Contacts with general practitioner, sick leave and work participation after electrical injuries: a register-based, matched cohort study

2020 ◽  
Vol 78 (1) ◽  
pp. 54-60
Author(s):  
Karin Biering ◽  
Jesper Medom Vestergaard ◽  
Kent Jacob Nielsen ◽  
Ole Carstensen ◽  
Anette Kærgaard
Keyword(s):  
Sick Leave ◽  
Conditional Logistic Regression ◽  
Electrical Current ◽  
Work Participation ◽  
Matched Cohort ◽  
Eye Injuries ◽  
Increased Risk ◽  
Increase Risk ◽  
Electrical Injuries

ObjectiveExposure to electrical current may cause injury with both mental and physiological consequences. This may lead to increased contacts with general practitioners (GP) and the injured person may develop reduced ability to work. We aimed to examine these outcomes in terms of work-participation, long-term sick leave and contacts with GPs.MethodsIn a matched cohort design, we identified 14 112 electrical injuries in two registries and matched these with both patients with distorsion injuries or eye injuries, and with persons from the same occupation, using year of injury, sex and age for matching. We defined the outcomes based on register information regarding contacts with GPs and public transfer income. After the injury, we determined if the person had a long-term sick leave episode during the first 6, 12 months and 5 years. We calculated work participation during the year and 5 years and the number of GP contacts in the year of the injury, the year after and 5 years after the injury and dichotomised this at twice the mean number of contacts in the study population. The associations were analysed using conditional logistic regression.ResultsWe found increased risk for all defined outcomes, with the highest estimates in the occupation match. The risk estimates were similar over time. Adjusting for previous work participation increased the estimates slightly, whereas adjusting for previous contacts with GPs reduced the estimates. Restricting to those with at longer hospitalisation increased the estimates.ConclusionElectrical injuries increase risk of long-term sick leave, low work participation and increased contacts with GPs.

scholarly journals Unspecified pain and other soft tissue disorders following electrical injuries: a register-based matched cohort study

2021 ◽  
Author(s):  
Per Hoegh Poulsen ◽  
Ole Carstensen ◽  
Anette Kærgaard ◽  
Jesper Medom Vestergaard ◽  
Kent J. Nielsen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Soft Tissue ◽  
Cox Regression ◽  
Conditional Logistic Regression ◽  
Electrical Injury ◽  
Matched Cohort ◽  
Eye Injuries ◽  
History Of ◽  
Electrical Injuries

Abstract Objective This study investigates whether individuals who have sustained an electrical injury (EI) are diagnosed with unspecified pain or pain related to the musculoskeletal system in the years following the injury. Methods Individuals listed in Danish registers as having sustained EIs were matched for sex, age, and year of injury in a cohort study with individuals having experienced dislocations/sprains (match 1), eye injuries (match 2), and a sample of individuals with the same occupation without a history of electrical injuries (match 3). Outcomes were unspecified pain and unspecified soft tissue disorders. Conditional logistic regression and conditional Cox regression were applied. Results We identified 14,112 individuals who sustained EIs. A higher risk of both outcomes was observed for all three matches, and was highest at the 6- and 12-month follow-ups. The risk of both outcomes was considerably higher for match 3. Conclusions This study confirms that exposure to EIs increases the risk of being diagnosed with unspecified pain or unspecified soft tissue disorders both at short and long terms. Our results also showed that the risk of unspecified pain as sequelae is related to the severity of the injury.

scholarly journals Porphyria Cutanea Tarda and Patterns of Long-term Sick Leave and Disability Pension: a 24-year Nationwide Matched Cohort Study

2021 ◽  
Author(s):  
Carl Michael Baravelli ◽  
Aasne Karine Aarsand ◽  
Sverre Sandberg ◽  
Mette Christophersen Tollånes
Keyword(s):  
Cohort Study ◽  
Sick Leave ◽  
Disability Pension ◽  
Porphyria Cutanea Tarda ◽  
Subcutaneous Tissue ◽  
Malignant Neoplasms ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Increased Risk

