Self-reported musculoskeletal pain predicts long-term increase in general health care use: A population-based cohort study with 20-year follow-up

Abstract Background The long-term outcome of brain abscess is unclear. Methods We used medical registries to conduct a nationwide population-based matched cohort study to examine the long-term risks of mortality and new-onset epilepsy in patients hospitalized with brain abscess in Denmark from 1982 through 2016. Comparison cohorts from the same population individually matched on age, sex, and residence were identified, as were siblings of all study participants (Figure 1). We computed cumulative incidences and hazard rate ratios (HRRs) for mortality and new-onset epilepsy among brain abscess patients, comparison cohorts and siblings. Population and appendicitis controls had similar characteristics and prognosis why only comparisons between brain abscess patients and population controls are detailed here. Results We identified 1,384 brain abscess patients with a median follow-up time of 5.9 years (IQR 1.1–14.2). The 1-year, 2–5 year, and 6–30-year mortality of patients after brain abscess was 21%, 16% and 27% when compared with 1%, 6% and 20% for matched population controls (Figure 2). Cox regression analyses adjusted for Charlson comorbidity index score showed 1-year, 2–5 year, and 6- to 30-year HRRs of 17.5 (95% CI 13.9–22.2), 2.61 (95% CI 2.16–3.16) and 1.94 (95% CI 1.62–2.31). The mortality in brain abscess patients compared with population controls was significantly increased regardless of sex or age group except among subjects 80 years or older, and in both previously healthy individuals and immuno-compromised persons. Among the 30-day survivors of brain abscess (median follow-up 7.6 years [IQR 2.2–15.5]), new-onset epilepsy occurred in 32% compared with 2% in matched population controls. Cause-specific Cox regression analysis adjusted for stroke, head trauma, alcohol abuse, and cancer showed 1-year, 2–5-year, and 6–30-year HRRs for new-onset epilepsy of 155 (95% CI 78.8–304), 37.7 (95% CI 23.0–59.9), and 8.93 (95% CI 5.62–14.2) (Figure 3). Comparisons between sibling cohorts suggested no substantial effect of family-related factors on the long-term risk of death or epilepsy after brain abscess (Figure 4). Conclusion Brain abscess is associated with an increased long-term risk of mortality and new-onset epilepsy for several years after the acute infection. Disclosures All authors: No reported disclosures.

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Opioid prescriptions in patients with osteoarthritis: a population-based cohort study

Rheumatology ◽

10.1093/rheumatology/kez646 ◽

2020 ◽

Vol 59 (9) ◽

pp. 2462-2470 ◽

Cited By ~ 2

Author(s):

Jacoline J van den Driest ◽

Dieuwke Schiphof ◽

Marcel de Wilde ◽

Patrick J E Bindels ◽

Johan van der Lei ◽

...

Keyword(s):

Cohort Study ◽

Patient Characteristics ◽

Population Based ◽

Prescription Rate ◽

Factors Associated ◽

Prescription Rates ◽

Care Information ◽

Information Database

Abstract Objectives To examine the incidence, prevalence and trends for opioid prescriptions in patients with OA. Furthermore, types of opioids prescribed and long-term prescription rates were examined. Finally, the patient characteristics associated with the prescription of opioids were assessed. Methods A population-based cohort study was conducted using the Integrated Primary Care Information database. Incidence and prevalence of opioid prescriptions were calculated for the period 2008–2017. Logistic regression was used to assess which patient characteristics were associated with opioid prescriptions. Results In total, 157 904 OA patients were included. The overall prescription rate remained fairly stable, at around 100 incident and 170 prevalent prescriptions per 1000 person years. However, the incident prescription rate for oxycodone increased from 7.1 to 40.7 per 1000 person years and for fentanyl from 4.2 to 7.4 per 1000 person years. The incident prescription rate for paracetamol/codeine decreased from 63.0 to 13.3 per 1000 person years. Per follow-up year, long-term use was found in 3% of the patients with incident OA. Finally, factors associated with more prescriptions were increasing age, OA in ≥2 joint groups [odds ratio (OR) 1.56; 95% CI: 1.51, 1.65] and the presence of other musculoskeletal disorders (OR 4.91; 95% CI: 4.76, 5.05). Men were less likely to be prescribed opioids (OR 0.78; 95% CI: 0.76, 0.80). Conclusion Prescription rates for opioids remained stable, but types of opioids prescribed changed. Oxycodone and fentanyl were increasingly prescribed, while prescriptions of paracetamol/codeine decreased. Since the benefit of opioids for OA pain is questionable and side effects are common, opioids should be prescribed with caution.

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Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study

Journal of Applied Research in Intellectual Disabilities ◽

10.1111/jar.12386 ◽

2017 ◽

Vol 31 ◽

pp. 68-81 ◽

Cited By ~ 22

Author(s):

Sally-Ann Cooper ◽

Laura Hughes-McCormack ◽

Nicola Greenlaw ◽

Alex McConnachie ◽

Linda Allan ◽

...

