scholarly journals Informal care and the impact on depression and anxiety among Swedish adults: a population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marlene Stratmann ◽  
Yvonne Forsell ◽  
Jette Möller ◽  
Yajun Liang
Keyword(s):  
Cohort Study ◽  
Informal Care ◽  
Cox Regression ◽  
Informal Caregiving ◽  
Population Based ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Short And Long Term ◽  
The Impact

Abstract Background As the population is ageing, the need for informal caregivers increases, and thus we need to know more about the effects on caregivers. This study aims to determine both cross-sectional and longitudinal associations between perceived limitation of informal caregiving and mental health of caregivers. Methods This population-based cohort study was based on the Swedish Psykisk hälsa, Arbete och RelaTioner (PART) study, and 9346 individuals aged 18–65 were included. Data were collected through questionnaires, interviews and Swedish registers. Informal care was defined as care given to a family member. Self-reported and diagnosed depression and anxiety were included as outcomes. Covariates included sex, age, social support and socio-economic position. Ordinal logistic regression and Cox regression were performed to determine the associations between caregiving and anxiety or depression. Results Self-reported depression and anxiety was only increased among those experiencing limitations (adjusted odds ratios [aOR] 2.00, 95% confidence intervals [CI] 1.63–2.47 for depression; aOR 2.07, 95% CI 1.57–2.74 for anxiety) compared to those not giving care, respectively. The adjusted hazard ratio (aHR) were increased for diagnosed depression (aHR 1.97, 95% CI 1.27–3.05) and for diagnosed anxiety (aHR 1.86, 95% CI 1.06–3.25) among those giving care and experiencing limitations, compared to those not giving care. No significant associations were found in caregivers without limitations. Conclusion Caregivers experiencing limitations showed a significant association with short- and long-term anxiety and depression. This study implies the importance of exploring the degree to which informal caregiving can be provided without adding burden to caregivers.

scholarly journals 1402. Long-Term Mortality and Epilepsy in Patients After Brain Abscess: A Nationwide Population-based Matched Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S510-S510
Author(s):  
Jacob Bodilsen ◽  
Michael Dalager-Pedersen ◽  
Diederik van de Beek ◽  
Matthijs C Brouwer ◽  
Henrik Nielsen
Keyword(s):  
Cohort Study ◽  
Brain Abscess ◽  
Cox Regression ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Population Controls ◽  
New Onset

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.

scholarly journals Maternal Hepatitis B Virus or Hepatitis C Virus Carrier Status and Long-Term Endocrine Morbidity of the Offspring—A Population-Based Cohort Study

2020 ◽  
Vol 9 (3) ◽  
pp. 796 ◽  
Author(s):  
Naim Abu Freha ◽  
Tamar Wainstock ◽  
Tzvi Najman Menachem ◽  
Eyal Sheiner
Keyword(s):  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Cox Regression ◽  
Population Based ◽  
Carrier Status ◽  
B Virus

This study aimed to investigate the long-term effect of maternal hepatitis B virus (HBV) or hepatitis C virus (HCV) carrier status on offspring endocrine morbidity. A population-based cohort study included all singleton deliveries between the years 1991–2014 at the Soroka University Medical Center, Beer-Sheva, Southern Israel. The mothers were subdivided into three groups, HBV carriers, HCV carriers and non-carriers. Data regarding the long-term endocrine morbidity of their offspring were compared between the groups. The study included 242,905 (99.7%) non-carrying mothers, 591 (0.2%) mothers who were carriers for HBV and 186 (0.1%) mothers who were carriers for HCV. The Kaplan–Meier’s survival curve demonstrated a significantly higher cumulative endocrine morbidity in children born to mothers with HCV (log-rank test, p = 0.002). Specifically, higher rates of hypoglycemia were noted among the offspring born to mothers who were carriers of HCV (1.1%; p = 0.001) compared with the offspring of mothers who were either carriers of HBV (0.2%) or non-carriers (0.1%). A Cox regression model controlled for maternal age, gestational age, maternal diabetes, hypertensive disorders of pregnancy, found maternal HCV carrier status to be independently associated with pediatric endocrine morbidity in the offspring (adjusted hazard ratio = 5.05, 95% CI: 1.625–15.695, p = 0.005). Maternal HCV carrier status is an independent risk factor for long-term endocrine morbidity.

