Atopic Dermatitis and Infertility: A Nationwide Retrospective Cohort Study

Background: Given that common pathophysiological factors play a role in atopic dermatitis (AD) and infertility, we assumed that the 2 conditions might demonstrate an epidemiological association. Large-scale epidemiological data on this topic are lacking. Objectives: The aim of this work was to evaluate the potential association between AD and infertility in a broad community-based population. Methods: A nationwide retrospective cohort study was conducted, analyzing the association between AD and infertility. We compared AD patients diagnosed by a dermatologist between 2002 and 2018 and a matched control group. The study population was subdivided according to age into adults (age ≥18 years) and children (age <18 years), and was further subdivided according to AD severity, classified as either mild or moderate-to-severe according to AD-related drug use and healthcare services utilization. Results: The study included 127,150 patients with AD and 127,071 comparison enrollees. AD was associated with a higher prevalence of infertility than that of the control group (1.4 and 1.1%, respectively). The prevalence of infertility, per 1,000 patient-years, was increased in patients with AD compared to that of the control group (2.17 and 1.7, respectively). Multivariate analysis for infertility demonstrated that AD was a key risk factor for infertility in both males and females with mild AD and moderate-to-severe AD. Conclusion: A significant association between AD and infertility was observed. This association suggests that infertility may be an additional manifestation of AD. Further studies are warranted to evaluate the impact of AD management in the setting of infertility and vice versa.

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Effects of Rurality and Geographical Distance on Unplanned Emergency Department Utilization for Children With Asthma: A Population Level Retrospective Cohort Study

Canadian Journal of Nursing Research ◽

10.1177/0844562120974241 ◽

2020 ◽

pp. 084456212097424

Author(s):

Jennifer Wilson ◽

Laurie Gedcke-Kerr ◽

Kevin Woo ◽

Pilar Camargo Plazas ◽

Joan Tranmer

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Level ◽

Healthcare Services ◽

Emergency Department Utilization ◽

Geographical Distance ◽

Children With Asthma ◽

The Impact

Background Asthma is a highly prevalent chronic disease among Ontario children; however, the extent to which rural status and distance are associated with unplanned emergency department (ED) use by this population is largely unknown. Objective To explore the impact of rurality and geographical distance to primary and specialist care services on healthcare utilization by analyzing the use of unplanned ED services. Methods A population level retrospective cohort study of Ontario children ages 5–14 with newly diagnosed asthma was conducted using health administrative data from Institute for Clinical Evaluative Sciences (ICES). Adjusted logistic regression models were used to analyze the association between unplanned ED use with rural status and distance to general practitioner/family physician (GP/FP) and specialist healthcare services, while controlling for confounders. Results In total, 19,732 individuals met the inclusion criteria. Individuals who lived in rural locations (OR 2.00, 95% CI 1.64–2.44) and travelled >50 km to a GP/FP (OR 1.25, 95% CI 1.06–1.48) or specialist (OR 1.20, 95% CI 1.05–1.38) were more likely to utilize an ED. Conclusion Children with asthma utilize healthcare services differently based on rural status and distance to services. To ensure equitable access to care, there is a need to accommodate for these factors in the planning and provision of asthma healthcare services.

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Evaluating the impact of prehospital care on mortality following major trauma in New Zealand: a retrospective cohort study

Injury Prevention ◽

10.1136/injuryprev-2020-044057 ◽

2021 ◽

pp. injuryprev-2020-044057

Author(s):

Bridget Kool ◽

Rebbecca Lilley ◽

Gabrielle Davie ◽

Pararangi Reid ◽

Ian Civil ◽

...

Keyword(s):

Cohort Study ◽

New Zealand ◽

Trauma Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Major Trauma ◽

Prehospital Care ◽

Healthcare Services ◽

Evidence Base ◽

The Impact

BackgroundInjury is a leading cause of death and health loss in New Zealand and internationally. The potentially fatal or severe consequences of many injuries can be reduced through an optimally structured prehospital trauma care system that can provide timely and appropriate care.ObjectiveTo investigate the relationship between emergency medical services (EMS) care and survival to hospital for major trauma cases in New Zealand.MethodsThis project is a retrospective cohort study of New Zealand major trauma cases attended by EMS providers over a 2-year period. Outcomes include survival to hospital and survival in hospital for at least 24 hours. The project has three phases: (1) identification of the cohort and assembling a bespoke longitudinal dataset linking EMS, New Zealand Major Trauma Registry and Coronial data; (2) describing the pathways and processes of care to inform an investigation of the relationships between types of EMS care and survival using propensity score modelling to adjust for case-mix differences; (3) assessment of the implications for future practice, policy and research.DiscussionThe study findings will help identify opportunities to optimise the delivery of EMS care in New Zealand by informing the development or revision of existing major trauma EMS policies and guidelines, and to provide a baseline for monitoring the impact of future initiatives. Establishing an evidence-base will support a whole-of-system appraisal that could include broader complex variables relating to healthcare services throughout the continuum of trauma care.

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DOP87 Disease clearance as a new therapeutic target in patients with Ulcerative Colitis: A multicenter retrospective cohort study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab073.126 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S118-S119

Author(s):

F D’Amico ◽

G Fiorino ◽

E Massarini ◽

V Solitano ◽

L Guillo ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Therapeutic Target ◽

Lower Risk ◽

Retrospective Cohort ◽

Control Group ◽

Mayo Score ◽

The Impact

Abstract Background Symptom control and endoscopic endoscopic healing have been the main treatment targets in patients with ulcerative colitis (UC). Recently, the concept of disease clearance has been proposed as a potential target in UC. We aimed to evaluate the impact of disease clearance on long-term outcomes in patients with UC. Methods A multicenter retrospective cohort study was conducted at the Humanitas Research Hospital-IRCCS (Italy) and at the Nancy University Hospital (France) between January 2014 and February 2021. All consecutive adult patients with confirmed UC undergoing colonoscopy with biopsies and available histological reports and clinical data within one month of colonoscopy were eligible for inclusion. Disease clearance was defined as clinical (partial Mayo score ≤2 with no subscore >1), endoscopic (endoscopic Mayo score= 0), and histological (Nancy index= 0) remission of disease. The first available endoscopic procedure was considered as baseline. Disease clearance was measured at baseline and during follow-up by comparing the occurrence of negative disease outcomes in patients who achieved or not disease clearance. Results A total of 302 patients were included (46.4% female). Disease clearance was detected in 42 patients (13.9%) at baseline. Median follow-up was 32.2 ± 20.2 months. No patient achieving disease clearance underwent surgery during follow-up compared with 22 subjects in the non-disease clearance group (0.0% vs 8.5%, p=0.1). Similarly, a lower hospitalization rate was detected in patients with disease clearance at baseline compared with the control group (7.1% vs 25.4%, p=0.01). Interestingly, 51/302 patients (16.9%) achieved both endoscopic and histologic remission. This subgroup experienced a significantly lower rate of hospitalization (7.8% vs 25.9%, p=0.008) and surgery (0.0% vs 8.8%, p=0.05) compared with patients with endoscopic and/or histologic disease activity. The Kaplan Meier curves confirmed that patients with disease clearance at baseline had a lower risk for surgery (p=0.04) and hospitalization (hazard ratio (HR)= 0.49, 95% confidence interval (CI) 0.08–2.29, p=0.009) (Figures 1–2). Conclusion Disease clearance is a new outcome that simultaneously takes into account remission of symptoms, endoscopy and histology. Patients with disease clearance are at significant lower risk for hospitalization and surgery and could be the ultimate therapeutic target for full disease control.

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