Vertebral fracture as a risk factor for self-harm: a retrospective cohort study

Abstract Background The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures. Methods Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95 % confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex. Results The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1 %), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95 %CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). Conclusions Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

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Vertebral fracture as a risk factor for self-harm: A retrospective cohort study

10.21203/rs.3.rs-820188/v1 ◽

2021 ◽

Author(s):

James A Prior ◽

Fay Crawford-Manning ◽

Rebecca Whittle ◽

Alyshah Abdul-Sultan ◽

Carolyn A. Chew-Graham ◽

...

Keyword(s):

Primary Care ◽

Risk Factor ◽

Cohort Study ◽

Vertebral Fracture ◽

Vertebral Fractures ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression Analysis ◽

Increased Risk ◽

Self Harm

Abstract Background The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures Methods Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex. Results The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). Conclusions Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

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Vertebral fracture as risk factors for self-harm: A retrospective cohort study

10.21203/rs.3.rs-106349/v1 ◽

2020 ◽

Author(s):

James Prior ◽

Fay Crawford-Manning ◽

Rebecca Whittle ◽

Alyshah Abdul-Sultan ◽

Carolyn Chew-Graham ◽

...

Keyword(s):

Cohort Study ◽

Vertebral Fracture ◽

Vertebral Fractures ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Age And Gender ◽

Cox Regression Analysis ◽

Increased Risk ◽

Self Harm ◽

And Gender

Abstract BackgroundThe prevention of self-harm is an international public health priority, It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures Methods Retrospective cohort study using data from the Clinical Practice Research Datalink. Patients with vertebral fracture were identified and matched to patients without fracture by age and gender. Incident self-harm was defined by medical record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by age and gender. ResultsThe number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), mean age was 74 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6).Greatest risk of self-harm was found in those with vertebral fractures who were younger (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). ConclusionsPrimary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Younger, male patients appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

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Trends in self-poisoning and psychotropic drug use in people aged 5–19 years: a population-based retrospective cohort study in Australia

BMJ Open ◽

10.1136/bmjopen-2018-026001 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026001 ◽

Cited By ~ 7

Author(s):

Rose Cairns ◽

Emily A Karanges ◽

Anselm Wong ◽

Jared A Brown ◽

Jeff Robinson ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Selective Serotonin Reuptake Inhibitors ◽

Age Groups ◽

Cohort Effect ◽

Population Based ◽

Psychotropic Medicine ◽

Increased Risk ◽

Self Harm

ObjectivesTo characterise trends in self-poisoning and psychotropic medicine use in young Australians.DesignPopulation-based retrospective cohort study.SettingCalls taken by the New South Wales and Victorian Poisons Information Centres (2006–2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).ParticipantsPeople aged 5–19 years.Main outcome measuresYearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).ResultsThere were 33 501 intentional poisonings in people aged 5–19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006–2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5–14 and 15–19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5–14 and 15–19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.ConclusionsOur results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

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COPD as a Risk Factor in Primary Care: A Canadian Retrospective Cohort Study

10.1183/13993003.congress-2019.pa5013 ◽

2019 ◽

Author(s):

Cliff Lindeman ◽

Anh Pham ◽

Tyler Williamson ◽

Neil Drummond ◽

Andrew Cave

Keyword(s):

Primary Care ◽

Risk Factor ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Parvovirus Enteritis and Other Risk Factors Associated With Persistent Gastrointestinal Signs in Dogs Later in Life: a Retrospective Cohort Study

10.21203/rs.3.rs-711893/v1 ◽

2021 ◽

Author(s):

Kanae Takada ◽

Anne M. Flemming ◽

Maarten J. Voordouw ◽

Anthony P. Carr

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Significant Risk ◽

Significant Risk Factor ◽

Health Problems ◽

Organ Systems ◽

Increased Risk

Abstract Background: Parvoviral enteritis is a viral gastrointestinal (GI) infection of dogs. Recovery from PE has been associated with persistent GI signs. The objectives of this study were: (i) To determine whether dogs that have recovered from PE (post-parvo dogs) had an increased risk of persistent GI signs compared to uninfected controls. (ii) To investigate the lifestyle and clinicopathologic factors that are associated with persistent GI signs in post-parvo dogs. Methods: Eighty-six post-parvo dogs and 52 age-matched control dogs were enrolled in this retrospective cohort study. The owners were interviewed about the health and habits of their dogs using a questionnaire. We used logistic regression to test whether parvovirus enteritis and other risk factors are associated with general health problems in all dogs and with persistent GI signs in post-parvo dogs.Results: The prevalence of persistent GI signs was significantly higher in post-parvo dogs compared to control dogs (57% vs 25%, P < 0.001). Markers of disease severity such as neutropenia, low body temperature, and treatment with an antiemetic medication (metoclopramide) were significant risk factors for persistent GI signs in post-parvo dogs. Persistent GI signs in post-parvo dogs was a risk factor for health problems in other organ systems.Conclusions: Parvovirus enteritis is a significant risk factor for persistent GI signs in dogs highlighting the importance of prevention. The risk factors identified in the present study may guide future investigations on the mechanisms that link parvovirus enteritis to chronic health problems in dogs.

