scholarly journals Evaluating the Effect of Ethnicity on the Risk of Venous Thromboembolism (VTE): A Systematic Review

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4714-4714
Author(s):  
Fatimah Al-Ani ◽  
Yo-Liang Teng ◽  
Alla Iansavichene ◽  
Alejandro Lazo-Langner
Keyword(s):  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Ethnic Groups ◽  
American Indians ◽  
Geographical Area ◽  
Significant Risk ◽  
Population Based ◽  
Incidence Rates ◽  
Discharge Data ◽  
Incidence Prevalence

Abstract Background Studies of hospital discharge data and large observational cohorts show that the incidence of venous thromboembolism (VTE) varies by race. We sought to determine the incidence of VTE in each of the following ethnic groups Caucasians, Africans, Asians, and Hispanics. Methods A systematic literature search strategy was used to identify potential studies in MEDLINE, EMBASE, and CENTRAL using an OVID interface. The methodological quality of eligible studies was assessed according to Newcastle-Ottawa Quality Assessment Scale. The primary outcome measure was to identify the incidence/prevalence of VTE of each ethnic group available for the study in the context of a population based study. Results Out of 3418 potential studies, 19 met our inclusion criteria (Table). Of these, 9 studies were population based studies: 5 reported VTE incidence per 100,000 person-years (PY), 2 measured the standardized incidence ratio, and 2 European studies assessed VTE rate according to country of origin but not ethnicity (data not shown). In addition, 7 studies measured the hospital incidence rate of VTE, and 3 assessed VTE prevalence. Data could not be pooled due to marked heterogeneity including varied periods of study. VTE incidence per 100,000 PY was found to be between 162 and 439 in Caucasians, 143 and 746 in Africans, 3.2 and 16.6 in Asians. Hospital incidence of VTE per 100,000 PY was found to be between 21 and 131 in Caucasians, 22 and 155 in Africans, 2 and 26 in Asians, 33.1 and 71 in American Indians/Alaskan Indians, and 9 in Hispanics. Conclusions Our findings suggest a wide variation in reported incidence rates for VTE among different ethnic groups, even within the same group. In general, studies in Asian populations suggest a lower incidence of VTE. A marked heterogeneity of study designs, population settings prevent drawing firm conclusions. A significant risk of bias cannot be excluded for several studies. Further studies assessing concurrently the risk of VTE among different ethnicities in the same geographical area are needed. Table 1. Summary of the included studies. Study Country Time Period f/u duration Sample size VTE incidence /Prevalence (95% CI) Zakai, 2014 US 439,090 person year 51,149 Zakai: ARIC US 1987-1996 15,792 (I) Cauc.: 166 (1.48-1.86) Afr.: 259 (2.21-3.03) Zakai: CHS US 1989-1997 5,888 (I) Cauc.: 439 (3.13-6.16) Afr.: 746 (4.68-11.90) Zakai: REGARDS, Southeast area US 2003-2007 30,239 (I) Cauc.: 162 (1.26-2.07) Afr.: 224 (1.72-2.92) Zakai: REGARDS, Rest of US US 2003-2007 30,239 (I) Cauc.: 205 (1.58-2.66) Afr.: 143 (1.02-2.00) Deitelzweig, 2010 US 2002 46,652 (P) per 100,000 persons Cauc.: M 457, F NA Afr.: M 584, F NA Hisp.: M 94, F 93 Others: M 329, F 345 2005 46,652 (P) per 100,000 persons Cauc.: M 643, F 446 Afr.: M 784, F 444 Hisp.: M 149, F 154 Others: M 285, F 297 DeMonaco, 2008 US 1997 37,892 (HI) Cauc.: 44 Afr.: 53 2001 37,892 (HI) Cauc.: 56 Afr.: 60 Heit, 2010 US 2003-2009 2,397 (P) N(%) Cauc.: Total= 1381 (69) Afr.: Total=272 (69) N(%) Cauc.: VTE = 551 (27) Afr.: VTE = 75 (19) Hooper, 2003 US 1980-1996 (HI) American Indians/Alaskan Indians: 33.1 Jang, 2011 Korea 2004 (I) Asians: VTE: 8.83, DVT: 3.91, PE: 3.74 2008 (I) Asians: VTE: 13.8, DVT: 5.31 , PE: 7.01 Kitamukai, 2003 Japan 2000 (I) Asians: 3.2 (29.2-33.9) Klatsky, 2000 US 1978-1994 1,822,302 total person years 128,934 (HI) Cauc.: 21 Afr.: 22 Asians: 2 Hisp.: 9 Others (unspecified): 15 Lee, 2010 Taiwan 2001 & 2002 11,566 person year Crude Incidence per 100,000 person year: Asians: VTE=15.9 Liu, 2002 China 1997-2000 (I) Asians: 16.6 Sakuma, 2009 Japan 2006 (I) Asians: PE= 6.19 (51.7- 72.1) DVT= 11.5 (98.2-132.9) Schneider, 2006 US 1998-2000 (HI) Cauc.: M 36.47 ; F 37.96 Afr.: M 53.64 ; F 61.53 Stein, Am J Med. 2004 US 1990-1999 (HI) Cauc.: VTE= 122 Afr.: VTE= 134 Asians: VTE= 23 Stein, Arch Intern Med. 2004 US 1996-2001 (HI) Cauc.: 131 Afr.: 155 American Indians and Alaskan Indians: 71 Tan, 2007 Singa-pore 1998-2001 271 pairs of cases and controls (P) N(%) Asians: 32.1% (29.0-35.3) White, 2005 US 1996 21,002 (SIR): Cauc.: 103 (101-105) Afr.: 138 (132-145) Asians: 29 (27-32) Hisp.: 61 (59-64) Others: 72 (65-80) White, 1998 US 1991-1994 17991 (SIR): Cauc.: 23 Afr.: 29.3 Asians: 6 Hisp.: 13.9 Abbreviations. f/u: follow up; CI: confidence interval; (I): incidence per 100,000 PY; (P): prevalence; (HI): Hospital Incidence per 100,000 PY; (SIR): Standardized Incidence Rate; M:male; F: female; N: total number. Cauc. Caucasians, Afr. Africans, Hisp. hispanics Disclosures Lazo-Langner: Pfizer: Honoraria; Bayer: Honoraria.

