scholarly journals Incidence and Comorbidity of Dementia with Lewy Bodies: A Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Sheng-Kung Yang ◽  
Weishan Chen ◽  
Chun-Hsien Su ◽  
Chung-Hsiang Liu
Keyword(s):  
Cohort Study ◽  
Dementia With Lewy Bodies ◽  
Large Scale ◽  
Retrospective Studies ◽  
Lewy Bodies ◽  
Epidemiological Studies ◽  
Population Based ◽  
Research Database ◽  
The Third ◽  
Taiwan National Health Insurance

Background and Aims. Dementia with Lewy bodies (DLB) is the third most common form of dementia. Epidemiological studies of DLB in Taiwan are scarce. In this study, we estimated the incidence of DLB and comorbidity in the population of Taiwan. Methods. Data were obtained from the Taiwan National Health Insurance Research Database (NHIRD). DLB patients between 2000 and 2013 were enrolled in assessments of incidence and comorbidity. Results. The incidence of DLB was shown to be 7.10 per 100,000 person-years (95% CI = 6.63–7.59), which increased with age. The average age at diagnosis was 76.3, and this was higher for males than for females. The comorbidity rates of hypertension and hyperlipidemia in DLB patients were higher in females than in males. Conclusions. Epidemiologic data from large-scale retrospective studies is crucial to the prevention of DLB.

scholarly journals Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sze-Wen Ting ◽  
Sze-Ya Ting ◽  
Yu-Sheng Lin ◽  
Ming-Shyan Lin ◽  
George Kuo
Keyword(s):  
Cohort Study ◽  
Herpes Zoster ◽  
Population Based ◽  
Research Database ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Reduced Risk ◽  
Systemic Therapies

AbstractThe incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.

scholarly journals The Temporal Relationship between Selected Mental Disorders and Substance-Related Disorders: A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Mu-Lin Chiu ◽  
Chi-Fung Cheng ◽  
Wen-Miin Liang ◽  
Pen-Tang Lin ◽  
Trong-Neng Wu ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Personality Disorders ◽  
Large Scale ◽  
Later Life ◽  
Population Based ◽  
Research Database ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
Substance Related Disorders

Introduction. Previous studies have examined the association between specific mental disorders, particularly mood and anxiety disorders, and substance-related disorders; but the temporal link between them remains unclear. This study aimed to examine whether individuals with specific mental disorders, including affective psychoses, neurotic disorders, schizophrenia, personality disorders, and adjustment reaction, have higher risks for subsequently developing substance-related disorders compared to those without. Methods. A large-scale study with longitudinal data was conducted using the Taiwan National Health Insurance Research Database (NHIRD) consisting of 2,000,118 patients’ medical records from 2000 to 2009. A total of 124,423 people diagnosed with selected mental disorders and the same number of people without the diagnoses of the selected disorders were identified between January 1, 2001, and December 31, 2006, and followed up for the diagnoses of substance-related disorders till the end of 2009. We estimated the risk for subsequently developing substance-related disorders among patients with the selected mental disorders compared to those without by using Cox proportional hazard models. The cumulative incidence of substance-related disorders was calculated using the Kaplan-Meier method. Results. The risk for developing substance-related disorders in patients with selected mental disorders is about 5 times (HR=5.09, 95% CI: 4.74-5.48) higher than those without after adjusting for potential confounding variables. From the multivariate analyses of subsamples stratified by age, sex, and urban and income levels, we found all adjusted hazard ratios were significantly higher than 1.0, ranging from 2.12 (95% CI: 1.72-2.62) to 14.55 (95% CI: 7.89-26.83). For children and adolescents aged 10-19 years, those with specific mental disorders had 14.55-fold higher risk for developing substance-related disorders in later life compared to their counterparts. Furthermore, patients with personality disorders had the highest risk (HR=25.05). Conclusions. The earlier onset of the selected mental disorders is a potential risk for developing substance-related disorders in later life, particularly for personality disorders. Health professionals should pay more attention to this at-risk population, especially to adolescents with mental disorders.

