scholarly journals Temporal Trends in Incidence and Case Fatality of Intracerebral Hemorrhage: The Tromsø Study 1995-2012

2016 ◽  
Vol 6 (2) ◽  
pp. 40-49 ◽  
Author(s):  
Maria Carlsson ◽  
Tom Wilsgaard ◽  
Stein Harald Johnsen ◽  
Anne Merete Vangen-Lønne ◽  
Maja-Lisa Løchen ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Incidence Rate ◽  
Temporal Trends ◽  
Case Fatality ◽  
Incidence Rates ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Incident Cases ◽  
Over Time ◽  
Age And Sex

Background: The aim of this study was to explore temporal trends in incidence and case fatality rates of intracerebral hemorrhage (ICH) over the last two decades in a Norwegian municipality. Methods: Incident cases of primary ICH were registered in the period from 1995 through 2012 in 32,530 participants of the longitudinal population-based Tromsø Study. Poisson regression models were used to obtain incidence rates over time in age- and sex-adjusted and age- and sex-specific models. Case fatality rates were calculated and age- and sex-adjusted trends over time were estimated using logistic regression. Results: A total of 226 ICHs were registered. The age- and sex-adjusted incidence rate [95% confidence interval (CI)] in the overall population was 0.42 (0.37-0.48) per 1,000 person-years. Age-adjusted incidence rates were 0.53 (0.43-0.62) in men and 0.33 (0.26-0.39) in women. In individuals aged <75 years, the age- and sex-adjusted incidence rate was 0.27 (0.22-0.32) and in individuals aged ≥75 years, it was 2.42 (1.95-2.89) per 1,000 person-years. There was no significant change in incidence rates over time. The incidence rate ratio (95% CI) in the overall population was 0.73 (0.47-1.12) in 2012 compared with 1995. The overall 30-day case fatality (95% CI) was 23.9% (18.3-29.5) and did not change substantially over time [odds ratio in 2012 vs. 1995 = 0.83 (95% CI 0.27-2.52)]. Conclusion: No significant changes in incidence and case fatality rates of ICH were observed during the last two decades.

Primary Intracerebral Hemorrhage in Izumo City, Japan: Incidence Rates and Outcome in Relation to the Site of Hemorrhage

Neurosurgery ◽  
2003 ◽  
Vol 53 (6) ◽  
pp. 1283-1298 ◽  
Author(s):  
Tetsuji Inagawa ◽  
Naohiko Ohbayashi ◽  
Akihiko Takechi ◽  
Masaaki Shibukawa ◽  
Kaita Yahara
Keyword(s):  
Glasgow Coma Scale ◽  
Intracerebral Hemorrhage ◽  
Survival Rates ◽  
Case Fatality ◽  
Incidence Rates ◽  
Coma Scale ◽  
Scale Scores ◽  
Adjusted Incidence ◽  
Age And Sex

Abstract OBJECTIVE The aim of this community-based study was to investigate the incidence rates and outcome of primary intracerebral hemorrhage (ICH) in relation to the site of hemorrhage. METHODS The subjects were 350 patients with primary first-ever ICH who were treated during the 8-year period 1991 to 1998 in Izumo City, Japan. RESULTS The crude and age- and sex-adjusted incidence rates for all types of ICH were 52 and 47 per 100,000 population, respectively, for all ages. The most common site of ICH was the putamen (120 patients, 34%), followed by the thalamus (115, 33%), lobar areas (53, 15%), brainstem (30, 9%), cerebellum (25, 7%), and caudate nucleus (7, 2%). The crude and age- and sex-adjusted annual incidence rates per 100,000 population were 18 and 16 for putaminal, 17 and 15 for thalamic, 8 and 7 for lobar, 4 and 3 for cerebellar, 4 and 4 for brainstem, and 1 and 1 for caudate hemorrhages, respectively. The Glasgow Coma Scale scores on admission were best in patients with cerebellar hemorrhage and worst in those with brainstem hemorrhage. Surgery was performed for 34% of putaminal, 9% of thalamic, 14% of caudate, 21% of lobar, and 32% of cerebellar hemorrhages but not for brainstem hemorrhages. The 30-day case fatality rate was 11% for putaminal, 9% for thalamic, 14% for caudate, 11% for lobar, 0% for cerebellar, and 53% for brainstem hemorrhages. When patients with ICH were analyzed as a whole, the overall survival rates at 30 days, 3 months, and 3 years were 87, 83, and 73%, respectively. Both the short-term and long-term outcomes after ICH were directly related to the site of hemorrhage and the severity of bleeding, which was assessed by the hematoma volume and Glasgow Coma Scale score. Overall, 190 (54%) of 350 patients had a favorable outcome, and 55 (16%) had died at discharge. CONCLUSION Marked differences were observed in the incidence rates and outcome of primary ICH in relation to the site of hemorrhage. The differences in outcome were primarily a result of differences in the severity of bleeding for each ICH subtype.