Keyword(s):

Health Care ◽

Cohort Study ◽

Primary Health Care ◽

General Population ◽

Intellectual Disabilities ◽

Population Based ◽

Long Term Conditions ◽

Primary Health ◽

Adults With Intellectual Disabilities

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Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

CJEM ◽

10.1017/cem.2015.1 ◽

2015 ◽

Vol 17 (5) ◽

pp. 497-506

Author(s):

Amanda S. Newton ◽

Conrad I. Tsang ◽

Rhonda J. Rosychuk

Keyword(s):

Health Care ◽

First Nations ◽

Emergency Departments ◽

Population Based ◽

Health Care Use ◽

Administrative Databases ◽

Sociodemographic Differences ◽

Kaplan Meier ◽

Self Harm

AbstractObjectiveTo examine sociodemographic variations among children <18 years in (1) rates of self-harm visits to emergency departments (EDs) and (2) physician follow-up after the self-harm visit in Alberta.MethodsA retrospective, population-based cohort (2002–2011) of ED visits for self-harm by individuals <18 years was conducted using administrative databases from Alberta, Canada. Individuals were grouped by First Nations status or type of health care premium subsidy (family receipt of government subsidy, human services program subsidy, no subsidy received). Visits from 104 EDs were summarized by crude and directly standardized visit rates (DSVRs) per 100,000 individuals. Kaplan-Meier estimates for median estimated time to physician follow-up were calculated with 95% confidence intervals (CIs).ResultsDuring the study period, visit rates decreased with the exception of children from families receiving government-sponsored program subsidy (DSVRs 163/100,000 to 250/100,000;p=0.032). First Nations children had disproportionately fewer follow-up visits compared to other children. The median time to follow-up for First Nations children was 39 days (95% CI: 32, 48) compared to 16 days for children from families receiving no subsidy (95% CI: 14, 19), who had the shortest follow-up time after an ED visit.ConclusionsSociodemographic differences were evident in ED visit rates as well as the number of and time to physician follow-up visit. The disparities experienced by First Nations children in the follow-up period highlight an opportunity for culturally-grounded risk and needs assessment in the ED to determine and facilitate timely and appropriate follow-up care.

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Data for a population based cohort study on abnormal findings of electrocardiograms (ECG), recorded during follow-up periodic examinations, and their association with long-term cardiovascular morbidity and all-cause mortality

Data in Brief ◽

10.1016/j.dib.2019.104474 ◽

2019 ◽

Vol 26 ◽

pp. 104474

Author(s):

Adam Goldman ◽

Hanoch Hod ◽

Angela Chetrit ◽

Rachel Dankner

Keyword(s):

Cohort Study ◽

Population Based ◽

Cardiovascular Morbidity ◽

All Cause Mortality

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A Population-Based 5-Year Cohort Study Including All Cases of Epithelial Ovarian Cancer in Western Sweden: 10-Year Survival and Prognostic Factors

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181991b13 ◽

2009 ◽

Vol 19 (1) ◽

pp. 116-123 ◽

Cited By ~ 30

Author(s):

Margaretha Åkeson ◽

Anne-Marie Jakobsen ◽

Britt-Marie Zetterqvist ◽

Erik Holmberg ◽

Mats Brännström ◽

...

Keyword(s):

Ovarian Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Residual Tumor ◽

Population Based ◽

Ca 125 ◽

Term Survival ◽

Ploidy Status

Epithelial ovarian cancer (EOC) is the major gynecologic cancer mortality cause in Sweden. The aim of the present study was to investigate the long-term survival and prognostic factors of a complete population-based 5-year cohort of 682 patients with invasive EOC in western Sweden (population around 1.6 million). Data relating to residual tumor after surgery, FIGO stage, grade, histopathologic subtype, ploidy status, adjuvant chemotherapy (the prepaclitaxel period), and disease state (recurrence and death) were reported to a quality register in a prospectively kept database and were controlled against the Swedish National Cancer Registry for completeness. The median follow-up durations for the prospectively collected data in the Cox analysis and for the survival analysis that was made for all patients were 81 months (range, 52-109 months) and 11.7 years (range, 8.7-14.1 years), respectively. No patient was lost to follow-up. The relative 10-year survival rate was 38.4% (95% confidence interval, 34.5%-42.8%). The median relative survival time was 4.3 years (95% confidence interval, 3.6%-5.2%). In the univariate Cox regression analysis, prognostic significances for age, stage, residual tumor, histopathologic subtype of serous cystadenocarcinoma, grade, CA-125, and ploidy status were seen. In the multivariate analysis, age, stage, residual tumor after surgery, and postoperative CA-125 were of prognostic significance. In conclusion, 4 major prognostic factors were found for EOC in this population-based cohort study that also presents nearly accurate long-term survival owing to the nonselective nature and completeness regarding patients and follow-up of the study.

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