The Incidence and Timing of Unprovoked Venous Thromboembolism Prior to the Diagnosis of Common Cancers.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2582-2582
Author(s):  
Richard White ◽  
Ted Wun ◽  
Arti Parikh-Patel ◽  
Danielle Harvey ◽  
Helen Chew
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Diagnosis ◽  
Large Population ◽  
Cell Cancer ◽  
Population Based ◽  
Incidence Rates ◽  
Myelogenous Leukemia ◽  
Data Set ◽  
Discharge Data ◽  
Diagnosis Of Cancer

Abstract Background. It is not clear how frequently unprovoked venous thromboembolism (VTE) reflects the presence of an underlying occult malignancy. Objective: To compare the expected and observed incidence of unprovoked VTE during a one year period immediately preceding the diagnosis of common types of cancer Design: Retrospective population-based cohort study using the California Cancer Registry linked with the California Patient Discharge Data Set. Setting: All non-federal hospitals in California. Patients: All cases over the age of 17 that were diagnosed with one of 19 common cancers between Jan. 1993 and Dec. 1995. Measurement. VTE was identified and classified as provoked (after surgery, pregnancy, trauma, medical hospitalization etc.) or unprovoked using an array of validated specific ICD-9-CM codes. VTE cases first diagnosed before the cancer diagnosis of cancer were labeled as having preceding VTE, and VTE cases diagnosed at the time of the cancer diagnosis were labeled as having concurrent VTE cases. Cancer cases with common malignant histologies were identified using the registry. The standardized incidence ratio (SIR) of unprovoked VTE was determined by calculating the expected incidence in the cancer cohorts using the 1995 and 1996 age, race and sex specific incidence rates of unprovoked VTE among California residents. Results. There were 250585 cancer cases; mean age was 66 years, 52% were women, 35% had metastatic or unknown stage cancer at the time of diagnosis; A total of 385 cancer cases had VTE in the preceding year, and 221 of these cases (0.09%) had unprovoked VTE, compared to 216 expected cases, SIR= 1.02 (95% CI= 0.9–1.2, p=NS). 50% of the cases with preceding unprovoked VTE had metastatic or unknown stage cancer (p<0.001). Only cases with lymphoma, renal cell cancer and acute myelogenous leukemia had an SIR significantly greater than 1.0 (SIR range = 2.1–5.3). Among the cases with preceding unprovoked VTE that were later diagnosed with metastatic or unknown stage cancer, there were 30 more VTE cases than expected, SIR = 1.4 (CI = 1.2–1.6), and a significantly greater proportion of these cases were diagnosed with VTE within 91 days of being diagnosed with cancer (p =0.001). 832 (0.33%) cases were diagnosed with VTE during the hospital stay when cancer was diagnosed, and 168 (20%) of the cases were admitted with a principal diagnosis of VTE; 68% of these 832 cases with concurrent VTE had metastatic or unknown stage cancer at the time of diagnosis (p<0.001 vrs entire cohort) Limitations. This was a retrospective study that relied on administrative data to identify cases and outcomes. The extent of any evaluation for cancer that might have occurred among the cases with preceding unprovoked VTE could not be determined. Conclusions: In this large population based cohort of cancer cases, the incidence of unprovoked VTE in the year prior to the diagnosis of cancer was not significantly higher than expected in the general population. Approximately 10% to 15% of the cases diagnosed with preceding unprovoked VTE had features suggesting a causal link between thromboembolism and the undiagnosed cancer. Many patients were diagnosed concurrently with cancer and VTE during the same hospitalization.

