Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study

AbstractObjective:To estimate the incidence of stillbirth, explore the associated maternal and fetal factors and to evaluate the most appropriate classification of stillbirth for a multiethnic population.Methods:This is a retrospective population-based study of stillbirth in a large tertiary unit. Data of each stillbirth with a gestational age >/=24 weeks in the year 2015 were collected from electronic medical records and analyzed.Results:The stillbirth rate for our multiethnic population is 7.81 per 1000 births. Maternal medical factors comprised 52.4% in which the rates of hypertensive disorders, diabetes and other medical disorders were 22.5%, 20.8% and 8.3%, respectively. The most common fetal factor was intrauterine growth restriction (IUGR) (22.5%) followed by congenital anomalies (21.6%). All cases were categorized using the Wigglesworth, Aberdeen, Tulip, ReCoDe and International Classification of Diseases-perinatal mortality (ICD-PM) classifications and the rates of unclassified stillbirths were 59.2%, 46.6%, 16.6%, 11.6% and 7.5%, respectively. An autopsy was performed in 9.1% of cases reflecting local religious and cultural sensitivities.Conclusion:This study highlighted the modifiable risk factors among the Middle Eastern population. The most appropriate classification was the ICD-PM. The low rates of autopsy prevented a detailed evaluation of stillbirths, therefore it is suggested that a minimally invasive autopsy [postmortem magnetic resonance imaging (MRI)] may improve the quality of care.

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Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1715426 ◽

2020 ◽

Author(s):

Neill Y. Li ◽

Alexander S. Kuczmarski ◽

Andrew M. Hresko ◽

Avi D. Goodman ◽

Joseph A. Gil ◽

...

Keyword(s):

Risk Factors ◽

International Classification Of Diseases ◽

Opioid Use ◽

Proximal Row Carpectomy ◽

Use Patterns ◽

Patient Demographics ◽

Implant Complications ◽

Increased Risk ◽

Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

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Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Heart ◽

10.1136/heartjnl-2021-319129 ◽

2021 ◽

pp. heartjnl-2021-319129

Author(s):

Marios Rossides ◽

Susanna Kullberg ◽

Johan Grunewald ◽

Anders Eklund ◽

Daniela Di Giuseppe ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

General Population ◽

Strong Predictor ◽

Strong Association ◽

International Classification Of Diseases ◽

Population Based ◽

Clinical Predictors ◽

Cox Models ◽

Classification Of Diseases

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.

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Prevalence and Incidence of Heart Failure Among Urban Patients in China: A National Population-Based Analysis

Circulation Heart Failure ◽

10.1161/circheartfailure.121.008406 ◽

2021 ◽

Author(s):

Hua Wang ◽

Ke Chai ◽

Minghui Du ◽

Shengfeng Wang ◽

Jian-Ping Cai ◽

...

Keyword(s):

Heart Failure ◽

Large Scale ◽

International Classification Of Diseases ◽

Population Based ◽

Unique Identifier ◽

Classification Of Diseases ◽

Per Capita ◽

Mean Cost ◽

Incident Cases

Background: Large-scale and population-based studies of heart failure (HF) incidence and prevalence are scarce in China. The study sought to estimate the prevalence, incidence, and cost of HF in China. Methods: We conducted a population-based study using records of 50.0 million individuals ≥25 years old from the national urban employee basic medical insurance from 6 provinces in China in 2017. Incident cases were individuals with a diagnosis of HF (International Classification of Diseases code, and text of diagnosis) in 2017 with a 4-year disease-free period (2013–2016). We calculated standardized rates by applying age standardization to the 2010 Chinese census population. Results: The age-standardized prevalence and incidence were 1.10% (1.10% among men and women) and 275 per 100 000 person-years (287 among men and 261 among women), respectively, accounting for 12.1 million patients with HF and 3.0 million patients with incident HF ≥25 years old. Both prevalence and incidence increased with increasing age (0.57%, 3.86%, and 7.55% for prevalence and 158, 892, and 1655 per 100 000 person-years for incidence among persons who were 25–64, 65–79, and ≥80 years of age, respectively). The inpatient mean cost per-capita was $4406.8 and the proportion with ≥3 hospitalizations among those hospitalized was 40.5%. The outpatient mean cost per-capita was $892.3. Conclusions: HF has placed a considerable burden on health systems in China, and strategies aimed at the prevention and treatment of HF are needed. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: ChiCTR2000029094.

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Readmission after Adult Uvulopalatopharyngoplasty: A Population-Based Inpatient Cohort Study in Taiwan

Otolaryngology ◽

10.1177/0194599818813337 ◽

2018 ◽

Vol 160 (3) ◽

pp. 559-566 ◽

Cited By ~ 8

Author(s):

Ying-Shuo Hsu ◽

Wei-Chung Hsu ◽

Jenq-Yuh Ko ◽

Te-Huei Yeh ◽

Chia-Hsuan Lee ◽

...

