scholarly journals The prevalence of diagnosed α1-antitrypsin deficiency and its comorbidities: results from a large population-based database

2016 ◽  
Vol 49 (1) ◽  
pp. 1600154 ◽  
Author(s):  
Timm Greulich ◽  
Christoph Nell ◽  
David Hohmann ◽  
Marco Grebe ◽  
Sabina Janciauskiene ◽  
...  
Keyword(s):  
Large Population ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Healthcare Utilisation ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Chronic Obstructive ◽  
Healthcare Database ◽  
Obstructive Pulmonary Disease ◽  
Antitrypsin Deficiency

α1-Antitrypsin deficiency (AATD) is a genetically determined disorder that is associated with different clinical manifestations. We aimed to assess the prevalence of diagnosed AATD and its comorbidities using a large healthcare database.In this retrospective longitudinal observational study, we analysed data from 4 million insurants. Using International Classification of Diseases revision 10 (ICD-10) codes, we assessed the prevalence, comorbidities and healthcare utilisation of AATD patients (E88.0 repeatedly coded) relative to non-AATD patients with chronic obstructive pulmonary disease (COPD), emphysema or asthma.In our study population, we identified 673 AATD patients (590 aged ≥30 years), corresponding to a prevalence of 23.73 per 100 000 in all age groups and 29.36 per 100 000 in those ≥30 years. Based on the number of AATD cases detected in the sample size (673 out of 2 836 585), we extrapolated that there were 19 162 AATD cases in Germany during the years studied. AATD patients had a higher prevalence of arterial hypertension, chronic kidney disease and diabetes relative to non-AATD asthma or emphysema patients. When compared to non-AATD COPD patients, AATD patients had significantly more consultations and more frequent and longer hospitalisations.Our data strengthen the assumption that AATD is associated with a variety of other diseases. Healthcare utilisation appears to be higher among AATD patients as compared to patients with non-AATD-related obstructive lung diseases.

scholarly journals Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033334 ◽  
Author(s):  
Deborah A Marshall ◽  
Xiaoxiao Liu ◽  
Cheryl Barnabe ◽  
Karen Yee ◽  
Peter D Faris ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Population Based ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Age Group ◽  
Case Definitions ◽  
Obstructive Pulmonary Disease ◽  
Physician Visits ◽  
Significant Difference

ObjectivesThe purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.DesignRetrospective cohort analysis.SettingAll residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.Primary outcome measuresWe selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.ConclusionsOur findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

scholarly journals Identifying Primary Spontaneous Pneumothorax from Administrative Databases: A Validation Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Eric Frechette ◽  
Keegan Guidolin ◽  
Ayman Seyam ◽  
Yun-Hee Choi ◽  
Sarah Jones ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Large Population ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Population Based ◽  
Primary Spontaneous Pneumothorax ◽  
Administrative Databases ◽  
Main Diagnosis ◽  
Hospital Administrative

Introduction. Primary spontaneous pneumothorax (PSP) is a disorder commonly encountered in healthy young individuals. There is no differentiation between PSP and secondary pneumothorax (SP) in the current version of the International Classification of Diseases (ICD-10). This complicates the conduct of epidemiological studies on the subject.Objective. To validate the accuracy of an algorithm that identifies cases of PSP from administrative databases.Methods. The charts of 150 patients who consulted the emergency room (ER) with a recorded main diagnosis of pneumothorax were reviewed to define the type of pneumothorax that occurred. The corresponding hospital administrative data collected during previous hospitalizations and ER visits were processed through the proposed algorithm. The results were compared over two different age groups.Results. There were 144 cases of pneumothorax correctly coded (96%). The results obtained from the PSP algorithm demonstrated a significantly higher sensitivity (97% versus 81%,p=0.038) and positive predictive value (87% versus 46%,p<0.001) in patients under 40 years of age than in older patients.Conclusions. The proposed algorithm is adequate to identify cases of PSP from administrative databases in the age group classically associated with the disease. This makes possible its utilization in large population-based studies.

scholarly journals Rates and Patterns of Chronic Obstructive Pulmonary Disease Exacerbations

2004 ◽  
Vol 11 (8) ◽  
pp. 559-564 ◽  
Author(s):  
Magda Nunes de Melo ◽  
Pierre Ernst ◽  
Samy Suissa
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Average Rate ◽  
Large Population ◽  
Population Based ◽  
Administrative Databases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Acute Exacerbations

