scholarly journals Cohort study to explore the association between the COVID-19 pandemic lockdown and admissions for violence in North East and North Cumbria

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052923
Author(s):  
Andrea Brown ◽  
Paul Collingwood ◽  
Julia L Newton
Keyword(s):  
Cohort Study ◽  
Lower Layer ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Emergency Admissions ◽  
Admission Rates ◽  
North East ◽  
Accident And Emergency ◽  
Classification Of Diseases ◽  
Icd 10

ObjectivesExplore the association between the first national lockdown associated with the COVID-19 pandemic on admissions for violence and the relationship with deprivation.DesignPopulation-based longitudinal cohort study.SettingNorth East and North Cumbria (NENC) area of England.ParticipantsAll individuals living in the NENC (total population 3.1 million) admitted 2017/2018, 2018/2019, 2019/2020.Main outcome measuresHospital Episode Statistics were extracted at Lower Layer Super Output Area and the Index of Multiple Deprivation 2019 decile applied. Directly standardised rates were explored for number of accident and emergency (A&E) attendances (per 1000); Alcohol-related admissions using Public Health England (PHE) Fingertips tool (per 100 000, ID 91414) and emergency admissions for violence (including sexual violence) (per 100 000) (ID 11201 classified by International Classification of Diseases (ICD)10 codes X85 to Y09).ResultsA&E attendances are higher in NENC compared with England (409.9 per 1000 v 359.2). A&E attendance was 81% higher in 2019/20 in the most deprived compared with the least deprived. Attendances dropped during the first national COVID-19 lockdown and by September 2020 had not returned to ‘normal’ levels.Admissions related to violence are a third higher in NENC (29% to 34% higher across 3 years) rates 7–10 times higher in most deprived than least deprived areas. Admission rates reduced during the first UK lock down but this bounced back by August higher than any of the previous 12 months.ConclusionEmergency admissions with violence appear to associate with the COVID-19 pandemic being initially higher than before the first national lockdown. This is in the context of overall A&E attendances which are lower post lockdown. Given that emergency admissions with violence have been consistently higher in the NENC compared with England over recent years, we suggest that targeted action is required in NENC to address health inequalities.

scholarly journals Clinical Association between Gout and Parkinson’s Disease: A Nationwide Population-Based Cohort Study in Korea

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1292
Author(s):  
Ji Hyoun Kim ◽  
In Ah Choi ◽  
Aryun Kim ◽  
Gilwon Kang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Study ◽  
Incidence Rate ◽  
Univariate Analysis ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Female Sex ◽  
Classification Of Diseases ◽  
Icd 10

Background and Objectives: This retrospective cohort study aimed to investigate the association between gout and Parkinson’s disease (PD) in Korea. Materials and Methods: Overall, 327,160 patients with gout and 327,160 age- and sex-matched controls were selected from the Korean National Health Insurance Service (NHIS) database. PD incidence was evaluated by reviewing NHIS records during the period from 2002 to 2019. Patients with a diagnosis of gout (International Classification of Diseases-10 (ICD-10), M10) who were prescribed medications for gout, including colchicine, allopurinol, febuxostat, and benzbromarone for at least 90 days were selected. Patients with PD who were assigned a diagnosis code (ICD-G20) and were registered in the rare incurable diseases (RID) system were extracted. Results: During follow-up, 912 patients with gout and 929 control participants developed PD. The incidence rate (IR) of overall PD (per 1000 person-years) was not significantly different between both groups (0.35 vs. 0.36 in gout and control groups, respectively). The incidence rate ratio (IRR) was 0.98 (95% CI: 0.89–1.07). The cumulative incidence of PD was not significantly different between the groups. No association between gout and PD was identified in univariate analysis (HR = 1.00, 95% CI: 0.91–1.10, p = 0.935). HR increased significantly with old age (HR = 92.08, 198, and 235.2 for 60–69 years, 70–79 years, and over 80 years, respectively), female sex (HR = 1.21, 95% CI: 1.07–1.37, p = 0.002), stroke (HR = 1.95, 95% CI: 1.76–2.16, p < 0.001), and hypertension (HR = 1.16, 95% CI: 1.01–1.34, p = 0.04). Dyslipidemia exhibited an inverse result for PD (HR = 0.6, 95% CI: 0.52–0.68, p < 0.001). Conclusions: This population-based study did not identify an association between gout and PD. Age, female sex, stroke, and hypertension were identified as independent risk factors for PD, and dyslipidemia demonstrated an inverse result for PD.

