Time course of dementia following sepsis in German health claims data

ObjectiveWe evaluated the short-, medium-, and long-term effects of sepsis on dementia incidence using German health claims data.MethodsA total of 161,567 patients (65 years or older) were followed from 2004 to 2015 at quarterly intervals. Time since sepsis was categorized into 0 (the effective quarter of sepsis diagnosis), 1–8, and ≥9 quarters since the latest diagnosis of sepsis, taking into account admission to intensive care unit and controlling for delirium, surgery, age, sex, and comorbidities. Incident dementia was defined for all persons who did not have a validated dementia diagnosis in 2004 and 2005 and who received a first-time, valid diagnosis between 2006 and 2015.ResultsDuring the quarter of sepsis diagnosis, patients not admitted to intensive care had a 3.14-fold (95% CI 2.83–3.49) increased risk, and those with intensive care stay had a 2.22-fold (95% CI: 1.83–2.70) increased risk of receiving an incident dementia diagnosis compared with patients without sepsis. The impact of sepsis on incident dementia remained in the following 2 years, remitting only thereafter.ConclusionsFor sepsis survivors, medium-term dementia risk remains elevated, whereas long-term risk may reach the level of those without sepsis, even after controlling for delirium. These findings encourage identifying modifiable components of hospital and rehabilitation care.

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Association of joint replacement surgery with incident dementia diagnosis in German claims data

International Psychogeriatrics ◽

10.1017/s1041610217002976 ◽

2018 ◽

Vol 30 (9) ◽

pp. 1375-1383 ◽

Cited By ~ 2

Author(s):

Stefan J. Teipel ◽

Thomas Fritze ◽

Martin Ellenrieder ◽

Britta Haenisch ◽

Wolfram Mittelmeier ◽

...

Keyword(s):

Joint Replacement ◽

Claims Data ◽

Incidence Rates ◽

Dementia Diagnosis ◽

Joint Replacement Surgery ◽

Replacement Surgery ◽

Incident Dementia ◽

Increased Risk ◽

Incident Cases

ABSTRACTBackground:Cognitive decline is an important complication of joint replacement surgeries in senior people.Methods:We determined incidence rates of dementia diagnosis following endoprosthetic joint replacement surgery (upper and lower extremities). The observation period covered up to 28 quarters using German claims data comprising 154,604 cases 65 years and older. Effects were controlled for cerebrovascular and vascular risk factors, age, sex, the presence of a diagnosis of delirium, and regular prescription of sedative or analgesic drugs (SAD).Results:The rate of incident dementia diagnoses in people without joint replacement surgery was 21.34 per 1,000 person years, compared with 80.76 incident cases when joint replacement surgery was conducted during the quarter of the incident dementia diagnosis; rates declined to 21.77 incident cases 7 and more quarters after joint replacement surgery had taken place. This pattern was maintained when controlling for delirium diagnosis and regular prescription of SAD. Among 10,563 patients with at least one joint replacement surgery, patients with a diagnosis of delirium in the quarter of the surgery were at increased risk of a dementia diagnosis compared to patients without such a diagnosis (HR=2.00, p < 0.001).Conclusion:In people surviving the high-risk phase for dementia immediately after surgery, long-term risk of dementia may reach the level of those without surgery. These findings encourage consequent perioperative management to reduce the risk of dementia as well as prospective studies of potentially beneficial effects of joint replacement surgery on mid- to long-term recovery of mobility and cognition in geriatric patients.

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PMS32 LONG–TERM PAIN Management Pathways of Patients with Osteoarthritis of the HIP/Knee before Joint Replacement — a Retrospective Cohort Study Based on German Health Claims DATA

Value in Health ◽

10.1016/j.jval.2020.08.1163 ◽

2020 ◽

Vol 23 ◽

pp. S598

Author(s):

M. Schild ◽

A. Mocek ◽

W. Galetzka ◽

T.C. Ploner ◽

U. Müller ◽

...

