scholarly journals Possible beneficial association between renin-angiotensin-aldosterone-system blockade usage and graft prognosis in allograft IgA nephropathy: a retrospective cohort study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sehoon Park ◽  
Chung Hee Baek ◽  
Heounjeong Go ◽  
Young Hoon Kim ◽  
Sang–il Min ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antihypertensive Medication ◽  
Single Agent ◽  
Mixed Effect ◽  
Renin Angiotensin Aldosterone System ◽  
Cox Regression Analysis ◽  
Renin Angiotensin ◽  
Medication Therapy

Abstract Background Although immunoglobulin A nephropathy (IgAN) is associated with an increased risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited. Methods In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and risk of 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used. Results A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft IgAN diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 [1.09–6.98]; P = 0.03). Conclusions In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.

scholarly journals Possible beneficial association between renin-angiotensin-aldosterone-system blockade usage and graft prognosis in allograft IgA nephropathy: A retrospective cohort study

2019 ◽  
Author(s):  
Sehoon Park ◽  
Chung Hee Baek ◽  
Heounjeong Go ◽  
Young Hoon Kim ◽  
Sang-il Min ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antihypertensive Medication ◽  
Single Agent ◽  
Mixed Effect ◽  
Renin Angiotensin Aldosterone System ◽  
Cox Regression Analysis ◽  
Renin Angiotensin ◽  
Medication Therapy

Abstract Background Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited. Methods In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used. Results A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 [1.09-6.98]; P=0.03). Conclusions In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.

scholarly journals Possible beneficial association between renin-angiotensin-aldosterone-system blockade usage and graft prognosis in allograft IgA nephropathy: A retrospective cohort study

2019 ◽  
Author(s):  
Sehoon Park ◽  
Chung Hee Baek ◽  
Heounjeong Go ◽  
Young Hoon Kim ◽  
Sang-il Min ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antihypertensive Medication ◽  
Single Agent ◽  
Mixed Effect ◽  
Renin Angiotensin Aldosterone System ◽  
Cox Regression Analysis ◽  
Renin Angiotensin ◽  
Medication Therapy

Abstract Background Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited. Methods In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used. Results A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 [1.09-6.98]; P=0.03). Conclusions In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.

scholarly journals Knowing Cancer Diagnosis is a Protective Factor for the Survival of Patients With Breast Cancer : A Retrospective Cohort Study

2020 ◽  
Author(s):  
Chen He ◽  
Wenxi Zhu ◽  
Yunxiang Tang ◽  
Yonghai Bai ◽  
Zheng Luo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Survival Time ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Cox Regression Analysis

Abstract Background: The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival has not been fully understood. This retrospective cohort study aims at exploring the association between early informed diagnosis and survival time in breast cancer patients.Methods: 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors including knowing cancer diagnosis status, gender, age, clinical-stage, surgical history, the grade of reporting hospital and diagnostic year were registered. We followed up all participants every 6 months until June 2017.Results: By June 2017, 18.04% of the participants died of breast cancer. Both the 3-year and 5-year survival rate of whom knew cancer diagnosis were longer (P<0.001). By stratified analysis, except subgroups of male patients and patients in stage III, patients knowing diagnosis showed a better prognosis in all the other subgroups (P<0.05). By Cox regression analysis, it was showed that not knowing cancer diagnosis was an independent risk factor for survival in breast cancer patients (P<0.001).Conclusions: Being aware of their cancer diagnosis plays a protective role in extending the survival time in breast cancer patients, which suggests medical staff and patients’ families disclose cancer diagnosis to patients timely.

The Co-management of Tuberculosis-diabetes Co-morbidities in Indonesia Under the National Tuberculosis Control Program: Results From a Retrospective Cohort Study From 2017-2019

2021 ◽  
Author(s):  
Weixi Jiang ◽  
Fauziah Mauly Rahman ◽  
Adik Wibowo ◽  
Adhi Sanjaya ◽  
Permata Imani Ima Silitonga ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Control Program ◽  
Mixed Effect ◽  
Factors Associated ◽  
Tb Treatment ◽  
National Tuberculosis ◽  
The Government

