scholarly journals Risk factors for surgery due to rotator cuff disease in a population-based cohort

2020 ◽  
Vol 102-B (3) ◽  
pp. 352-359 ◽  
Author(s):  
Elizabeth L. Yanik ◽  
Graham A. Colditz ◽  
Rick W. Wright ◽  
Nancy L. Saccone ◽  
Bradley A. Evanoff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Rotator Cuff Disease ◽  
Physical Demands ◽  
Deprivation Score ◽  
Male Sex ◽  
The Uk ◽  
Occupational Physical Demands

Aims Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. The aim of this study was to evaluate the relationship between numerous risk factors and the incidence of surgery for RCD in a large cohort. Methods A population-based cohort of people aged between 40 and 69 years in the UK (the UK Biobank) was studied. People who underwent surgery for RCD were identified through a link with NHS inpatient records covering a mean of eight years after enrolment. Multivariate Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with surgery for RCD accounting for confounders. The risk factors which were considered included age, sex, race, education, Townsend deprivation index, body mass index (BMI), occupational demands, and exposure to smoking. Results Of the 421,894 people who were included, 47% were male. The mean age at the time of enrolment was 56 years (40 to 69). A total of 2,156 people were identified who underwent surgery for RCD. Each decade increase in age was associated with a 55% increase in the incidence of RCD surgery (95% confidence interval (CI) 46% to 64%). Male sex, non-white race, lower deprivation score, and higher BMI were significantly associated with a higher risk of surgery for RCD (all p < 0.050). Greater occupational physical demands were significantly associated with higher rates of RCD surgery (HR = 2.1, 1.8, and 1.4 for ‘always’, ‘usually’, and ‘sometimes’ doing heavy manual labour vs ‘never’, all p < 0.001). Former smokers had significantly higher rates of RCD surgery than those who had never smoked (HR 1.23 (95% CI 1.12 to 1.35), p < 0.001), while current smokers had similar rates to those who had never smoked (HR 0.94 (95% CI 0.80 to 1.11)). Among those who had never smoked, the risk of surgery was higher among those with more than one household member who smoked (HR 1.78 (95% CI 1.08 to 2.92)). The risk of RCD surgery was not significantly related to other measurements of secondhand smoking. Conclusion Many factors were independently associated with surgery for RCD, including older age, male sex, higher BMI, lower deprivation score, and higher occupational physical demands. Several of the risk factors which were identified are modifiable, suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals, such as reducing obesity and modifying occupational demands. Cite this article: Bone Joint J 2020;102-B(3):352–359

scholarly journals Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica Gong ◽  
Katie Harris ◽  
Sanne A. E. Peters ◽  
Mark Woodward
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Sex Differences ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Sex Difference ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Uk Biobank ◽  
The Uk

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.

Active monitoring of 12760 clozapine recipients in the UK and Ireland

1999 ◽  
Vol 175 (6) ◽  
pp. 576-580 ◽  
Author(s):  
Janet Munro ◽  
Desmond O'Sullivan ◽  
Christopher Andrews ◽  
Alejandro Arana ◽  
Ann Mortimer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Treatment Resistant ◽  
Active Monitoring ◽  
Case Register ◽  
Proportional Hazards Regression ◽  
Age Related ◽  
The Uk ◽  
To Receive

BackgroundPeople prescribed clozapine for treatment-resistant schizophrenia have mandatory haematological monitoring through a case register for identifying reversible neutropenia.AimsTo quantify risk factors for agranulocytosis in subjects receiving clozapine.MethodData from 12 760 subjects registered to receive clozapine from January 1990 to April 1997 were analysed. Risk factors for agranulocytosis were quantified using a Cox proportional-hazards regression analysis.ResultsThe risk for agranulocytosis in Asian subjects was 2.4 times that in Caucasians (P=0.03). There was an age-related increase in risk of 53% per decade (P=0.0001).ConclusionsThe case register yielded valuable information for guiding research into the causes of the haematological reactions.

scholarly journals The impact of risk factor trends on intracerebral hemorrhage incidence over the last two decades—The Tromsø Study

2018 ◽  
Vol 14 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Maria Carlsson ◽  
Tom Wilsgaard ◽  
Stein Harald Johnsen ◽  
Liv-Hege Johnsen ◽  
Maja-Lisa Løchen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Intracerebral Hemorrhage ◽  
Proportional Hazards ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Intracerebral Hemorrhages ◽  
The Impact

