp. 675-684 ◽

Cited By ~ 16

Author(s):

Lasse Wegener Lund ◽

J.F. Winther ◽

L. Cederkvist ◽

K.K. Andersen ◽

S.O. Dalton ◽

...

Keyword(s):

Cohort Study ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Population Based ◽

Danish Population ◽

Increased Risk ◽

Antidepressant Use

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Risk factors for developing cardiac toxicities in cancer patients treated with panitumumab combination therapy

10.21203/rs.2.12419/v1 ◽

2019 ◽

Author(s):

Wei-xiang Qi ◽

shengguang zhao ◽

Jiayi Chen

Keyword(s):

Cardiac Arrhythmias ◽

Cardiac Event ◽

Cardiac Toxicity ◽

Controlled Trials ◽

Cardiac Diseases ◽

Ischemic Event ◽

Randomized Controlled ◽

Increased Risk ◽

History Of ◽

Or History

Abstract Background Panitumumab, a novel anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb), has been approved for the treatment of advanced colorectal cancer (CRC), and it is also being studied in other types of cancer. However, an increased risk of cardiac toxicities has been observed in some trials. The current study aims to evaluate the patterns and risk of cardiac toxicities by performing post hoc analyses of randomized controlled trials that evaluated treatment with or without panitumumab in advanced cancer patients. Methods Data were obtained from four randomized controlled trials (NCT00115765, NCT00339183, NCT00364013, and NCT00460265) which included a total of 3,243 patients with metastatic colorectal or head and neck carcinoma. The incidence of cardiac toxicity was assessed by simple incidence rates and rates per 100 person-years. Univariate and multivariate cox proportional hazards regression was conducted to investigate factors predicting the development of any cardiac event, cardiac arrhythmias and ischemic event. Results In comparison with controls, the use of panitumumab-containing therapy in cancer was associated with a significantly increased risk of developing cardiac arrhythmias (HR1.42, 95%CI: 1.02-1.96, p=0.036), but not for any cardiac event (HR1.16, 95%CI: 0.90-1.50, p=0.24) or ischemic event (HR 0.61, 95%CI: 0.35-1.07, p=0.087). The absolute rate of developing cardiac arrhythmia was 10.0 events per 100 person-years for those receiving combination therapy and 7.5 events per 100 person-years for those receiving chemotherapy alone. Within multivariate cox regression analysis for factors predicting any cardiac toxicity, pre-existing hypertension(p=0.0013) or history of cardiac diseases (p=0.01) were predictive for occurrence of any cardiac toxicity. Additionally, development of cardiac arrhythmias was associated with a pre-existing hypertension (p=0.033), history of cardiac disease (p=0.055) or panitumumab usage (p=0.046) in multivariate regression analysis. Conclusion The addition of panitumumab to chemotherapy increases the risk of developing cardiac arrhythmia, but not for any cardiac toxicity or ischemic events. Patients with pre-existing hypertension or history of cardiac diseases are at high risk for developing cardiac toxicities when receiving panitumumab treatment.

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Major depression and first-time hospitalization with ischemic heart disease, cardiac procedures and mortality in the general population: A retrospective Danish population-based cohort study

European Journal of Preventive Cardiology ◽

10.1177/2047487312467874 ◽

2012 ◽

Vol 21 (5) ◽

pp. 532-540 ◽

Cited By ~ 19

Author(s):

Christiane Gasse ◽

Thomas M Laursen ◽

Bernhard T Baune

Keyword(s):

Cohort Study ◽

Heart Disease ◽

Major Depression ◽

General Population ◽

Ischemic Heart Disease ◽

Population Based ◽

Ischemic Heart ◽

Danish Population ◽

Cardiac Procedures ◽

First Time

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Sequelae and Comorbidities of COVID-19 Manifestations on the Cardiac and the Vascular Systems

Frontiers in Physiology ◽

10.3389/fphys.2021.748972 ◽

2022 ◽

Vol 12 ◽

Author(s):

Yashvardhan Batta ◽

Cody King ◽

John Johnson ◽

Natasha Haddad ◽

Myriam Boueri ◽

...

Keyword(s):

Cardiac Arrhythmias ◽

De Novo ◽

Case Fatality ◽

Severe Illness ◽

Cardiac Complications ◽

Protective Mechanism ◽

Significant Group ◽

Presenting Symptoms ◽

Increased Risk ◽

Depth Analysis

COVID-19 patients with pre-existing cardiovascular conditions are at greater risk of severe illness due to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus. This review evaluates the highest risk factors for these patients, not limited to pre-existing hypertension, cardiac arrhythmias, hypercoagulation, ischemic heart disease, and a history of underlying heart conditions. SARS-CoV-2 may also precipitate de novo cardiac complications. The interplay between existing cardiac conditions and de novo cardiac complications is the focus of this review. In particular, SARS-CoV-2 patients present with hypercoagulation conditions, cardiac arrhythmias, as significant complications. Also, cardiac arrhythmias are another well-known cardiovascular-related complication seen in COVID-19 infections and merit discussion in this review. Amid the pandemic, myocardial infarction (MI) has been reported to a high degree in SARS-CoV-2 patients. Currently, the specific causative mechanism of the increased incidence of MI is unclear. However, studies suggest several links to high angiotensin-converting enzyme 2 (ACE2) expression in myocardial and endothelial cells, systemic hyper-inflammation, an imbalance between myocardial oxygen supply and demand, and loss of ACE2-mediated cardio-protection. Furthermore, hypertension and SARS-CoV-2 infection patients’ prognosis has shown mixed results across current studies. For this reason, an in-depth analysis of the interactions between SARS-CoV2 and the ACE2 cardio-protective mechanism is warranted. Similarly, ACE2 receptors are also expressed in the cerebral cortex tissue, both in neurons and glia. Therefore, it seems very possible for both cardiovascular and cerebrovascular systems to be damaged leading to further dysregulation and increased risk of mortality risk. This review aims to discuss the current literature related to potential complications of COVID-19 infection with hypertension and the vasculature, including the cervical one. Finally, age is a significant prognostic indicator among COVID-19 patients. For a mean age group of 70 years, the main presenting symptoms include fever, shortness of breath, and a persistent cough. Elderly patients with cardiovascular comorbidities, particularly hypertension and diabetes, represent a significant group of critical cases with increased case fatality rates. With the current understanding of COVID-19, it is essential to explore the mechanisms by which SARS-CoV-2 operates to improve clinical outcomes for patients suffering from underlying cardiovascular diseases and reduce the risk of such conditions de novo.

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