scholarly journals Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study

2020 ◽  
Author(s):  
Frederikke Vestergaard Nielsen ◽  
Mette Rønn Nielsen ◽  
Ida Lund Lorenzen ◽  
Jesper Amstrup ◽  
Torben Anders Kløjgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
International Classification Of Diseases ◽  
Rank Test ◽  
Test Results ◽  
Historical Cohort ◽  
Specific Diagnosis ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Icd 10

Abstract Background The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality. Methods A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10 th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. Results We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were ‘unspecified disease’ (Z039), constituting 47.0 % (n 35,279). In children 0-9 years old, ‘febrile convulsions’ was the most frequent non-specific diagnosis used in 54.3 % (n 1,602). Overall, 1- and 30-day mortality was 2.2 % (n 1,205) and 6.0 % (n 3,258). The highest mortality was in the diagnostic group ‘suspected cardiovascular disease’ (Z035) and ‘unspecified disease’ (Z039) with 1-day mortality 2.6 % (n 43) and 2.4 % (n 589), and 30 day mortality of 6.32 % (n 104) and 8.1 % (n 1,975). Conclusion Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.

scholarly journals Links Between Strokes and Hereditary Hemorrhagic Telangiectasia: A Population-Based Study

2018 ◽  
Vol 46 (1) ◽  
pp. 44-50
Author(s):  
Farah N. Chowdhury ◽  
G. Sanjaya Chandrarathne ◽  
Kristopher D. Masilamani ◽  
Jennifer T. N. LaBranche ◽  
Shaun Malo ◽  
...  
Keyword(s):  
General Population ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Female Gender ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Centre Of Excellence ◽  
Classification Of Diseases ◽  
Icd 10

AbstractBackgroundHereditary hemorrhagic telangiectasia (HHT) is a disease of abnormal vasculature where patients are predisposed to strokes of multiple etiologies. We assessed yearly stroke incidence among Albertans with HHT and compared with the general population. Given the tendency for stroke in HHT patients, we expected HHT patients to have higher stroke incidence, in particular at younger ages.MethodsPopulation-based administrative health data on inpatient and ambulatory admissions were extracted over a 16-year period using International Classification of Diseases (ICD)-9 and ICD-10, Canada codes. We analyzed overall occurrence of strokes in Alberta by age, gender, stroke subtype, and diagnosis of HHT.ResultsThe age-standardized incidence rate of stroke in HHT was 450 per 100,000 compared with 260 per 100,000 in the general population with a rate ratio of 1.73 (95% confidence interval (CI) [1.046-2.842]). This study found a higher HHT prevalence in Alberta (1 in 3800) compared to the world average of 1 in 5000. Women were also more likely to be diagnosed with HHT, with a 3.25:1 female gender preponderance in the yearly incidence.InterpretationThis study not only shows that HHT patients are at higher risk of having a stroke but also quantifies that risk using an age-adjusted metric in Alberta. This province has a higher than expected disease burden of HHT, with the majority of cases affecting women. Our study found that acute ischemic strokes and transient ischemic attacks are far more common than hemorrhage in HHT. As HHT is a rare, multi-system, chronic disease, these patients should be referred to an HHT Centre of Excellence.

Symptoms and characteristics of cancer patient visits to an emergency room.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18306-e18306
Author(s):  
Michael Gallaway ◽  
Nimi Idaikkadar
Keyword(s):  
Cancer Patients ◽  
Acute Care ◽  
International Classification Of Diseases ◽  
Population Based ◽  
P Value ◽  
Surveillance Program ◽  
Cancer Type ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Ed Visits