Nationwide trends in the incidence of orbital lymphoma from 1999 to 2016 in South Korea

2020 ◽  
pp. bjophthalmol-2020-316796
Author(s):  
Su Kyung Jung ◽  
Jiwon Lim ◽  
Suk Woo Yang ◽  
Young-Joo Won
Keyword(s):  
South Korea ◽  
B Cell ◽  
Incidence Rate ◽  
Cell Lymphoma ◽  
Survival Rates ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Percent Change ◽  
Orbital Lymphoma

Background/AimsLymphomas are the most frequent neoplasm of the orbit. However, the epidemiology of orbital lymphomas is not well reported. This study aimed to provide a population-based report on the epidemiology of orbital lymphomas and measure the trends in the incidence of orbital lymphoma cancer in South Korea.MethodsNationwide cancer incidence data from 1999 to 2016 were obtained from the Korea Central Cancer Registry. Age-standardised incidence rates and annual percent changes were calculated according to sex and histological types. The analysis according to the Surveillance, Epidemiology, and End Results summary stage classifications was performed from 2006 to 2016. Survival rates were estimated for cases diagnosed from 1999 to 2016.ResultsA total of 630 patients (median age: 54 years) with orbital lymphoma in the orbital soft tissue were included in this study. The age-standardised incidence rates increased from 0.03 to 0.08 per 100 000 individuals between 1999 and 2016, with an annual percent change of 6.61%. The most common histopathological type of orbital lymphoma was extra marginal zone B cell lymphoma, accounting for 82.2% of all orbital lymphomas during 1999–2016, followed by diffuse large B cell lymphoma (9.2%). Five-year, 10-year and 15-year overall survival (OS) of orbital lymphoma was 90.8%, 83.8% and 75.8%, respectively. OS showed a significant decrease as age increased and no significant differences between men and women.ConclusionThe incidence rate of orbital lymphoma is very low in South Korea. However, the incidence rate has increased over the past years. Orbital lymphomas have a worse prognosis as age increases.

scholarly journals The Incidence, Characteristics, and Outcomes of Community and Hospital-Associated S. aureus Disease in Fulton County, Georgia

2020 ◽  
Vol 41 (S1) ◽  
pp. s81-s82
Author(s):  
Andrew Webster ◽  
Scott Fridkin ◽  
Susan Ray
Keyword(s):  
Hospital Discharge ◽  
Population Based ◽  
Incidence Rates ◽  
Outcome Data ◽  
Hospital Discharge Data ◽  
Invasive Infection ◽  
Emerging Infections ◽  
Inpatient Hospitalization ◽  
Discharge Data ◽  
Total Treatment

