Higher mortality risk among injured individuals in a population-based matched cohort study

ObjectiveTo investigate suicide and mortality risk in deployed military veterans versus non-deployed comparators who had gone through military conscription testing.DesignPopulation-based matched cohort study.SettingSweden.ParticipantsParticipants were identified from the Military Service Conscription Register and deployment status from the Swedish Military Information Personnel Register. Of 1.9 million conscripts, 21 721 had deployed at some time between 1990 and 2013 (deployed military veterans). Non-deployed comparators were matched to deployed military veterans in two ways: (1) by cognitive ability, psychological assessment, mental health, body mass index, sex, birth-year and conscription-year (carefully matched), with further adjustment for exercise capacity and suicide attempt history; and (2) by sex, birth-year and conscription-year (age- and sex-matched).Main outcomeSuicide retrieved from the Swedish National Patient and Causes of Death Register until 31 December 2013.ResultsDuring a median follow-up of 12 years, 39 and 211 deaths by suicide occurred in deployed military veterans (n=21 627) and carefully matched non-deployed comparators (n=107 284), respectively (15 vs 16/100 000 person-years; adjusted HR (aHR) 1.07; 95% CI 0.75 to 1.52; p=0.72) and 329 in age- and sex-matched non-deployed comparators (n=108 140; 25/100 000 person-years; aHR 0.59; 95% CI 0.42 to 0.82; p=0.002). There were 284 and 1444 deaths by suicide or attempted suicides in deployed military veterans and carefully matched non-deployed comparators, respectively (109 vs 112; aHR 0.99; 95% CI 0.88 to 1.13; p=0.93) and 2061 in age- and sex-matched non-deployed comparators (158; aHR 0.69; 95% CI 0.61 to 0.79; p<0.001). The corresponding figures for all-cause mortality for carefully matched non-deployed comparators were 159 and 820 (61 vs 63/100 000 person-years; aHR 0.97; 95% CI 0.82 to 1.15; p=0.71) and 1289 for age- and sex-matched non-deployed comparators (98/100 000 person-years; aHR 0.62; 95% CI 0.52 to 0.73; p<0.001).ConclusionDeployed military veterans had similar suicide and mortality risk as non-deployed comparators after accounting for psychological, psychiatric and physical factors. Studies of mental health in deployed veterans need to adjust for more factors than age and sex for comparisons to be meaningful.

Download Full-text

Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study

Archives of Osteoporosis ◽

10.1007/s11657-017-0359-7 ◽

2017 ◽

Vol 12 (1) ◽

Cited By ~ 8

Author(s):

Reidar P. Lystad ◽

Cate M. Cameron ◽

Rebecca J. Mitchell

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Mortality Risk ◽

Population Based ◽

Matched Cohort ◽

Matched Cohort Study

Download Full-text

Association of Alcohol Use Disorder on Alcohol‐related Cancers, Diabetes, Ischemic Heart Disease, and Death: A Population‐based, Matched Cohort Study

Addiction ◽

10.1111/add.15646 ◽

2021 ◽

Author(s):

Christine Leong ◽

James M. Bolton ◽

Okechukwu Ekuma ◽

Heather J. Prior ◽

Deepa Singal ◽

...

Keyword(s):

Cohort Study ◽

Heart Disease ◽

Alcohol Use ◽

Ischemic Heart Disease ◽

Alcohol Use Disorder ◽

Population Based ◽

Ischemic Heart ◽

Matched Cohort ◽

Matched Cohort Study

Download Full-text

PO-19 Initiation of low-dose aspirin and risk of colorectal neoplasms: a population-based matched cohort study in Denmark

Thrombosis Research ◽

10.1016/s0049-3848(21)00192-4 ◽

2021 ◽

Vol 200 ◽

pp. S26

Author(s):

E. Schønfeldt Troelsen ◽

D. Körmendiné Farkas ◽

R. Erichsen ◽

T. Sørensen

Keyword(s):

Cohort Study ◽

Colorectal Neoplasms ◽

Low Dose ◽

Population Based ◽

Matched Cohort ◽

Matched Cohort Study ◽

Dose Aspirin ◽

Low Dose Aspirin

Download Full-text

Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03960-z ◽

2021 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Jacques P. Brown ◽

Jonathan D. Adachi ◽

Emil Schemitsch ◽

Jean-Eric Tarride ◽

Vivien Brown ◽

...

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Fragility Fracture ◽

Mortality Risk ◽

Real World ◽

First Year ◽

Matched Cohort ◽

Matched Cohort Study ◽

Fracture Cohort ◽

One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

Download Full-text