scholarly journals Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242466
Author(s):  
Yi-Sin Wong ◽  
Ching-Fang Tsai ◽  
Yueh-Han Hsu ◽  
Cheung-Ter Ong
Keyword(s):  
Cohort Study ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Population Based ◽  
Primary Diagnosis ◽  
Antiplatelet Drugs ◽  
Study Endpoint ◽  
Research Database ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance

Background In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention. Purpose To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke prevention. Methods This population-based case-cohort study utilized the data obtained from a randomized sample of one million subjects in the Taiwan National Health Insurance Research Database. Patients who were hospitalized owing to the primary diagnosis of ischemic stroke from January 1, 2000 to December 31, 2010 and treated with aspirin, ticlopidine, or clopidogrel were included in the study. Propensity score matching with a 1:4 ratio was performed to compare aspirin with ticlopidine and clopidogrel. The criteria for inclusion were the use of one of the three antiplatelet drugs for more than 14 days within the first month after the stroke and then continued use of the antiplatelet drugs until the study endpoint of recurrent stroke. Results During the 3-year follow-up period, the recurrent stroke rates were 1.62% (42/2585), 1.48% (3/203), and 2.55% (8/314) in the aspirin, ticlopidine, and clopidogrel groups, respectively. Compared with the patients treated with aspirin, those treated with clopidogrel and ticlopidine showed competing risk-adjusted hazard ratios of recurrent stroke of 2.27 (1.02–5.07) and 0.62 (0.08–4.86), respectively. Conclusion Compared with the patients treated with aspirin, those treated with clopidogrel were at a higher risk of recurrent stroke. For stroke prevention, aspirin was superior to clopidogrel whereas ticlopidine was not inferior to aspirin.

Flavor Disorder Is Associated with Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study

2021 ◽  
Author(s):  
Chien-Han Tsao ◽  
Hsin-Hsin Huang ◽  
Yao-Min Hung ◽  
Hung ◽  
James Cheng-Chung Wei ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
Airway Remodeling ◽  
Upper Airway ◽  
Population Based ◽  
Research Database ◽  
Hazard Ratios ◽  
Obstructive Sleep ◽  
Taiwan National Health Insurance

Abstract Background: Flavor sensation was the joint perception of smell and taste sensation was associated with the pleasure of life. Obstructive sleep apnea (OSA) had been demonstrated the presence of upper airway remodeling which altered sensory and motor function due to hypoxia or snore vibration. This study aims to investigate whether OSA is associated with the risk of flavor disorder (FD). Methods: We conducted a nationwide cohort study using the Taiwan National Health Insurance Research Database, one million subjects were sampled with data collected from 1999 to 2013 and 9,191 identified diagnosed OSA patients were included. Each patient was matched with non-OSA controls from the general population by propensity score matching (1:1) based on age, gender, hypertension, hyperlipidemia, ankylosing spondylitis, and Charlson comorbidity index, 8,037 OSA and an equal number of non-OSA subjects were used to compared in this study. The incidence of FD was assessed at the end of 2013 and cumulative incidences, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: The adjusted HR (aHR)of FD for the OSA group was 2.082-fold (95% CI = 1.149–3.773, p=0.0155) higher than non-OSA group. The stratified analyses revealed aHR of FD for the hyperlipidemia group was 2.264-fold (95% CI = 1.061–4.832, p=0.035). Subgroup analysis showed the subjected of female OSA had more risk to develop FD (aHR:2.345, 95% CI = 1.026–5.357, p=0.043). Conclusion: A higher risk of developing FD was found among the newly diagnosed OSA cohort during the longer than 10-year follow-up period

scholarly journals Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study

2020 ◽  
Vol 17 (17) ◽  
pp. 6049
Author(s):  
Yuh-Shin Chang ◽  
Ming-Cheng Tai ◽  
Shih-Feng Weng ◽  
Jhi-Joung Wang ◽  
Sung-Huei Tseng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Population Based ◽  
Control Group ◽  
Study Cohort ◽  
Research Database ◽  
Taiwan National Health Insurance ◽  
Cox Proportional Hazard Regression

