scholarly journals Association between spinal curvature disorders and injury: a nationwide population-based retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023604
Author(s):  
Yen-Liang Kuo ◽  
Chi-Hsiang Chung ◽  
Tsai-Wang Huang ◽  
Chang-Huei Tsao ◽  
Shan-Yueh Chang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Population Based ◽  
Spinal Curvature ◽  
Fracture Dislocation ◽  
Control Group ◽  
Research Database ◽  
Risk Of Injury

ObjectivesInjury is an important issue in public health. Spinal curvature disorders are deformities characterised by excessive curves of the spine. The prevalence of spinal curvature disorders is not low, but its relationship with injury has not been studied. The aim of this study is to investigate whether spinal curvature disorders increase the risk of injury.DesignPopulation-based retrospective cohort study.SettingUsing data from the Taiwan National Health Insurance Research Database from 2000 to 2010.Participants and exposurePatients with spinal curvature disorders were selected using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. A cohort without spinal curvature was randomly frequency-matched to the spinal curvature disorders cohort at a ratio of 2:1 according to age, sex and index year.Primary outcome measuresThe risk of injury was analysed using Cox’s proportional hazards regression models adjusting for age, sex, comorbidities, urbanisation level and socioeconomic status.ResultsA total of 20 566 patients with spinal curvature disorders and 41 132 controls were enrolled in this study. The risk of injury was 2.209 times higher (95% CI 2.118 to 2.303) in patients with spinal curvature disorders than in the control group. The spinal curvature disorders cohort exhibited higher risk of developing injury compared with the control group, regardless of age, sex, comorbidities, urbanisation level and subgroup of spinal curvature disorders. Based on the subgroup analysis, the spinal curvature disorders cohort had higher risks of unintentional injury and injury diagnoses such as fracture, dislocation, open wound, superficial injury/contusion, crushing and injury to nerves and spinal cord compared with the control cohort.ConclusionsPatients with spinal curvature disorders have a significantly higher risk of developing injury than patients without spinal curvature disorders. Aggressive detection and management of spinal curvature disorders may be beneficial for injury prevention.

scholarly journals The association between vertebrobasilar insufficiency and the risk of dementia: a nationwide register-based retrospective cohort study in Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017001
Author(s):  
Fu-Chi Yang ◽  
Shao-Yuan Chen ◽  
Jiu-Haw Yin ◽  
Chun-Chieh Lin ◽  
Yueh-Feng Sung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Vertebrobasilar Insufficiency ◽  
Confounding Factors ◽  
Increased Risk

ObjectivesNeurodegenerative disorders are reportedly characterised by decreased regional cerebral blood flow. However, the association between vertebrobasilar insufficiency (VBI) and dementia remains unclear. In this nationwide, population-based, retrospective cohort study, we explored the potential association between VBI and dementia.DesignNationwide population-based cohort study.SettingPatients with VBI were newly diagnosed between 2000 and 2005 from the Taiwan National Health Insurance Research Database.ParticipantsWe included 3642 subjects as the VBI group. The control cohort included 14 568 randomly selected age-matched and sex-matched VBI-free individuals.Outcome measuresAll subjects were followed until the diagnosis of dementia, death or the end of 2010. Patients with VBI, dementia (viz, vascular and non-vascular, including Alzheimer’s) subtypes and other confounding factors were identified according to the International Classification of Diseases Clinical Modification Codes. Cox proportional hazards regression analysis was employed to examine adjusted HRs after adjusting for confounding factors.ResultsPatients with VBI had a 1.807-fold (95% CI 1.643 to 1.988, p<0.001) higher risk to develop all-cause dementia than individuals without VBI. The risk was significantly higher in the VBI group than in the non-VBI group regardless of age (<65 years: HR: 2.997, 95% CI 1.451 to 6.454, p<0.001; ≥65 years: HR: 1.752, 95% CI 1.584 to 1.937, p<0.001). The VBI group had a higher risk of all-cause dementia than the non-VBI group regardless of sex and follow-up time intervals (<1 year, 1–2 years and≥2 years).ConclusionPatients with VBI appear to have an increased risk of developing dementia. Further research is needed to investigate the underlying pathophysiology.

scholarly journals Creatinine-to-body weight ratio is a predictor of incident diabetes: a population-based retrospective cohort study