Incidence and prevalence of intracranial aneurysms and hemorrhage in Olmsted County, Minnesota, 1965 to 1995

Neurology ◽  
1998 ◽  
Vol 51 (2) ◽  
pp. 405-411 ◽  
Author(s):  
V. V. Menghini ◽  
R. D. Brown ◽  
J. D. Sicks ◽  
W. M. O'Fallon ◽  
D. O. Wiebers
Keyword(s):  
Incidence Rate ◽  
Medical Records ◽  
Population Based ◽  
Incidence Rates ◽  
Olmsted County ◽  
Anterior Circulation ◽  
Unique Data ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Age And Sex

Background: There are no previous reports of the incidence rate of intracranial saccular aneurysms in a defined population.Methods: Medical records of all residents of Olmsted County, MN, with a possible intracranial saccular aneurysm (IA) were reviewed. Incidence rates and prevalence of symptomatic and asymptomatic IAs, aneurysmal intracranial hemorrhage (ICH), and frequency of IA detection based on size and site were determined.Results: A total of 348 IAs were detected among 270 persons during the 31-year period from 1965 to 1995, including 188 symptomatic patients at presentation(166 with ICH). The age- and sex-adjusted incidence rate for IAs excluding asymptomatic autopsy cases was 9.0/100,000 person-years (P-Y; 95% CI, 7.8 to 10.2). The rate of detection in women (10.7/100,000 P-Y; 95% CI, 8.9 to 12.4) was higher than in men. The highest incidence of IA was among those age 55 to 64 years in men, and 65 to 74 years in women. The incidence rate of aneurysmal ICH was 6.9/100,000 P-Y (95% CI, 5.9 to 8.0). Aneurysms were seven times more likely to be detected in the anterior circulation, and this ratio was not altered significantly by age or gender. On January 1, 1990, the age- and sex-adjusted prevalence rate of identified IAs was 83.4/100,000 population (95% CI, 64.1 to 102.7).Conclusions: This study provides unique data on the population-based incidence and prevalence rates of IAs.

scholarly journals Population-based incidence of conjunctival tumours in Olmsted County, Minnesota

2018 ◽  
Vol 102 (12) ◽  
pp. 1728-1734 ◽  
Author(s):  
Lauren A Dalvin ◽  
Diva R Salomão ◽  
Sanjay V Patel
Keyword(s):  
Incidence Rate ◽  
Population Based ◽  
Incidence Rates ◽  
Medical Record Linkage ◽  
Olmsted County ◽  
Rochester Epidemiology Project ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Over Time

