scholarly journals Causes of Death in People With Cardiovascular Disease: A UK Biobank Cohort Study

2021 ◽  
Author(s):  
Michael Drozd ◽  
Mar Pujades‐Rodriguez ◽  
Fei Sun ◽  
Kevin N. Franks ◽  
Patrick J. Lillie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Causes Of Death ◽  
Sociodemographic Factors ◽  
Cardiovascular Death ◽  
Uk Biobank ◽  
Personalized Care ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Background Therapeutic advances have reduced cardiovascular death rates in people with cardiovascular diseases (CVD). We aimed to define the rates of cardiovascular and noncardiovascular death in people with specified CVDs or accruing cardiovascular multimorbidity. Methods and Results We studied 493 280 UK residents enrolled in the UK Biobank cohort study. The proportion of deaths attributed to cardiovascular, cancer, infection, or other causes were calculated in groups defined by 9 distinct self‐reported CVDs at baseline, or by the number of these CVDs at baseline. Poisson regression analyses were then used to define adjusted incidence rate ratios for these causes of death, accounting for sociodemographic factors and comorbidity. Of 27 729 deaths, 20.4% were primarily attributed to CVD, 53.6% to cancer, 5.0% to infection, and 21.0% to other causes. As cardiovascular multimorbidity increased, the proportion of cardiovascular and infection‐related deaths was greater, contrasting with cancer and other deaths. Compared with people without CVD, those with 3 or more CVDs experienced adjusted incidence rate ratios of 7.0 (6.2–7.8) for cardiovascular death, 4.4 (3.4–5.6) for infection death, 1.5 (1.4–1.7) for cancer death, and 2.0 (1.7–2.4) for other causes of death. There was substantial heterogeneity in causes of death, both in terms of crude proportions and adjusted incidence rate ratios, among the 9 studied baseline CVDs. Conclusions Noncardiovascular death is common in people with CVD, although its contribution varies widely between people with different CVDs. Holistic and personalized care are likely to be important tools for continuing to improve outcomes in people with CVD.

Substantial Within-Country Variation in the Incidence of Subarachnoid Hemorrhage: A Nationwide Finnish Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012129
Author(s):  
Ilari Rautalin ◽  
Joni Valdemar Lindbohm ◽  
Jaakko Kaprio ◽  
Miikka Korja
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Poisson Regression ◽  
Causes Of Death ◽  
Incidence Rates ◽  
Poisson Regression Model ◽  
Geographical Regions ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence ◽  
Finnish Study

Objective:To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland.Methods:By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. Based on the SAH patients’ home residence, we divided SAHs into five geographical regions: 1) Southern, 2) Central, 3) Western, 4) Eastern, and 5) Northern Finland. We calculated crude and European age-standardized (ESP2013) SAH incidence rates for each region, and used a Poisson regression model to calculate age-, sex- and calendar year-adjusted incidence rate ratios (IRRs) and 95% confidence intervals for regional and time-dependent differences.Results:During the total 106 510 337 cumulative person-years, we identified 9 443 first-ever SAH cases, of which 24% died before hospitalization. As compared to Western Finland, where the SAH incidence was the lowest (7.4 per 100 000 persons), the ESP-standardized SAH incidence was 1.4 times higher in Eastern (10.2 per 100 000 persons; adjusted IRR=1.37 (1.27–1.47)) and Northern Finland (10.4 per 100 000 persons; adjusted IRR=1.40 (1.30–1.51)). These differences were similar when men and women were analyzed independently. Although SAH incidence rates decreased in all five regions over two decades, the rate of decrease varied significantly by region.Conclusion:SAH incidence appears to vary substantially by region in Finland. Our results suggest that regional SAH studies can identify high-risk subpopulations, but can also considerably over- or underestimate incidence on a nationwide level.

scholarly journals A Statistical Test for the Equality of Differently Adjusted Incidence Rate Ratios