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Jiacheng He
Keyword(s):  
Body Weight ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Weight Ratio ◽  
Threshold Effect ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Incident Type

Abstract Purpose Creatinine to body weight (Cre/BW) ratio is considered the independent risk factor for incident type 2 diabetes mellitus (T2DM), but research on this relationship is limited. The relationship between the Cre/BW ratio and T2DM among Chinse individuals is still ambiguous. This study aimed to evaluate the correlation between the Cre/BW ratio and the risk of T2DM in the Chinese population. Methods This is a retrospective cohort study from a prospectively collected database. We included a total of 200,658 adults free of T2DM at baseline. The risk of incident T2DM according to Cre/BW ratio was estimated using multivariable Cox proportional hazards models, and a two-piece wise linear regression model was developed to find out the threshold effect. Results With a median follow-up of 3.13 ± 0.94 years, a total of 4001 (1.99%) participants developed T2DM. Overall, there was an L-shaped relation of Cre/BW ratio with the risk of incident T2DM (P for non-linearity < 0.001). When the Cre/BW ratio (× 100) was less than 0.86, the risk of T2DM decreased significantly as the Cre/BW ratio increased [0.01 (0.00, 0.10), P < 0.001]. When the Cre/BW ratio (× 100) was between 0.86 and 1.36, the reduction in the risk of developing T2DM was not as significant as before [0.22 (0.12, 0.38), P < 0.001]. In contrast, when the Cre/BW ratio (× 100) was greater than 1.36, the reduction in T2DM incidence became significantly flatter than before [0.73 (0.29,1.8), P = 0.49]. Conclusion There was an L-shaped relation of Cre/BW ratio with incidence of T2DM in general Chinese adults. A negative curvilinear association between Cre/BW ratio and incident T2DM was present, with a saturation effect predicted at 0.86 and 1.36 of Cre/BW ratio (× 100).

scholarly journals Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

2020 ◽  
Author(s):  
Shao-Ang Chu ◽  
Te-Yuan Chen ◽  
Po-Yuan Chen ◽  
Wei-Jie Tzeng ◽  
Cheng-Loong Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Acupuncture Treatment ◽  
Lower Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Post Stroke ◽  
Incidence Of Dementia

Abstract BACKGROUND Stroke has been recognized as one of the major causes of adult disability worldwide, and post-stroke dementia may affect up to one-third of stroke survivors. This condition could be prevented if we could recognize and treat it earlier. Acupuncture as a complementary treatment for stroke has been shown to be beneficial for subsequent post-stroke rehabilitation. Our study investigated if acupuncture served additional advantages to decreasing the incidence of post-stroke dementia. METHODS We provide a retrospective cohort study from Taiwan National Health Insurance Research Database. This study compared the incidence of post-stroke dementia between cohorts with and without acupuncture treatment by calculating adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of acupuncture associated with post-stroke dementia using Cox proportional hazard regressions. The study group was composed of 9,547 patients who received first hospitalization for the treatment of stroke between 2002 and 2004; of which, 47,735 comparison patients were defined as the control group. The two groups were followed-up until the diagnosis of dementia presented or until the end of 2007. RESULTS The adjusted HRs of developing dementia among patients with stroke was 4.705 times the average (range, 4.353–5.085), and the incidence of dementia was higher in males. The study group tended to have less incidence of all kinds of dementia after acupuncture treatment, and patients without stroke receiving acupuncture had a lower probability of dementia than those untreated during the follow-up period. CONCLUSIONS This study presents evidence that acupuncture serves as an effective and alternative procedure to lower the risk of post-stroke dementia and the overall incidence of dementia in Taiwanese population.

scholarly journals Keloid risk in patients with atopic dermatitis: a nationwide retrospective cohort study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022865 ◽  
Author(s):  
Ying-Yi Lu ◽  
Chun-Ching Lu ◽  
Wei-Wen Yu ◽  
Li Zhang ◽  
Qing-Rui Wang ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Secondary Outcome ◽  
Severe Atopic Dermatitis ◽  
Secondary Outcome Measure ◽  
Research Database ◽  
Cox Proportional Hazard Regression