AimTo determine population-based incidence of conjunctival tumours in Olmsted County, Minnesota.MethodsThe Rochester Epidemiology Project medical record linkage system was used to identify patients with conjunctival tumours in Olmsted County (1 January 1980 to 31 December 2015). Records were reviewed for demographics, types of tumours, histopathology, treatment and clinical course. Incidence rate of all tumours was calculated per 1 000 000 person-years. Poisson regression analysis was used to assess changes in incidence over time.ResultsThere were 504 patients with conjunctival tumours, giving an age-adjusted and sex-adjusted incidence rate of 125 per 1 000 000 (CI 113.5 to 135.5). Incidence increased over time (P<0.001). Most tumours (474, 94%) were benign. Of benign lesions, melanocytic lesions accounted for the majority (431, 86%), with adjusted incidence rates of 10.8 (CI 7.7 to 13.9) for complexion-associated melanosis, 49.7 (CI 42.9 to 56.6) for nevus and 44.1 (37.5–50.8) for primary acquired melanosis. Malignant lesions were rare (30, 6%) with 6 cases of melanoma, 21 cases of ocular surface squamous neoplasia (OSSN), 1 case of Langerhans cell histiocytosis and 2 cases of lymphoma. Adjusted incidence rates of conjunctival melanoma and OSSN were 1.5 (CI 0.3 to 2.8) and 6.1 (CI 3.5 to 8.7), respectively. Outcomes for melanoma (mean follow-up 14 years, range 0–34) and OSSN (mean follow-up 4 years, range 0–24) were favourable in 29 cases, with one fatality due to metastatic melanoma.ConclusionsIn a population-based setting, most conjunctival tumours are benign, and the majority of lesions are melanocytic. While it is important to remain vigilant for malignancies, most conjunctival lesions in a community-based practice are not life-threatening.

scholarly journals Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

2022 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Matteo Riccò ◽  
Simona Peruzzi ◽  
Federica Balzarini ◽  
Alessandro Zaniboni ◽  
Silvia Ranzieri
Keyword(s):  
Incidence Rate ◽  
Central Italy ◽  
Denv Infection ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Annual Reports ◽  
Foreign Born ◽  
Time Period ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

Epidemiology of Myeloproliferative Neoplasms in Norway

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1858-1858
Author(s):  
Christina Roaldsnes ◽  
Anders Waage ◽  
Mette Nørgaard ◽  
Waleed Ghanima
Keyword(s):  
Incidence Rate ◽  
Cancer Registry ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Relative Survival ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Jak2 Mutation ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background: Polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are clonal hematological disorders collectively named as myeloproliferative neoplasms (MPN). Discovery of JAK2 mutation in 2005, altered WHO classification for MPN diagnosis in 2008 and availability of new treatment of MPN may have substantial effect on epidemiology of MPN. Published data on epidemiology of MPN after the discovery of JAK2 mutation and the introduction of 2008 WHO classifications for MPN, in particular on the prevalence of MPN, are scarce. We aimed to study the epidemiology of MPN in Norway and to explore the impact of JAK-2 mutation and new guidelines on the incidence of MPN using data from the Norwegian cancer registry. Method: We identified 2344 persons diagnosed with MPN from the Norwegian Cancer Registry diagnosed between 1995 and 2012. Registration of cancer in the Norwegian Cancer Registry is mandatory according to the law. We report age-adjusted incidence, prevalence and relative survival of MPN. Age adjusted incidence was reported for 2 years periods from 1995 to 2012. The prevalence was calculated according to the Norwegian population per 31.12.2011. Results: A total of 945 cases of PV was identified with a median age at diagnosis of 70 years; 471 males (50%) and 474 females (50%). The overall age-adjusted incidence rate both genders was 0.4/10⁵ in 1995-1997, 0.5/10⁵ in 1998-2000, 0.7/10⁵ in 2001-2003, 0.8/10⁵ in 2004-2007, 2008-2009 and 0.7/10⁵ in 2010-12. We identified a total of 762 cases of ET with a median age at diagnosis of 65 years, 297 males (39%) and 465 females (61%). The overall age adjusted incidence rate both genders being 0.3/10⁵ in 1995-1997 and 1998-2000, 0.5/10⁵ in 2001-2003 and 2004-2006, 0.9/10⁵ in 2007-2009 and 2010-2012. A total of 418 cases of MF was identified with a median age at diagnosis of 71 years; 243 males (58%) and 175 females (42%). Age adjusted incidence rates of both genders were 0.2/10⁵ from 1995-2006, 0.3/10⁵ in 2007-2009 and 0.5/10⁵ in 2010-2012. There were a total of 219 persons with unclassified MPN both genders,119 males (54%) and 100 females (46%) and age adjusted incidence rate varied from 0.1-0.2 to 0.1/10⁵ 1995-2012. Per 31.12.2011 the prevalence of PV, ET and MF was 9.2, 8.6 and 3.0 per 10⁵ inhabitants respectively. The survival curves for males and females for the three conditions are shown in the figure. Conclusions: This population-based study shows that the incidence of ET and MF almost doubled during the years 2007-2012 as compared to 1995-2006 as shown in the table. This increment in the incidence may possibly be related to improved diagnostics including the JAK2 mutation and the introduction of 2008 WHO-guidelines for MPN. Surprisingly, the discovery of JAK2 does not seem to have had impact on the incidence of PV as indicated by steady incidence rates since 2001. The relative survival was only slightly reduced for PV and ET, but substantially reduced for MF. Only 50% of patients with MF survive for more than 5 years. Table Incidence of MPN per 105 inhabitants during the period 1995 to 2012 in Norway 1995-97 1998-2000 2001-03 2004-06 2007-09 2010-12 PV 0.4 0.5 0.7 0.8 0.8 0.7 ET 0.3 0.3 0.5 0.5 0.9 0.9 MF 0.2 0.2 0.2 0.2 0.3 0.5 Figure showing the relative survival of PV, ET and MF Figure. showing the relative survival of PV, ET and MF Disclosures Roaldsnes: Novartis Norge AS: Research Funding. Ghanima:Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