Background Studies on the relationship between temporal trends in risk factors and incidence rates of intracerebral hemorrhage are scarce. Aims To analyze temporal trends in risk factors and incidence rates of intracerebral hemorrhage using individual data from a population-based study. Methods We included 28,167 participants of the Tromsø Study enrolled between 1994 and 2008. First-ever intracerebral hemorrhages were registered through 31 December 2013. Hazard ratios (HRs) for intracerebral hemorrhage were analyzed by Cox proportional hazards models, risk factor levels over time by generalized estimating equations, and incidence rate ratios (IRR) by Poisson regression. Results We registered 219 intracerebral hemorrhages. Age, male sex, systolic blood pressure (BP), diastolic BP, and hypertension were associated with intracerebral hemorrhage. Hypertension was more strongly associated with non-lobar intracerebral hemorrhage (HR 5.08, 95% CI 2.86–9.01) than lobar intracerebral hemorrhage (HR 1.91, 95% CI 1.12–3.25). In women, incidence decreased significantly (IRR 0.46, 95% CI 0.23–0.90), driven by a decrease in non-lobar intracerebral hemorrhage. Incidence rates in men remained stable (IRR 1.27, 95% CI 0.69–2.31). BP levels were lower and decreased more steeply in women than in men. The majority with hypertension were untreated, and a high proportion of those treated did not reach treatment goals. Conclusions We observed a significant decrease in intracerebral hemorrhage incidence in women, but not in men. A steeper BP decrease in women may have contributed to the diverging trends. The high proportion of untreated and sub-optimally treated hypertension calls for improved strategies for prevention of intracerebral hemorrhage.

scholarly journals Improvement of Abandonment of Therapy in Pediatric Patients with Cancer in Guatemala

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 76s-76s ◽  
Author(s):  
Elysia Alvarez ◽  
Midori Seppa ◽  
Kevin Messacar ◽  
John Kurap ◽  
E. Alejandro Sweet-Cordero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychosocial Intervention ◽  
Intervention Program ◽  
Proportional Hazards ◽  
Conflicts Of Interest ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Middle Income ◽  
Targeted Interventions ◽  
Increased Risk

Abstract 59 Background: Abandonment of therapy is a major cause of therapeutic failure in the treatment of childhood cancer in Low and Middle Income Countries (LMIC). This study examines factors associated with increased risk of therapy abandonment in Guatemalan children with cancer and the rates of therapy abandonment before and after implementation of a multidisciplinary psychosocial intervention program. Methods: A retrospective population-based study was performed to identify risk factors for abandonment of therapy in Guatemalan children, ages 0-18, with cancer who were seen at UNOP from 2001-2008. Patient data was collected from the Pediatric Oncology Networked Database (POND4Kids). Abandonment was defined as a lapse of 4 weeks in planned treatment or failure to begin treatment for a potentially curable cancer. Cox proportional hazards analysis identified the effect of age, sex, year of diagnosis, distance travelled to UNOP, ethnicity, and principal diagnosis on abandonment of therapy. Kaplan Meier analysis was used to evaluate survival. Results: A retrospective analysis of 1,789 charts was performed and 367 patients abandoned therapy. The rate of abandonment decreased from 27% in 2001 to 7% in 2008 following a multidisciplinary psychosocial intervention program. Greater distance to UNOP (p = 0.00), younger age (p = 0.02) and earlier year of diagnosis (p = 0.00) were associated with increased risk of abandonment. Abandonment of therapy correlated with decreased survival. The cumulative survival at 8.3 years was 0.57 ± 0.02 (survival±SE) for those who completed therapy vs 0.06 ± 0.02 for those who abandoned and refused therapy (p=0.000) in an abandonment sensitive analysis. Conclusion: This study identified distance, age, and year of diagnosis as risk factors for abandonment of therapy for pediatric cancer in Guatemala. This study highlights risk factors for abandonment of therapy and the role of targeted interventions in altering rates of abandonment that could be replicated in other LMIC countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

scholarly journals Risk factors of severe adult-onset asthma: a multi-factor approach

2020 ◽  
Author(s):  
Sanna Toppila-Salmi ◽  
Riikka Lemmetyinen ◽  
Sebastien Chanoine ◽  
Jussi Karjalainen ◽  
Juha Pekkanen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Asthma ◽  
Professional Training ◽  
Univariate Analysis ◽  
Personal Characteristics ◽  
Population Based ◽  
Additional Risk Factor ◽  
Adult Onset ◽  
Asthma Symptoms ◽  
Male Sex