Keyword(s):

Cohort Study ◽

Pain Management ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Claims Data ◽

Health Claims ◽

Osteoarthritis Of The Hip ◽

German Health ◽

Health Claims Data

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Risk of Long-Term Care Dependence for Dementia Patients is Associated with Type of Physician: An Analysis of German Health Claims Data for the Years 2006 to 2010

Journal of Alzheimer s Disease ◽

10.3233/jad-142082 ◽

2015 ◽

Vol 47 (2) ◽

pp. 443-452 ◽

Cited By ~ 2

Author(s):

Anne Fink ◽

Gabriele Doblhammer

Keyword(s):

Long Term Care ◽

Claims Data ◽

Health Claims ◽

Term Care ◽

German Health ◽

Dementia Patients ◽

Health Claims Data

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Predictive modeling of nontuberculous mycobacterial pulmonary disease epidemiology using German health claims data

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.01.003 ◽

2021 ◽

Vol 104 ◽

pp. 398-406

Author(s):

Felix C. Ringshausen ◽

Raphael Ewen ◽

Jan Multmeier ◽

Bondo Monga ◽

Marko Obradovic ◽

...

Keyword(s):

Pulmonary Disease ◽

Predictive Modeling ◽

Claims Data ◽

Health Claims ◽

Disease Epidemiology ◽

German Health ◽

Health Claims Data

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Different treatment forms of type II diabetes and the risk of dementia in German health claims data

Acta Diabetologica ◽

10.1007/s00592-019-01332-7 ◽

2019 ◽

Vol 56 (9) ◽

pp. 995-1003 ◽

Cited By ~ 2

Author(s):

Nikolaus Buchmann ◽

Anne Fink ◽

Christina Tegeler ◽

Ilja Demuth ◽

Gabriele Doblhammer ◽

...

Keyword(s):

Type Ii Diabetes ◽

Claims Data ◽

Health Claims ◽

Type Ii ◽

German Health ◽

Health Claims Data

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Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis

Rheumatology Advances in Practice ◽

10.1093/rap/rkaa033 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Jürgen Rech ◽

Michael Sticherling ◽

Daniel Stoessel ◽

Mona H C Biermann ◽

Benjamin M Häberle ◽

...

Keyword(s):

Risk Factors ◽

Psoriatic Arthritis ◽

Odds Ratio ◽

Claims Data ◽

Health Claims ◽

Comorbid Disease ◽

Data Set ◽

Increased Risk ◽

Systemic Inflammatory Disease ◽

Health Claims Data

Abstract Objective Psoriasis is a systemic inflammatory disease often accompanied by comorbidities, including metabolic syndrome, cardiovascular diseases and depression. Up to 41% of psoriasis patients develop psoriatic arthritis (PsA), making it one of the most relevant manifestations. A large health claims data set was analysed to determine the rate of PsA development in psoriasis patients. Furthermore, comorbid disease profiles of psoriasis patients with or without PsA were compared, and potential risk factors for the development of PsA were identified. Methods This was a non-interventional, retrospective analysis of anonymized insurance health claims data using a subset of the Institute of Applied Health Research Berlin (InGef) database. The primary outcome was the prevalence and incidence of diagnosed PsA among psoriasis patients in Germany. Risk factors for the development of PsA in psoriasis patients were determined by conditional logistic regression analysis. Results The cumulative percentage of patients with existing psoriasis developing concomitant PsA over 4 years was 3.44%, with a mean time to diagnosis of PsA of 1.5 years. Psoriasis patients diagnosed with acute rheumatism (odds ratio: 2.93, 95% CI = 1.76, 4.86; P < 0.001) or pain in unspecific joints (odds ratio: 1.74, 95% CI = 1.01, 2.99; P = 0.047) showed an increased risk for development of PsA later on. Interestingly, fewer than half of the patients with concomitant PsA consulted a rheumatologist. Conclusions Unspecific arthritic symptoms are likely to precede PsA diagnoses and can develop soon after onset of psoriasis, with accumulating risk over time. There is a high unmet need for early rheumatological assessment of psoriasis patients.

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