Differences in colon cancer incidence rates by latitude.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14627-e14627
Author(s):  
Binay Kumar Shah ◽  
Krishna Bilas Ghimire ◽  
Barsha Nepal
Keyword(s):  
Colon Cancer ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Southern Region ◽  
Southern Latitude ◽  
Northern Latitude ◽  
The North ◽  
Northern Regions ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

e14627 Background: There is significant decrease in the ultraviolet B photons reaching the earth’s surface during November to February (Holick MF Am J Clin Nutr. 2004 Dec; 80(6 Suppl):1678S-88S). This results in little if any vitamin D3 production in the skin during this period. This study was conducted to evaluate difference in colon cancer age adjusted incidence rates in the northern (latitude ≥37o N) and the southern (latitude < 37oN) regions in the contiguous United States during 1973-2008. Methods: Patients, aged 20 years and older, who had been diagnosed with colong cancer during January 1973 and December 2008, were selected from the Surveillance, Epidemiology, and End Results (SEER) 13 database. Based on the counties’ centroid, northern (latitude ≥37o N) and southern (latitude < 37oN) regions were determined. We compared age adjusted incidence rates (AAIR) of colon cancer in the southern and northern regions among cohorts of patients categorized by age (≥20, 20-64, ≥65 years), gender (Men, Women) and Race (Caucasians, Blacks, Others). The AAIR was calculated per 100,000 population. We used SEER*Stat software to calculate age adjusted incidence rate, incidence ratio, confidence interval (CI, 95%) and P value. Results: There were 314,975 cases of colon cancer diagnosed among 608,245,557 US population during 1973-2008. The overall colon cancer AAIR was 57.1 per 100,000 population studied. The incidence rates were 49.1 in the south and 58.7 in the north of 37oN latitude, (95% CI 1.18-1.20, p<0.05). The AAIRs for patients in the age group 20-64 years were 17.9 and 18.8 in the southern and northern regions, (CI 95%, 1.0346-1.0697), p<0.0005 respectively. The incidence rates for patients aged ≥65 years were 194.3 and 243.9 in the southern and northern regions, (CI 95%, 1.0346-1.0697) p<0.0005. Similarly, the AAIRs were significantly higher in the northern region compared to southern region for both sexes and all ethnic groups. Conclusions: Colon cancer age-adjusted incidence rate is significantly higher in the Northern compared to the Southern region of the US. The higher incidence of colon cancer in the North may be related to lack of sunlight exposure and relative vitamin D deficiency.

scholarly journals Gram-Negative Bloodstream Infection: Implications of Antimicrobial Resistance on Clinical Outcomes and Therapy

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 922
Author(s):  
Majdi N. Al-Hasan
Keyword(s):  
Antimicrobial Resistance ◽  
Incidence Rate ◽  
Bloodstream Infection ◽  
Clinical Outcomes ◽  
Gram Negative ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Age And Sex