ObjectiveThe pathogenesis of keloid is largely unknown. Because keloid and atopic dermatitis have overlapping pathophysiological mechanisms, we aimed to evaluate keloid risk in patients with atopic dermatitis.Study designPopulation-based retrospective cohort study.SettingThe Taiwan National Health Insurance Research Database was used to analyse data for people who had been diagnosed with atopic dermatitis.ParticipantsWe identified 8371 patients with newly diagnosed atopic dermatitis during 1996–2010. An additional 33 484 controls without atopic dermatitis were randomly identified and frequency matched at a one-to-four ratio.Primary and secondary outcome measureThe association between atopic dermatitis and keloid risk was estimated using Cox proportional hazard regression models.ResultsAfter adjustment for covariates, the atopic dermatitis patients have a 3.19-fold greater risk of developing keloid compared with the non-atopic dermatitis group (3.19vs1.07 per 1000 person-years, respectively). During the study period, 163 patients with atopic dermatitis and 532 patients without atopic dermatitis developed keloid. Notably, keloid risk increased with severity of atopic dermatitis, particularly in patients with moderate to severe atopic dermatitis.ConclusionsOur results indicate that patients with atopic dermatitis had a higher than normal risk of developing keloid and suggest that atopic dermatitis may be an independent risk factor for keloid.

scholarly journals Patients With Ankylosing Spondylitis Are Associated With High Risk of Fibromyalgia: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Shuo-Yan Gau ◽  
Yung-Heng Lee ◽  
Hsi-Kai Tsou ◽  
Jing-Yang Huang ◽  
Xinpeng Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Subsequent Development ◽  
Population Based ◽  
Incidence Rates ◽  
Research Database

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.

scholarly journals The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Po-Chang Wang ◽  
Tien-Hsing Chen ◽  
Chang-Min Chung ◽  
Mei-Yen Chen ◽  
Jung-Jung Chang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hazard Ratio ◽  
Control Group ◽  
Research Database ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein

AbstractLittle is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes (T2DM). The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) in T2DM. A total of 1,628,675 patients with T2DM with or without a history of DVT from 2001 to 2013 were identified in the National Health Insurance Research Database of Taiwan. Before matching, the patients in the DVT group (n = 2020) were older than the control group (66.3 vs. 58.3 years). Patients in the DVT group were more likely to be female than the control group (54.3% vs. 47.5%). Before matching, the DVT group had higher prevalence of most comorbidities, more prescription of antiplatelet, antihypertensive agents and insulins, but less prescription of metformin and sulfonylurea. During a mean follow-up of 5.2 years (standard deviation: 3.9 years), the matched DVT group (n = 2017) have a significantly increased risk of MALE (8.4% vs. 5.2%; subdistribution hazard ratio [SHR] 1.60, 95% CI 1.34–1.90), foot ulcer (5.2% vs. 2.6%, SHR 1.96, 95% CI 1.57–2.45), gangrene (3.4% vs. 2.3%, SHR 1.44, 95% CI 1.10–1.90) and amputation (2.5% vs. 1.7%; SHR 1.42, 95% CI 1.03–1.95) than the 10,085 matched controls without DVT. They also tended to have a greater risk of all-cause mortality (38.1% vs. 33.1%; hazard ratio [HR] 1.18, 95% CI 1.09–1.27) and systemic thromboembolism (4.2% vs. 2.6%; SHR 1.56, 95% CI 1.22–1.99), respectively. We showed the presence of DVT may be associated with an increased risk of MALEs, major amputation, and thromboembolism, contributing to a higher mortality rate in T2DM.

Traditional Chinese medicine use may reduce medical utility in patients with asthma: a nationwide population-based retrospective cohort study

QJM ◽  
2020 ◽  
Author(s):  
P F Liao ◽  
Y T Wang ◽  
Y H Wang ◽  
J Y Chiou ◽  
J C C Wei
Keyword(s):  
Cohort Study ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Research Database ◽  
Continuous Variables ◽  
Emergency Visits ◽  
Asthma Patients