2007 ◽  
Vol 167 (5) ◽  
pp. 517-522 ◽  
Author(s):  
K. Hoffmann ◽  
T. Pischon ◽  
M. Schulz ◽  
M. B. Schulze ◽  
J. Ray ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Statistical Test ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

scholarly journals Excess Mortality Attributable to COVID-19 Among Assisted Living Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Kali Thomas ◽  
Wenhan Zhang ◽  
David Dosa ◽  
Paula Carder ◽  
Philip Sloane ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Confidence Intervals ◽  
Assisted Living ◽  
Excess Mortality ◽  
Mortality Rates ◽  
All Cause Mortality ◽  
National Cohort ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Abstract This study examines the excess mortality attributable to COVID-19 among a national cohort of assisted living (AL) residents. To do this, we compare the weekly rate of all-cause mortality during 1/1/20-8/11/20 with the same weeks in 2019 and calculated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). All-cause mortality rates, nationally, were 14% higher in 2020 compared with 2019 (mean, 2.309 vs. 2.020, respectively, per 1000 residents per week; adjusted IRR, 1.169; 95% CI 1.165-1.173). Among the 10 states with the highest community spread, the excess mortality attributable to COVID-19 was 24% higher, with 2.388 deaths per 1000 residents per week in 2020 during January-August vs 1.928 in 2019 (adjusted IRR, 1.241; 95% CI 1.233-1.250). These results suggest that AL residents suffered excess mortality due to COVID-19.

Prevalence and 5-year trend of incidence for medical illnesses after the diagnosis of bipolar disorder: A nationwide cohort study

2021 ◽  
pp. 000486742110468
Author(s):  
Pao-Huan Chen ◽  
Shang-Ying Tsai ◽  
Chun-Hung Pan ◽  
Yi-Lung Chen ◽  
Sheng-Siang Su ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Human Immunodeficiency Virus ◽  
Heart Disease ◽  
Incidence Rate ◽  
Cerebrovascular Diseases ◽  
First Year ◽  
Immunodeficiency Virus ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Objective: Medical comorbidities are prevalent in patients with bipolar disorder. Evaluating longitudinal trends of the incidence of medical illnesses enables implementation of early prevention strategies to reduce the high mortality rate in this at-risk population. However, the incidence risks of medical illnesses in the early stages of bipolar disorder remain unclear. This study investigated the incidence and 5-year trend of medical illnesses following bipolar disorder diagnosis. Methods: We identified 11,884 patients aged 13–40 years who were newly diagnosed as having bipolar disorder during 1996–2012 and 47,536 age- and sex-matched controls (1:4 ratio) who represented the general population from Taiwan’s National Health Insurance Research Database. We estimated the prevalence and incidence of individual medical illnesses yearly across the first 5 years after the index date. The adjusted incidence rate ratio was calculated to compare the occurrence of specific medical illnesses each year between the bipolar disorder group and control group using the Poisson regression model. Results: Apart from the prevalence, the adjusted incidence rate ratios of most medical illnesses were >1.00 across the first 5-year period after bipolar disorder diagnosis. Cerebrovascular diseases, ischaemic heart disease, congestive heart failure, other forms of heart disease, renal disease and human immunodeficiency virus infection exhibited the highest adjusted incidence rate ratios during the first year. Except for that of renal disease, the 5-year trends of the adjusted incidence rate ratios decreased for cerebrovascular diseases, cardiovascular diseases (e.g. ischaemic heart disease, other forms of heart disease, and vein and lymphatic disease), gastrointestinal diseases (e.g. chronic hepatic disease and ulcer disease) and communicable diseases (e.g. human immunodeficiency virus infection, upper respiratory tract infection and pneumonia). Conclusion: Incidence risks of medical illnesses are increased in the first year after bipolar disorder diagnosis. Clinicians must carefully evaluate medical illnesses during this period because the mortality rates from medical illnesses are particularly high in people with bipolar disorder.

Inflammatory Bowel Disease and Risk of Major Bleeding During Anticoagulation for Venous Thromboembolism

2021 ◽  
Author(s):  
Susanna Scharrer ◽  
Christian Primas ◽  
Sabine Eichinger ◽  
Sebastian Tonko ◽  
Maximilian Kutschera ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Fatal Bleeding ◽  
Adjusted Incidence Rate ◽  
Inflammatory Bowel ◽  
Adjusted Incidence