e18306 Background: Cancer patients are increasingly likely to visit an emergency department (ED) for acute care compared to the general population. Cancer patients who visit the ED often have long wait times, increased exposure to infection, and lesser quality treatment. The Centers for Medicare & Medicaid Services (CMS) is encouraging efforts to decrease survivor acute care visits. The purpose of this study was to examine cancer-related ED visits using a national population-based sample to understand why they are seeking care in an ED. Methods: A retrospective cohort study of U.S. patients who visited EDs between June 1, 2017 and May 31, 2018 was conducted using the National Syndromic Surveillance Program (NSSP) BioSense Platform. Cancer patients were identified using International Classification of Diseases, 10th Revision (ICD-10) codes for any cancer type and specifically for cancers of the bladder, female breast, cervix, colon and rectum, kidney, liver, lung, ovary, pancreas, prostate, or uterus. Symptoms were identified using syndromic definitions and key-word queries. Significance testing (p-value ≤0.01), was used to assess differences in the prevalence of symptoms by cancer type. Results: There were 97 million visits to EDs during the study period, 710,297 (0.8%) were among cancer survivors. Slightly more were female (50.1%) than male (49.5%); more were aged 65 or older (53.6%) than 18-64 (1.4-35.3%). The most common symptoms were pain (19%), gastrointestinal (14%), respiratory (12%), neurologic (5%), fever (5%), and injury (4%). Prevalence of symptoms differed significantly by cancer type. Some symptoms were higher among those with specific cancer types compared to all cancers in aggregate: pain (cervical, liver, pancreas); gastrointestinal (pancreas, liver, colorectal); respiratory (lung); neurologic (liver, lung), fever (pancreas, liver), injury (prostate), and bleeding (colorectal, liver). Conclusions: Use of NSSP data enabled a descriptive characterization of more than half of the U.S. ED visits among cancer patients. These comprehensive findings inform best practices to reduce unplanned acute care and help inform possible modifications in treatment and care protocols among survivors of specific cancers.

scholarly journals Post-colonoscopy colorectal cancers identified by probabilistic and deterministic linkage: results in an Australian prospective cohort

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026138 ◽  
Author(s):  
Kavitha Subramaniam ◽  
P W Ang ◽  
Teresa Neeman ◽  
Mitali Fadia ◽  
Doug Taupin
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Prospective Cohort ◽  
Cancer Registries ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Primary Outcome Measure ◽  
Colorectal Cancers ◽  
Diagnosis Codes ◽  
Classification Of Diseases

ObjectivePost-colonoscopy colorectal cancers (PCCRCs) are recognised as a critical quality indicator. Benchmarking of PCCRC rate has been hampered by the strong influence of different definitions and methodologies. We adopted a rigorous methodology with high-detail individual data to determine PCCRC rates in a prospective cohort representing a single jurisdiction.SettingWe performed a cohort study of individuals who underwent colonoscopy between 2001 and 2008 at a single centre serving Australian Capital Territory (ACT) and enclaving New South Wales (NSW) region. These individuals were linked to subsequent colorectal cancer (CRC) diagnosis, within 5 years of a negative colonoscopy, through regional cancer registries and hospital records using probabilistic and deterministic record linkage. All cases were verified by pathology review. Predictors of PCCRCs were extracted.Participants7818 individuals had a colonoscopy in the cohort. Linkage to cancer registries detected 384 and 98 CRCs for notification dates of 2001–2013 (ACT) and 2001–2010 (NSW). A further 55 CRCs were identified from a search of electronic medical records using International Classification of Diseases-10 diagnosis codes. After verification and exclusions, 385/537 CRCs (58% male) were included.Primary outcome measurePCCRC rates.ResultsThere were 15 PCCRCs in our cohort. The PCCRC incidence rate was 0.384/1000 person-years and the 5-year PCCRC risk was estimated as 0.192% (95% CI 0.095 to 0.289). The index colonoscopy prior to PCCRC was more likely to show diverticulosis (p=0.017 for association, OR 3.56, p=0.014) and have poor bowel preparation (p=0.017 for association, OR 4.19, p=0.009).ConclusionIn this population-based cohort study, the PCCRC incidence rate was 0.384/1000 person-years and the 5-year PCCRC risk was 0.192%. These data show the ‘real world’ accuracy of colonoscopy for CRC exclusion.

