Substantial Within-Country Variation in the Incidence of Subarachnoid Hemorrhage: A Nationwide Finnish Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012129
Author(s):  
Ilari Rautalin ◽  
Joni Valdemar Lindbohm ◽  
Jaakko Kaprio ◽  
Miikka Korja
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Poisson Regression ◽  
Causes Of Death ◽  
Incidence Rates ◽  
Poisson Regression Model ◽  
Geographical Regions ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence ◽  
Finnish Study

Objective:To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland.Methods:By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. Based on the SAH patients’ home residence, we divided SAHs into five geographical regions: 1) Southern, 2) Central, 3) Western, 4) Eastern, and 5) Northern Finland. We calculated crude and European age-standardized (ESP2013) SAH incidence rates for each region, and used a Poisson regression model to calculate age-, sex- and calendar year-adjusted incidence rate ratios (IRRs) and 95% confidence intervals for regional and time-dependent differences.Results:During the total 106 510 337 cumulative person-years, we identified 9 443 first-ever SAH cases, of which 24% died before hospitalization. As compared to Western Finland, where the SAH incidence was the lowest (7.4 per 100 000 persons), the ESP-standardized SAH incidence was 1.4 times higher in Eastern (10.2 per 100 000 persons; adjusted IRR=1.37 (1.27–1.47)) and Northern Finland (10.4 per 100 000 persons; adjusted IRR=1.40 (1.30–1.51)). These differences were similar when men and women were analyzed independently. Although SAH incidence rates decreased in all five regions over two decades, the rate of decrease varied significantly by region.Conclusion:SAH incidence appears to vary substantially by region in Finland. Our results suggest that regional SAH studies can identify high-risk subpopulations, but can also considerably over- or underestimate incidence on a nationwide level.

scholarly journals Causes of Death in People With Cardiovascular Disease: A UK Biobank Cohort Study

2021 ◽  
Author(s):  
Michael Drozd ◽  
Mar Pujades‐Rodriguez ◽  
Fei Sun ◽  
Kevin N. Franks ◽  
Patrick J. Lillie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Causes Of Death ◽  
Sociodemographic Factors ◽  
Cardiovascular Death ◽  
Uk Biobank ◽  
Personalized Care ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Background Therapeutic advances have reduced cardiovascular death rates in people with cardiovascular diseases (CVD). We aimed to define the rates of cardiovascular and noncardiovascular death in people with specified CVDs or accruing cardiovascular multimorbidity. Methods and Results We studied 493 280 UK residents enrolled in the UK Biobank cohort study. The proportion of deaths attributed to cardiovascular, cancer, infection, or other causes were calculated in groups defined by 9 distinct self‐reported CVDs at baseline, or by the number of these CVDs at baseline. Poisson regression analyses were then used to define adjusted incidence rate ratios for these causes of death, accounting for sociodemographic factors and comorbidity. Of 27 729 deaths, 20.4% were primarily attributed to CVD, 53.6% to cancer, 5.0% to infection, and 21.0% to other causes. As cardiovascular multimorbidity increased, the proportion of cardiovascular and infection‐related deaths was greater, contrasting with cancer and other deaths. Compared with people without CVD, those with 3 or more CVDs experienced adjusted incidence rate ratios of 7.0 (6.2–7.8) for cardiovascular death, 4.4 (3.4–5.6) for infection death, 1.5 (1.4–1.7) for cancer death, and 2.0 (1.7–2.4) for other causes of death. There was substantial heterogeneity in causes of death, both in terms of crude proportions and adjusted incidence rate ratios, among the 9 studied baseline CVDs. Conclusions Noncardiovascular death is common in people with CVD, although its contribution varies widely between people with different CVDs. Holistic and personalized care are likely to be important tools for continuing to improve outcomes in people with CVD.

