Incidence, predictors and patterns of care of patients with very severe hypertriglyceridemia in Ontario, Canada: a population-based cohort study

Abstract Background The incidence of severe (S-HTG) and very severe hypertriglyceridemia (VS-HTG) among Canadians is unknown. This study aimed to determine the incidence, characteristics, predictors and care patterns for individuals with VS-HTG. Methods Using linked administrative healthcare databases, a population-based cohort study of Ontario adults was conducted to determine incidence of new onset S-HTG (serum triglycerides (TG) > 10–20 mmol/L) and VS-HTG (TG > 20 mmol/L) between 2010 and 2015. Socio-demographic and clinical characteristics of those with VS-HTG were compared to those who had no measured TG value > 3 mmol/L. Univariable and multivariable logistic regression were used to determine predictors for VS-HTG. Healthcare patterns were evaluated for 2 years following first incidence of TG > 20 mmol/L. Results Incidence of S-HTG and VS-HTG in Ontario was 0.16 and 0.027% among 10,766,770 adults ≥18 years and 0.25 and 0.041% among 7,040,865 adults with at least one measured TG, respectively. Predictors of VS-HTG included younger age [odds ratios (OR) 0.64/decade, 95% confidence intervals (CI) 0.62–0.66], male sex (OR 3.83; 95% CI 3.5–4.1), diabetes (OR 5.38; 95% CI 4.93–5.88), hypertension (OR 1.69; 95% CI 1.54–1.86), chronic liver disease (OR 1.71; 95% CI 1.48–1.97), alcohol abuse (OR 2.47; 95% CI 1.90–3.19), obesity (OR 1.49; 95% CI 1.13–1.98), and chronic kidney disease (OR 1.39; 95% CI 1.19–1.63). Conclusion The 5-year incidence of S-HTG and VS-HTG in Canadian adults was 1 in 400 and 1 in 2500, respectively. Males, those with diabetes, obese individuals and those with alcohol abuse are at highest risk for VS-HTG and may benefit from increased surveillance.

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Gender- and age-related differences of statin use on incident dementia in patients with rheumatoid arthritis: a Nationwide population-based cohort study

Lipids in Health and Disease ◽

10.1186/s12944-021-01465-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Tsung-Kun Lin ◽

Jing-Yang Huang ◽

Lung-Fa Pan ◽

Gwo-Ping Jong

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Subgroup Analysis ◽

Cox Regression ◽

Population Based ◽

Age Related ◽

Hazard Ratios ◽

Incident Dementia ◽

Gender And Age ◽

New Onset

Abstract Background Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA. Methods We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003–2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted. Results Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97–1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients. Conclusion No association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40–60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.

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Gender- and Age-related Differences of Statin Use on Incident Dementia in Patients with Rheumatoid Arthritis: A Nationwide Population-based Cohort Study

10.21203/rs.3.rs-249981/v1 ◽

2021 ◽

Author(s):

Tsung-Kun Lin ◽

Jing-Yang Huang ◽

Lung-Fa Pan ◽

Gwo-Ping Jong

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Subgroup Analysis ◽

Older Patients ◽

Cox Regression ◽

Population Based ◽

Age Related ◽

Hazard Ratios ◽

Gender And Age ◽

New Onset

Abstract Background: Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA.Methods: We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003–2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted.Results: Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95%CI: 0.97–1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients.Conclusion: There is no association between the use of statin and the risk of NOD in patients with RA, but these parameters are influenced by gender and age. The decreased risk of NOD in patients with RA was greater among male and older patients. The use of statin in older male patients with RA for the prevention of dementia may be needed in clinical practice.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1266 ◽

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.