Abstract Background: Porphyria cutanea tarda (PCT) is a skin disorder caused by a defect in the liver enzyme uroporphyrinogen decarboxylase and is associated with hepatitis C virus infection, high alcohol intake, smoking and iron overload. Data on the long-term morbidity of PCT is lacking. Methods: We conducted a nationwide matched cohort study over a 24-year period. The study sample included 534 persons aged 18-67 years with a biochemically confirmed PCT diagnosis and a sample of 21,360 persons randomly selected from the working age population, matched on age, sex and educational attainment. We investigated if persons with sporadic and familial PCT had an increased risk of long-term sick leave (LTSL) or disability pension. We further assessed risk before (pre-PCT), during (during-PCT) and after (post-PCT) the typical period of first onset to diagnosis, treatment and remission. Results: Overall, persons with PCT had a 40% increased risk (hazard ratio [HR]=1.4, 95% confidence interval [CI]=1.3, 1.5) of LTSL and a 50% increased risk (HR=1.5, CI=1.3, 1.7) of disability pension. Risk of disability pension was increased pre-PCT (HR=1.3, CI: 1.3 (1.0, 1.6), during-PCT (HR: 1.5, CI: 1.0, 2.2) and post-PCT (HR=2.0, CI: 1.5, 2.6). For LTSL, risk was increased pre-PCT (HR=1.3, CI: 1.1, 1.4) and during-PCT (HR=1.5, CI: 1.1, 2.1), but not post-PCT. Risk was greatest in persons with sporadic than familial PCT. Diagnostic reasons for disability pension that were increased compared to matched controls were PCT or skin disease in 11 of 199 cases (PCT: n=7, incident rate ratios [IRR]=49.2, CI=38.8, 62.4; diseases of the skin & subcutaneous tissue, n=4, IRR=4.2, CI=1.6, 11.0). The vast majority of diagnostic reasons for accessing disability pension were related to comorbidities, PCT susceptibility factors and more general health issues such as: malignant neoplasms (n=12, IRR=2.4, CI=1.4, 4.2), substance and alcohol dependence (n=7, IRR=5.0, CI=2.5, 10.1), neurotic and mood – disorders (n=21, IRR=1.7, CI=1.1, 2.6), and diseases of the musculoskeletal system & connective tissue (n=71, IRR=2.5, CI=1.9, 3.2).Conclusions: Persons with PCT have an increased risk of LTSL and disability pension indicating significant morbidity in this patient group. Appropriate long-term follow-up and monitoring for relapses and co-morbid diseases are recommended.

scholarly journals Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024980 ◽  
Author(s):  
Tiia T M Reho ◽  
Salla A Atkins ◽  
Nina Talola ◽  
Markku P T Sumanen ◽  
Mervi Viljamaa ◽  
...  
Keyword(s):  
Primary Care ◽  
Longitudinal Study ◽  
Occupational Health ◽  
Sick Leave ◽  
Diagnostic Codes ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Increased Risk ◽  
Working Age

ObjectivesFrequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care.Setting and participantsThis is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days).ResultsBoth occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension.ConclusionBoth occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.

Association between statin use and the risks of glaucoma in Australia: a 10-year cohort study

2021 ◽  
pp. bjophthalmol-2021-318789
Author(s):  
Yixiong Yuan ◽  
Wei Wang ◽  
Xianwen Shang ◽  
Ruilin Xiong ◽  
Jason Ha ◽  
...  
Keyword(s):  
Large Scale ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Case Group ◽  
Conditional Logistic Regression Model ◽  
The People ◽  
Increased Risk ◽  
Nested Case Control ◽  
Statin Use

SynopsisIn a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users.PurposeTo investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study.MethodsThis nested case–control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009–2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset.ResultsThe proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use (>3 years vs <1 year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset.ConclusionsLong-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.

