scholarly journals The elevated risk of sight-threatening cataract in diabetes with retinopathy: a cohort study

2020 ◽  
Author(s):  
Chan-Wei Nien ◽  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Shih-Chun Chao ◽  
Hung-Jui Hsu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Multivariable Analysis ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
And Gender ◽  
Cox Proportional Hazard Regression

Abstract Background To survey the effect of diabetic retinopathy (DR) on the development of sight-threatening cataract via National Health Insurance Research Database of Taiwan.Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. The age and gender-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR with considering multiple factors of cataract formation.Results A total of 3,297 DR patients, 13,188 DM control patients and 13,188 non-DM controls were enrolled. There were 919 events (27.87 percent) of sight-threatening cataract in the study group while another 1,108 events (8.40 percent) in the DM control group and 957 events (7.26 percent) in the non-DM control group. After multivariable analysis, the study group showed a higher aHR of cataract surgery (2.93, 95% CI: 2.60-3.30) and a higher cumulative probability of cataract surgery compared to both the DM control and non-DM control groups (both Log rank P<0.001). Besides, both the proliferative DR (3.90, 95% CI: 3.42-4.45) and non-proliferative DR (2.35, 95% CI: 2.08-2.65) subgroups showed a higher aHR of cataract surgery than the DM control group.Conclusion The presence of DR will increase the risk for development of sight-threatening cataract that surgery is warranted, and the effect is prominent in both the proliferative DR and non-proliferative DR.

scholarly journals The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan-Wei Nien ◽  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Shih-Chun Chao ◽  
Hung-Jui Hsu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Abstract Background The effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan. Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation. Results A total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group. Conclusion The presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

scholarly journals The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

2019 ◽  
Vol 16 (22) ◽  
pp. 4456
Author(s):  
Siu-Fung Chau ◽  
Pei-Hsuan Wu ◽  
Chi-Chin Sun ◽  
Jing-Yang Huang ◽  
Chan-Wei Nien ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Conditional Logistic Regression ◽  
Sinus Surgery ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Code ◽  
Research Database ◽  
Age And Gender ◽  
And Gender

This study investigates the development of glaucoma in subjects with surgery-indicated chronic rhinosinusitis (CRS) by the use of the National Health Insurance Research Database in Taiwan. Individuals that received the functional endoscopic sinus surgery (FESS) with a diagnostic code of CRS were regarded as surgery-indicated CRS and enrolled in the study group. Four non-CRS patients were age- and gender-matched to each patient in the study group. The exclusion criteria included legal blindness, ocular tumor, history of eyeball removal, and previous glaucoma. The outcome was regarded as the development of glaucoma, and conditional logistic regression was used for the statistical analysis, which involved multiple potential risk factors in the multivariate model. A total of 6506 patients with surgery-indicated CRS that received FESS and another 26,024 non-CRS individuals were enrolled after exclusion. The age and gender distributions were identical between the two groups due to matching. There were 108 and 294 glaucoma events in the study group and control group, respectively, during the follow-up period, and the study group had a significantly higher adjusted hazard ratio (1.291, 95% confidential interval: 1.031–1.615). The cumulative probability analysis also revealed a correlation between the occurrence of glaucoma and the CRS disease interval. In the subgroup analysis, the chance of developing open-angle glaucoma and normal-tension glaucoma was significantly higher in the study group than in the control group. In conclusion, the existence of surgery-indicated CRS is a significant risk factor for the development of glaucoma, which correlated with the disease interval.

scholarly journals The Development of Dry Eye Disease after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3829
Author(s):  
Chia-Yi Lee ◽  
Kun-Lin Yang ◽  
Chi-Chin Sun ◽  
Jing-Yang Huang ◽  
Hung-Chih Chen ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Sinus Surgery ◽  
Eye Disease ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Code ◽  
Research Database

We aim to evaluate the risk of dry eye disease (DED) occurrence in patients with surgery-indicated chronic rhinosinusitis (CRS) via the national health insurance research database in Taiwan. After exclusion, patients with a diagnostic code of CRS and had received functional endoscopic sinus surgery (FESS) were regarded as having surgery-indicated CRS and enrolled in the study group, then each patient in the study group was age- and gender-matched to four non-CRS patients that served as the control group. The outcome was considered as the development of DED and Cox proportional hazard regression was used for the statistical analysis, which involved multiple potential risk factors of DED. A total of 6076 patients with surgery-indicated CRS that received FESS and another 24,304 non-CRS individuals were enrolled after exclusion. There were 317 and 770 DED events in the study group and the control group during the 16-year follow-up interval, and the study group demonstrated a significantly higher adjusted hazard ratio (1490, 95% confidence intervals (CI): 1.303-1.702) of DED development compared to the control group in the multivariable analysis. In addition, the cumulative probability analysis illustrated a positive correlation of DED occurrence and the disease period of surgery-indicated CRS (p < 0.0001). In the subgroup analysis, both genders revealed a higher but not significant incidence of developing DED in the study group. In conclusion, the existence of surgery-indicated CRS will increase the risk of developing DED, which correlated to the disease interval.

scholarly journals Patient flow dynamics in hospital systems during times of COVID-19: Cox proportional hazard regression analysis.

