Three Risk Stratification Tools and Postoperative Pneumonia After Noncardiothoracic Surgery

Background Postoperative in-hospital pneumonia is a serious complication. This study aims to investigate the association between 3 preoperative stratification tools (American Society of Anesthesiologists Physical Status [ASA-PS] score, Charlson Comorbidity Index [CCI], and Rockwood Frailty Deficit Index [FI]) and risk for postoperative pneumonia. Methods We identified adult patients who developed postoperative pneumonia following noncardiothoracic surgery under general anesthesia, between January 1, 2016 and December 31, 2017. Patients with postoperative pneumonia were 1:1 matched to control subjects based on age, sex, and the exact type of operations. Medical records were reviewed to identify variables that may be associated with risk for developing postoperative pneumonia. Analyses adjusted for clinical characteristics were performed using the conditional logistic regression, taking into account 1:1 matched set case-control study design. Results We identified 211 cases of postoperative pneumonia, and all 3 tested stratification tools were associated with increased risk: ASA-PS (after all adjustments of American Society of Anesthesiologists (ASA) III, odds ratio 4.17 [95% confidence interval 1.74-10.01]; ASA > III 24.03 [6.54-88.32]), CCI (CCI values > 3, 1.29 [1.02-1.63] per unit CCI score), and frail FI score 3.25 (1.45-7.27). Because of incomplete intake documentation, the FI could not be calculated in 57 (13.5%) patients, but these “unknown frailty” patients were also at increased risk for postoperative pneumonia, 3.15 (1.29-7.72). Discussion Three commonly used stratification indices (ASA-PS score, CCI, and FI) were associated with increased risk for postoperative pneumonia. Patients unable to complete intake form to calculate the FI were also at increased risk.

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Peripartum Predictors of the Risk of Postpartum Depressive Disorder: Results of a Case-Control Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238726 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8726 ◽

Cited By ~ 1

Author(s):

Kornelia Zaręba ◽

Jolanta Banasiewicz ◽

Hanna Rozenek ◽

Stanisław Wójtowicz ◽

Grzegorz Jakiel

Keyword(s):

Risk Factors ◽

Mood Disorders ◽

Medical Records ◽

Case Control Study ◽

Uterine Cavity ◽

Control Group ◽

Gynecology And Obstetrics ◽

Increased Risk ◽

Retrospective Comparative Study ◽

Control Study

Background: The study aimed at the identification of the risk factors present during delivery, which might be present in prophylactic programs concerning postpartum mood disorders. Material and Method: This was a retrospective comparative study. The study material included data retrieved from the medical records of patients hospitalized in the Teaching Department of Gynecology and Obstetrics of Professor Orłowski Hospital in Warsaw, in the years 2010–2017. The EPDS data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in the EPDS and the control group was made up of 75 women who obtained no more than 5 points in the EPDS. Results: The women in whom we noted an increased risk of developing mood disorders had blood loss >1000 mL and had a significantly longer stage II and III of labor than the control group. Other risk factors were cesarean section, vaginal delivery with the curettage of the uterine cavity, slightly lower APGAR scores (0.4 pts), and lower birth weight (approximately 350 g) of the child. Women at a low risk of postpartum mood disorders more commonly underwent episiotomy during delivery (76%). Conclusions: Increased supervision and support should be offered to women who experienced the above-mentioned risk factors.

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Pharmacologic treatment and SUDEP risk

Neurology ◽

10.1212/wnl.0000000000010874 ◽

2020 ◽

Vol 95 (18) ◽

pp. e2509-e2518 ◽

Cited By ~ 1

Author(s):

Olafur Sveinsson ◽

Tomas Andersson ◽

Peter Mattsson ◽

Sofia Carlsson ◽

Torbjörn Tomson

Keyword(s):