scholarly journals Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8331
Author(s):  
Isabel Cardoso ◽  
Peder Frederiksen ◽  
Ina Olmer Specht ◽  
Mina Nicole Händel ◽  
Fanney Thorsteinsdottir ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Regression Model ◽  
Incidence Rate ◽  
Poisson Regression ◽  
Linkage Study ◽  
Incidence Rates ◽  
Age Group ◽  
Poisson Regression Model ◽  
Birth Cohorts ◽  
Age And Sex

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992–2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6–24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2–30.7)) than among boys (18.5 (18.0–19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0–5 years and 12–15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

Decreasing incidence of subarachnoid hemorrhage

2018 ◽  
Vol 11 (3) ◽  
pp. 320-322 ◽  
Author(s):  
Patrick Nicholson ◽  
Alan O’Hare ◽  
Sarah Power ◽  
Seamus Looby ◽  
Mohsen Javadpour ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Population Data ◽  
Incidence Rates ◽  
Public Hospitals ◽  
National Database ◽  
Irish Hospital ◽  
Acute Subarachnoid Hemorrhage ◽  
Adjusted Rate ◽  
Using Data ◽  
Adjusted Incidence

ObjectiveTo determine the incidence and trends in subarachnoid hemorrhage in Ireland using data from a national database.Materials and methodsWe performed a retrospective nationwide query of the Irish Hospital In-patient Enquiry System (HIPE). This is a national database of all in-patient activity in acute public hospitals in Ireland. Each HIPE entry records one episode of in-patient care. The study period ranged from 1997 to 2015. Population data was obtained from the Irish Central Statistics Office, and the annual prevalence of smoking from the Irish National Tobacco Control Office. We were therefore able to calculate both crude annual acute subarachnoid hemorrhage (SAH) incidence rates, as well as population-standardized rates, and compared them with trends in the annual smoking rates.ResultsThe mean number of SAH cases per year is 549, with 465 cases in 1997 and 517 in 2015 (range: 465–624). The absolute incidence of SAH, therefore, remained relatively stable. Due to population increases over time, the population-adjusted rate of SAH therefore decreased, from 126.9/million people/year in 1997 to 111.5/million people/year in 2015. Nationally, there was a decrease in smoking prevalence, from 31% in 1998 to 19.2% in 2015. There was a statistically significant correlation between decreasing smoking rates and decreasing population-adjusted incidence of SAH (P=<0.0001).ConclusionsOur data suggests that the incidence of non-traumatic subarachnoid hemorrhage in our population appears to be decreasing, a decrease which is correlated with decreasing smoking rates. This provides important data both in terms of the epidemiology of SAH, as well as the possible role of public-health interventions in tackling both smoking and declining rates of SAH.

scholarly journals Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

2022 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Matteo Riccò ◽  
Simona Peruzzi ◽  
Federica Balzarini ◽  
Alessandro Zaniboni ◽  
Silvia Ranzieri
Keyword(s):  
Incidence Rate ◽  
Central Italy ◽  
Denv Infection ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Annual Reports ◽  
Foreign Born ◽  
Time Period ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

scholarly journals A Statistical Test for the Equality of Differently Adjusted Incidence Rate Ratios

2007 ◽  
Vol 167 (5) ◽  
pp. 517-522 ◽  
Author(s):  
K. Hoffmann ◽  
T. Pischon ◽  
M. Schulz ◽  
M. B. Schulze ◽  
J. Ray ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Statistical Test ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

scholarly journals Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001–2013: a population-based cohort study

Sexual Health ◽  
2017 ◽  
Vol 14 (6) ◽  
pp. 574 ◽  
Author(s):  
Joanne Reekie ◽  
Basil Donovan ◽  
Rebecca Guy ◽  
Jane S. Hocking ◽  
John M. Kaldor ◽  
...  
Keyword(s):  
Age Groups ◽  
Population Based ◽  
Reproductive Age ◽  
Nucleic Acid Amplification ◽  
Effective Prevention ◽  
Aboriginal Women ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence ◽  
Over Time