This retrospective, nationwide, matched-cohort study included 4488 new-onset keratoconus (KCN) patients, ≥12 years old, recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The control group included 26,928 non-KCN patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence rate of mitral valve prolapse (MVP) was 1.77 times (95% confidence interval (CI) = 1.09–2.88; p = 0.0206) higher in KCN patients ≥40 years old and 1.49 times (95% CI = 1.12–1.98; p = 0.0060) higher in female KCN patients than in controls. After using the Cox proportional hazard regression analysis to adjust for potential confounders, including hypertension, hyperlipidemia, and congestive heart failure, KCN maintained an independent risk factor, MVP being 1.77 times (adjusted hazard ratio (HR) = 1.77, 95% CI = 1.09–2.88) and 1.48 times (adjusted HR = 1.48, 95% CI = 1.11–1.97) more likely to develop in patients ≥40 years old and female patients in the study cohort, respectively. We found that KCN patients ≥40 years of age and female KCN patients have increased risks of MVP. Therefore, it is recommended that KCN patients should be alerted to MVP.

scholarly journals High 1-year risk of stroke in patients with hepatocellular carcinoma: a nationwide registry-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jin-Yi Hsu ◽  
Peter Pin-Sung Liu ◽  
An-Bang Liu ◽  
Huei-Kai Huang ◽  
Ching-Hui Loh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Stroke Risk ◽  
Population Based ◽  
Research Database ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
Baseline Characteristics ◽  
Coagulation Dysfunction ◽  
The Relationship

AbstractPatients with hepatocellular carcinoma (HCC) might be more vulnerable to develop stroke than other cancer patients because of HCC-associated coagulation dysfunction. However, limited studies have investigated the relationship between HCC and stroke. This nationwide population-based cohort study enrolled all patients with HCC diagnosed between 2011 and 2015 from the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database; an age- and sex-matched cohort without cancer was included. The primary outcome was the 1-year risk for first-ever stroke after the index date. The Fine and Gray competing risk regression model was used to estimate the 1-year stroke risk with adjusted hazard ratios (aHRs). After propensity score matching, each cohort has 18,506 patients with similar baseline characteristics. Compared with the cancer-free cohort, the aHRs in the HCC cohort for overall, ischemic, and hemorrhagic strokes were 1.59 [95% confidence interval (CI), 1.35–1.88], 1.38 [95% CI, 1.15–1.65], and 2.62 [95% CI, 1.79–3.84], respectively. On subgroup analysis, HCC patients without cirrhosis, those with stage 3 or 4 cancer had a higher stroke risk than cancer-free cohort. Therefore, stroke prevention should be considered in patients with HCC, especially in those without cirrhosis and with stage 3 or 4 cancer.

scholarly journals To Investigate the Risk of Herpes Zoster in Women With Endometriosis: A Taiwan National Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chao-Yu Hsu ◽  
Der-Shin Ke ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Herpes Zoster ◽  
Ethnic Differences ◽  
Population Based ◽  
Research Database ◽  
Newly Diagnosed ◽  
Loss To Follow Up ◽  
Taiwanese Women ◽  
Taiwan National Health Insurance

Background: The objective of this study is to investigate the occurrence of herpes zoster (HZ) in patients with endometriosis.Methods: This retrospective population-based cohort study was conducted using the Taiwan National Health Insurance Research Database. Between 2000 and 2012, women aged ≥20 years with newly diagnosed endometriosis were enrolled into the endometriosis group. Each patient with endometriosis was randomly matched to 4 controls according to age and index year. All the patients were traced from the index date to HZ diagnosis, loss to follow-up, death, or the end of December 2013.Results: In total, 19,147 patients with newly diagnosed endometriosis and 76,588 participants without endometriosis were enrolled. The incidence of HZ was higher in endometriosis persons (5.36 per 1,000 person-years) than in matched controls (4.43 per 1,000 person-years) (p < 0.001). After adjustment for age and comorbidities, patients with endometriosis age ≤ 49 years (adjusted hazard ratio [aHR] = 1.17) (p < 0.001) and 50–64 years (aHR = 1.27) (p < 0.05) showed significantly higher risk of HZ than the corresponding controls. Among women without any comorbidities, patients with endometriosis were 1.22 times (p < 0.001) more likely to have HZ than those without endometriosis.Conclusion: Taiwanese women with endometriosis may have a higher rate of HZ occurrence. Endometriosis seems to be a high burden for affected women. Therefore, we suggest that clinicians should be aware of HZ among women with endometriosis, although there may be ethnic differences.