Medical Records ◽

Case Control Study ◽

Unexpected Death ◽

Increased Risk ◽

National Patient ◽

Potential Risk Factors ◽

Clonic Seizures ◽

Reduce Risk ◽

Control Study ◽

Reduced Risk

ObjectiveWe conducted a nationwide case–control study in Sweden to test the hypothesis that antiepileptic drugs (AEDs) mono- or polytherapy, adherence, antidepressants, neuroleptics, β-blockers, and statins are associated with sudden unexpected death in epilepsy (SUDEP) risk.MethodsIncluded were 255 SUDEP cases and 1,148 matched controls. Information on clinical factors and medications came from medical records and the National Patient and Prescription Registers. The association between SUDEP and medications was assessed by odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for potential risk factors including type of epilepsy, living conditions, comorbidity, and frequency of generalized tonic-clonic seizures (GTCS).ResultsPolytherapy, especially taking 3 or more AEDs, was associated with a substantially reduced risk of SUDEP (OR 0.31, 95% CI 0.14–0.67). Combinations including lamotrigine (OR 0.55, 95% CI 0.31–0.97), valproic acid (OR 0.53, 95% CI 0.29–0.98), and levetiracetam (OR 0.49, 95% CI 0.27–0.90) were associated with reduced risk. No specific AED was associated with increased risk. Regarding monotherapy, although numbers were limited, the lowest SUDEP risk was seen in users of levetiracetam (0.10, 95% CI 0.02–0.61). Having nonadherence mentioned in the medical record was associated with an OR of 2.75 (95% CI 1.58–4.78). Statin use was associated with a reduced SUDEP risk (OR 0.34, 95% CI 0.11–0.99) but selective serotonin reuptake inhibitor use was not.ConclusionThese results provide support for the importance of medication adherence and intensified AED treatment for patients with poorly controlled GTCS in the effort to reduce SUDEP risk and suggest that comedication with statins may reduce risk.

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Association Between Drug Exposure and Occurrence of Parkinsonism in Korea: A Population-Based Case-Control Study

Annals of Pharmacotherapy ◽

10.1177/1060028019859543 ◽

2019 ◽

Vol 53 (11) ◽

pp. 1102-1110 ◽

Cited By ~ 7

Author(s):

Siin Kim ◽

Sang-Myung Cheon ◽

Hae Sun Suh

Keyword(s):

Cumulative Dose ◽

Drug Exposure ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Population Level ◽

Population Based ◽

Case Control ◽

Drug Induced ◽

Increased Risk ◽

Control Study

Background: Although drug-induced parkinsonism is reversible in most cases, some patients can suffer from persistent/recurrent symptoms. Therefore, prevention is the most efficient way to manage drug-induced parkinsonism. However, there is a paucity of studies exploring the relationship between parkinsonism and drug exposure. Objective: To examine the association between drug exposure and the risk of parkinsonism using Korean population-based data. Methods: We conducted a matched case-control study using the National Health Insurance Service—National Sample Cohort database. Cases and controls were defined as individuals with and without parkinsonism, respectively, between 2007 and 2013. Cases and controls were matched for sex, age group, income, type of insurance, and Charlson comorbidity index. Drug exposures, including propulsives, antipsychotics, and flunarizine, were identified at 1 year before the first date of parkinsonism and stratified by recency and cumulative dose. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs. Results: We identified 5496 cases and 5496 controls. ORs for current use group of propulsives, antipsychotics, and flunarizine compared with those of the never use group were 2.812 (95% CI = 2.466-3.206), 3.009 (95% CI = 1.667-5.431), and 4.950 (95% CI = 2.711-9.037), respectively. ORs were greater in those more recently exposed and those exposed to higher cumulative doses. Conclusion and Relevance: At the population level, use of propulsives, antipsychotics, and flunarizine had a significant association with the increased risk of parkinsonism, depending on recency and cumulative dose. Drugs associated with parkinsonism should be used with careful monitoring to prevent drug-induced parkinsonism.