Background: This study aimed to examine trends in chlamydia and gonorrhoea testing and positivity in Aboriginal and non-Aboriginal women of reproductive age. Methods: A cohort of 318002 women, born between 1974 and 1995, residing in Western Australia (WA) was determined from birth registrations and the 2014 electoral roll. This cohort was then probabilistically linked to all records of chlamydia and gonorrhoea nucleic acid amplification tests conducted by two large WA pathology laboratories between 1 January 2001 and 31 December 2013. Trends in chlamydia and gonorrhoea testing and positivity were investigated over time and stratified by Aboriginality and age group. Results: The proportion of women tested annually for chlamydia increased significantly between 2001 and 2013 from 24.5% to 36.6% in Aboriginal and 4.0% to 8.5% in non-Aboriginal women (both P-values <0.001). Concurrent testing was high (>80%) and so patterns of gonorrhoea testing were similar. Chlamydia and gonorrhoea positivity were substantially higher in Aboriginal compared with non-Aboriginal women; age-, region- and year-adjusted incidence rate ratios were 1.52 (95% confidence interval (CI) 1.50–1.69, P < 0.001) and 11.80 (95% CI 10.77–12.91, P < 0.001) respectively. Chlamydia positivity increased significantly in non-Aboriginal women aged 15–19 peaking in 2011 at 13.3% (95% CI 12.5–14.2%); trends were less consistent among 15–19-year-old Aboriginal women but positivity also peaked in 2011 at 18.5% (95% CI 16.9–20.2%). Gonorrhoea positivity was 9.7% (95% CI 9.3–10.1%), 6.7% (95% CI 6.4–7.0%), 4.7% (4.4–5.0%), and 3.1% (2.8–3.4%) among Aboriginal women aged respectively 15–19, 20–24, 25–29 and ≥30 years, compared with <1% in all age groups in non-Aboriginal women. Over time, gonorrhoea positivity declined in all age groups among Aboriginal and non-Aboriginal women. Conclusion: Between 2001 and 2013 in WA chlamydia and gonorrhoea positivity remained highest in young Aboriginal women despite chlamydia positivity increasing among young non-Aboriginal women. More effective prevention strategies, particularly for young Aboriginal women, are needed to address these disparities.