scholarly journals Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

2020 ◽  
Author(s):  
Ahmed Nasr ◽  
Viviane Grandpierre ◽  
Katrina J Sullivan ◽  
Coralie A Wong ◽  
Eric I Benchimol
Keyword(s):  
Chronic Constipation ◽  
Chronic Diarrhea ◽  
Conditional Logistic Regression ◽  
Hirschsprung Disease ◽  
Older Age ◽  
Long Term Outcomes ◽  
Increased Risk ◽  
Age At Surgery ◽  
Region Of Residence

Abstract Background The only curative treatment for Hirschsprung disease (HD) is surgical repair. However, some patients experience poor postoperative outcomes. We determined long-term outcomes of all HD patients in Ontario, Canada’s most populous province. Methods We conducted a retrospective cohort study including all children with HD born between April 1, 1991 and March 31, 2014 in Ontario using linked health administrative data. Each HD case was matched to five non-HD controls on sex, date of birth, region of residence and income and followed to March 31, 2016. Chronic diarrhea and constipation were identified using combinations of outpatient physician billing codes in both HD patients and non-HD residents of the province. We determined risk factors associated with diarrhea and constipation, including surgery type and sociodemographic characteristics, using multivariable conditional logistic regression, and reported adjusted odds ratios (aORs). Results There were 3,265,172 children born in the study period, of whom 673 had HD. Compared to controls, chronic constipation was more common in HD patients (27.5% versus 2.1%; aOR 17.2, 95% CI 12.6 to 23.4), as was chronic diarrhea (29.9% versus 6.9%, aOR 5.22, 95% CI 4.19 to 6.50). In HD patients, older age at surgery was associated with increased risk of chronic constipation (OR 2.71, 95% CI 1.75 to 4.20). Surgery type, sex, rural/urban residence and income were not associated with risk of chronic constipation or diarrhea. Conclusion Chronic constipation and diarrhea were common following surgery for HD. Older age at surgery was associated with subsequent risk of chronic constipation. Surgery type was not associated with increased risk of chronic constipation or diarrhea.

scholarly journals Drug interactions and risk of acute bleeding leading to hospitalisation or death in patients with chronic atrial fibrillation treated with warfarin

2005 ◽  
Vol 94 (09) ◽  
pp. 537-543 ◽  
Author(s):  
Jennifer Hollowell ◽  
Christoph R. Meier ◽  
Walter E. Haefeli ◽  
Christiane Gasse
Keyword(s):  
Atrial Fibrillation ◽  
Drug Interactions ◽  
Conditional Logistic Regression ◽  
General Practice Research Database ◽  
Practice Research ◽  
Control Analysis ◽  
Research Database ◽  
Nonvalvular Atrial Fibrillation ◽  
Increased Risk

SummaryAlthough drug interactions with warfarin are an important cause of excessive anticoagulation, their impact on the risk of serious bleeding is unknown. We therefore performed a cohort study and a nested case-control analysis to determine the risk of serious bleeding in 4152 patients (aged 40–84 years) with nonvalvular atrial fibrillation (AF) taking long-term warfarin (>3 months). The study population was drawn from the UK General Practice Research Database. More than half (58%) of eligible patients used potentially interacting drugs during continuous warfarin treatment. Among 45 identified cases of incident idiopathic bleeds (resulting in hospitalisation within 30 days or death within 7 days) and 143 matched controls, more cases than controls took ≥1 potentially interacting drug within the preceding 30 days (62.2% vs. 35.7%) and used >4 drugs (polypharmacy) within the preceding 90 days (80.0% vs. 66.4%). Conditional logistic regression analysis yielded an odds ratio (OR) of 3.4 (95% confidence interval [CI]: 1.4–8.5) for the risk of serious bleeding in patients treated with warfarin and ≥1 drugs potentially increasing the effect of warfarin vs. warfarin alone adjusted for polypharmacy, diabetes, hypertension, heart failure, and thyroid disease; the adjusted OR for the combined use of warfarin and aspirin vs. warfarin alone was 4.5 (95% CI: 1.1–18.1). We conclude that concurrent use of potentially interacting drugs with warfarin is associated with a 3 to 4.5-fold increased risk of serious bleeding in long-term warfarin users.