Abstract Background The aim was to identify risk factors of severe adult-onset asthma. Methods We used data from 1350 population-based asthmatics (Adult Asthma in Finland) with adult-onset asthma (age range 31-93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma AND asthma symptoms causing much harm AND regular impairment AND (≥1 oral corticosteroid course/year OR regular oral corticosteroids OR wake up in the night due to asthma symptoms/wheezing attach ≥ a few times/month). Sixteen covariates covering several domains (personal characteristics, education, life-style, early life factors, asthma characteristics and multimorbidities) were selected based on literature and were studied in association with severe asthma using logistic regressions. Results The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, low education, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and Non-steroidal anti-inflammatory drug (NSAID) -exacerbated respiratory disease (NERD) (p<0.05); and trends for association (p<0.2) were observed for severe childhood infection, presence of chronic rhinosinusitis with nasal polyps, and being the 1 st child. The 10 variables (being 1 st child was removed due to multicolinearity) were thus entered in a multivariate regression model and severe asthma was significantly associated with male sex (OR [CI95%] = 1.96 [1.16-3.30]), ever smoking (1.98 [1.11-3.52]), chronic comorbidities (2.68 [1.35-5.31]), NERD (3.29 [1.75-6.19]), and ≥ 2 siblings (2.51 [1.17-5.41]). There was a dose-response effect of the total sum of these five factors on severe asthma (OR [CI95%] = 2.30 [1.81-2.93] for each increase of one unit of the score). Conclusions Male sex, smoking, NERD, comorbidity, age and number of siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be additive; each additional risk factor gradually increase with the risk of severe asthma.

scholarly journals Identification of a Novel Genetic Marker for Risk of Degenerative Rotator Cuff Disease Surgery in the UK Biobank

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elizabeth L. Yanik ◽  
Jay D. Keener ◽  
Shiow J. Lin ◽  
Graham A. Colditz ◽  
Rick W. Wright ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Genetic Marker ◽  
Uk Biobank ◽  
Rotator Cuff Disease ◽  
The Uk

scholarly journals The irreversible HCV-associated risk of gastric cancer following interferon-based therapy: a joint study of hospital-based cases and nationwide population-based cohorts

2019 ◽  
Vol 12 ◽  
pp. 175628481985573 ◽  
Author(s):  
Chun-Wei Chen ◽  
Jur-Shan Cheng ◽  
Tai-Di Chen ◽  
Puo-Hsien Le ◽  
Hsin-Ping Ku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Cancer Risk ◽  
Cancer Patients ◽  
Population Based ◽  
Hcv Infection ◽  
Research Database ◽  
Gastric Cancer Risk ◽  
Male Sex ◽  
Gastric Cancer Patients

Background: Hepatitis C virus (HCV) infection causes many extrahepatic malignancies; whether it increases gastric cancer risk and the risk reverses after anti-HCV therapy remain elusive. Method: A nationwide population-based cohort study of Taiwan National Health Insurance Research Database (TNHIRD) was conducted. In parallel, the risk factors and HCV-core-protein expressions were surveyed in gastric cancer patients from a tertiary care center. Results: From 2003 to 2012, of 11,712,928 patients, three 1:4:4, propensity-score-matched TNHIRD cohorts including HCV-treated (7545 patients with interferon-based therapy ⩾ 6 months), HCV-untreated ( n = 30,180), and HCV-uninfected cohorts ( n = 30,180) were enrolled. The cumulative incidences of gastric cancer [HCV-treated: 0.452%; 95% confidence interval (CI): 0.149–1.136%; HCV-untreated: 0.472%; 95% CI: 0.274–0.776%; HCV-uninfected: 0.146%; 95% CI 0.071–0.280%] were lowest in HCV-uninfected cohort ( p = 0.0028), but indifferent between treated and untreated cohorts. HCV infection [hazards ratio (HR): 2.364; 95% CI: 1.337–4.181], male sex (HR: 1.823; 95% CI: 1.09–3.05) and age ⩾ 49 years (HR: 3.066; 95% CI: 1.56–6.026) were associated with incident gastric cancers. Among 887 (males: 68.4%; mean age: 66.5 ± 12.9 years, 2008–2018) hospitalized gastric cancer patients, HCV Ab-positive rate was 7.8%. None of the investigated factors exhibited different rates between HCV Ab-positive and Ab-negative patients. No HCV-core-positive cells were demonstrated in gastric cancer tissues. Conclusions: HCV infection, male sex and old age were risk factors for gastric cancer development. HCV-associated gastric cancer risk might be neither reversed by interferon-based therapy, nor associated with in situ HCV-core-related carcinogenesis.

scholarly journals Predictors of 10-year hospital use in a community-dwelling population of Brazilian elderly: the Bambuí cohort study of aging

2011 ◽  
Vol 27 (suppl 3) ◽  
pp. s336-s344 ◽  
Author(s):  
James Macinko ◽  
Vitor Camargos ◽  
Josélia O. A. Firmo ◽  
Maria Fernanda Lima-Costa
Keyword(s):  
Cohort Study ◽  
Chronic Conditions ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Proportional Hazards Models ◽  
Cox Proportional Hazards Models ◽  
Male Sex