Background: Due to reliance on hospital discharge data for case identification, the burden of noninvasive and community-acquired S. aureus disease is often underestimated. To determine the full burden of S. aureus infections, we utilized population-based surveillance in a large urban county. Methods: The Georgia Emerging Infections Program (GA EIP) conducted CDC-funded, population-based surveillance by finding cases of S. aureus infections in 8 counties around Atlanta in 2017. Cases were residents with S. aureus isolated from either a normally sterile site in a 30-day period (invasive cases) or another site in a 14-day period (noninvasive cases). Medical records (all invasive and 1:4 sample of noninvasive cases) among Fulton County residents were abstracted for clinical, treatment, and outcome data. Cases treated were mapped to standard therapeutic site codes. Noninvasive specimens were reviewed and attributed to an invasive case if both occurred within 2 weeks. Incidence rates were calculated using 2017 census population and using a weight-adjusted cohort to account for sampling. Results: In total, 1,186 noninvasive (1:4 sample) and 529 invasive cases of S. aureus in Fulton county were reviewed. Only 35 of 1,186 (2.9%) noninvasive cases were temporally linked to invasive cases, resulting in 5,133 cases after extrapolation (529 invasive, 4,604 noninvasive). All invasive cases and 3,776 of 4,604 noninvasive cases (82%) were treated (4,305 total). Treatment was highest in skin (90%) and abscess (97%), lowest in urine (62%) and sputum (60%), and consisted of antibacterial agents alone (65%) or in addition to drainage procedures (35%). Overall, 41% of all cases were hospitalized, 12% required ICU admission, and 2.7% died, almost exclusively with bloodstream and pulmonary infections. Attribution of noninvasive infection was most often outside healthcare settings (87%); only 341 (7.9%) were hospital-onset cases; however, 34% of cases had had healthcare exposure in the preceding year, most often inpatient hospitalization (75%) or recent surgery (35%). Estimated countywide incidence was 414 per 100,000 (130 for MRSA and 284 for MSSA), invasive infection was 50 per 100,000. Among treated cases, 57% were SSTI, and the proportion of cases caused by MRSA was ~33% but varied slightly by therapeutic site (Fig. 1). Conclusions: The incidence of treated S. aureus infection in our large urban county is estimated to be 414 per 100,000 persons, which exceeds previously estimated rates based on hospital discharge data. Only 12% of treated infections were invasive, and <1 in 10 were hospital onset. Also, two-thirds of treated disease cases were MSSA; most were SSTIs.Funding: Proprietary Organization: Pfizer.Disclosures: Scott Fridkin, consulting fee - vaccine industry (spouse).

Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

2014 ◽  
Vol 112 (08) ◽  
pp. 255-263 ◽  
Author(s):  
Alexander T. Cohen ◽  
Luke Bamber ◽  
Stephan Rietbrock ◽  
Carlos Martinez
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Recurrence Rates ◽  
Recurrent Vte ◽  
Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

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 Changes in Uterine Cancer Incidence Rates in Egypt

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Saad Alshahrani ◽  
Amr S. Soliman ◽  
Ahmed Hablas ◽  
Mohamed Ramadan ◽  
Jane L. Meza ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Urban Areas ◽  
Nile Delta ◽  
Uterine Cancer ◽  
Developed Countries ◽  
Population Based ◽  
Incidence Rates ◽  
Specific Rate ◽  
Crude Rate ◽  
Rural And Urban Areas