scholarly journals Exposure to airborne cadmium and breast cancer stage, grade and histology at diagnosis: findings from the E3N cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amina Amadou ◽  
Delphine Praud ◽  
Thomas Coudon ◽  
Aurélie M. N. Danjou ◽  
Elodie Faure ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Conditional Logistic Regression ◽  
Positive Association ◽  
Cadmium Exposure ◽  
Tubular Carcinoma ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Estrogenic Properties ◽  
Nested Case Control

AbstractMolecular studies suggest that cadmium due to its estrogenic properties, might play a role in breast cancer (BC) progression. However epidemiological evidence is limited. This study explored the association between long-term exposure to airborne cadmium and risk of BC by stage, grade of differentiation, and histological types at diagnosis. A nested case–control study of 4401 cases and 4401 matched controls was conducted within the French E3N cohort. A Geographic Information System (GIS)-based metric demonstrated to reliably characterize long-term environmental exposures was employed to evaluate airborne exposure to cadmium. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. There was no relationship between cadmium exposure and stage of BC. Also, no association between cadmium exposure and grade of differentiation of BC was observed. However, further analyses by histological type suggested a positive association between cadmium and risk of invasive tubular carcinoma (ITC) BC [ORQ5 vs Q1 = 3.4 (95% CI 1.1–10.7)]. The restricted cubic spline assessment suggested a dose–response relationship between cadmium and ITC BC subtype. Our results do not support the hypothesis that airborne cadmium exposure may play a role in advanced BC risk, but suggest that cadmium may be associated with an increased risk of ITC.

scholarly journals Development of a Web-Based System for Exploring Cancer Risk With Long-term Use of Drugs: Logistic Regression Approach

10.2196/21401 ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e21401
Author(s):  
Hsuan-Chia Yang ◽  
Md Mohaimenul Islam ◽  
Phung Anh Alex Nguyen ◽  
Ching-Huan Wang ◽  
Tahmina Nasrin Poly ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cancer Risk ◽  
Drug Exposure ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Research Database ◽  
Web Based ◽  
Increased Risk ◽  
Web Based System

Background Existing epidemiological evidence regarding the association between the long-term use of drugs and cancer risk remains controversial. Objective We aimed to have a comprehensive view of the cancer risk of the long-term use of drugs. Methods A nationwide population-based, nested, case-control study was conducted within the National Health Insurance Research Database sample cohort of 1999 to 2013 in Taiwan. We identified cases in adults aged 20 years and older who were receiving treatment for at least two months before the index date. We randomly selected control patients from the patients without a cancer diagnosis during the 15 years (1999-2013) of the study period. Case and control patients were matched 1:4 based on age, sex, and visit date. Conditional logistic regression was used to estimate the association between drug exposure and cancer risk by adjusting potential confounders such as drugs and comorbidities. Results There were 79,245 cancer cases and 316,980 matched controls included in this study. Of the 45,368 associations, there were 2419, 1302, 662, and 366 associations found statistically significant at a level of P<.05, P<.01, P<.001, and P<.0001, respectively. Benzodiazepine derivatives were associated with an increased risk of brain cancer (adjusted odds ratio [AOR] 1.379, 95% CI 1.138-1.670; P=.001). Statins were associated with a reduced risk of liver cancer (AOR 0.470, 95% CI 0.426-0.517; P<.0001) and gastric cancer (AOR 0.781, 95% CI 0.678-0.900; P<.001). Our web-based system, which collected comprehensive data of associations, contained 2 domains: (1) the drug and cancer association page and (2) the overview page. Conclusions Our web-based system provides an overview of comprehensive quantified data of drug-cancer associations. With all the quantified data visualized, the system is expected to facilitate further research on cancer risk and prevention, potentially serving as a stepping-stone to consulting and exploring associations between the long-term use of drugs and cancer risk.

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