2020 ◽  
Author(s):  
Sudhir Bhandari ◽  
Amit Tak ◽  
Sanjay Singhal ◽  
Jyotsna Shukla ◽  
Bhoopendra Patel ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Survival Rate ◽  
Hospital Stay ◽  
Cox Model ◽  
Patient Flow ◽  
Proportional Hazard ◽  
Age And Gender ◽  
Cox Proportional Hazard ◽  
And Gender ◽  
Cox Proportional Hazard Regression

Abstract Objectives: The present study is aimed at estimating patient flow dynamical parameters and requirement of hospital beds. Secondly, the effects of age and gender on parameters were evaluated. Patients and Methods: In this retrospective cohort study, 987 COVID-19 patients were enrolled from SMS Medical College, Jaipur (Rajasthan, India). The survival analysis was carried out from 29 Feb to 19 May 2020 for two hazards – ‘Hazard 1’ was hospital discharge and ‘Hazard 2’ was hospital death. The starting point for survival analysis of the two hazards was considered to be hospital admission . The survival curves were estimated and additional effects of age and gender were evaluated using Cox proportional hazard regression analysis. Results: The Kaplan Meier estimates of lengths of hospital stay (Median =10 days, IQR =10 days) and median survival rate ( more than 60 days due to large amount of censored data) were obtained. The Cox Model for ‘Hazard 1’ showed no significant effect of age and gender on duration of hospital stay. Similarly, the Cox Model 2 showed no significant difference of gender on survival rate. The case fatality rate 8.1 % , recovery rate 78.8% , mortality rate 0.10 per 100 person--days and hospital admission rate 0.35 per 105 person-days were estimated.Conclusion : The study estimates hospital bed requirement based on patient flow dynamic parameters. Furthermore, study concludes that average length of hospital stay were similar for patients of both genders and all age groups.

Abstract TP186: Incidence and Risk Factors for Stroke and All-Cause Mortality in Korean Adults Congenital Heart Diseases

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jin-Man Jung ◽  
Hong Ju Shin ◽  
Jae-Young Kim ◽  
Woo-Keun Seo
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Heart Diseases ◽  
Multivariable Analysis ◽  
Control Group ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
All Cause Mortality

Objective: To compare incidence of ischemic stroke, hemorrhagic stroke and all-cause mortality in Korean adults congenital heart disease (ACHD) to that of control and scrutinize risk factors for these outcomes. Methods: Subjects aged over 20 were collected from the Korea National Health Insurance Service from 2006 through 2017. ACHD group as case was extracted from the diagnosis records related to CHD according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD 10). Those without CHD (control group) was selected as 4 controls for each patient through random sampling. We compared incidence rate of ischemic stroke, hemorrhagic stroke and all-cause mortality. Cox proportional hazard models were used to investigate relevant risk factors for each of outcomes. Results: Case and control group were 49,445 and 249,649, respectively. Age-adjusted rates of ischemic stroke, hemorrhagic stroke and all-cause mortality in case was by about 4 times more higher than those of control. Cumulative survival plot demonstrated that ACHD was associated with ischemic stroke (HR 1.31 95% CI 1.25-1.36), hemorrhagic stroke (HR 1.49 95% CI 1.36-1.63), and all-cause mortality (HR 1.41 95% CI 1.35-1.46). Case group was associated with younger age, female, hypertension, diabetes mellitus, coronary artery disease, heart failure, atrial fibrillation (all p <.001). In Cox proportional hazard model for ischemic stroke, diabetes (HR 2.13 95% CI 1.93-2.35) and coararctation of aorta (HR 1.54 95% CI 1.13 - 2.09) carried highest risk. In multivariable analysis for hemorrhagic stroke, hypertension (HR 2.28 95% CI 1.74-2.98) was highest risk factor. Multivariable analysis for all-cause mortality showed that congestive heart failure (HR 1.78 95% CI 1.65-1.92) and Eisenmenger syndrome (HR 2.91 95% CI 2.53-3.35) was highest risk factor. Conclusions: Korean ACHD patients have significantly higher incidence of co-morbidities including hypertension, diabetes mellitus, several heart diseases. They have a higher tendency of ischemic, hemorrhagic stroke and mortality. These findings suggest that medical surveillance and risk factor management is sustainedly needed for ACHD patients to reduce stroke and mortality in the future.