Background. Uterine cancer is one of the top-ranking cancers in women with wide international variations in incidence rates. Developed countries have higher incidence rates than the developing countries. Egypt has significantly lower incidence of uterine cancer than other countries in the Middle East. This study aimed at verifying the incidence rate of uterine cancer and characterizing the demographic and clinical profiles of patients residing in the Gharbiah province in the Nile delta region of Egypt. Methods. Data from 660 uterine cancer patients diagnosed during the period of 1999 to 2010 were abstracted from the Gharbiah Cancer Registry, the only population-based registry in Egypt. The data included age, marital status, number of children, residence, smoking, occupation, date and basis of diagnosis, tumor topography, morphology, stage and grade, and treatment. Crude rate, age-standardized rate (ASR), and age-specific rate were calculated and associated with demographic and clinical characteristics of patients. Results. The study confirmed the low ASR of uterine cancer in Egypt, (4.1 per 100,000 (95% CI: 3.8–4.4)). The incidence rate increased significantly over the 12-year period. The crude rate (CR) was 1.95, 95% CI (1.64–2.25) in 1999–2002; 2.9, 95% CI (2.5–3.2) in 2003–2006; and 3.5, 95% CI (3.1–3.9) in 2007–2010. The rate ratio was 1.5, 95% CI (1.2–1.8) in 2003–2006 and 1.8, 95% CI (1.5–2.2) in 2007–2010 compared to 1999–2002. The majority of patients (83%) were postmenopausal with the highest age-specific rate in the 60–69-year age group (22.07 per 100,000 (95% CI: 19.3–25.2). The majority of patients were diagnosed at early stages (60% localized and 5% regional), had adenocarcinoma (68%), and resided in urban areas (54%). Conclusions. The study confirmed the low incidence rate of uterine cancer in the Gharbiah province of Egypt and significant increase in incidence in recent years. Future studies should focus on verifying the possible effect of hysterectomy on lowering the incidence, the factors related to the changes in rates between rural and urban areas, and the possible impact of nutritional and epidemiologic transitions on the increasing rates.

scholarly journals Long-Term Incidence of Venous Thromboembolism in Cancer: The Scandinavian Thrombosis and Cancer Cohort

TH Open ◽  
2018 ◽  
Vol 02 (02) ◽  
pp. e131-e138 ◽  
Author(s):  
Inger Lise Gade ◽  
Sigrid Brækkan ◽  
Inger Anne Næss ◽  
John-Bjarne Hansen ◽  
Suzanne Cannegieter ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Diagnosis ◽  
Population Based ◽  
Incidence Rates ◽  
Solid Cancer ◽  
Background Population ◽  
Hematological Cancers ◽  
Cancer Types ◽  
After Cancer ◽  
Rate Ratios

AbstractThe risk of venous thromboembolism (VTE) in patients who survive the first years after a cancer diagnosis after the acute effects of disease and treatment in comparison to a similar background population has been sparsely investigated. The aim of the study was to investigate if incidence rates (IRs) of VTE differed in patients who were alive at least 2 years after a cancer diagnosis without VTE compared with cancer-free references in a population-based cohort study. The study entry was 2 years after a first cancer diagnosis. For each cancer-exposed subject, five reference subjects were identified within the cohort. The IRs were calculated as number of VTEs per 1,000 person years (×10−3 p-y) in total and in distinct cancer types and corresponding reference subjects. Incidence rate ratios (IRRs) were calculated by Poisson's regression. During a mean follow-up of 5.3 years, 110 VTEs occurred among the 7,288 cancer-exposed subjects and 321 VTEs occurred among the 36,297 identified reference subjects. The IR of VTE was higher for cancer-exposed subjects compared with reference subjects, IRs 3.7 × 10−3 p-y, 95% CI: 3.1 to 4.5 and 1.9 × 10−3 p-y, 95% CI: 1.7 to 2.2, respectively. IRs of VTE in most solid cancer types declined to almost the same level as in the reference subjects 2 years after cancer diagnosis, but remained higher in hematological cancers, IRR 4.0, 95% CI: 2.0 to 7.8.

scholarly journals Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
José M. de Miguel-Yanes ◽  
Rodrigo Jiménez-García ◽  
Valentín Hernández-Barrera ◽  
Javier de Miguel-Díez ◽  
Manuel Méndez-Bailón ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Infective Endocarditis ◽  
Population Based ◽  
Incidence Rates ◽  
Discharge Data ◽  
Admission Rates ◽  
Diabetes Status ◽  
Patients With Diabetes ◽  
Diabetes Mellitus Status