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Calcium Use Increases Risk of Calciphylaxis: A Case-Control Study

Peritoneal Dialysis International ◽

10.1177/089686089901900310 ◽

1999 ◽

Vol 19 (3) ◽

pp. 248-252 ◽

Cited By ~ 55

Author(s):

James M. Zacharias ◽

Bunny Fontaine ◽

Adrian Fine

Keyword(s):

Risk Factor ◽

Peritoneal Dialysis ◽

Calcium Carbonate ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Laboratory Data ◽

Case Control ◽

Calcium Deposition ◽

Increased Risk ◽

Control Study

Objective To investigate the risk factors for the development of calciphylaxis in renal failure, a poorly understood and often fatal condition characterized by calcium deposition in tissues. Design Retrospective case-control study. Setting University hospital peritoneal dialysis center. Patients Eight continuous ambulatory peritoneal dialysis (CAPD) patients with calciphylaxis were identified in a 3-year period. We matched up to five controls for dialysis modality and length of time on dialysis with each case. Statistics Multivariate conditional logistic regression analysis for matched case-controls. Main Outcome Measures Laboratory data and demographics were collected as well as cumulative calcium and vitamin D ingestion over the year prior to disease onset. Results All the patients were female, versus only 38% (14/37) of controls ( p < 0.0001). While not statistically significant, a majority of the patients were diabetic [62.5% (5/8) vs 32% (12/37)]. Peak and average levels of serum calcium, phosphate, calcium x phosphate product, parathyroid hormone (PTH), albumin, iron, total iron-binding capacity (TIBC), and ferritin were not significantly different in cases compared with controls. The use of calcitriol alone or with calcium carbonate was not found to be a significant risk factor for the development of calciphylaxis. In a multivariate analysis, iron intake seemed to be protective, contrary to previous reports, while the use of calcium carbonate was associated with a strong trend to increased risk of calciphylaxis development (odds ratio = 1.029/g and 1.011/g calcium ingested per month, at 1 and 2 – 3 months prior to calciphylaxis development; p = 0.0556 and 0.0565, respectively). Conclusion These data, although limited by the small numbers of index cases, suggest that calcium ingestion is a risk factor for calciphylaxis. The increased use of calcium salts as a phosphate binder in recent years might explain the apparent increased incidence of calciphylaxis in our and other centers. The preponderance of female diabetics among cases reported elsewhere was confirmed in our study.

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Metformin and Risk of Alzheimer’s Disease Among Community-Dwelling People With Diabetes: A National Case-Control Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz234 ◽

2019 ◽

Vol 105 (4) ◽

pp. e963-e972 ◽

Cited By ~ 10

Author(s):

Janet K Sluggett ◽

Marjaana Koponen ◽

J Simon Bell ◽

Heidi Taipale ◽

Antti Tanskanen ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Community Dwelling ◽

High Dose ◽

Defined Daily Doses ◽

Increased Risk ◽

Control Study

Abstract Context Type 2 diabetes has been linked with an increased risk of Alzheimer’s disease (AD). Studies on the association between metformin use and AD have reported conflicting results. Objective To investigate whether metformin use modifies the association between diabetes and incident, clinically verified AD. Design Nested case-control study. Setting All community-dwelling people in Finland. Participants Cases were all community-dwelling Finns with AD diagnosed from 2005 to 2011 and with diabetes diagnosed ≥ 3 years before AD (n = 9862). Cases were matched with up to 2 control persons by age, sex, and diabetes duration (n = 19 550). Main outcome measure Cumulative metformin exposure was determined from reimbursed dispensings over a 10- to 16-year period. Adjusted odds ratios (aORs) were calculated using conditional logistic regression to estimate associations, with adjustment for potential confounders. Results A total of 7225 (73.3%) cases and 14528 (74.3%) controls received metformin at least once. Metformin use (ever use) was not associated with incident AD (aOR 0.99; 95% confidence interval [CI], 0.94–1.05). The adjusted odds of AD were lower among people dispensed metformin for ≥ 10 years (aOR 0.85; 95% CI, 0.76–0.95), those dispensed cumulative defined daily doses (DDDs) of < 1825–3650 (aOR 0.91; 95% CI, 0.84–0.98) and > 3650 DDDs (aOR 0.77; 95% CI, 0.67–0.88), and among persons dispensed an average of 2 g metformin daily (aOR 0.89; 95% CI, 0.82–0.96). Conclusion In this large national sample we found no evidence that metformin use increases the risk of AD. Conversely, long-term and high-dose metformin use was associated with a lower risk of incident AD in older people with diabetes.

