scholarly journals Incidence, Patient-Related Risk Factors, and Outcomes of Postoperative Pneumonia after Cholecystectomy: A Population-Based Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yun-Hui Teng ◽  
Fu-Chao Liu ◽  
Keng-Hao Liu ◽  
Jr-Rung Lin ◽  
Huang-Ping Yu
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Large Population ◽  
Population Based ◽  
Clinical Population ◽  
Postoperative Pneumonia ◽  
Control Group ◽  
Research Database ◽  
Related Risk ◽  
Age And Sex

Background. Cholecystectomy is one of the most common surgical procedures performed worldwide. The objective of this large, population-based cohort study is to explore the risk factors of pneumonia after cholecystectomy in Taiwan. Methods. From the Taiwanese National Health Insurance Research Database, we selected all patients who underwent cholecystectomy by using ICD-9-codes, from January 1, 1998, to December 31, 2016. The patients were separated into two groups based on the presence or absence of postoperative pneumonia. Basic information, comorbidities, and postoperative complications were evaluated using a t -test or chi-square test. There were 6056 patients in the pneumonia group and 24224 patients in the control group. These two groups were shown in a ratio of 1 : 4 and were matched by age and sex. The log-rank test was used to examine differences in postoperative mortality between patients with and without pneumonia. Preoperative risk factors were analyzed using logistic regression analysis, after adjusting for age and sex. Results. The final dataset included 282184 cholecystectomy patients. Of these patients, 6056 (2.15%) had postoperative new-onset pneumonia. The patient-related risk factors for pneumonia after cholecystectomy in the order of relevance were chronic obstructive pulmonary disease, congestive heart failure, cerebrovascular disease, diabetes mellitus, surgical type, hemodialysis, coronary artery disease, and liver cirrhosis. Compared to patients without postcholecystectomy pneumonia, those with postcholecystectomy pneumonia had higher rates of mortality (within first month, 1.72% vs. 2.28%, P < 0.005 ) and admission to intensive care unit (15.02% vs. 41.80%, P < 0.0001 ) and longer hospital stays (10.71 vs. 18.55 days, P < 0.0001 ). Conclusion. Our results show that postcholecystectomy associated with pneumonia had higher rates of morbidity and mortality in this clinical population. Early identification and possible management of risk factors for pneumonia could improve outcomes of cholecystectomy and lower the risk for patient comorbidities after surgery.

scholarly journals Association Between Subconjunctival Hemorrhage and Acute Coronary Syndrome: A 14-Year Nationwide Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ping-Hao Chiang ◽  
Jung-Nien Lai ◽  
Yun-Chi Chiang ◽  
Kai-Chieh Hu ◽  
Min-Yen Hsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Coronary Syndrome ◽  
Subconjunctival Hemorrhage ◽  
Related Risk ◽  
Patients With Diabetes

Purpose: Subconjunctival hemorrhage (SCH) is usually a benign ocular disorder that causes painless, redness under the conjunctiva. However, since SCH and acute coronary syndrome (ACS) share many vascular risk factors, studies have suggested that these two disorders may be significantly associated with each other, and evaluate the concomitance of ACS in patients with SCH.Methods: This population-based cohort study, enrolled 35,260 Taiwanese patients, and used the Taiwan National Health Insurance Research Database to identify patients with ACS and SCH. Outcomes were compared between the with and without SCH groups. The study population was followed until the date of ACS onset, the date of withdrawal, death, or December 31st 2013, whichever came first.Results: Of the 85,925 patients identified with SCH between 1996 and 2013, 68,295 were excluded based on the study's exclusion criteria, and a total of 17,630 patients with SCH who were diagnosed by ophthalmologists between 2000 and 2012 were eligible for analysis. After 1:1 propensity score matching for 5-year age groups, gender, and the index year, the results showed that SCH was more common in the 40–59 age group (53.82%) and females (58.66%). As for the ACS-related risk factors, patients with diabetes mellitus (aHR = 1.58, 95% CI = [1.38, 1.81]), hypertension (aHR = 1.71, 95% CI = [1.49, 1.96]) and patients taking aspirin (aHR = 1.67, 95% CI = [1.47, 1.90]) had a notably higher risk of ACS. However, it was found that there were no significant differences in the occurrence of ACS between the non-SCH and SCH patients.Conclusion: This results of this study regarding the risk factors and epidemiology of SCH and ACS were in keeping with previously reported findings. However, the results revealed no significant association between SCH and ACS.