Abstract Background The main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national hospital discharge data. Methods We estimated admission rates by diabetes status. We analyzed comorbidity, therapeutic procedures, and outcomes. We built Poisson regression models to compare the adjusted time-trends in admission rates. Type 2 diabetes cases were matched with controls using propensity score matching (PSM). We tested in-hospital mortality (IHM) in logistic regression analyses. Results We identified 16,626 hospitalizations in patients aged ≥ 40 years for IE in Spain, 2001–2015. The incidence of IE increased significantly from 6.0/100,000 per year to 13.1/100,000 per year (p < 0.001) in the population with type 2 diabetes, and from 3.9/100,000 per year to 5.5/100,000 per year (p < 0.001) in the population without diabetes, over the study period. The adjusted incidence of IE was 2.2-times higher among patients with diabetes than among those without diabetes (IRR = 2.2; 95% CI 2.1–2.3). People with type 2 diabetes less often underwent heart valve surgery than people without diabetes (13.9% vs. 17.3%; p < 0.001). Although IHM decreased significantly in both groups over time, it represented 20.8% of IE cases among diabetes patients and 19.9% among PSM matched controls (p = 0.337). Type 2 diabetes was not associated with a higher IHM in people admitted to the hospital for IE (OR = 1.1; 95% CI 0.9–1.2). Conclusion Incidence rates of IE in Spain, among those with and without T2DM, have increased during the period 2001–2015 with significantly higher incidence rates in the T2DM population. In our population based study and after PSM we found that T2DM was not a predictor of IHM in IE.

scholarly journals Trends of venous thromboembolism risk before and after diagnosis of gout: a general population-based study

Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 1099-1107 ◽  
Author(s):  
Lingyi Li ◽  
Natalie McCormick ◽  
Eric C Sayre ◽  
John M Esdaile ◽  
Diane Lacaille ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
General Population ◽  
Population Based ◽  
Incidence Rates ◽  
Vein Thrombosis ◽  
Hazard Ratios ◽  
Thrombosis Risk ◽  
Before And After ◽  
Health Database ◽  
Deep Vein

Abstract Objective To estimate the overall risk and the temporal trend of venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE) before and after gout diagnosis in an incident gout cohort compared with the general population. Methods We conducted a matched cohort study using a province-wide population-based administrative health database in Canada. We calculated incidence rates (IRs) and multivariable adjusted hazard ratios (HRs) for the risk of VTE, DVT and PE before and after gout diagnosis. Results Among 130 708 incident individuals with gout (64% male, mean age 59 years), 2071 developed VTE, 1377 developed DVT and 1012 developed PE. IRs per 1000 person-years for gout were 2.63, 1.74 and 1.28 compared with 2.03, 1.28 and 1.06 for non-gout, respectively. The fully adjusted HRs (95% CI) for VTE, DVT and PE were 1.22 (1.13, 1.32), 1.28 (1.17, 1.41) and 1.16 (1.05, 1.29). For the pre-gout period, the fully adjusted HRs (95% CI) were 1.51 (1.38, 1.64), 1.55 (1.40, 1.72) and 1.47 (1.31, 1.66) for VTE, DVT and PE. During the third, second and first years preceding gout, the fully adjusted HRs for VTE were 1.44, 1.56 and 1.62. During the first, second, third, fourth and fifth years after gout, the fully adjusted HRs were 1.63, 1.29, 1.33, 1.28 and 1.22. Similar trends were also seen for DVT and PE. Conclusion Increased risks of VTE, DVT and PE were found both before and after gout diagnosis. The risk increased gradually before gout, peaking in the year prior to diagnosis, and then progressively declined. Gout-associated inflammation may contribute to venous thrombosis risk.

A Population-Based Study of Incidence of Myeloproliferative Neoplasms in Sweden Between 2000 and 2012

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1605-1605
Author(s):  
Malin Hultcrantz ◽  
Therese M-L Andersson ◽  
Ola Landgren ◽  
Paul W Dickman ◽  
Bjorn Andreasson ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Confidence Intervals ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Incidence Rate ◽  
Swedish Population ◽  
Population Based Study ◽  
Cancer Register