scholarly journals Chronic Pain Increases the Risk of Dementia: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 24 (6) ◽  
pp. E849-E856
Keyword(s):  
Chronic Pain ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Population Based ◽  
Study Cohort ◽  
Research Database ◽  
Age Group ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
The Impact

BACKGROUND: Chronic pain (CP) may increase the risk of cognitive impairment; however, the association between CP and dementia is still unclear. OBJECTIVES: Therefore, we conducted this study to clarify the association between CP and dementia. STUDY DESIGN: Retrospective cohort study. SETTINGS: Nationwide population based. METHODS: This study recruited 27,792 patients (>= 50 years) with CP from the Taiwan National Health Insurance Research Database between January 1, 2000, and December 31, 2015, as the study cohort. The comparison cohort consists of patients without CP who were matched 1:1 for age, gender, and index date with the study cohort. A comparison of the risk of dementia between the two cohorts was performed by following up until 2015. RESULTS: The prevalence of CP was 13.4% in the population aged >= 50 years. Patients with CP had a higher risk of dementia than those without CP (adjusted hazard ratio [AHR]: 1.21; 95% confidence interval [CI]: 1.15-1.26). Compared with the other age subgroups, the 50-64 years age group with CP had the highest risk of dementia (AHR: 1.28; 95% CI: 1.14-1.43). The impact of CP on the increased risk of dementia was more prominent in the younger age subgroup and decreased with aging. The increased risk of dementia in patients with CP was persistent, even following up for more than 5 years (AHR: 1.19; 95% CI: 1.12-1.26). LIMITATIONS: Using “analgesics use at least 3 months” as the surrogate criteria of CP may underestimate the diagnosis of CP. CONCLUSIONS: CP was associated with a higher risk of dementia, especially in the 50-64 years age group. Early treatment of CP for the prevention of dementia is suggested. KEY WORDS: Chronic pain. cognitive impairment, dementia

scholarly journals Increased non-typhoidal Salmonella hospitalizations in transfusion-naïve thalassemia children: a nationwide population-based cohort study

2021 ◽  
Author(s):  
Fang-Ju Lin ◽  
Jiunn-Ming Sheen ◽  
Yao-Hsu Yang ◽  
Kuang-Che Kuo
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Population Based ◽  
List Type ◽  
Research Database ◽  
Thalassemia Patient ◽  
Urbanization Level ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
History Of

Abstract Introduction Although non-typhoidal Salmonella (NTS) infection usually causes self-limited enterocolitis, several risk factors have been found to predispose individuals to more severe NTS infections. However, few studies have discussed the association between NTS infection and pediatric thalassemia populations. Material and methods A nationwide population-based retrospective cohort study was conducted using medical records of the selected children from the Taiwan National Health Insurance Research Database. Immunocompromised individuals or patients with a history of transfusion or splenectomy were excluded. One thalassemia patient was matched with four non-thalassemia patients based on their year of birth, sex, and urbanization level. Results In this cohort, 912 patients with thalassemia and 3648 comparison cohort were analyzed. The mean age of NTS hospitalization was 2.0 ± 1.4 in thalassemia cohort and 2.6 ± 2.4 in non-thalassemia cohort. Transfusion-naïve thalassemia children were proved to have a higher rate of NTS hospitalization (6.90 vs 4.11 per 1000 person-year; p = 0.0004) than the non-thalassemia cohort, with an adjusted hazard ratio (HR) of 1.68 (95% confidence interval [CI] = 1.26–2.24). Conclusion Our research shows that transfusion-naïve thalassemia is associated with an increased risk of NTS hospitalization. Further prospective study comparing the incidence and severity of NTS infection among children with and without thalassemia is needed. Impact Pediatric transfusion-naïve thalassemia patients have an 1.68-fold increased risk for hospitalization due to non-typhoidal Salmonella (NTS) infection. This is the first nationwide population-based cohort study based on an extremely large database that shows pediatric transfusion-naïve thalassemia patients have an increased risk for NTS hospitalizations. Besides the previously known risk factors such as extremes of age, sickle cell disease, or immunosuppressing conditions, clinicians must also take thalassemia as a possible risk factor for more severe NTS disease.

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