scholarly journals Dermatologic Vasculature Diseases as a Risk Factor of Subconjunctival Hemorrhage

2019 ◽  
Vol 16 (16) ◽  
pp. 2865
Author(s):  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Jing-Yang Huang ◽  
Chi-Chin Sun ◽  
Chao-Bin Yeh ◽  
...  
Keyword(s):  
Risk Factor ◽  
Survival Analysis ◽  
Cox Regression ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Subconjunctival Hemorrhage ◽  
The Relationship

To evaluate the relationship between subconjunctival hemorrhage (SCH) and dermatologic vasculature diseases (DVDs) via the national health insurance research database (NHIRD) of Taiwan. This retrospective cohort study used data from the NHIRD for the 2009 to 2013 period. Patients diagnosed with DVDs were enrolled in the study group, and a propensity score-matching population was selected as the control group after exclusion. The main outcome was set as the development of SCH in both groups. Multivariable Cox regression analysis and survival analysis were performed to estimate the adjusted hazard ratio (aHR) and cumulative probability of SCH. A total number of 3426 patients were enrolled and split equally into the study and the control groups. There was no prominent difference between the age, gender, urbanization, income level, systemic co-morbidities, and ocular diseases between the two groups after matching. During the whole study period, 131 patients in the study group and 98 patients in the control group developed SCH with a significant higher aHR of 2.69 in the study group (p < 0.05). In the survival analysis, the study group also demonstrated a higher cumulative probability of developing SCH than the control group throughout the study period (p = 0.02). In conclusion, the presence of DVDs may be a risk factor for the development of SCH.

scholarly journals Gout as a Risk Factor for Dry Eye Disease: A Population-Based Cohort Study

2019 ◽  
Vol 8 (1) ◽  
pp. 62 ◽  
Author(s):  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Chi-Chin Sun ◽  
Hung-Yu Lin ◽  
Ko-Hsiu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Age Related Macular Degeneration ◽  
Eye Disease ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Increased Risk

This study evaluated the effect of gout on the risk of dry eye disease (DED) by using the National Health Insurance Research Database (NHIRD). Data for 30,192 gout patients (21,081 men and 9111 women) and 30,192 non-gout patients (21,005 men and 9187 women) were analyzed. Approximately 1 million patients were randomly sampled from the NHIRD registry. After applying exclusion criteria, patients diagnosed with gout were enrolled in the study group. Thereafter, each individual in the study group underwent the matching process via the propensity score with another non-gout individual, which constituted the control group. The main outcome was defined as the development of DED in accordance with the corresponding International Classification of Diseases, Ninth Revision. In addition to DED, other risk factors including age, sex, and urbanization, and several co-morbidities were included in the multivariate model. The incidence of DED with the adjusted hazard ratio (aHR) and cumulative probability were evaluated in the gout and non-gout patients. A total of 2913 DED events were observed in the study group, whereas 2631 DED events were observed in the control group. A higher incidence rate ratio was found in the study group after adjustment (aHR: 1.065). Moreover, the cumulative probability indicated a significantly increased risk of DED in the study group (p = 0.001). The other potential risk factors of DED according to the multivariate analysis include older age, female gender, higher degree of urbanization, keratopathy, age-related macular degeneration, glaucoma, cataract, ischemic heart disease, hyperlipidemia, peripheral vascular disease, chronic pulmonary disease, rheumatic disease, peptic ulcer disease, liver disease, and malignancy. In conclusion, gout increased the risk of DED after adjustment, and the risk is positively correlated to a longer disease period.

Association between the use of antidepressants and the risk of preterm birth among pregnant women with depression: a retrospective cohort study in Taiwan

2021 ◽  
pp. jim-2020-001683
Author(s):  
Li-Fen Chen ◽  
Ching-En Lin ◽  
Chi-Hsiang Chung ◽  
Ching-Huang Lai ◽  
Wu-Chien Chien
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Retrospective Cohort ◽  
Regression Models ◽  
Perinatal Depression ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Mother And Child ◽  
Cox Proportional Hazard Regression