scholarly journals Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Hongyun Shan ◽  
Fei Li ◽  
Jun Zhang ◽  
Hui Wang ◽  
Jiong Li
Keyword(s):  
Cohort Study ◽  
Eating Disorder ◽  
Behavioral Disorders ◽  
Neurodevelopmental Disorders ◽  
Cox Regression ◽  
Population Based ◽  
Autism Spectrum ◽  
Emotional Behavioral Disorders ◽  
Hyperactivity Disorder

Background: There are limited data concerning the long-term mental health of children with feeding and eating disorder (FED). We aimed to investigate whether children with FED are at greater risks of developing emotional/behavioral disorders with onset usually during childhood, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID).Methods: We conducted a population-based cohort study, including all singleton births in Denmark from January 1, 1995, to December 31, 2015. For each child diagnosed with FED, 10 age- and sex-matched controls who did not meet the criteria for FED were randomly selected from the general population. Associations were estimated with Cox regression modes adjusting for other perinatal and maternal factors, and sibling analyses were performed for controlling potential confounding by shared familial (genetic or environmental) factors.Results: Of the 1,256,989 individuals in the cohort, there were 1967 (53.4% girls) children diagnosed with FED. Children with FED had higher risks for clinically diagnosed emotional/behavioral disorders with onset usually in childhood (hazard ratio [HR], 2.78; 95% CI, 2.34–3.31), ADHD (HR, 1.74; 95% CI, 1.33–2.26), ASD (HR, 3.05; 95% CI, 2.36–3.94), and ID (HR, 6.38; 95% CI, 4.48–9.11), compared with matched controls. Girls with FED are at greater risks for emotional/behavioral disorders and ID, but not ADHD and ASD. Alike, in sibling analysis, increased rates are also observed for other neurodevelopmental disorders, but not for ADHD.Conclusion: Children with FED are associated with substantially increased risks of emotional/behavioral disorders, ADHD, ASD, and ID. This study highlights the importance of carefully monitoring neurodevelopmental disorders in children with FED.

Optimal delivery timing for dizygotic twins – the short- and long-term perspective

2020 ◽  
pp. 1-6
Author(s):  
Majdi Imterat ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Ruslan Sergienko ◽  
Daniella Landau ◽  
...  
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Medical Center ◽  
Clinical Importance ◽  
Dizygotic Twin ◽  
Long Term Outcomes ◽  
Dizygotic Twins ◽  
Short And Long Term ◽  
The Impact

Abstract Major obstetrics and gynecology societies offer inconsistent recommendation regarding optimal delivery timing in uncomplicated dizygotic twins. We sought to investigate the impact of delivery timing within term gestation, in dizygotic twins, on the short- and long-term offspring morbidity. A prospectively analyzed cohort of dizygotic twin deliveries was conducted. All women delivered at a regional tertiary medical center, at term (≥37 0/7), between the years 1991 and 2014, were included. The primary exposure was delivery at 37 0/7–37 + 6/7 weeks, while delivery at ≥38 0/7 weeks’ gestation was considered the reference. Neonatal short- and long-term outcomes according to hospitalizations of offspring up to 18 years of age due to cardiac, respiratory, hematological, neurological, and infectious morbidity were compared. Kaplan–Meier survival curves were used to compare cumulative incidences per each major-system hospitalization. Cox regression models were used to estimate the adjusted hazard ratios, while adjusting for variables with clinical importance. During the study period, 612 dizygotic twin deliveries met the inclusion criteria. Of them, 200 (31.3%) occurred at 37–37 6/7 weeks, and 412 (68.7%) occurred at ≥38 0/7 weeks’ gestation. In the long-term analysis, rates of hospitalizations involving several major morbidity categories exhibited comparable rates in both groups. The Cox regression models did not demonstrate an independent association between gestational age within term and later major pediatric morbidity in offspring (total long-term morbidity: adjusted hazard ratio 1.33, 95% confidence interval 0.77–2.29). Dizygotic twin deliveries occurring at different gestational ages within term do not appear to significantly impact on major short- and long-term outcomes.