BACKGROUND:Acute exacerbations of chronic obstructive pulmonary disease (COPD) are believed to be a common occurrence in patients with COPD and are known to be associated with considerable morbidity.OBJECTIVE:To describe the frequency of treated COPD exacerbations in a large population-based cohort.SUBJECTS AND METHODS:A cohort of newly treated patients with COPD was formed from the administrative databases of Saskatchewan Health. The outcome was the occurrence of all moderate or severe exacerbations from 1990 to 1999. Exacerbations were defined in three ways: dispensing of a prescription for a systemic antibiotic; dispensing of both a prescription for an antibiotic and a prescription for an oral corticosteroid on the same day; and requiring a hospitalization with a primary discharge diagnosis of COPD.RESULTS:There were 5645 patients who entered the COPD cohort between 1990 and 1997, of whom 4453 experienced at least one exacerbation requiring treatment during follow-up. The overall rate of acute exacerbations was 1.12/person-year. It was constant across all age groups, and was similar in both men and women (1.13/person-year versus 1.11/person-year, respectively). The rate of exacerbations was highest in the first trimester of therapy for the disease (1.39/person-year) and stabilized thereafter at 1.04 exacerbations/person-year.CONCLUSIONS:The results indicate that in a population-based cohort of patients with COPD, the average rate of exacerbations was 1.12/person-year. Men and women had similar rates of exacerbations.

scholarly journals A Population-Based Cohort Study on Chronic Comorbidity Risk Factors for Adverse Dengue Outcomes

2021 ◽  
Author(s):  
Chia-En Lien ◽  
Yiing-Jenq Chou ◽  
Yi-Jung Shen ◽  
Theodore Tsai ◽  
Nicole Huang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Age Groups ◽  
Cost Benefit ◽  
Population Based ◽  
Noncommunicable Diseases ◽  
Chronic Obstructive ◽  
Research Database ◽  
Obstructive Pulmonary Disease ◽  
Economic Analyses

The global burden of dengue is increasing against a background of rising global prevalence of chronic noncommunicable diseases (NCDs) and an epidemiological shift of dengue toward older age groups. The contribution of NCDs toward risk for adverse clinical and healthcare utilization outcomes was assessed in a national linked-database study. About 51,433 adult dengue cases between 2014 and 2015 were assessed for outpatient and inpatient claims data in Taiwan’s National Health Insurance Research Database for the 30 days after their dengue diagnosis. A multivariable logistic regression with generalized estimating equations was used to estimate the probability of adverse dengue outcomes in patients with NCDs compared with dengue patients without underlying diseases. Rheumatoid arthritis and related disease were associated with the highest risk of hospitalization after dengue diagnosis (odds ratio: 1.78; 95% CI: 1.37–2.30), followed by stroke, chronic kidney disease (CKD), liver cirrhosis, asthma, coronary artery disease, chronic obstructive pulmonary disease, diabetes, congestive heart failure, hypertension, and malignancy. Chronic kidney disease and diabetes were associated with higher risks of hospitalization, intensive care unit (ICU) use, and all-cause mortality. After adjusting for socioeconomic status and other variables, the number of coexisting chronic diseases was associated with increasing risk of adverse dengue outcomes. Specific NCDs were associated with longer hospitalizations, ICU admission, and higher healthcare costs. Quantifying the risks of adverse dengue outcomes and health expenditures among dengue patients with preexisting NCDs provides insights for improved clinical management and essential inputs for health economic analyses on the cost-benefit of risk-based routine or catch-up immunization programs.

scholarly journals Chronic obstructive pulmonary disease and the risk of 12 cardiovascular diseases: a population-based study using UK primary care data

Thorax ◽  
2018 ◽  
Vol 73 (9) ◽  
pp. 877-879 ◽  
Author(s):  
Ann D Morgan ◽  
Kieran J Rothnie ◽  
Krishnan Bhaskaran ◽  
Liam Smeeth ◽  
Jennifer K Quint
Keyword(s):  
Cardiovascular Diseases ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Chronic Obstructive ◽  
Population Based Study ◽  
Obstructive Pulmonary Disease ◽  
Arterial Circulation ◽  
Relative Risks ◽  
Cohort Study Design