The age- and sex-adjusted incidence rate of Gram-negative bloodstream infection (GN-BSI) is 84 [...]

scholarly journals Incidence rates and contemporary trends in primary urethral cancer

2021 ◽  
Author(s):  
Mike Wenzel ◽  
Luigi Nocera ◽  
Claudia Collà Ruvolo ◽  
Christoph Würnschimmel ◽  
Zhe Tian ◽  
...  
Keyword(s):  
African Americans ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Regression Analyses ◽  
Histological Subtype ◽  
Annual Percent Change ◽  
Percent Change ◽  
Log Linear ◽  
Incident Cases ◽  
Over Time

Abstract Purpose: We assessed contemporary incidence rates and trends of primary urethral cancer. Methods: We identified urethral cancer patients within Surveillance, Epidemiology and End Results registry (SEER, 2004–2016). Age-standardized incidence rates per 1,000,000 (ASR) were calculated. Log linear regression analyses were used to compute average annual percent change (AAPC). Results: From 2004–2016, 1,907 patients with urethral cancer were diagnosed (ASR 1.69; AAPC: -0.98%, p = 0.3). ASR rates were higher in males than in females (2.70 vs. 0.55), respectively and did not change over the time (both p = 0.3). Highest incidence rates were recorded in respectively ≥ 75 (0.77), 55–74 (0.71) and ≤ 54 (0.19) years of age categories, in that order. African Americans exhibited highest incidence rate (3.33) followed by Caucasians (1.72), other race groups (1.57) and Hispanics (1.57), in that order. A significant decrease occurred over time in Hispanics, but not in other race groups. In African Americans, male and female sex-stratified incidence rates were higher than in any other race group. Urothelial histological subtype exhibited highest incidence rate (0.92), followed by squamous cell carcinoma (0.41), adenocarcinoma (0.29) and other histologies (0.20). In stage stratified analyses, T1N0M0 stage exhibited highest incidence rate. However, it decreased over time (-3.00%, p = 0.02) in favor of T1 − 4N1 − 2M0 stage (+ 2.11%, p = 0.02). Conclusion: Urethral cancer is rare. Its incidence rates are highest in males, elderly patients, African Americans and in urothelial histological subtype. Most incident cases are T1N0M0, but over time, the incidence of T1N0M0 decreased in favor of T1 − 4N1 − 2M0.