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Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study

Gut ◽

10.1136/gutjnl-2018-317610 ◽

2019 ◽

Vol 68 (9) ◽

pp. 1597-1605 ◽

Cited By ~ 5

Author(s):

Simone N Vigod ◽

Paul Kurdyak ◽

Hilary K Brown ◽

Geoffrey C Nguyen ◽

Laura E Targownik ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Mental Illness ◽

Cohort Study ◽

Bowel Disease ◽

Post Partum ◽

Population Based ◽

Incidence Rates ◽

Increased Risk ◽

Inflammatory Bowel ◽

New Onset

ObjectivePatients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post partum.DesignThis cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002–2014). The incidence of new-onset mental illness from conception to 1-year post partum was compared between 3721 women with and 798 908 without IBD, generating adjusted HRs (aHR). Logistic regression was used to identify correlates of new-onset mental illness in the IBD group.ResultsAbout 22.7% of women with IBD had new-onset mental illness versus 20.4% without, corresponding to incidence rates of 150.2 and 132.8 per 1000 patient-years (aHR 1.12, 95% CI 1.05 to 1.20), or one extra case of new-onset mental illness per 43 pregnant women with IBD. The risk was elevated in the post partum (aHR 1.20, 95% CI 1.09 to 1.31), but not during pregnancy, and for Crohn’s disease (aHR 1.12, 95% CI 1.02 to 1.23), but not ulcerative colitis. The risk was specifically elevated for a new-onset mood or anxiety disorder (aHR 1.14, 95% CI 1.04 to 1.26) and alcohol or substance use disorders (aHR 2.73, 95% CI 1.42 to 5.26). Predictors of a mental illness diagnosis were maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care and infant mortality.ConclusionWomen with IBD were at an increased risk of new-onset psychiatric diagnosis in the postpartum period, but not during pregnancy. Providers should look to increase opportunities for prevention, early identification and treatment accordingly.

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Examining the risk of depression or self-harm associated with incretin-based therapies used to manage hyperglycaemia in patients with type 2 diabetes: a cohort study using the UK Clinical Practice Research Datalink

BMJ Open ◽

10.1136/bmjopen-2018-023830 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023830 ◽

Cited By ~ 3

Author(s):

John-Michael Gamble ◽

Eugene Chibrikov ◽

William K Midodzi ◽

Laurie K Twells ◽

Sumit R Majumdar

Keyword(s):

Cohort Study ◽

Clinical Practice ◽

Population Based ◽

Practice Research ◽

Primary Study ◽

Clinical Practice Research Datalink ◽

Glucose Lowering ◽

Self Harm ◽

The Uk ◽

New Onset

ObjectivesTo compare population-based incidence rates of new-onset depression or self-harm in patients initiating incretin-based therapies with that of sulfonylureas (SU) and other glucose-lowering agents.DesignPopulation-based cohort study.SettingPatients attending primary care practices registered with the UK-based Clinical Practice Research Datalink (CPRD).ParticipantsUsing the UK-based CPRD, we identified two incretin-based therapies cohorts: (1) dipeptidyl peptidase-4 inhibitor (DPP-4i)-cohort, consisting of new users of DPP-4i and SU and (2) glucagon-like peptide-1 receptor agonists (GLP-1RA)-cohort, consisting of new users of GLP-1RA and SU, between January 2007 and January 2016. Patients with a prior history of depression, self-harm and other serious psychiatric conditions were excluded.Main outcome measuresThe primary study outcome comprised a composite of new-onset depression or self-harm. Unadjusted and adjusted Cox proportional hazards regression was used to quantify the association between incretin-based therapies and depression or self-harm. Deciles of High-Dimensional Propensity Scores and concurrent number of glucose-lowering agents were used to adjust for potential confounding.ResultsWe identified new users of 6206 DPP-4i and 22 128 SU in the DPP-4i-cohort, and 501 GLP-1RA and 16 409 SU new users in the GLP-1RA-cohort. The incidence of depression or self-harm was 8.2 vs 11.7 events/1000 person-years in the DPP-4i-cohort and 18.2 vs 13.6 events/1000 person-years in the GLP-1RA-cohort for incretin-based therapies versus SU, respectively. Incretin-based therapies were not associated with an increased or decreased incidence of depression or self-harm compared with SU (DPP-4i-cohort: unadjusted HR 0.70, 95% CI 0.51 to 0.96; adjusted HR 0.80, 95% CI 0.57 to 1.13; GLP-1RA-cohort: unadjusted HR 1.36, 95% CI 0.72 to 2.58; adjusted HR 1.25, 95% CI 0.63 to 2.50). Consistent results were observed for other glucose-lowering comparators including insulin and thiazolidinediones.ConclusionsOur findings suggest that the two incretin-based therapies are not associated with an increased or decreased risk of depression or self-harm.