scholarly journals Short- and Long-Term Major Cardiovascular Adverse Events in Carotid Artery Interventions: A Nationwide Population-Based Cohort Study in Taiwan

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0121016 ◽  
Author(s):  
Ming-Lung Tsai ◽  
Chun-Tai Mao ◽  
Dong-Yi Chen ◽  
I-Chang Hsieh ◽  
Ming-Shien Wen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Carotid Artery ◽  
Adverse Events ◽  
Population Based ◽  
Short And Long Term

scholarly journals Impact of chemotherapy delay on short- and long-term survival in younger and older AML patients: a Danish population-based cohort study

Leukemia ◽  
2014 ◽  
Vol 28 (9) ◽  
pp. 1926-1929 ◽  
Author(s):  
L S G Østgard ◽  
J M Nørgaard ◽  
H Sengeløv ◽  
M S Holm ◽  
M K Jensen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Danish Population ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

scholarly journals Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

2021 ◽  
Vol 14 (10) ◽  
pp. 1553-1559
Author(s):  
Susanne Hopf ◽  
◽  
Irene Schmidtmann ◽  
Norbert Pfeiffer ◽  
Esther Maria Hoffmann ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Optic Disc ◽  
Cox Regression ◽  
Group Analysis ◽  
Normal Tension Glaucoma ◽  
Short And Long Term ◽  
The Impact

AIM: To investigate short- and long-term intraocular pressure (IOP) fluctuations and further ocular and demographic parameters as predictors for normal tension glaucoma (NTG) progression. METHODS: This retrospective, longitudinal cohort study included 137 eyes of 75 patients with NTG, defined by glaucomatous optic disc or visual field defect with normal IOP (<21 mm Hg), independently from therapy regimen. IOP fluctuation, mean, and maximum were inspected with a mean follow-up of 38mo [standard deviation (SD) 18mo]. Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry, Heidelberg retina tomograph (HRT) imaging, and optic disc photographs. The impact of IOP parameters, myopia, sex, cup-to-disc-ratio, and visual field results on progression of NTG were analyzed using Cox regression models. A sub-group analysis with results from optical coherence tomography (OCT) was performed. RESULTS: IOP fluctuations, average, and maximum were not risk factors for progression in NTG patients, although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression (P=0.054). The 46/137 (33.5%) eyes progressed over the follow-up period. Overall progression (at least three progression confirmations) occurred in 28/137 eyes (20.4%). Most progressions were detected by perimetry (36/46). Long-term IOP mean over all pressure profiles was 12.8 mm Hg (SD 1.3 mm Hg); IOP fluctuation was 1.4 mm Hg (SD 0.8 mm Hg). The progression-free five-year rate was 58.2% (SD 6.5%). CONCLUSION: Short- and long-term IOP fluctuations do not result in progression of NTG. As functional changes are most likely to happen, NTG should be monitored with visual field testing more often than with other devices.

Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study

2003 ◽  
Vol 14 (5) ◽  
pp. 296-304 ◽  
Author(s):  
Doris H�gglund ◽  
Marie-Louise Walker-Engstr�m ◽  
Gregor Larsson ◽  
Jerzy Leppert
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Population Based ◽  
Cross Sectional ◽  
Professional Help

Impact Of Comorbidity and Performance Status On Treatment Intent and Outcome In AML Patients. A Danish Population-Based Cohort Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3879-3879 ◽  
Author(s):  
Lene S.G. Østgård ◽  
Mette Nørgaard ◽  
Henrik Sengeløv ◽  
Jan M. Nørgaard
Keyword(s):  
Cohort Study ◽  
Complete Remission ◽  
Performance Status ◽  
Population Based ◽  
Comorbid Disease ◽  
Curative Intent ◽  
Short And Long Term ◽  
And Performance ◽  
Long Term Mortality

Abstract Background With an aging population, the burden of comorbidity in AML patients is expected to increase. Evidence on how to integrate comorbidity and functional status into clinical decision making is sparse and prior studies have been predictive and limited by single center study design, and small sample sizes. Objectives To examine the impact of comorbidity and WHO Performance Status (PS) on intent of treatment in Danish AML patients. Secondary, to determine the prognostic impact of comorbidity and PS on achievement of complete remission, short- and long-term mortality in AML patients treated with curative intent. Methods In a nationwide cohort study, we identified all AML (non-promyelocytic leukemia) patients diagnosed in Denmark from 2000-2013 using a population-based leukemia registry (n=2785) which prospectively collects clinical data. We excluded patients with unknown intent of treatment (n=25). We identified comorbid conditions through the Danish National Registry of Patients. Comorbidity was evaluated according to presence of 17 of the 19 chronic diseases (HIV and leukemia excluded) in the Charlson Comorbidity Index with separate adjustment for all diseases associated with secondary AML (modified CCI (mCCI)). Crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) for receiving treatment with curative intent were estimated. We used Cox proportional hazards regression to assess the influence of comorbidity and performance status on 90-day and 90-day to 3-year mortality in patients treated with curative intent (n=1444) by estimating crude and adjusted mortality ratios (MRs) and corresponding 95% CIs. We adjusted for age, gender, leukocyte count, prior chemo-/radiotherapy, and prior hematological diseases. Results Of 2760 patients 52% were treated with curative intent. Median age was 69 years (palliative intent: 78 vs. curative intent: 58). Overall, 60% of patients did not have any comorbidity, 26% had 1 comorbid disease, and 13% had 2 or more comorbidities. In patients treated with curative intent, the corresponding prevalences were 76%, 19%, and 6%. Overall, 26% of patients had PS=0, 42% had PS=1, and 32% had PS ≥2. The corresponding figures in patients treated with curative intent were 33%, 47%, and 20%. Dementia and heart failure were the two individual comorbid diseases most strongly associated with opting-out of intensive treatment (prevalence ratio 0.11 (95%CI 0.01-0.67) and 0.24 (95%CI 0.15-0.37). In patients treated with curative intent, those with comorbidity had lower complete remission rate than those without comorbidity, 66% (95%CI 60.7-70.7) vs. 74% (95%CI 70.8-76.9) whereas choice of chemotherapy regimen and dose did not differ. Compared to patients without comorbidity (mCCI=0), the adjusted ORs for treatment with curative intent were 0.57 (95%CI 0.41-0.73) for patients with 1 comorbid disease and 0.32 (95%CI 0.22-0.47) for 2 or more. Compared to patients with PS=0, the adjusted ORs of treatment with curative intent were 0.80 (95%CI 0.58-1.09) for PS 1, 0.45 (95%CI 0.31-0.65) for PS 2, and 0.09 (95%CI 0.05-0.14) for PS≥3. Crude survival curves according to comorbidity and PS are shown below. Crude and adjusted MRs are listed in table 1. Conclusions The chance of being allocated to intensive chemotherapy decreased dramatically with increasing number of comorbid diseases and increasing PS. Surprisingly, among patients treated with curative intent presence of comorbidity was not associated with an increase in short-term mortality, and if any, only a slight increase in long-term mortality. High PS was strongly associated with both short- and long-term mortality. Our findings may be explained by the selection process before treatment with curative intent and raises the question whether more patients with comorbidity and low PS at time of diagnosis may benefit from intensive treatment. Disclosures: No relevant conflicts of interest to declare.

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