Abstract Background: Indonesia suffers from a high burden of tuberculosis (TB) and diabetes (DM). The government initiated national TB-DM co-management activities under the National TB Control Program in 2017. This study investigates the detection and treatment outcomes of TB-DM in Jakarta after implementing these activities, and identifies the main factors associated with these outcomes. Methods: A retrospective cohort study was conducted using TB registry data in two districts of Jakarta, East Jakarta (low-income) and South Jakarta (high-income). A 5-step cascade analysis was used: diagnosed TB patients; TB patients tested for DM; diagnosed TB-DM patients; and patients received and completed TB treatment/cured. We conducted descriptive analyses to understand the characteristics of TB and TB-DM patients, and used a two-level mixed-effect logistic regression to explore factors associated with having a DM test and completing TB treatment/being cured. Results: Over the study period (2017-2019) 50.8% of the new pulmonary TB patients aged over 15 were tested for DM. The percentage increased from 41.7% in 2017-2018 to 60.1% in 2019. Of the TB patients tested for DM, 20.8% were diagnosed with DM. Over 90% of the detected TB-DM patients received standard TB treatment, 86.3% of whom completed treatment/were cured. Patients in East Jakarta were more likely to be tested for DM and to complete standard TB treatment/be cured than patients in South Jakarta (P<0.001). Bacteriologically positive TB patients were more likely to be tested for DM (OR=1.37, 95% CI 1.17,1.60). Patients diagnosed in sub-district level healthcare centers had a higher likelihood of being tested for DM than those in government and private hospitals (P<0.05). Receiving DM treatment was associated with a higher likelihood of completing TB treatment/being cured (OR=1.82, 95% CI 1.20, 2.77).Conclusions: TB-DM case detection significantly improved in 2019 after introducing TB-DM co-management activities in Jakarta, while gaps in TB-DM co-management existed between bacteriologically positive and clinically diagnosed TB patients, and across different types of health facilities. Collaboration between TB and DM departments should be strengthened, and more resources need to be mobilized to further improve the co-management of TB-DM in Indonesia.

scholarly journals 1024. First Episode Infective Endocarditis in Persons Who Inject Drugs (PWIDs); A Retrospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S305-S305
Author(s):  
Laura Rodger ◽  
Dresden GlockerLauf ◽  
Esfandiar Shojaei ◽  
Adeel Sherazi ◽  
Brian Hallam ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
First Episode ◽  
Persons Who Inject Drugs ◽  
Cox Regression Analysis ◽  
Lower Survival ◽  
Valvular Surgery

Abstract Background Persons who inject drugs (PWID) represent a distinct demographic of patients with infective endocarditis (IE). Many centers do not perform valvular surgery on these patients due to concerns about poor outcomes. Methods Retrospective cohort study comparing PWID patients to non-PWID patients presenting between February 2007 and March 2016 in London, Ontario, among adult (&gt;18) inpatients with first episode IE. Results In 370 first episode IE cases, 53.9% occurred in PWIDs. PWID patients were younger (35.4 SD 10.0 vs. 59.4 SD 14.9) (P &lt; 0.001), more likely to have right-sided infection [125/202 (62%), vs. 16/168 (9.5%) (P &lt; 0.001)], and more often due to S. aureus (156/202 (77.3%) vs. 54/168 (32.1%), P &lt; 0.001). Myocardial and aortic root abscesses were less common in PWIDs [17/202 (8.4%) vs. 50/168 (30%) (P &lt; 0.01)]. There was no difference in the frequency of noncardiac complications. In total, 36.5% of patients were treated surgically with PWID patients less likely to undergo surgery [39/202 (19.3%) vs. 98/168 (58%) P &lt; 0.001]. Cox regression analysis identified the protective effect of cardiac surgery with regards to survival in all patients, with a hazard ratio of 0.49 (95% CI 0.31–0.76, P &lt; 0.001), as well as among PWIDs (HR 0.39, 95% CI 0.17–0.87, P = 0.02). Among all patients, lower survival was associated with older age (HR 1.03, 95% CI 1.00–1.05, P &lt; 0.001), injection drug use (HR 2.72, 95% CI 1.52–4.88, P &lt; 0.001), left-sided infection (HR 3.48, 95% CI 2.01–6.03, P &lt; 0.001), and bilateral infection (HR 3.19, 95% CI 1.45–7.01, P = 0.004). The lower survival of left-sided infection (HR 4.01, 95% CI 1.97–8.18, P &lt; 0.001) or bilateral infection (HR 6.94, 95% CI 2.39–20.2,P &lt; 0.001) was re-demonstrated in PWIDs. Conclusion This study identifies important clinical differences between PWIDs and nondrug users with respect to valve involvement, causative organism, complications, and management strategies. Our results highlight the important role of surgical treatment in a carefully selected PWID patient population. Disclosures All authors: No reported disclosures.