Risks for cardiovascular diseases (CVDs) other than myocardial infarction and stroke in the general COPD population are not well quantified. We used a matched cohort study design and Cox regression to estimate relative risks for 12 separate CVDs in a large population-based cohort of patients with COPD over a 12-year period. Associations between COPD and individual CVDs were heterogeneous, with the highest relative risks observed for heart failure and diseases of the arterial circulation (in excess of 2.5 for those aged 64–75 years). Relative risks declined with increasing age but for most CVD outcomes remained unchanged over the study period.

scholarly journals Case-finding for alpha1-antitrypsin deficiency in Kazakh patients with COPD

2017 ◽  
Vol 12 ◽  
Author(s):  
Ilaria Ferrarotti ◽  
Ardak Zhumagaliyeva ◽  
Stefania Ottaviani ◽  
Timm Greulich ◽  
Marina Gorrini ◽  
...  
Keyword(s):  
Large Population ◽  
General Concept ◽  
Dried Blood Spot ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Care Givers ◽  
Kazakh Population ◽  
Antitrypsin Deficiency ◽  
Alpha1 Antitrypsin ◽  
Blood Spot

Background: Alpha-1-antitrypsin deficiency (AATD) is an under-diagnosed condition in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to screen for AATD in Kazakh patients with COPD using dried blood spot specimens. Methods: The alpha1-antitrypsin (AAT) concentration was determined by nephelometry, PCR was used to detect PiS and PiZ alleles; and isoelectric focusing was used to confirm questionable genotype results and detect rare AAT variants. Results: To this aim, 187 Kazakh subjects with COPD were recruited. Blood samples were collected as dried blood spot. Genotyping of 187 samples revealed 3 (1.6%) PI*MZ and 1 (0.53%) PI*MS, Phenotyping identified also two sample (1.1%) with phenotype PiMI. Allelic frequencies of pathological mutations Z, S and I resulted 0.8%, 0.3%, 0.5%, respectively, in COPD Kazakh population. Conclusions: This study proved that AATD is present in the Kazakh population. These results support the general concept of targeted screening for AAT deficiency in countries like Kazakhstan, with a large population of COPD patients and low awareness among care-givers about this genetic condition.

Epidemiologic study of patients with psoriatic arthritis in a real-world analysis: a cohort study of the French health insurance database

Rheumatology ◽  
2020 ◽  
Author(s):  
Laura Pina Vegas ◽  
Emilie Sbidian ◽  
Laetitia Penso ◽  
Pascal Claudepierre
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Epidemiologic Study ◽  
International Classification Of Diseases ◽  
Chronic Obstructive ◽  
First Line ◽  
Healthcare Database ◽  
Obstructive Pulmonary Disease ◽  
Classification Of Diseases ◽  
Synthetic Dmards

Abstract Objective PsA is a chronic inflammatory arthritis with heterogeneous disease manifestations. Data on the prevalence of PsA in adults differ widely depending on the study and the country. This study aimed to estimate the prevalence and incidence of PsA in France, characterize comorbidities associated to PsA and identify prescribed treatments. Methods This nationwide cohort study involved the administrative healthcare database (Système National des Données de Santé) of the French health insurance scheme linked to the national hospital discharge database. All adults with PsA registered in the database and identified with a specific International Classification of Diseases, 10th revision code (M07) were included between 1 January 2015 and 31 December 2018. Results A total of 63 598 patients were identified as having PsA [55.9 years (s.d. 14.4), 45.6% males]. The prevalence of PsA was estimated at 0.1% and the incidence at 8.4 per 100 000 person-years in the general population. The most common comorbidities were hypertension, diabetes, chronic obstructive pulmonary disease and dyslipidaemia. The prevalence of treatment with conventional synthetic DMARDs (csDMARDs), biological or biosimilar DMARDs (b/bsDMARDs) and apremilast for PsA was 25.9% (16 453), 30.4% (19 325) and 3.5% (2231), respectively. Overall, 8966 (14.1%) patients were new users of csDMARDs, 8311 (13.1%) were new users of b/bsDMARDs and 1529 (7.4%) were new users of apremilast. The most common first-line csDMARD was methotrexate (70.9%) and the most frequent first-line b/bsDMARD was adalimumab (30.8%). Conclusion Our results lead to a better understanding of PsA. Results were similar to those from other published studies using other data sources, which highlights the reliability of insurance databases for studies.

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