Keyword(s):

Odds Ratio ◽

International Classification Of Diseases ◽

Population Based ◽

Factors Associated ◽

Risk Of Bleeding ◽

Increased Risk ◽

Classification Of Diseases ◽

Insurance Database ◽

Population Based Survey

Objective To investigate readmissions among adult inpatients who underwent uvulopalatopharyngoplasty (UPPP) in Taiwan. Design Population-based survey. Setting Retrospective study with the National Health Insurance Database. Methods All cases of inpatient adult UPPP (age >20 years) from 1997 to 2012 were identified through International Classification of Diseases, Ninth Revision, Clinical Modification. Factors associated with readmission within 30 days after surgery were analyzed. Results A total of 38,839 adults with UPPP were identified (mean age, 39.3 years; men, 73.7%). The incidence of UPPP was 14.6 per 100 000 adults, which increased from 1997 to 2012 (6.7 to 16.7 per 100,000, Ptrend < .001). The rates of readmission for any reason, readmission for bleeding, reoperation for bleeding, and 30-day mortality were 4.2%, 1.7%, 1.0%, and 0.14%, respectively. Young age increased the risk of reoperation for bleeding, and old age increased the risk of readmission for any reason and mortality. Men had an increased risk of readmission and reoperation. Hypertension was associated with an increased risk of readmission for any reason (odds ratio [OR], 1.29; 95% CI, 1.10-1.51), bleeding-related readmission (OR, 1.89; 95% CI, 1.52-2.36), and reoperation (OR, 2.47; 95% CI, 1.84-3.30). Concurrent hypopharyngeal surgery was associated with an increased risk of readmission for any reason (OR, 1.34; 95% CI, 1.07-1.66) and bleeding-related readmission (OR, 1.69; 95% CI, 1.25-2.27). Finally, the use of steroids was associated with an increased risk of bleeding-related readmission and reoperation. Conclusions The incidence of adult UPPP increased from 1997 to 2012 in Taiwan. Age, sex, comorbidity, concurrent hypopharyngeal surgery, and drug administration were associated with readmission after inpatient UPPP.

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Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193416687914 ◽

2017 ◽

Vol 42 (7) ◽

pp. 673-677 ◽

Cited By ~ 11

Author(s):

J. Nordenskjöld ◽

M. Englund ◽

C. Zhou ◽

I. Atroshi

Keyword(s):

General Population ◽

International Classification Of Diseases ◽

Population Based ◽

Dupuytren’S Disease ◽

Level Of Evidence ◽

Dupuytren's Disease ◽

Population Based Study ◽

Classification Of Diseases ◽

First Time

The prevalence and incidence of doctor-diagnosed Dupuytren’s disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren’s disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren’s disease; the prevalence among men was 1.35% and among women 0.5%. Of all people diagnosed, 56% had received treatment (87% fasciectomy). In 2013, the incidence of first-time doctor-diagnosed Dupuytren’s disease among men was 14 and among women five per 10,000. The annual incidence among men aged ⩾50 years was 27 per 10,000. Clinically important Dupuytren’s disease is common in the general population. Level of evidence: III

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Progress of Diabetic Severity and Risk of Dementia

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-1677 ◽

2015 ◽

Vol 100 (8) ◽

pp. 2899-2908 ◽

Cited By ~ 9

Author(s):

Wei-Che Chiu ◽

Wen-Chao Ho ◽

Ding-Lieh Liao ◽

Meng-Hung Lin ◽

Chih-Chiang Chiu ◽

...

Keyword(s):

Severity Index ◽

International Classification Of Diseases ◽

Population Based ◽

International Classification ◽

Diabetic Patients ◽

Research Database ◽

Classification Of Diseases ◽

New Onset

Context: Diabetes is a risk factor for dementia, but the effects of diabetic severity on dementia are unclear. Objective: The purpose of this study was to investigate the association between the severity and progress of diabetes and the risk of dementia. Design and Setting: We conducted a 12-year population-based cohort study of new-onset diabetic patients from the Taiwan National Health Insurance Research Database. The diabetic severity was evaluated by the adapted Diabetes Complications Severity Index (aDCSI) from the prediabetic period to the end of follow-up. Cox proportional hazard regressions were used to calculate the hazard ratios (HRs) of the scores and change in the aDCSI. Participants: Participants were 431,178 new-onset diabetic patients who were older than 50 years and had to receive antidiabetic medications. Main Outcome: Dementia cases were identified by International Classification of Diseases, ninth revision, code (International Classification of Diseases, ninth revision, codes 290.0, 290.1, 290.2, 290.3, 290.4, 294.1, 331.0), and the date of the initial dementia diagnosis was used as the index date. Results: The scores and change in the aDCSI were associated with the risk of dementia when adjusting for patient factors, comorbidity, antidiabetic drugs, and drug adherence. At the end of the follow-up, the risks for dementia were 1.04, 1.40, 1.54, and 1.70 (P < .001 for trend) in patients with an aDCSI score of 1, 2, 3, and greater than 3, respectively. Compared with the mildly progressive patients, the adjusted HRs increased as the aDCSI increased (2 y HRs: 1.30, 1.53, and 1.97; final HRs: 2.38, 6.95, and 24.0 with the change in the aDCSI score per year: 0.51–1.00, 1.01–2.00, and > 2.00 vs < 0.50 with P < .001 for trend). Conclusions: The diabetic severity and progression reflected the risk of dementia, and the early change in the aDCSI could predict the risk of dementia in new-onset diabetic patients.