Our study was aimed to investigate the association between the use of antidepressants and the risk of preterm birth in pregnant women who have had perinatal depression. We extracted data from the Taiwanese National Health Insurance Research Database (NHIRD) and analyzed them using multivariate Cox proportional hazard regression models. Identified from the NHIRD, we matched 1789 women aged 18–55 years who were using antidepressants during pregnancy and 1789 women who were experiencing depression but who were not using antidepressants during pregnancy for age, index date, and medical comorbidities. We enrolled the women in our study, which we conducted using 12 years’ worth of data between 2000 and 2012, and then followed up individually with them for up to 1 year to identify any occurrence of preterm birth. Results highlighted that, compared with the women with perinatal depression who were not using antidepressants during pregnancy, the women taking antidepressants had a 1.762-fold risk of preterm birth (adjusted HR=1.762, 95% CI 1.351 to 2.294, p<0.001). The use of antidepressants in women with perinatal depression may increase the risk of preterm birth. However, the decision to start, stop, or change the use of antidepressants during pregnancy requires evaluating the risks of treatment versus untreated depression for both mother and child.

scholarly journals Correlation between Fasting Blood Glucose Level at Admission and Mortality in COVID-19 Patients: A Retrospective Study

2020 ◽  
Author(s):  
Bin Zhu ◽  
Chunguo Jiang ◽  
Xiaokai Feng ◽  
Yanfei Zheng ◽  
Jie Yang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Single Center Study ◽  
And Gender ◽  
Cox Proportional Hazard Regression ◽  
Relationship Of ◽  
The Relationship

Abstract Background Coronavirus disease-19 (COVID-19) has spread rapidly, with a growing number of cases confirmed around the world. This study explores the relationship of fasting blood glucose (FBG) at admission with mortality. Methods In this retrospective, single-center study, we analyzed the clinical characteristics of confirmed cases of COVID-19 in Wu Han from 29 January 2020 to 23 February 2020. Cox proportional hazard regression analysis was performed to evaluate the relationship between FBG and mortality. Results A total of 107 patients were enrolled in our study. The average age was 59.49 ± 13.33 and the FBG at admission was 7.35 ± 3.13 mmol/L. There were 16 people died of COVID-19 with an average age 68.1 ± 9.5 and the FBG was 8.94 ± 4.76 mmol/L. Regression analysis showed that there were significant association between FBG and death (HR = 1.13, 95%CI: 1.02-1.24). After adjusting for covariables, the significance still exists. In addition, our result showed that FBG > 7.0 mmol/L or diabetic mellitus can significantly increase mortality after adjusting for the age and gender. Conclusions This study suggests that FBG at admission is an effective and reliable indicator for disease prognosis in COVID-19 patients.

scholarly journals Association Between Preeclampsia Risk and Fine Air Pollutants and Acidic Gases: A Cohort Analysis in Taiwan

2021 ◽  
Vol 9 ◽  
Author(s):  
Shih-Yi Lin ◽  
Yu-Cih Yang ◽  
Jun-Wei Su ◽  
Jie-Sian Wang ◽  
Chang-Cheng Jiang ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Air Pollutant ◽  
Research Database ◽  
Proportional Hazard ◽  
Acidic Gases ◽  
Cox Proportional Hazard ◽  
Taiwan National Health Insurance ◽  
Daily Concentration ◽  
Cox Proportional Hazard Regression ◽  
Combined Data

Background: Fine air pollutant particles have been reported to be associated with risk of preeclampsia. The association between air pollutant exposure and preeclampsia risk in heavily air polluted Taiwan warrants investigation.Methods: We combined data from Taiwan National Health Insurance (NHI) Research Database (NHIRD) and Taiwan Air Quality Monitoring Database. Women aged 16–55 years were followed from January 1, 2000, until appearance of ICD-9 coding of preeclampsia withdrawal from the NHI program, or December 31, 2013. Daily concentration of NOx, NO, NO2, and CO was calculated by Kriging method. The Cox proportional hazard regression model was used for risk assessment.Results: For NOx, Relative to Quartile [Q] 1 concentrations, the Q2 (adjusted hazard ratio adjusted = 2.20, 95% CI = 1.50–3.22), Q3 (aHR = 7.28, 95% CI = 4.78–11.0), and Q4 (aHR = 23.7, 95% CI = 13.7–41.1) concentrations were associated with a significantly higher preeclampsia or eclampsia risk. Similarly, for NO, relative to Q1 concentrations, the Q2 (aHR = 1.82, 95% CI = 1.26–2.63), Q3 (aHR = 7.53, 95% CI = 5.12–11.0), and Q4 (aHR = 11.1, 95% CI = 6.72–18.3) concentrations were correlated with significantly higher preeclampsia or eclampsia risk. Furthermore, for NO2, relative to Q1 concentration, the Q2 (aHR = 1.99, 95% CI = 1.37–2.90), Q3 (aHR = 6.15, 95% CI = 3.95–9.57), and Q4 (aHR = 32.7, 95% CI = 19.7–54.3) concentrations also associated with a significantly higher preeclampsia or eclampsia risk.Conclusion: Women exposed to higher NOX, NO, NO2, and CO concentrations demonstrated higher preeclampsia incidence.

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