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Is Opium Use Associated with an Increased Risk of Lung Cancer? A Case-Control Study

10.21203/rs.2.15585/v3 ◽

2020 ◽

Author(s):

Ahmad Naghibzadeh Tahami ◽

Maryam Marzban ◽

Vahid Yazdi Feyzabadi ◽

Shahryar Dabiri ◽

Shokrollah Mohseni ◽

...

Keyword(s):

Lung Cancer ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Daily Intake ◽

Case Control ◽

Control Group ◽

Related Risk ◽

Increased Risk ◽

Control Study ◽

Opium Use

Abstract Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. This study aimed to investigate the association between the use of O&D and LC incidence.Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 280 healthy controls matched by age, sex, and place of residence were included. Data, including O&D use, cigarette smoking, alcohol use, and diet, were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats.Results: Opium ever-use was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) =5.95, 95 % CI: 1.87 -18.92). Participants were divided into low and high use groups based on the median of opium use in the control group. A significant dose-response relation was observed between the amount of daily O&D use and LC; and the relation was stronger in high users (AOR low users = 3.81 % CI: 1.13 -12.77 and OR high users= 9.36, 95% CI: 2.05 -42.72). Also, LC was higher among participants starting the use of O&D at younger ages (≤ 41 years old vs never users AOR = 8.64, 95 % CI: 1.90 -39.18) compared to those who started at an older age ( >41 years old vs never users, AOR = 4.71, 95 % CI: 1.38 - 16.08). The association between opium, and lung cancer among non-smokers was OR: 6.50 (95% CI: 2.89 to 14.64).Conclusion: The results of this study show that opium use is probably a dose related risk factor for lung cancer.

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Association between congenital heart defects and maternal manganese and iron concentrations: a case–control study in China

Environmental Science and Pollution Research ◽

10.1007/s11356-021-17054-9 ◽

2021 ◽

Author(s):

Meixian Wang ◽

Yan Tian ◽

Ping Yu ◽

Nana Li ◽

Ying Deng ◽

...

Keyword(s):

Case Control Study ◽

Iron Status ◽

Heart Defects ◽

Conditional Logistic Regression ◽

Case Control ◽

Manganese Concentration ◽

High Concentration ◽

Increased Risk ◽

Control Study ◽

Iron Concentrations

Abstract To investigate the correlation between maternal manganese and iron concentrations and the risk of CHD among their infant. A multi-center hospital-based case control study was conducted in China. There were 322 cases and 333 controls have been selected from pregnant women who received prenatal examinations. Correlations between CHDs and maternal manganese and iron concentrations were estimated by conditional logistic regression. Moreover, the interaction between manganese and iron on CHDs was analyzed. Compared with the controls, mothers whose hair manganese concentration was 3.01 μg/g or more were more likely to have a child with CHD than those with a lower concentration. The adjusted OR was 2.68 (95%CI = 1.44–4.99). The results suggested that mothers whose iron content was 52.95 μg/g or more had a significantly higher risk of having a child with CHD (aOR = 2.87, 95%CI = 1.54–5.37). No interaction between maternal manganese and iron concentrations was observed in the multiplicative or additive model. The concurrently existing high concentration of manganese and iron may bring higher risk of CHD (OR = 7.02). Women with excessive manganese concentrations have a significantly increased risk of having offspring with CHDs. The high maternal iron status also correlates with CHDs. The concurrently existing high concentration of manganese and iron may bring higher risk of CHD.

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Use of antibiotics and colorectal cancer risk: a primary care nested case–control study in Belgium

BMJ Open ◽

10.1136/bmjopen-2021-053511 ◽

2021 ◽

Vol 11 (12) ◽

pp. e053511

Author(s):

Johannes Van der Meer ◽

Pavlos Mamouris ◽

Vahid Nassiri ◽

Bert Vaes ◽

Marjan van den Akker

Keyword(s):

Colorectal Cancer ◽

General Practice ◽

Cancer Risk ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Colorectal Cancer Risk ◽