We use data from a population-based cohort of elderly Brazilians to assess predictors of hospitalizations during ten years of follow-up. Participants were 1,448 persons aged 60 years and over at baseline (1997). The outcome was self-reported number of hospitalizations per year. Slightly more than a fifth (23%) experienced no hospitalizations during the 10 year follow-up. About 30% had 1-2 events, 31% had between 3 and 7 events, and about 18% had 8 or more events during this time. Results of multivariable hurdle and Cox proportional hazards models showed that the risk of hospitalization was positively associated with male sex, increased age, chronic conditions, and visits to the doctors in the previous 12 months. Underweight was a predictor of any hospitalization, while obesity was an inconsistent predictor of hospitalization.

scholarly journals Incidence and maternal-fetal risk factors of stillbirth: A population-based historical cohort and a nested case-control study

2019 ◽  
Author(s):  
Zahra Maleki ◽  
Haleh Ghaem ◽  
Mozhgan Seif ◽  
Sedigheh Foruhari
Keyword(s):  
Risk Factors ◽  
Regression Model ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Gestational Hypertension ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Historical Cohort ◽  
Significance Level ◽  
Fetal Risk

Abstract Background: For parents, stillbirth is a disappointing phenomenon; thus, identifying the associated risk factors can be beneficial in order to prevent this event. This study aimed to investigate the incidence and risk factors associated with stillbirth.Methods: In this historical cohort study, a total of 18129 birth records were investigated. For each case of stillbirth, three live birth infants on the same day and same hospital were selected as the controls, which were matched for gestational age. The data was collected using a researcher-made checklist. Finally, data were analyzed using STATA, 13.0 with Cox proportional hazards regression model at the significance level of 0.05.Results: The cumulative incidence of still birth was 9.48 per 1000 live births. Based on multivariate Cox regression model, five risk factors for stillbirth were identified, including male gender, fetal diseases, gestational hypertension, gestational diabetes, and hypothyroidism, (all hazard ratios > 1 and p<0.05).Conclusion: For the first time, maternal hypothyroidism, oligohydramnios and polyhydramnios were shown as risk factors for stillbirth, which were not evaluated in any previous study. The findings of this study suggest that some maternal and fetal risk factors can be recognized as predictors of stillbirth, which might help to prevent and detect high-risk parents at early stages in order to avoid adverse health consequences in the mother and her neonate.

scholarly journals Risk Factors of Severe Adult-onset Asthma: A Multi-factor Approach

2021 ◽  
Author(s):  
Sanna Toppila-Salmi ◽  
Riikka Lemmetyinen ◽  
Sebastien Chanoine ◽  
Jussi Karjalainen ◽  
Juha Pekkanen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Asthma ◽  
Professional Training ◽  
Univariate Analysis ◽  
Personal Characteristics ◽  
Population Based ◽  
Additional Risk Factor ◽  
Adult Onset ◽  
Asthma Symptoms ◽  
Male Sex

Abstract Background: The aim was to identify risk factors of severe adult-onset asthma.Methods: We used data from 1350 population-based asthmatics (Adult Asthma in Finland) with adult-onset asthma (age range 31-93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma AND asthma symptoms causing much harm AND regular impairment AND (≥1 oral corticosteroid course/year OR regular oral corticosteroids OR wake up in the night due to asthma symptoms/wheezing attach ≥ a few times/month). Sixteen covariates covering several domains (personal characteristics, education, life-style, early life factors, asthma characteristics and multimorbidities) were selected based on literature and were studied in association with severe asthma using logistic regressions. Results: The study population included 100 (7.4 %) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, low education, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and Non-steroidal anti-inflammatory drug (NSAID) -exacerbated respiratory disease (NERD) (p<0.05); and trends for association (p<0.2) were observed for severe childhood infection, presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being 1st child was removed due to multicolinearity) were thus entered in a multivariate regression model and severe asthma was significantly associated with male sex (OR [CI95%] = 1.96 [1.16-3.30]), ever smoking (1.98 [1.11-3.52]), chronic comorbidities (2.68 [1.35-5.31]), NERD (3.29 [1.75-6.19]), and ≥ 2 siblings (2.51 [1.17-5.41]). There was a dose-response effect of the total sum of these five factors on severe asthma (OR [CI95%] = 2.30 [1.81-2.93] for each increase of one unit of the score). Conclusions: Male sex, smoking, NERD, comorbidity, age and number of siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be additive; each additional risk factor gradually increase with the risk of severe asthma.

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