scholarly journals Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2356
Author(s):  
Eun Hui Bae ◽  
Bongseong Kim ◽  
Su Hyun Song ◽  
Tae Ryom Oh ◽  
Sang Heon Suh ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Population Based ◽  
Renal Outcome ◽  
Persistent Proteinuria ◽  
Inflammatory Dermatosis ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Stage Renal Disease ◽  
End Stage

Psoriasis, a chronic inflammatory dermatosis, has been associated with chronic kidney disease or end-stage renal disease. However, the association of the changes or amount of proteinuria with psoriasis development has not been evaluated. Using the Korean National Health Screening database, we assessed psoriasis development until 2018 in 6,576,851 Koreans who underwent health examinations in 2009 and 2011. Psoriasis was defined using the International Classification of Diseases, 10th revision (ICD-10) code L40. The risk of psoriasis was evaluated according to change in proteinuria (never [Neg (no proteinuria)/Neg], new [Neg/Pos (proteinuria present)], past [Pos/Neg] and persistent [Pos/Pos] proteinuria) and the proteinuria amount. During a median 7.23-year follow-up, 162,468 (2.47%) individuals developed psoriasis. After adjustments, the hazard ratio (HR) for psoriasis was higher in the persistent proteinuria group (1.32 [1.24–1.40]) than in the never proteinuria group. The past proteinuria group showed better renal outcome (1.03 [1.00–1.07]) than the new (1.05 [1.01–1.07]) and never proteinuria (reference, 1.00) groups did. The amount of random urine proteinuria was associated with increased HR for psoriasis. Subgroup analyses for age, sex, estimated glomerular filtration rate (eGFR), hypertension and diabetes showed that the persistent proteinuria group had a higher risk of psoriasis than the never proteinuria group, especially at eGFR < 60 mL/min/1.73 m2. Persistent proteinuria is associated with psoriasis risk, and the proteinuria amount significantly affects psoriasis development.

Association Between Neonates With Laryngomalacia and Neonatal Abstinence Syndrome

2021 ◽  
pp. 000348942110482
Author(s):  
Elizabeth J. Abraham ◽  
David O’Neil Danis ◽  
Jessica R. Levi
Keyword(s):  
International Classification Of Diseases ◽  
Population Based ◽  
Withdrawal Symptoms ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Neonatal Withdrawal ◽  
Registry Analysis

Objective: Laryngomalacia (LM) is the most common congenital anomaly of the larynx. The cause of LM is still largely unknown, but a neurological mechanism has gained the most acceptance. There have not been any studies examining the prevalence of LM in infants with Neonatal Abstinence Syndrome (NAS). The aim of our study is to determine if infants with NAS are more likely to be diagnosed with LM. Methods: This study was a population-based inpatient registry analysis. We examined nationwide neonatal discharges in 2016 using the Kids’ Inpatient Database (KID). Only patients listed as neonates were included. The International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) codes for neonatal withdrawal symptoms from maternal use of drugs of addiction (P96.1) and diagnoses denoting LM were used. To quantify associations between the LM and NAS groups, prevalence rates and odds ratios (ORs) were used. Results: There were 3 970 065 weighted neonatal discharges in the 2016 KID. Among patients included in our dataset, 0.809% (32 128) had NAS and 0.075% (2974) had LM. There was an increased odds ratio for neonates with NAS and LM (OR of 2.85, 95% CI = 2.24-3.63) compared to infants without NAS. Multiple logistic regression accounting for possible confounders produced an adjusted OR of 1.68 (95% CI = 1.29-2.19). Conclusion: Our study found an association between NAS and LM. This suggests that prenatal exposure to opioids or possibly the sequelae of withdrawal symptoms may be risk factors for the development of LM.

scholarly journals Gastrointestinal perforations in patients with rheumatoid arthritis treated with biological disease-modifying antirheumatic drugs in Sweden: a nationwide cohort study

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001201 ◽  
Author(s):  
Andrei Barbulescu ◽  
Bénédicte Delcoigne ◽  
Johan Askling ◽  
Thomas Frisell
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Treatment Guidelines ◽  
International Classification Of Diseases ◽  
Incidence Rates ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Population Controls ◽  
Necrosis Factor