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Clinical characteristics, management and survival in young adults diagnosed with malignant melanoma: A population-based cohort study

Acta Oncologica ◽

10.3109/0284186x.2013.854928 ◽

2013 ◽

Vol 53 (5) ◽

pp. 688-696 ◽

Cited By ~ 7

Author(s):

Anna Plym ◽

Gustav J. Ullenhag ◽

Mats Breivald ◽

Mats Lambe ◽

Anders Berglund

Keyword(s):

Young Adults ◽

Cohort Study ◽

Malignant Melanoma ◽

Clinical Characteristics ◽

Population Based

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DOP025 High rate of IBD in younger age groups among 1 degree relatives to IBD affected cases, a population-based cohort study 1977–2011

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(14)60050-7 ◽

2014 ◽

Vol 8 ◽

pp. S26-S27

Author(s):

F. Trier Moller ◽

V. Andersen ◽

T. Jess

Keyword(s):

Cohort Study ◽

Age Groups ◽

Population Based ◽

High Rate ◽

Younger Age

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Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache

10.21203/rs.3.rs-41140/v1 ◽

2020 ◽

Author(s):

Yugang Wang ◽

Qi Fang

Keyword(s):

Risk Factors ◽

Clinical Characteristics ◽

Sinus Thrombosis ◽

Chloride Ion ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Younger Age ◽

Headache Patients ◽

New Onset

Abstract Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.

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Pharmacological Treatment After Acute Coronary Syndrome: Baseline Clinical Characteristics and Sex Differences in a Population-Based Cohort Study.

10.21203/rs.3.rs-80142/v1 ◽

2020 ◽

Author(s):

Gerard Sotorra-Figuerola ◽

Dan Ouchi ◽

Ana García-Sangenís ◽

Maria Giner-Soriano ◽

Rosa Morros

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Secondary Prevention ◽

Clinical Characteristics ◽

Beta Blockers ◽

Study Groups ◽

Population Based ◽

First Episode ◽

Source Information ◽

Coronary Syndrome

Abstract Background: Cardiovascular disease remains the most common cause of death worldwide. Some differences between sexes in secondary prevention pharmacological therapies after an acute coronary syndrome (ACS) have been described, being women less likely to be treated. The aim was to to describe baseline socio-demographic and clinical characteristics and drugs prescribed for secondary prevention after a first episode of ACS in a Primary Health Care cohort population in Catalonia (Spain) and to assess differences between sexes.Methods: Population-based observational cohort study of patients with a first episode of ACS during 2009-2016. Data source: Information System for Research in Primary Care (SIDIAP) database. Results: There were 8,071 patients included, 71.3% of them were men and 80.2% had an acute myocardial infarction (AMI). Their mean age was 65.3, being older the women than the men. The most frequent comorbidities were hypertension, dyslipidaemia and diabetes and they were more common in women. Antiplatelets (91.3%) and statins (85.7%) were the study drugs most prescribed. The uses of all comedications were significantly higher in women, except for nitrates. The combination of four study groups was initially prescribed in 47.7% of patients and combination of beta-blockers, statins and antiplatelets was prescribed in 18.4%. More men than women received all recommended pharmacological groups.Conclusion: Women were older, had more comorbidities and received more comedication. Most patients were treated with a combination of four or three study drugs for secondary prevention. Men initiated more treatments for secondary prevention and dual antiplatelet therapy than women.

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