scholarly journals The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ling-Yin Kuo ◽  
Po-Ting Hsu ◽  
Wen-Tien Wu ◽  
Ru-Ping Lee ◽  
Jen-Hung Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Fracture Group ◽  
Related Risk ◽  
And Control

Abstract Background People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. Material and methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012 and focused on people who were older than 60 years. Patients with hip fracture undergoing surgical intervention and without hip fracture were matched at a ratio of 1:1 for age, sex, comorbidities, and index year. The incidence and hazard ratios of age, sex, and multiple comorbidities related to MD and its subgroups were calculated using Cox proportional hazards regression models. Results A total of 1408 patients in the hip fracture group and a total of 1408 patients in the control group (no fracture) were included. The overall incidence of MD for the hip fracture and control groups per 100 person-years were 0.8 and 0.5, respectively. Among MD, the incidences of transient MD, depression, and dementia were significantly higher in the hip fracture group than in the control group. Conclusions The prevalence of newly developed MD, especially transient MD, depression, and dementia, was higher in the geriatric patients with hip fracture undergoing surgery than that in the control group. Prompt and aggressive prevention protocols and persistent follow-up of MD development is highly necessary in this aged society.

scholarly journals The Risk of Mortality among Psoriatic Patients with Varying Severity: A Nationwide Population-Based Cohort Study in Taiwan

2018 ◽  
Vol 15 (12) ◽  
pp. 2622 ◽  
Author(s):  
Ying-Xiu Dai ◽  
Ming-Chun Hsu ◽  
Hsiao-Yun Hu ◽  
Yun-Ting Chang ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Mortality Risk ◽  
Psoriasis Patient ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Severe Psoriasis ◽  
Control Group ◽  
Research Database ◽  
Control Subjects

Background: Previous studies showed conflicting results regarding the mortality risk in psoriasis patients with respect to disease severity and presence of psoriatic arthritis. This study aimed to determine the mortality risk in patients with mild and severe psoriasis and patients with psoriatic arthritis (PsA). Methods: A nationwide population-based cohort study was conducted based on data from the Taiwan National Health Insurance Research Database between 2002 and 2012. Incident psoriasis subjects were classified into two groups: psoriasis without arthritis and psoriasis with arthritis. Patients who had received systemic therapy and/or phototherapy were classified as having severe psoriasis; otherwise, patients were classified as having mild psoriasis. Control subjects without psoriasis were selected to match each psoriasis patient from the database within the same observational period. Cox proportional hazards analysis was used to compare the hazard ratio (HR) of time to death. Results: A total of 106,701 patients with psoriasis were included in this study. After controlling for demographics and comorbidities, psoriasis patients had a higher mortality risk compared with the control group (HR 1.41; 95% confidence interval (CI) 1.36 to 1.46). Compared with psoriasis alone, the mortality risk was not increased for PsA (HR = 1.01; 95% CI 0.93 to 1.10). Besides, severe psoriasis did not increase mortality risk compared with mild psoriasis (HR = 1.0; 95% CI 0.95 to 1.06). Conclusions: Patients with psoriasis had a higher mortality risk compared with control subjects, whereas psoriasis severity and presence of PsA had no impact on mortality risk in psoriasis patients.

scholarly journals Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2753 ◽  
Author(s):  
Chi-Kuei Hsu ◽  
Chih-Cheng Lai ◽  
Kun Wang ◽  
Likwang Chen
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
Reflux Disease ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Esophageal Reflux

This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD) in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05). A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]). The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012). In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

Mortality among Patients with Giant Cell Arteritis: A Large-scale Population-based Cohort Study

2019 ◽  
Vol 47 (9) ◽  
pp. 1385-1391 ◽  
Author(s):  
Niv Ben-Shabat ◽  
Shmuel Tiosano ◽  
Ora Shovman ◽  
Doron Comaneshter ◽  
Yehuda Shoenfeld ◽  
...  
Keyword(s):  
Cohort Study ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Median Survival ◽  
Mortality Risk ◽  
Large Scale ◽  
Large Population ◽  
Population Based ◽  
Medical Database ◽  
Age And Sex