ObjectivesTo compare incidence rates of gastrointestinal (GI) perforations between patients with RA and the general population, and between patients treated with tumour necrosis factor inhibitors (TNFi) and non-TNFi biologics.MethodsIn this nationwide cohort study, a total of 63 532 patients with RA, with 26 050 biological treatment episodes (TNFi, rituximab, abatacept or tocilizumab) and 76 304 general population controls, were followed between 2009 and 2017 until the first outcome event. The main outcome was hospitalisation or death due to lower GI perforations, identified according to a prespecified list of ICD-10 (International Classification of Diseases, 10th revision) codes. Inverse probability of treatment weighting was used for adjustment.ResultsThe sex-standardised and age-standardised incidence rates of lower GI perforations were 1.1 (95% CI 1.0 to 1.3) events per 1000 person-years among general population controls, 1.6 (1.5–1.7) among bionaïve patients and ranged from 1.8 (1.4–3.6) (TNFi) to 4.5 (2.7–10.4) (tocilizumab) among biologics-treated patients. After adjustment for glucocorticoid use, the risk in bionaïve, TNFi-treated, abatacept-treated or rituximab-treated patients with RA was no longer different from the general population, while for tocilizumab it remained significantly higher. Comparing tocilizumab to TNFi, the adjusted HR for lower GI perforations was 2.2 (1.3–3.8), corresponding to one additional GI perforation per 451 patient-years treated with tocilizumab instead of TNFi.ConclusionTocilizumab was associated with a higher risk of lower GI perforations compared with alternative biologics. In absolute numbers, the risk remained low on all biologics commonly used to treat RA, but the accumulated evidence across settings and outcome definitions supports that this risk should be considered in treatment guidelines for RA.

scholarly journals Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study

2020 ◽  
Author(s):  
Frederikke Vestergaard Nielsen ◽  
Mette Rønn Nielsen ◽  
Ida Lund Lorenzen ◽  
Jesper Amstrup ◽  
Torben Anders Kløjgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
International Classification Of Diseases ◽  
Rank Test ◽  
Historical Cohort ◽  
Specific Diagnosis ◽  
Log Rank Test ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Icd 10

Abstract Background The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality.Methods A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. Results We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were ‘unspecified disease’ (Z039), constituting 47.0 % (n 35,279). In children 0-9 years old, ‘febrile convulsions’ was the most frequent non-specific diagnosis used in 54.3 % (n 1,602). Overall, 1- and 30-day mortality was 2.2 % (n 1,205) and 6.0 % (n 3,258). The highest mortality was in the diagnostic group ‘suspected cardiovascular disease’ (Z035) and ‘unspecified disease’ (Z039) with 1-day mortality 2.6 % (n 43) and 2.4 % (n 589), and 30 day mortality of 6.32 % (n 104) and 8.1 % (n 1,975).Conclusion Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.

scholarly journals Epidemiology of Endometriosis in Spain and Its Autonomous Communities: A Large, Nationwide Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7861
Author(s):  
Almudena Ávalos Marfil ◽  
Enriqueta Barranco Castillo ◽  
Raúl Martos García ◽  
Nicolás Mendoza Ladrón de Guevara ◽  
Maryna Mazheika
Keyword(s):  
National Level ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Reproductive Age ◽  
Hospital Data ◽  
Autonomous Communities ◽  
Spanish Study ◽  
Classification Of Diseases ◽  
Icd 10

A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital discharge registry of Spain. This analysis was carried out with hospital data with a diagnosis of endometriosis (International Classification of Diseases (ICD)-9 code 617.xx and ICD-10 code N80.xx) and covered the period from 1 January 2014 to 31 December 2017 and a population of 12,775,911 women of reproductive age (15–54 years). The data were then analyzed at the national level and separately for each autonomous community. This nationwide Spanish study estimated the overall incidence of endometriosis among autonomous communities in Spain to be 16.1 per 10,000 women (range, 6.8 to 24). The mean age of the 20,547 women diagnosed with endometriosis during the study period was 36.8 ± 5.4 years. The types (proportions) of endometriosis were uterine (28.4%), tubo-ovarian (35.2%), peritoneal (8.1%), vesical (6.8%) and intestinal (3.2%) endometriosis. Further studies are needed to assess the reasons for the decrease in the observed incidence and for the significant differences in the regional incidence rates of this disease.

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