scholarly journals Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data

2022 ◽  
Author(s):  
Yongho Jee ◽  
Hyun Jung Lee ◽  
Youn Jin Kim ◽  
Dong Yeon Kim ◽  
Jae Hee Woo
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Spinal Anesthesia ◽  
National Health Insurance ◽  
National Health ◽  
Epidural Anesthesia ◽  
Postpartum Hemorrhage ◽  
Univariate Analysis ◽  
Cesarean Sections ◽  
Odds Ratios

Background: Postpartum hemorrhage (PPH) is a major cause of maternal mortality. An increasing incidence of PPH has been reported in many countries. The risk factors for PPH differ among studies and it can occur in patients with no known risk factors. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section.Methods: We extracted data on cesarean sections performed between January 2008 and June 2013 from the National Health Insurance Service database. The anesthetic methods were categorized into general, spinal and epidural anesthesia. To compare the likelihood of PPH among deliveries using different anesthetic methods, crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression analysis.Results: Data from 330,324 cesarean sections were analyzed, and 21,636 cases of PPH were identified. Univariate analysis showed that general and epidural anesthesia increased the risk of PPH compared to spinal anesthesia. The OR for PPH was highest for morbidly adherent placenta, followed by placenta previa, placental abruption, and hypertension. When other clinical covariates were controlled for, general and epidural anesthesia still remained significant risk factors for PPH compared to spinal anesthesia.Conclusions: This study showed that general and epidural anesthesia elevated the risk of PPH compared to spinal anesthesia during cesarean section. Since we could not consider the potential bias of group differences in indications, more in-depth clinical trials are needed to validate our findings. Obstetric factors such as placental abnormalities had high odds ratios and thus are more important than the choice of anesthetic method, which should be based on the patient’s clinical condition and institutional resources.

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

Prediagnosis Smoking, Obesity, Insulin Resistance, and Second Primary Cancer Risk in Male Cancer Survivors: National Health Insurance Corporation Study

2007 ◽  
Vol 25 (30) ◽  
pp. 4835-4843 ◽  
Author(s):  
Sang Min Park ◽  
Min Kyung Lim ◽  
Kyu Won Jung ◽  
Soon Ae Shin ◽  
Keun-Young Yoo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Health Insurance ◽  
Cancer Survivors ◽  
National Health Insurance ◽  
National Health ◽  
Smoking History ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer

Purpose Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). Patients and Methods We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. Results We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI ≥ 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration ≥ 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. Conclusion Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.

The Association of Adolescent Fatness and Fitness With Risk Factors for Adult Metabolic Syndrome: A 22-Year Follow-up Study

2014 ◽  
Vol 11 (4) ◽  
pp. 823-830 ◽  
Author(s):  
Yoonsuk Jekal ◽  
YoonMyung Kim ◽  
Ji Eun Yun ◽  
Eun Sung Kim ◽  
Masayo Naruse ◽  
...  
Keyword(s):  
Risk Factors ◽  
High School ◽  
Metabolic Syndrome ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Examination ◽  
Follow Up Study ◽  
Fitness Levels

Background:Few studies have been conducted to explore the associations of fatness and fitness during adolescence with risk factors of metabolic syndrome (MetS) during adulthood, particularly in Asians.Methods:Adolescent anthropometric and fitness data were collected during the participants’ high school years (N = 15,896) and their corresponding health examination data from adulthood were taken from the National Health Insurance Corporation (NHIC) in Korea. A total of 1,006 participants (6.3%) were analyzed in the study.Results:The odds ratios (ORs) for being overweight (BMI ≥ 25 kg/m2) during adulthood was 11.87 (95% CI: 4.19–33.59) in men and 8.44 (95% CI: 1.78–40.02) in women, respectively, in the fattest group vs. the leanest group during adolescence. Participants with low fitness levels during adolescence were more likely to be overweight and have abnormal MetS risk factors in adulthood vs. those with high fitness levels. Joint exposure analyses of fatness and fitness showed that male participants who were more fat and unfit during adolescence had 4.11 (95% CI: 1.19–14.14) and 3.04 (95% CI: 1.17–11.12) times higher risk of having abnormal glucose and MetS risks during adulthood, respectively.Conclusions:Fatness and fitness levels during adolescence appear to be significantly associated with the MetS risk factors and prevalence in adulthood in Koreans.

scholarly journals The Associations of Tonsillectomy with Adenoidectomy with Pneumonia and Appendicitis Based on National Sample Cohort Data from the Korean National Health Insurance Service

2021 ◽  
Author(s):  
Junhui Jeong ◽  
Jung Kyu Choi ◽  
Hyun Seung Choi ◽  
Chang Eui Hong ◽  
Hyang Ae Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Significant Risk ◽  
National Sample ◽  
Population Based ◽  
Control Group ◽  
Number Of Patients ◽  
Korean National Health Insurance

