scholarly journals Risk of Infective Endocarditis After Invasive Dental Treatments

Circulation ◽  
2018 ◽  
Vol 138 (4) ◽  
pp. 356-363 ◽  
Author(s):  
Tzu-Ting Chen ◽  
Yi-Chun Yeh ◽  
Kuo-Liong Chien ◽  
Mei-Shu Lai ◽  
Yu-Kang Tu
Keyword(s):  
Infective Endocarditis ◽  
Confidence Interval ◽  
Regression Model ◽  
Conditional Logistic Regression ◽  
Case Series ◽  
Crossover Design ◽  
The Self ◽  
Series Design ◽  
Case Crossover ◽  
Study Designs

Background: Invasive dental treatments (IDTs) can yield temporary bacteremia and have therefore been considered a potential risk factor of infective endocarditis (IE). It is hypothesized that, through the trauma caused by IDTs, bacteria gain entry to the bloodstream and may attach to abnormal heart valves or damaged heart tissue, giving rise to IE. However, the association between IDTs and IE remains controversial. The aim of this study is to estimate the association between IDTs and IE. Methods: The data in this study were obtained from the Health Insurance Database in Taiwan. We selected 2 case-only study designs, case-crossover and self-controlled case series, to analyze the data. The advantage of these methods is that confounding factors that do not vary with time are adjusted for implicitly. In the case-crossover design, a conditional logistic regression model with exposure to IDTs was used to estimate the risks of IE following an IDT with 4, 8, 12, and 16 weeks delay, respectively. In the self-controlled case series design, a conditional Poisson regression model was used to estimate the risk of IE for the risk periods of 1 to 4, 5 to 8, 9 to 12, and 13 to 16 weeks following an IDT. Results: In total, 9120 and 8181 patients with IE were included in case-crossover design and self-controlled case series design, respectively. In the case-crossover design, 277 cases and 249 controls received IDTs during the exposure period, and the odds ratio was 1.12 (95% confidence interval, 0.94–1.34) for 4 weeks. In the self-controlled case series design, we observed that 407 IEs occurred during the first 4 weeks after IDTs, and the age-adjusted incidence rate ratio was 1.14 (95% confidence interval, 1.02–1.26) for 1 to 4 weeks after IDTs. Conclusions: In both study designs, we did not observe a clinically larger risk for IE in the short periods after IDTs. We also found no association between IDTs and IE among patients with a high risk of IE. Therefore, antibiotic prophylaxis for the prevention of IE is not required for the Taiwanese population.

Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments

2018 ◽  
Vol 98 (2) ◽  
pp. 157-163 ◽  
Author(s):  
T.T. Chen ◽  
F. D’Aiuto ◽  
Y.C. Yeh ◽  
M.S. Lai ◽  
K.L. Chien ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Regression Model ◽  
Conditional Logistic Regression ◽  
Case Series ◽  
Claim Database ◽  
Conditional Logistic Regression Model ◽  
Series Design ◽  
Case Crossover ◽  
Study Designs

The association between invasive dental treatments (IDTs) and a short-term risk of myocardial infarction (MI) and ischemic stroke (IS) remains controversial. Bacterial dissemination from the oral cavity and systemic inflammation linked to IDT can induce a state of acute vascular dysfunction. The aim of study is to investigate the relation of IDTs to MI and IS by using case-only study designs to analyze data from a large Taiwanese cohort. A nationwide population-based study was undertaken by using the case-crossover and self-controlled case series design to analyze the Taiwanese National Health Care Claim database. Conditional logistic regression model and conditional Poisson regression model were used to estimate the risks of MI/IS. In addition, we used burn patients as negative controls to explore the potential effect of residual confounding. In total, 123,819 MI patients and 327,179 IS patients in the case-crossover design and 117,655 MI patients and 298,757 IS patients were included in the self-controlled case series design. Results from both study designs showed that the risk of MI within the first 24 wk after IDT was not significantly different from or close to unity except for a modest risk during the first week for patients without other comorbidities (odds ratios [95% confidence intervals] of 1.31 [1.08–1.58] and 1.15 [1.01–1.31] for 3 d and 7 d, respectively). We also observed no association between IDTs and IS, or the risk ratio was close to unity. IDTs did not appear to be associated with a transient risk of MI and IS in the Taiwanese population, with consistent findings from both case-only study designs. However, we cannot exclude that dental infections and diseases may yield a long-term risk of MI and IS.