Epidemiology of Myeloproliferative Neoplasms in Norway

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1858-1858
Author(s):  
Christina Roaldsnes ◽  
Anders Waage ◽  
Mette Nørgaard ◽  
Waleed Ghanima
Keyword(s):  
Incidence Rate ◽  
Cancer Registry ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Relative Survival ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Jak2 Mutation ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background: Polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are clonal hematological disorders collectively named as myeloproliferative neoplasms (MPN). Discovery of JAK2 mutation in 2005, altered WHO classification for MPN diagnosis in 2008 and availability of new treatment of MPN may have substantial effect on epidemiology of MPN. Published data on epidemiology of MPN after the discovery of JAK2 mutation and the introduction of 2008 WHO classifications for MPN, in particular on the prevalence of MPN, are scarce. We aimed to study the epidemiology of MPN in Norway and to explore the impact of JAK-2 mutation and new guidelines on the incidence of MPN using data from the Norwegian cancer registry. Method: We identified 2344 persons diagnosed with MPN from the Norwegian Cancer Registry diagnosed between 1995 and 2012. Registration of cancer in the Norwegian Cancer Registry is mandatory according to the law. We report age-adjusted incidence, prevalence and relative survival of MPN. Age adjusted incidence was reported for 2 years periods from 1995 to 2012. The prevalence was calculated according to the Norwegian population per 31.12.2011. Results: A total of 945 cases of PV was identified with a median age at diagnosis of 70 years; 471 males (50%) and 474 females (50%). The overall age-adjusted incidence rate both genders was 0.4/10⁵ in 1995-1997, 0.5/10⁵ in 1998-2000, 0.7/10⁵ in 2001-2003, 0.8/10⁵ in 2004-2007, 2008-2009 and 0.7/10⁵ in 2010-12. We identified a total of 762 cases of ET with a median age at diagnosis of 65 years, 297 males (39%) and 465 females (61%). The overall age adjusted incidence rate both genders being 0.3/10⁵ in 1995-1997 and 1998-2000, 0.5/10⁵ in 2001-2003 and 2004-2006, 0.9/10⁵ in 2007-2009 and 2010-2012. A total of 418 cases of MF was identified with a median age at diagnosis of 71 years; 243 males (58%) and 175 females (42%). Age adjusted incidence rates of both genders were 0.2/10⁵ from 1995-2006, 0.3/10⁵ in 2007-2009 and 0.5/10⁵ in 2010-2012. There were a total of 219 persons with unclassified MPN both genders,119 males (54%) and 100 females (46%) and age adjusted incidence rate varied from 0.1-0.2 to 0.1/10⁵ 1995-2012. Per 31.12.2011 the prevalence of PV, ET and MF was 9.2, 8.6 and 3.0 per 10⁵ inhabitants respectively. The survival curves for males and females for the three conditions are shown in the figure. Conclusions: This population-based study shows that the incidence of ET and MF almost doubled during the years 2007-2012 as compared to 1995-2006 as shown in the table. This increment in the incidence may possibly be related to improved diagnostics including the JAK2 mutation and the introduction of 2008 WHO-guidelines for MPN. Surprisingly, the discovery of JAK2 does not seem to have had impact on the incidence of PV as indicated by steady incidence rates since 2001. The relative survival was only slightly reduced for PV and ET, but substantially reduced for MF. Only 50% of patients with MF survive for more than 5 years. Table Incidence of MPN per 105 inhabitants during the period 1995 to 2012 in Norway 1995-97 1998-2000 2001-03 2004-06 2007-09 2010-12 PV 0.4 0.5 0.7 0.8 0.8 0.7 ET 0.3 0.3 0.5 0.5 0.9 0.9 MF 0.2 0.2 0.2 0.2 0.3 0.5 Figure showing the relative survival of PV, ET and MF Figure. showing the relative survival of PV, ET and MF Disclosures Roaldsnes: Novartis Norge AS: Research Funding. Ghanima:Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals The initial impact of a national BNT162b2 mRNA COVID-19 vaccine rollout

2021 ◽  
Author(s):  
Ahmed Zaqout ◽  
Joanne Daghfal ◽  
Israa Alaqad ◽  
Saleh A.N. Hussein ◽  
Abdullah Aldushain ◽  
...  
Keyword(s):  
Protective Effect ◽  
Incidence Rate ◽  
Confidence Intervals ◽  
Poisson Regression ◽  
Incidence Rates ◽  
Post Vaccination ◽  
Time Periods ◽  
Rate Ratios ◽  
Vaccination Period

AbstractObjectiveWe herein report the initial impact of a national BNT162b2 rollout on SARS-CoV-2 infections in Qatar.MethodsWe included all individuals who by 16 March 2021 had completed ≥14 days of follow up after the receipt of BNT162b2. We calculated incidence rates (IR) and their 95% confidence intervals (CI), during days 1–7, 8–14, 15–21, 22–28, and >28 days post-vaccination. Poisson regression was used to calculate incidence rate ratios (IRR) relative to the first 7-day post-vaccination period.ResultsWe included 199,219 individuals with 6,521,124 person-days of follow up. SARS-CoV-2 infection was confirmed in 1,877 (0.9%), of which 489 (26.1%) were asymptomatic and 123 (6.6%) required oxygen support. The median time from first vaccination to SARS-CoV-2 confirmation was 11.9 days (IQR 7.7–18.2). Compared with the first 7-day post-vaccination period, SARS-CoV-2 infections were lower by 65.8–84.7% during days 15–21, days 22–28, and >28 days (P <0.001 for each). For severe COVID-19, the incidence rates were 75.7– 93.3% lower (P <0.001 for each) during the corresponding time periods.ConclusionOur results are consistent with an early protective effect of BNT162b2 against all degrees of SARS-CoV-2 severity.