Objective.Studies regarding mortality among patients with giant cell arteritis (GCA) have yielded conflicting results. Thus in this large population-based study we aimed to examine whether GCA is associated with increased mortality, and if so, the effect of age at diagnosis and sex on the association.Methods.We used the medical database of Clalit Health Services for this retrospective cohort study. Followup was from January 1, 2002, and continued until death or end of followup on September 1, 2018. Incident GCA patients were compared with age- and sex-matched controls. Estimated median survival times were calculated using the Kaplan-Meier method. HR for all-cause mortality were obtained by the Cox proportional hazard model, adjusted for sociodemographic variables and cardiovascular risk factors.Results.The study included 7294 patients with GCA and 33,688 controls. The mean age at start of followup was 72.1 ± 9.9 years with 69.2% females. Estimated median survival time was 13.1 years (95% CI 12.6–13.5) in patients with GCA compared with 14.4 years (95% CI 14.1–14.6) in controls (p < 0.001). The multivariate analysis demonstrated increased mortality risk in the first 2 years after diagnosis (HR 1.14, 95% CI 1.04–1.25) and > 10 years after diagnosis (HR 1.14, 95% CI 1.02–1.3). The mortality risk was higher in patients diagnosed at ≤ 70 years of age [HR 1.5 (95% CI 1.14–1.99) 0–2 yrs; HR 1.38 (95% CI 1.1–1.7) > 10 yrs].Conclusion.Patients with GCA have a minor decrease in longterm survival compared to age- and sex-matched controls. The seen difference is due to excess mortality in the first 2 years, and > 10 years after diagnosis. Patients diagnosed ≤ 70 years of age are at greater risk.

scholarly journals Migraine and subsequent chronic kidney disease risk: a nationwide population-based cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018483 ◽  
Author(s):  
Shuo-Chun Weng ◽  
Chia-Lin Wu ◽  
Chew-Teng Kor ◽  
Ping-Fang Chiu ◽  
Ming-Ju Wu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Disease Risk ◽  
Population Based ◽  
Interactive Effects ◽  
Control Group ◽  
Research Database ◽  
Control Subjects

ObjectiveWe compared the incidence and risk of chronic kidney disease (CKD) between subjects with new-onset migraine and matched controls without migraine in this large-scale retrospective cohort study.DesignPopulation-based cohort study.Setting8880 subjects with migraine and 503 070 subjects without migraine were enrolled between January 1, 2000 and December 31, 2013, all diagnosed to be without kidney disease. All the participants were registered in the National Health Insurance Research Database.ParticipantsFinally, data from 7156 subjects with migraine and 7156 propensity-score-matched control subjects were analysed.Primary outcome measureWe used Cox proportional hazards regression to estimate adjusted HRs for incident CKD; subgroup analyses were performed to assess the interactive effects of migraine with demographics, comorbidities and long-term medications.ResultsThe incidence of CKD was higher in the migraine group than in the control group. The risk of developing CKD was significantly higher in subjects with migraine than without migraine (P=0.031). Subjects with migraine aged <65 years (age 40–64 (adjusted HR (aHR) 1.35; 95% CI 1.05 to 1.73); age <40 (aHR 1.55; 95% CI 1.02 to 2.36)), with ≥1 comorbid diseases (1–2 diseases (aHR 1.30; 95% CI 1.01 to 1.68); ≥3 diseases (aHR 1.45; 95% CI 1.01 to 2.07)), and not receiving anti-migraine agents (aHR 1.26; 95% CI 1.04 to 1.54) were at a higher risk of developing CKD compared with the control subjects. The interaction between migraine and comorbidities was not significant; age, male gender and long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) were independent risk factors for CKD in subjects with migraine.ConclusionMigraine may be an independent risk factor for CKD. Young subjects with migraine, and those with comorbid conditions or without medical control, are likely to be at higher risk for CKD. Ageing, male sex and NSAIDs tend to have an association with CKD in subjects with migraine.

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