Oral Antibiotics ◽

Increased Risk ◽

Control Study

ObjectivesTo examine the association between the use of oral antibiotics and subsequent colorectal cancer risk.DesignMatched case–control study.SettingGeneral practice centres participating in the Integrated Computerised Network database in Flanders, Belgium.ParticipantsIn total, 1705 cases of colorectal cancer diagnosed between 01 January 2010 and 31 December 2015 were matched to 6749 controls by age, sex, comorbidity and general practice centre.Primary outcome measureThe association between the number of prescriptions for oral antibiotics and the incidence of colorectal cancer over a period of 1–10 years, estimated by a conditional logistic regression model.ResultsA significantly increased risk of colorectal cancer (OR 1.25, 95% CI 1.10 to 1.44) was found in subjects with one or more prescriptions compared with those with none after correction for diabetes mellitus. No dose-response relationship was found.ConclusionsThis study resulted in a modestly higher risk of having colorectal cancer diagnosed after antibiotic exposure. The main limitation was missing data on known risk factors, in particular smoking behaviour. This study did not allow us to examine the causality of the relationship, indicating the need of further investigation.

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Associations of Bisphenol Exposure With The Risk of Gestational Diabetes Mellitus: A Nested Case-Control Study In Guangxi, China

10.21203/rs.3.rs-840656/v1 ◽

2021 ◽

Author(s):

Peng Tang ◽

Jun Liang ◽

Qian Liao ◽

Huishen Huang ◽

Xiaojing Guo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Negatively Associated ◽

Increased Risk ◽

Nested Case Control ◽

Control Study

Abstract A growing number of epidemiologic studies have estimated the associations between endocrine-disrupting chemicals and gestational diabetes mellitus (GDM). However, reports on the association between bisphenol A (BPA) substitutes and GDM are limited. This investigation aimed to explore the associations of maternal serum BPA, bisphenol B (BPB), bisphenol F (BPF), bisphenol S (BPS), and tetrabromobisphenol A (TBBPA) with the risk of GDM. A nested case-control study was performed among 500 pregnant women. Associations between the serum bisphenol levels and the risk of GDM were assessed by conditional logistic regression analysis and two-mixture modeling approaches (Bayesian kernel machine regression [BKMR] and quantile g-computation). BPA and TBBPA were negatively associated with the risk of GDM in the adjusted models, respectively. Intermediate BPS levels were associated with increased odds (OR: 1.84; 95% CI: 1.04, 3.27) of GDM compared with the low concentration groups only based on the single-bisphenol models. Associations between BPA, BPS, and TBBPA with the risk of GDM were also found in the BKMR analysis. The quantile g-computation (OR: 0.55; 95% CI: 0.43, 0.69) and BKMR models revealed a statistically significant and negative joint effect of the five bisphenols on the risk of GDM. This study demonstrates the association between exposure to BPS with the increased risk of GDM. In addition, exposure to BPA and TBBPA were associated with the reduced risk of GDM. Moreover, exposure to the mixture of the five bisphenols was negatively associated with the risk of GDM.

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Is Opium Use Associated with an Increased Risk of Lung Cancer? A Case-Control Study

10.21203/rs.2.14374/v1 ◽

2019 ◽

Author(s):

Ahmad Naghibzadeh-Tahami ◽

Maryam Marzban ◽

Vahid Yazdi-Feyzabadi ◽

Shahryar Dabiri ◽

Reza Abbasi Rayeni ◽

...

Keyword(s):

Lung Cancer ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Test Results ◽

Increased Risk ◽

Study Support ◽

Control Study ◽

Opium Use ◽

Structured Questionnaire

Abstract Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. The aim of this study was to investigate the association between the use of O&D and LC incidence. Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 284 healthy controls matched by age, sex, and place of residence were included. Data including O&D use, cigarette smoking, alcohol use, and diet were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression test. Results: The use of opium was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) = 7.95, 95% CI: 3.78 -16.73). A significant dose-response relation between the use of opium and its derivatives was observed (low use AOR = 7.47, 95% CI: 2.33-23.98 and high use AOR = 11.57, 95% CI: 2.25-59.49). Also, there was a relation between starting to use O&D at lower ages and an increased risk of LC (AOR = 5.78, 95 % CI: 2.36 - 14.14). Conclusion: The results of this study support that opium use could be considered as a strong risk factor for LC. Thus, it is highly suggested that tailored policies to be applied in order to reduce use of opium.

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