scholarly journals Excess Mortality Attributable to COVID-19 Among Assisted Living Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Kali Thomas ◽  
Wenhan Zhang ◽  
David Dosa ◽  
Paula Carder ◽  
Philip Sloane ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Confidence Intervals ◽  
Assisted Living ◽  
Excess Mortality ◽  
Mortality Rates ◽  
All Cause Mortality ◽  
National Cohort ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Abstract This study examines the excess mortality attributable to COVID-19 among a national cohort of assisted living (AL) residents. To do this, we compare the weekly rate of all-cause mortality during 1/1/20-8/11/20 with the same weeks in 2019 and calculated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). All-cause mortality rates, nationally, were 14% higher in 2020 compared with 2019 (mean, 2.309 vs. 2.020, respectively, per 1000 residents per week; adjusted IRR, 1.169; 95% CI 1.165-1.173). Among the 10 states with the highest community spread, the excess mortality attributable to COVID-19 was 24% higher, with 2.388 deaths per 1000 residents per week in 2020 during January-August vs 1.928 in 2019 (adjusted IRR, 1.241; 95% CI 1.233-1.250). These results suggest that AL residents suffered excess mortality due to COVID-19.

Differences in colon cancer incidence rates by latitude.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14627-e14627
Author(s):  
Binay Kumar Shah ◽  
Krishna Bilas Ghimire ◽  
Barsha Nepal
Keyword(s):  
Colon Cancer ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Southern Region ◽  
Southern Latitude ◽  
Northern Latitude ◽  
The North ◽  
Northern Regions ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

e14627 Background: There is significant decrease in the ultraviolet B photons reaching the earth’s surface during November to February (Holick MF Am J Clin Nutr. 2004 Dec; 80(6 Suppl):1678S-88S). This results in little if any vitamin D3 production in the skin during this period. This study was conducted to evaluate difference in colon cancer age adjusted incidence rates in the northern (latitude ≥37o N) and the southern (latitude < 37oN) regions in the contiguous United States during 1973-2008. Methods: Patients, aged 20 years and older, who had been diagnosed with colong cancer during January 1973 and December 2008, were selected from the Surveillance, Epidemiology, and End Results (SEER) 13 database. Based on the counties’ centroid, northern (latitude ≥37o N) and southern (latitude < 37oN) regions were determined. We compared age adjusted incidence rates (AAIR) of colon cancer in the southern and northern regions among cohorts of patients categorized by age (≥20, 20-64, ≥65 years), gender (Men, Women) and Race (Caucasians, Blacks, Others). The AAIR was calculated per 100,000 population. We used SEER*Stat software to calculate age adjusted incidence rate, incidence ratio, confidence interval (CI, 95%) and P value. Results: There were 314,975 cases of colon cancer diagnosed among 608,245,557 US population during 1973-2008. The overall colon cancer AAIR was 57.1 per 100,000 population studied. The incidence rates were 49.1 in the south and 58.7 in the north of 37oN latitude, (95% CI 1.18-1.20, p<0.05). The AAIRs for patients in the age group 20-64 years were 17.9 and 18.8 in the southern and northern regions, (CI 95%, 1.0346-1.0697), p<0.0005 respectively. The incidence rates for patients aged ≥65 years were 194.3 and 243.9 in the southern and northern regions, (CI 95%, 1.0346-1.0697) p<0.0005. Similarly, the AAIRs were significantly higher in the northern region compared to southern region for both sexes and all ethnic groups. Conclusions: Colon cancer age-adjusted incidence rate is significantly higher in the Northern compared to the Southern region of the US. The higher incidence of colon cancer in the North may be related to lack of sunlight exposure and relative vitamin D deficiency.

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