Abstract Background Little is known about the bleeding risk in patients with inflammatory bowel disease (IBD) and venous thromboembolism (VTE) treated with anticoagulation. Our aim was to elucidate the rate of major bleeding (MB) events in a well-defined cohort of patients with IBD during anticoagulation after VTE. Methods This study is a retrospective follow-up analysis of a multicenter cohort study investigating the incidence and recurrence rate of VTE in IBD. Data on MB and IBD- and VTE-related parameters were collected via telephone interview and chart review. The objective of the study was to evaluate the impact of anticoagulation for VTE on the risk of MB by comparing time periods with anticoagulation vs those without anticoagulation. A random-effects Poisson regression model was used. Results We included 107 patients (52 women, 40 with ulcerative colitis, 64 with Crohn disease, and 3 with unclassified IBD) in the study. The overall observation time was 388 patient-years with and 1445 patient-years without anticoagulation. In total, 23 MB events were registered in 21 patients, among whom 13 MB events occurred without anticoagulation and 10 occurred with anticoagulation. No fatal bleeding during anticoagulation was registered. The incidence rate for MB events was 2.6/100 patient-years during periods exposed to anticoagulation and 0.9/100 patient-years during the unexposed time. Exposure to anticoagulation (adjusted incidence rate ratio, 3.7; 95% confidence interval, 1.5-9.0; P = 0.003) and ulcerative colitis (adjusted incidence rate ratio, 3.5; 95% confidence interval, 1.5-8.1; P = 0.003) were independent risk factors for MB events. Conclusion The risk of major but not fatal bleeding is increased in patients with IBD during anticoagulation. Our findings indicate that this risk may be outweighed by the high VTE recurrence rate in patients with IBD.

Emotional states and future risk of venous thromboembolism

2012 ◽  
Vol 107 (03) ◽  
pp. 485-493 ◽  
Author(s):  
Sigrid K. Brækkan ◽  
Ida J. Hansen-Krone ◽  
John-Bjarne Hansen ◽  
Kristin F. Enga
Keyword(s):  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Population Based ◽  
Emotional States ◽  
Depressive Feelings ◽  
Increased Risk ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Reduced Risk

SummaryEmotional states of depression and loneliness are reported to be associated with higher risk and optimism with lower risk of arterial cardiovascular disease (CVD) and death. The relation between emotional states and risk of venous thromboembolism (VTE) has not been explored previously. We aimed to investigate the associations between self-reported emotional states and risk of incident VTE in a population-based, prospective study. The frequency of feeling depressed, lonely and happy/optimistic were registered by self-administered questionnaires, along with major co-morbidities and lifestyle habits, in 25,964 subjects aged 25–96 years, enrolled in the Tromsø Study in 1994–1995. Incident VTE-events were registered from the date of inclusion until September 1, 2007. There were 440 incident VTE-events during a median of 12.4 years of follow-up. Subjects who often felt depressed had 1.6-fold (95% CI:1.02–2.50) higher risk of VTE compared to those not depressed in analyses adjusted for other risk factors (age, sex , body mass index, oes-trogens), lifestyle (smoking, alcohol consumption, educational level) and co-morbidities (diabetes, CVD, and cancer). Often feeling lonely was not associated with VTE. However, the incidence rate of VTE in subjects who concurrently felt often lonely and depressed was higher than for depression alone (age-and sex-adjusted incidence rate: 3.27 vs. 2.21). Oppositely, subjects who often felt happy/optimistic had 40% reduced risk of VTE (HR 0.60, 95% CI: 0.41–0.87). Our findings suggest that self-reported emotional states are associated with risk of VTE. Depressive feelings were associated with increased risk, while happiness/ optimism was associated with reduced risk of VTE.