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Association of Gestational Age with Postpartum Hemorrhage

Anesthesiology ◽

10.1097/aln.0000000000003730 ◽

2021 ◽

Author(s):

Alexander J. Butwick ◽

Can Liu ◽

Nan Guo ◽

Jason Bentley ◽

Elliot K. Main ◽

...

Keyword(s):

Gestational Age ◽

Postpartum Hemorrhage ◽

International Classification Of Diseases ◽

Population Based ◽

International Classification ◽

Sensitivity Analyses ◽

Multiple Gestation ◽

Classification Of Diseases ◽

Gestational Age At Delivery

Background Risk factors for postpartum hemorrhage, such as chorioamnionitis and multiple gestation, have been identified in previous epidemiologic studies. However, existing data describing the association between gestational age at delivery and postpartum hemorrhage are conflicting. The aim of this study was to assess the association between gestational age at delivery and postpartum hemorrhage. Methods The authors conducted a population-based retrospective cohort study of women who underwent live birth delivery in Sweden between 2014 and 2017 and in California between 2011 and 2015. The primary exposure was gestational age at delivery. The primary outcome was postpartum hemorrhage, classified using International Classification of Diseases, Ninth Revision—Clinical Modification codes for California births and a blood loss greater than 1,000 ml for Swedish births. The authors accounted for demographic and obstetric factors as potential confounders in the analyses. Results The incidences of postpartum hemorrhage in Sweden (23,323/328,729; 7.1%) and in California (66,583/2,079,637; 3.2%) were not comparable. In Sweden and California, the incidence of postpartum hemorrhage was highest for deliveries between 41 and 42 weeks’ gestation (7,186/75,539 [9.5%] and 8,921/160,267 [5.6%], respectively). Compared to deliveries between 37 and 38 weeks, deliveries between 41 and 42 weeks had the highest adjusted odds of postpartum hemorrhage (1.62 [95% CI, 1.56 to 1.69] in Sweden and 2.04 [95% CI, 1.98 to 2.09] in California). In both cohorts, the authors observed a nonlinear (J-shaped) association between gestational age and postpartum hemorrhage risk, with 39 weeks as the nadir. In the sensitivity analyses, similar findings were observed among cesarean deliveries only, when postpartum hemorrhage was classified only by International Classification of Diseases, Tenth Revision—Clinical Modification codes, and after excluding women with abnormal placentation disorders. Conclusions The postpartum hemorrhage incidence in Sweden and California was not comparable. When assessing a woman’s risk for postpartum hemorrhage, clinicians should be aware of the heightened odds in women who deliver between 41 and 42 weeks’ gestation. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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1699: Prevalence of Renal Cysts in a Middle-Eastern Population: An Evaluation of Characteristics and Risk Factors

The Journal of Urology ◽

10.1016/s0022-5347(18)31887-1 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 564-564

Author(s):

Ashraf A. Mosharafa

Keyword(s):

Risk Factors ◽

Middle Eastern ◽

Renal Cysts ◽

Eastern Population ◽

Middle Eastern Population

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Major Factors Associated with Congenital Malformations in the Agadir Region of Morocco

Journal of Medical Research and Health Sciences ◽

10.15520/jmrhs.v3i8.238 ◽

2020 ◽

Vol 3 (8) ◽

Author(s):

SAID EL MADIDI

Keyword(s):

Risk Factors ◽

Congenital Malformations ◽

International Classification Of Diseases ◽

The Body ◽

Explanatory Variables ◽

Classification Of Diseases ◽

History Of ◽

Major Factors

Introduction: Congenital malformations are a global health problem around the world. MCs is one of the main causes of death and disability of newborns worldwide, but the majority of its risk factors are still poorly understood. Objective: The aim of this study is to determine the main causes that are related to the incidence of congenital malformations (CMs) in the region of Agadir in Morocco. Material and Methods: A prospective cases-control study at regional level was conducted in the pediatrics and neonatology department of Hassan II hospital in Agadir from April 2016 to April 2018. Data on child and maternal variables were recorded for 3701 newborns. The types of congenital malformations have been classified according to the codes of the International Classification of Diseases. Univariate analyzes were performed to identify the variables associated with the etiology of the malformations. Multiple logistic regression was used to characterize the associations between the MC and the determining explanatory variables taken into account simultaneously. Results: The results of these studies showed that there is a significant association between the incidence of the Congenital anomalies and the level of the consanguinity of the child, the prematurity of childbirth, the family history of CMs, the body mass index of the mother and the presence of major trauma during pregnancy. Conclusion: our results have made it possible to highlight the existence of an association between a certain number of risk factors and the occurrence of congenital malformations. Additional studies are needed to confirm and clarify the role of these risk factors.

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