Use of the self-controlled case-series method in vaccine safety studies: review and recommendations for best practice

2011 ◽  
Vol 139 (12) ◽  
pp. 1805-1817 ◽  
Author(s):  
Y. G. WELDESELASSIE ◽  
H. J. WHITAKER ◽  
C. P. FARRINGTON
Keyword(s):  
Adverse Events ◽  
Best Practice ◽  
Good Practice ◽  
Case Series ◽  
Vaccine Safety ◽  
The Self ◽  
Series Method ◽  
Safety Studies ◽  
Definition Of ◽  
Study Designs

SUMMARYThe self-controlled case-series method was originally developed to investigate potential associations between vaccines and adverse events, and is now commonly used for this purpose. This study reviews applications of the method to vaccine safety investigations in the period 1995–2010. In total, 40 studies were reviewed. The application of the self-controlled case-series method in these studies is critically examined, with particular reference to the definition of observation and risk periods, control of confounders, assumptions and potential biases, methodological and presentation issues, power and sample size, and software. Comparisons with other study designs undertaken in the papers reviewed are also highlighted. Some recommendations are presented, with the emphasis on promoting good practice.

Empirical Performance of the Self-Controlled Case Series Design: Lessons for Developing a Risk Identification and Analysis System

Drug Safety ◽  
2013 ◽  
Vol 36 (S1) ◽  
pp. 83-93 ◽  
Author(s):  
Marc A. Suchard ◽  
Ivan Zorych ◽  
Shawn E. Simpson ◽  
Martijn J. Schuemie ◽  
Patrick B. Ryan ◽  
...  
Keyword(s):  
Case Series ◽  
Risk Identification ◽  
The Self ◽  
Series Design ◽  
Empirical Performance ◽  
Analysis System

scholarly journals The Self‐Controlled Case Series Design as a Viable Alternative to Studying Clinically Relevant Drug Interactions

2019 ◽  
Vol 107 (2) ◽  
pp. 321-322 ◽  
Author(s):  
Meijia Zhou ◽  
Charles E. Leonard ◽  
Warren B. Bilker ◽  
Sean Hennessy
Keyword(s):  
Drug Interactions ◽  
Case Series ◽  
The Self ◽  
Viable Alternative ◽  
Series Design

scholarly journals Impact of Heat Waves on Hospitalisation and Mortality in Nursing Homes: A Case-Crossover Study

2021 ◽  
Vol 18 (20) ◽  
pp. 10697
Author(s):  
Ine Van den Wyngaert ◽  
Katrien De Troeyer ◽  
Bert Vaes ◽  
Mahmoud Alsaiqali ◽  
Bert Van Schaeybroeck ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Nursing Homes ◽  
Confidence Interval ◽  
Crossover Study ◽  
Heat Waves ◽  
Conditional Logistic Regression ◽  
Odds Ratios ◽  
Mortality And Morbidity ◽  
Case Crossover ◽  
The Impact

Climate change leads to more days with extremely hot temperatures. Previous analyses of heat waves have documented a short-term rise in mortality. The results on the relationship between high temperatures and hospitalisations, especially in vulnerable patients admitted to nursing homes, are inconsistent. The objective of this research was to examine the discrepancy between heat-related mortality and morbidity in nursing homes. A time-stratified case-crossover study about the impact of heat waves on mortality and hospitalisations between 1 January 2013 and 31 December 2017 was conducted in 10 nursing homes over 5 years in Flanders, Belgium. In this study, the events were deaths and hospitalisations. We selected our control days during the same month as the events and matched them by day of the week. Heat waves were the exposure. Conditional logistic regression models were applied. The associations were reported as odds ratios at lag 0, 1, 2, and 3 and their 95% confidence intervals. In the investigated time period, 3048 hospitalisations took place and 1888 residents died. The conditional logistic regression showed that odds ratios of mortality and hospitalisations during heat waves were 1.61 (95% confidence interval 1.10–2.37) and 0.96 (95% confidence interval 0.67–1.36), respectively, at lag 0. Therefore, the increase in mortality during heat waves was statistically significant, but no significant changes in hospitalisations were obtained. Our result suggests that heat waves have an adverse effect on mortality in Flemish nursing homes but have no significant effect on the number of hospitalisations.

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