scholarly journals Spatial and temporal analysis of myocardial infarction incidence in Zanjan province, Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohsen Soleimani ◽  
Nasser Bagheri
Keyword(s):  
Myocardial Infarction ◽  
Spatial Analysis ◽  
High Risk ◽  
Incidence Rate ◽  
Temporal Analysis ◽  
Analysis Methods ◽  
Spatial And Temporal Analysis ◽  
Risk Areas ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background Myocardial Infarction (MI) is a major important public health concern and has huge burden on health system across the world. This study aimed to explore the spatial and temporal analysis of the incidence of MI to identify potential clusters of the incidence of MI patterns across rural areas in Zanjan province, Iran. Materials & methods This was a retrospective and geospatial analysis study of the incidence of MI data from nine hospitals during 2014–2018. Three different spatial analysis methods (Spatial autocorrelation, hot spot analysis and cluster and outlier analysis) were used to identify potential clusters and high-risk areas of the incidence of MI at the study area. Results Three thousand eight hundred twenty patients were registered at Zanjan hospitals due to MI during 2014–2018. The overall age-adjusted incidence rate of MI was 343 cases per 100,000 person which was raised from 88 cases in 2014 to 114 cases in 2018 per 100,000 person-year (a 30% increase, P < 0.001). Golabar region had the highest age-adjusted incidence rate of MI (515 cases per 100,000 person). Five hot spots and one high-high cluster were detected using spatial analysis methods. Conclusion This study showed that there is a great deal of spatial variations in the pattern of the incidence of MI in Zanjan province. The high incidence rate of MI in the study area compared to the national average, is a warning to local health authorities to determine the possible causes of disease incidence and potential drivers of high-risk areas. The spatial cluster analysis provides new evidence for policy-makers to design tailored interventions to reduce the incidence of MI and allocate health resource to unmet need areas.

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.

scholarly journals Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study

Thorax ◽  
2018 ◽  
Vol 73 (9) ◽  
pp. 825-832 ◽  
Author(s):  
Alessandro Marcon ◽  
Francesca Locatelli ◽  
Dirk Keidel ◽  
Anna B Beckmeyer-Borowko ◽  
Isa Cerveri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Dose Response ◽  
Respiratory Health ◽  
Heart Diseases ◽  
Airflow Obstruction ◽  
Occupational Exposures ◽  
Airway Responsiveness ◽  
History Of ◽  
Rate Ratios

BackgroundIt has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk.ObjectiveWe studied prospectively whether airway responsiveness is associated with the risk of developing COPD.MethodsWe pooled data from two multicentre cohort studies that collected data from three time points using similar methods (European Community Respiratory Health Survey and Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). We classified subjects (median age 37 years, 1st–3rd quartiles: 29–44) by their level of airway responsiveness using quintiles of methacholine dose–response slope at the first examination (1991–1994). Then, we excluded subjects with airflow obstruction at the second examination (1999–2003) and analysed incidence of COPD (postbronchodilator FEV1/FVC below the lower limit of normal) at the third examination (2010–2014) as a function of responsiveness, adjusting for sex, age, education, body mass index, history of asthma, smoking, occupational exposures and indicators of airway calibre.ResultsWe observed 108 new cases of COPD among 4205 subjects during a median time of 9 years. Compared with the least responsive group (incidence rate 0.6 per 1000/year), adjusted incidence rate ratios for COPD ranged from 1.79 (95% CI 0.52 to 6.13) to 8.91 (95% CI 3.67 to 21.66) for increasing airway responsiveness. Similar dose–response associations were observed between smokers and non-smokers, and stronger associations were found among subjects without a history of asthma or asthma-like symptoms.ConclusionsOur study suggests that increased airway responsiveness is an independent risk factor for COPD. Further research should clarify whether early treatment in patients with high responsiveness can slow down disease progression.

Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study

2021 ◽  
pp. 1-11
Author(s):  
Benjamin T. Schumacher ◽  
John Bellettiere ◽  
Michael J. LaMonte ◽  
Kelly R. Evenson ◽  
Chongzhi Di ◽  
...  
Keyword(s):  
Physical Function ◽  
Older Women ◽  
Incidence Rate ◽  
Fall Risk ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Steps Per Day ◽  
Falls In Older Adults ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Steps per day were measured by accelerometer for 7 days among 5,545 women aged 63–97 years between 2012 and 2014. Incident falls were ascertained from daily fall calendars for 13 months. Median steps per day were 3,216. There were 5,473 falls recorded over 61,564 fall calendar-months. The adjusted incidence rate ratio comparing women in the highest versus lowest step quartiles was 0.71 (95% confidence interval [0.54, 0.95]; ptrend across quartiles = .01). After further adjustment for physical function using the Short Physical Performance Battery, the incidence rate ratio was 0.86 ([0.64, 1.16]; ptrend = .27). Mediation analysis estimated that 63.7% of the association may be mediated by physical function (p = .03). In conclusion, higher steps per day were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults.

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