Abstract Introduction The association between tonsillectomy with adenoidectomy (T&A) with appendicitis is controversial, and the association of T&A with pneumonia has not been investigated. Objective To investigate the associations of T&A with pneumonia and appendicitis using data from the Korean National Health Insurance Service National Sample Cohort. Methods We selected patients between the ages of 3 and 10 years who had undergone T&A in 2005 and were monitored since the performance of the T&A until 2013. The control group was established to have similar propensities for demographic characteristics compared to the T&A group. For eight years after the T&A, the number of patients with a diagnosis of pneumonia, patients who were admitted due to pneumonia, and those who underwent appendectomy were analyzed. The risk factors for pneumonia and appendectomy were analyzed. Results The number of pneumonia diagnoses was significantly higher in the T&A group than in the control group (p = 0.023), but there were no significant differences in the number of admissions due to pneumonia between the 2 groups (p = 0.155). Younger age and T&A were significant risk factors for the development of pneumonia. There were no significant differences in the number of appendectomies between the T&A and the control groups (p = 0.425), neither were there significant risk factors for appendectomy. Conclusion Tonsillectomy with adenoidectomy was associated with an increase in pneumonia diagnoses, but it was not associated with the number of appendectomies. The associations of T&A with pneumonia and appendicitis were analyzed in this population-based study.

scholarly journals A Study on Risk Factors of the Incidence of Prostate Cancer Using National Health Insurance Service: Effects of BMI on Age

2019 ◽  
Vol 44 (4) ◽  
pp. 410-418 ◽  
Author(s):  
Hye Sim Kim ◽  
Tae Hwa Go ◽  
Dae Ryong Kang ◽  
Jae Hung Jung ◽  
Sung Won Kwon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health

scholarly journals P772 Trends and risk factors of elderly-onset Crohn’s disease: A nationwide cohort study in South Korea

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
J M Moon ◽  
E A Kang ◽  
K Han ◽  
S W Hong ◽  
H Soh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Health Insurance ◽  
Alcohol Consumption ◽  
National Health Insurance ◽  
National Health ◽  
Age Groups ◽  
Middle Aged ◽  
Aged Group

Abstract Background The incidence of inflammatory bowel disease (IBD) is increasing in Asia. Numerous risk factors associated with IBD development have been investigated. This study aimed to demonstrate the risk factors of Crohn’s disease (CD) diagnosed in persons aged >40 years in South Korea and to specify any differences between age groups by using the National Health Insurance Service (NHIS) database. Methods Using the National Health Insurance Service (NHIS) database, a total of 14,060,821 persons aged >40 years who underwent national health screening in 2009 were followed up until December 2017. Patients with newly diagnosed CD were enrolled and compared with non-CD cohort. CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration programme codes from the NHIS database. The mean follow-up periods were 7.39 years. Age and sex were adjusted for in the multivariate analysis model. Results During the follow-up, 1337 (1.33/100,000) patients developed CD. Men in the middle-aged group (40–64 years) had a higher risk than women (adjusted HR [aHR] 1.46, 95% CI 1.29–1.66); however, this difference tended to disappear as the age of onset increases. In the middle-aged group, patients with a history of smoking (adjusted hazard ratio [aHR] 1.29, 95% confidence interval [CI] 1.06–1.58) and anemia (aHR 1.99, 95% CI 1.67–2.36) had a significantly higher CD risk. In the elderly group (age, ³65 years), ex-smoking and anemia also increased the CD risk (aHR 1.58 [95% CI 1.16–2.18] and 1.91 [95% CI 1.53–2.38], respectively). Especially in the middle-aged group, those with chronic kidney disease (CKD) had a statistically elevated CD risk (aHR 1.38, 95% CI 1.06–1.79). Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups. (Middle-aged: aHR 0.76 [95%CI 0.65–0.87] and aHR 0.38 [95%CI 0.27–0.53], respectively) (elderly-group: aHR 0.57 [95%CI 0.42–0.77] and aHR 0.52 [95%CI 0.32-.83], respectively) For regular physical activity and dyslipidemia, negative correlation between CD incidences was proved only in the middle-aged group (aHR 0.85 [95%CI 0.74–0.96] and aHR 0. [95%CI 0.75 [95% CI 0.63–0.89], respectively). Conclusion This study demonstrated four risk factors (ex-smoking, anemia, CKD, and lower BMI) and three possible protective factors (alcohol consumption, physical activity, and dyslipidemia) for CD in Asians age >40 years. Individuals with potential risk factors need more cautious monitoring for CD.

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