MO514CARDIORENAL OUTCOMES AND MORTALITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A MULTINATIONAL PROSPECTIVE COHORT STUDY (PROVALID)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Stefanie Thöni ◽  
Felix Keller ◽  
Sara Denicolo ◽  
Susanne Eder ◽  
Laszlo Rosivall ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Netherlands ◽  
Incidence Rate ◽  
Composite Endpoint ◽  
Incidence Rates ◽  
European Countries ◽  
All Cause Mortality ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background and Aims PROVALID is a prospective, observational, multinational cohort study in 4000 patients with type 2 diabetes mellitus. Our aim was to determine the incidence rate of renal and cardiovascular endpoints, as well as all-cause-mortality in different European countries and to identify risk factors associated with the investigated outcomes. Method Potential risk factors associated with the investigated outcomes were identified by calculation of the incidence rate ratio. Crude and adjusted incidence rates for every country were estimated using generalized linear (poisson) regression models and corresponding 95 % confidence intervals were computed. Incidence rates were adjusted for different risk factors including age, sex, estimated GFR, albuminuria, HbA1c, LDL, HDL, total cholesterol, systolic blood pressure, BMI and cardiovascular and renal comorbidities; among these several show significant impact on outcomes. The renal outcome was a composite of a sustained decline in the estimated GFR of at least 40%, a sustained increase in albuminuria of at least 30 % including the progression from normo- to micro- or macroalbuminuria, end-stage kidney disease, or death from renal causes. The cardiovascular composite endpoint was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Results 3461 participants of four European countries (Austria 18 %, Hungary 41 %, Netherlands 26 % and Scotland 15 %) with a mean follow up time of 3.9 years were included into this study. Participants from Poland were excluded due to missing follow-up data. In total, 9.2 % and 6.4 % participants reached the renal and cardiovascular composite endpoint, respectively. 7.0 % of the participants died within this timeframe. The adjusted incidence rate for the renal endpoint ranged from 14.5 to 25.3 (per 1000 patient-years) with no significant differences between countries. On average, the incidence rate was lower in Scotland (IR, 14.5; 95 % CI, 8.7 to 22.5) and in the Netherlands (IR, 15.7; 95 % CI, 10.9 to 21.8) compared to Hungary (IR, 25.3; 95 % CI, 20.7 to 30.6) and Austria (IR 21.3; 95 % CI, 16.2 to 27.5). The adjusted incidence rate for the cardiovascular endpoint ranged from 7.0 to 20.3 and was significantly lower in Hungary (IR, 7.0; 95 % CI, 5.1 to 9.3) and the Netherlands (IR, 7.6; 95 % CI, 4.4 to 12.2) compared to Austria (IR, 16.7; 95 % CI, 12.4 to 22.1) and Scotland (IR, 20.3; 95 % CI, 13.8 to 28.9). The adjusted incidence rate for all-cause-mortality ranged from 4.2 to 15.9 and was significantly lower in the Netherlands (IR, 4.2; 95 % CI, 2.2 to 7.6) compared to Scotland (IR, 15.9; 95 % CI, 10.9 to 22.6). No significant difference in the incidence rates between Austria (IR, 9.8; 95 % CI, 7.0 to 13.4) and Hungary (IR, 9.3; 95 % CI, 6.8 to 12.4) was found. Conclusion After adjustment for known risk factors, incidence rates of cardiovascular endpoints, as well as all-cause-mortality still vary significantly between four European countries. This may be due to manifold reasons. Further analysis of the national therapeutic practice pattern within the PROVALID cohort may provide additional information.

scholarly journals Patients With MEN1 Are at an Increased Risk for Venous Thromboembolism

2020 ◽  
Author(s):  
Maya E Lee ◽  
Yashira M Ortega-Sustache ◽  
Sunita K Agarwal ◽  
Aisha Tepede ◽  
James Welch ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Natural History Study ◽  
Search Terms ◽  
Increased Risk ◽  
Mechanistic Investigation ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background Multiple endocrine neoplasia type 1 (MEN1) is a rare inherited disorder predisposing the development of multiple functional and nonfunctional neuroendocrine tumors (NETs). Only uncommon MEN1-associated functional NETs such as glucagonomas (&lt;1%) and adenocorticotropic hormone-producing tumors (&lt;5%) are known to be associated with hypercoagulability. It is unknown if patients with MEN1 generally have an increased risk of venous thromboembolism (VTE). Methods We queried a prospective natural history study of germline mutation-positive MEN1 patients (n = 286) between 1991 and 2019 for all lifetime events of VTE. The search terms were: DVT, thromb, embol, PE, pulmonary embolism, clot, hematology consult, anticoagulant, coumadin, lovenox, xarelto, warfarin, aspirin, rivaroxaban, and apixaban. Incidence rates were calculated, accounting for age and sex. Comparisons were made to published incidence rates in healthy populations, different types of cancer, and Cushing’s syndrome. Results Thirty-six subjects (median age 45 years, range 16–75) experienced a VTE event, yielding a prevalence rate of 12.9%. The age–sex adjusted incidence rate of VTE is 9.11 per 1000 patient-years, with a sex-adjusted lifetime incidence rate of 2.81 per 1000 patient-years. MEN1-associated lifetime incidence rates are ~2-fold higher than the estimated annual incidence rate in the general population and are comparable to the known risk in the setting of various types of cancer. Approximately 80% of patients who had a VTE were diagnosed with pancreatic NETs, of which 24% were insulinomas. Fourteen patients (42%) experienced perioperative VTE events. Conclusions MEN1 patients have an increased risk of VTE. Further mechanistic investigation and validation from other MEN1 cohorts are needed to confirm the increased prevalence of VTE in MEN1.

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