scholarly journals Associated Factories and Time to Occurrence of Tuberculosis Among Children on HIV/AIDS Care in Assosa and Pawe General Hospitals North West Ethiopia: A Retrospective Cohort Study 2020

2020 ◽  
Author(s):  
Fassikaw kebede Bizuneh ◽  
Tadese Tollosa Daba ◽  
Belayneh Mengist Mitike ◽  
Tamrat sheawno Fikretsion ◽  
Belete Negese Negese
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Cox Model ◽  
Incidence Density ◽  
Human Immune Deficiency Virus ◽  
Cox Regression Analysis ◽  
Hiv Aids

Abstract Background: Tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied in Ethiopia, but among children on HIV/AIDS care is overlooked. Knowledge of the time when TB develops during successive follow up could be helpful for time relevant intervention strategies.Methods: health institution based retrospective cohort study conducted among 421 children on HIV/AIDS from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05.Result: Totally 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 8 years (IQR=2-15). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1).Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children.

scholarly journals Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054098
Author(s):  
Jo-Hui Pan ◽  
Chih-Hung Cheng ◽  
Chao-Ling Wang ◽  
Chia-Yen Dai ◽  
Chau-Chyun Sheu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Cumulative Incidence ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Secondary Outcome ◽  
Matched Cohort ◽  
Cox Regression Analysis ◽  
Control Subjects

ObjectivesThis study was conducted to explore the association between pneumoconiosis and pneumothorax.DesignRetrospective cohort study.SettingNationwide population-based study using the Taiwan National Health Insurance Database.ParticipantsA total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).Primary and secondary outcome measuresThe incidence and the cumulative incidence of pneumothorax.ResultsBoth incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients.ConclusionsOur study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.

scholarly journals Association Between Use of Preoperative Antihypertensive Medication and 90-Day Mortality After Noncardiac Surgery: A Retrospective Cohort Study

2020 ◽  
Vol 33 (6) ◽  
pp. 534-542
Author(s):  
Chami Im ◽  
Tak Kyu Oh ◽  
In-Ae Song
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Antihypertensive Medication ◽  
Noncardiac Surgery ◽  
Hypertensive Patients

Abstract Background This study aimed to determine whether use of preoperative antihypertensive medication is associated with postoperative 90-day mortality in the hypertensive adult population that underwent elective noncardiac surgery. Methods In this retrospective cohort study, medical records of preoperative hypertensive patients who underwent noncardiac surgery at a single tertiary academic hospital from 2012 to 2018 were reviewed. Among the hypertensive patients, those prescribed to take antihypertensive medication continuously for more than 1 month before admission were defined as the HTN MED group; others were defined as the non-HTN MED group. Multiple imputation, propensity score (PS) matching, and logistic regression analysis were used for statistical analysis. Results Overall, 35,589 preoperative hypertensive adult patients (HTN MED group: 26,154 patients, non-HTN MED group: 9,435 patients) were included in the analysis. After PS matching, each group comprised 6,205 patients; thus, 12,410 patients were included in the final analysis. The odds for 90-day mortality of the HTN MED group in the PS-matched cohort were 41% lower (odds ratio: 0.59, 95% confidence interval: 0.41–0.85; P = 0.005) than those of the non-HTN MED group. Comparable results were obtained in the multivariable logistic regression analysis of the entire cohort (odds ratio: 0.54, 95% confidence interval: 0.41–0.72; P &lt; 0.001). Conclusions This study showed that the use of preoperative antihypertensive medication was associated with lower 90-day mortality among hypertensive patients who underwent noncardiac surgery. Therefore, preoperative screening and treatment with appropriate antihypertensive medication are important for hypertensive patients.

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