Abstract Background The Myeloproliferative neoplasms (MPNs) consists of the subtypes polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF), and MPN unclassifiable (MPN-U). The incidence rates of these diseases vary substantially between different reports, ranging from 1.15 to 4.99/100,000 person-years. However, in a recent metaanalysis, there was no significant difference in MPN incidence between Europe and North America and the variations in incidence may therefore reflect the quality of the cancer registers and reporting of MPNs. In addition, there is a limited number of reports on MPN incidence during more recent years. Therefore, we assessed the incidence of MPN based on the Swedish Cancer Register, a high-quality population-based cancer register between 2000 and 2012. Patients and Methods The Swedish Cancer Register was used to identify all patients diagnosed with an MPN between January 1st 2000 and December 31st 2012. These Swedish Cancer Registers have very high levels of quality and completeness. Between 2008 and 2012, the reporting of newly diagnosed MPN to the cancer register was >92%. Information on the Swedish population was obtained from the Human Mortality Database (www.mortality.org). Based on information from these registers, incidence rates of MPNs with 95% confidence intervals (CIs) were calculated. Confidence intervals were estimated on the log scale. In addition, the incidence rate in relation to MPN subtype, age group (18-39, 40-49, 50-59, 60-69, 70-79, and ³80 years), as well as calendar year of diagnosis was assessed. Results A total of 5,442 MPN patients were reported to the cancer register between 2000 and 2012. During these years, there were 1,810 incident cases of PV, 1,862 of ET, 636 of PMF, and 1,134 with MPN-U. Between January 1st 2000 and December 31st 2012, the population in Sweden increased from 8,861,426 to 9,555,893 inhabitants. The overall annual incidence rate of MPN was 5.83 (95% CI 5.68-5.99)/100,000 persons. The incidence rate of PV was 1.94 (1.85-2.03), ET 2.00 (1.91-2.09), PMF 0.68 (0.63-0.74), and MPN-U 1.22 (1.15-1.29) per 100,000 person-years. In addition, there was a strong correlation between age and incidence of MPN with incidence rates being substantially higher among the older age groups (Table). The overall incidence rate of MPNs increased during the study period, from 5.06 (4.55-5.62)/100,000 person-years in the year 2000 to 5.98 (5.45-6.55)/100,000 person-years in 2012. The incidence rate of PV was similar throughout the study period, the incidence was 2.05 (1.74-2.42)/100,000 person-years in 2000 and 2.12 (1.81-2.47)/100,000 person-years in 2012. The annual incidence rate of ET and PMF increased, from 1.62 (1.34-1.95) to 2.49 (2.15-2.87) per 100,000 persons for ET and from 0.36 (0.24-0.53) to 0.86 (0.67-1.10) per 100,000 persons for PMF between 2000 and 2012. Conversely, the incidence of MPN-U decreased, 1.03 (0.81-1.29) to 0.52 (0.38-0.71)/100,000 person-years between 2000 and 2012. Summary and Conclusions In this large population-based study, the incidence of MPN was higher than previously reported in both European and North American studies. As earlier lower incidence rates likely are an effect of limited coverage of cancer registers, there may be an underreporting of MPNs in many European and American countries. The increase in MPN incidence rates during the study period may reflect increasing life expectancy of the Swedish population, improved reporting to the cancer register as well as changes in the classification and diagnostic systems. Similarly, the decrease in incidence of MPN-U is also likely a result of improved diagnostics during more recent years. In conclusion, the MPN incidences rates reported here are presumably more accurate compared to earlier reports due to the high level of coverage and accuracy of the Swedish registers. Table 1. Incidence rates of MPNs overall and in relation to subtype and age at diagnosis Total number MPN diagnosed 2000-2012 Incidence/100 000 person-years (95% confidence interval) All MPN 5,442 5.83 (5.68-5.99) Subtype PV 1,810 1.94 (1.85-2.03) ET 1,862 2.00 (1.91-2.09) PMF 636 0.68 (0.63-0.74) MPN-U 1,134 1.22 (1.15-1.29) Age at diagnosis (years) 18-39 226 0.67 (0.59-0.76) 40-49 361 2.26 (2.04-2.51) 50-59 769 4.92 (4.58-5.28) 60-69 1,228 9.54 (9.02-10.1) 70-79 1,680 18.99 (18.1-19.9) >80 1,178 18.92 (17.87-20.03) Disclosures Landgren: BMJ Publishing: Honoraria; Bristol-Myers Squibb: Honoraria; Medscape: Honoraria; Onyx: Honoraria; Celgene: Honoraria; International Myeloma Foundation: Research Funding; Medscape: Consultancy; BMJ Publishing: Consultancy; Onyx: Research Funding; Bristol-Myers Squibb: Consultancy; Onyx: Consultancy; Celgene: Consultancy.

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