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P–524 Is polycystic ovary syndrome really a risk factor for embryonic chromosomal aberrations? A multicenter retrospective cohort study

Human Reproduction ◽

10.1093/humrep/deab130.523 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

L Luo ◽

L Zhang ◽

Q Wang

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Chromosomal Aberrations ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Maternal Age ◽

Pregnancy Loss ◽

Chromosomal Abnormalities ◽

Blastocyst Formation ◽

Increased Risk

Abstract Study question Does the rate of embryonic chromosomal aberrations increase in the setting of PCOS independent of maternal age and BMI? Summary answer Controlling for maternal age and BMI, embryonic chromosomal aberration rate was not significantly different with controlled women undergoing preimplantation genetic testing for monogenic defects (PGT-M). What is known already It has been reported that women with PCOS have higher risk of early spontaneous pregnancy loss, and it is well known that embryonic chromosomal abnormalities play an important role as a direct factor. However, whether PCOS women have increased risk of embryonic chromosomal aberrations remains inconclusive. Study design, size, duration A multicenter retrospective cohort study was undertaken examining the incidence of chromosomal abnormalities in blastocysts using next-generation sequencing (NGS) for women undergoing PGT-M with and without PCOS (1398 PGT cycles, 5577 blastocysts) from 3 university-affiliated IVF centers between 2015 and 2019. Participants/materials, setting, methods: The blastocyst formation rate and the incidence of chromosomal abnormalities were compared between 163 PCOS women and 1235 non-PCOS women. Main results and the role of chance: Stratification analysis by maternal age with matched BMI showed no differences with regard to blastocyst formation rates for women with and without PCOS aged 20–29y (55.0% vs. 58.5%), 30–34y (54.7% vs. 58.9%) and >35y (56.7% vs. 52.4%), P > 0.05. The total embryonic chromosomal aberration rates for women aged 20–29y, 30–34y and >35y with and without PCOS were were also comparable, which were respectively 121/331 (36.4%) vs. 496/1209 (41.0%); 89/251 (35.5%) vs. 903/2175 (41.5%) and 72/130 (55.4%) vs. 789/1481 (53.3%), P > 0.05. Multivariate regression showed that controlling for maternal age and BMI, PCOS were not an independent risk factor for embryonic chromosomal abnormalities (OR = 0.89, 95% CI = 0.62 ∼ 1.35, P = 0.73). Limitations, reasons for caution The study is mainly limited by its retrospective design and relatively smaller sample size for PCOS group which carries inherent potential for bias (i.e. misclassifification and errors due to inadequate clinical notes). Wider implications of the findings: Our results indicated that chromosomal abnormalities might not be the most important causal factor for the increased risk of early pregnancy loss for women with PCOS. By contrary, the non-chromosomal embryonic aberrations and/or maternal intrauterine factors could play more important role and needs to be clarifified Trial registration number not applicable’

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Sex Differences in Mortality after Myocardial Infarction: A Retrospective Cohort Study

10.21203/rs.3.rs-349531/v1 ◽

2021 ◽

Author(s):

Neda Shafiabadi Hassani ◽

Reza Pirdehghan ◽

Mohammadhossein Mozafarybazargany ◽

Roya Sepahvandi ◽

Zeynab Khodaprast ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Sex Differences ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Increased Risk

Abstract BACKGROUND: We aimed to examine sex differences in mortality after myocardial infarction. METHODS: This retrospective cohort study included all first admitted patients 50 years or older with acute myocardial infarction hospitalized in Rajaei hospital of Karaj city, Iran, between 23th March 2013 and 1th January 2020. Data was retrieved from the hospital information system (HIS) database, including patient’s demographic and socioeconomic characteristics, medical history, acute myocardial infarction (AMI) type, treatment and procedures, and outcome of hospitalization. Simple and multivariate cox regression models were used to assess the association of gender with in-hospital mortality after AMI. Results were presented as crude and adjusted hazard ratios along with their 95% confidence interval (HR (95% CI).RESULTS: Results from the multivariable Cox regression analysis revealed that females had a higher risk of death than males after ST segment Elevation MI (STEMI) (adjusted HR (95% CI): 1.64 (1.15 – 2.36), P=0.007). However, in subgroup analysis by age groups, this significant increased risk was observed only in female patients aged 50 to 64 years than their male counterparts. There was no significant differences between males and females after non-STEMI and unspecified MI.CONCLUSIONS: Based on our findings, women aged 50 to 64 years may be more likely to die during hospitalization after STEMI than men.

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