Summary Background Many patients with atopic diseases, including asthma, have sought complementary and alternative medicine and traditional Chinese medicine (TCM) treatments. But, limited clinical studies have yet examined TCM effects on medical utility in asthma patients. Aim To assess the medical utility of TCM in patients with asthma. Design Population-based retrospective cohort study. Methods We performed a 13-year population-based retrospective cohort study. A total of 5235 asthma patients who were TCM users and 5235 propensity-score matched asthma patients who never used TCM were sampled from the Taiwan National Health Insurance Research Database from 2000 to 2012. We compared these two groups of patients to calculate their medical utility, including numbers of emergency visits and hospitalizations until 2013. Univariate analyses were performed using Chi-square tests for dichotomous variables and t-tests for continuous variables. Cox proportional hazard models were conducted to investigate the medical utility of asthma after TCM use. Results Compared with non-TCM patients, TCM patients had a significantly decreased medical utility of asthma admission [adjusted odds ratio (OR) = 0.63; 95% confidence interval (CI): 0.46–0.85; P &lt; 0.05], especially in patients who used TCM for &gt;60 days. Asthma medical utility in asthma emergencies was significantly higher for male than for female patients (adjusted OR = 1.45; 95% CI: 1.08–1.96). The most frequently used TCMs for asthma control or cough treatment were antitussive agents. Conclusion This population-based retrospective cohort study showed a significantly decreased medical utility of emergency visits and admissions in TCM patients, especially using TCM for &gt;60 days.

scholarly journals Association between Proton Pump Inhibitor Use and CNS Infection Risk: A Retrospective Cohort Study

2018 ◽  
Vol 7 (9) ◽  
pp. 252 ◽  
Author(s):  
Wei-Te Hung ◽  
Ying-Hock Teng ◽  
Shun-Fa Yang ◽  
Han-Wei Yeh ◽  
Ying-Tung Yeh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Proton Pump ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cns Infection ◽  
Research Database

This study investigated the incidence of central nervous system (CNS) infection following the use of proton pump inhibitors (PPIs). A retrospective cohort study was conducted in Taiwan by using data from the National Health Insurance Research Database. We identified and enrolled 16,241 patients with CNS infection who used PPIs (PPI users). The patients were individually propensity score matched (1:1) according to age, sex, hypertension, hyperlipidemia, Charlson comorbidity index (CCI), H2 blocker, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid, and immunosuppressant use with 16,241 controls (PPI nonusers). A Cox proportional hazards model was used to estimate adjusted hazard ratio (aHR) for CNS infection in the PPI users and nonusers. After adjustment for other confounding factors, the incidence of CNS infection in the PPI users was 2.23-fold higher than that in the PPI nonusers (95% CI = 1.27–3.94). In addition, the PPI users exhibited a higher risk of CNS infection than the nonusers in the hypertension and CCI = 1 groups (aHR = 3.80, 95% CI = 1.40–10.32; aHR = 2.47, 95% CI = 1.07–5.70 in the PPI users and nonusers, respectively). In conclusions, according to these results, we concluded that the incidence of CNS infection was higher in the PPI users than in the nonusers.

scholarly journals Transfusion-naïve Thalassemia Pediatric Patients have Higher Incidence of Asthma: A Nationwide Population-based Retrospective Cohort Study

2020 ◽  
Author(s):  
Hsin-Yi Hsieh ◽  
Lin-Chi Huang ◽  
Hong-Ren Yu ◽  
Kuang-Che Kuo ◽  
Yi-Chen Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Research Database ◽  
Thalassemia Patient ◽  
Propensity Score Model ◽  
Score Model

Abstract Background: Few studies have studied the association between asthma and pediatric transfusion naïve thalassemia. Methods: A nationwide population-based retrospective cohort study was conducted using medical records of selected children from the 2010 Registry for Beneficiaries of the Taiwan National Health Insurance Research Database, with a follow-up period extending to the end of 2013. One thalassemia patient was matched with four control patients without thalassemia according to year of birth, sex, and the propensity score model based on comorbidities. Results: In this study, 794 patients with thalassemia and 3176 controls were included. Transfusion-naïve thalassemia children had higher rates to develop asthma (41.03 vs 36.69 per 1000 person-y; P = 0.032) than the non-thalassemia controls with an adjusted hazard ratio of 1.16 (95% confidence interval (CI) = 1.01–1.33). Boys in the thalassemia cohort had a significantly higher adjusted hazard ratio of asthma than those in the non-thalassemia cohort (adjusted hazard ratio = 1.20, 95% CI = 1.02–1.42). In thalassemic patients without atopic dermatitis, the risk of asthma was 1.25-fold higher than in the non-thalassemic ones (95% CI=1.07–1.47). Conclusions: Transfusion-naïve thalassemia children are more likely to have asthma. We need to pay more attention to it in order to diagnosis asthma earlier and to prevent asthma attacked earlier.

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