scholarly journals Vertebral fracture as risk factors for self-harm: A retrospective cohort study

2020 ◽  
Author(s):  
James Prior ◽  
Fay Crawford-Manning ◽  
Rebecca Whittle ◽  
Alyshah Abdul-Sultan ◽  
Carolyn Chew-Graham ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Age And Gender ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Self Harm ◽  
And Gender

Abstract BackgroundThe prevention of self-harm is an international public health priority, It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures Methods Retrospective cohort study using data from the Clinical Practice Research Datalink. Patients with vertebral fracture were identified and matched to patients without fracture by age and gender. Incident self-harm was defined by medical record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by age and gender. ResultsThe number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), mean age was 74 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6).Greatest risk of self-harm was found in those with vertebral fractures who were younger (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). ConclusionsPrimary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Younger, male patients appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

scholarly journals Vertebral fracture as a risk factor for self-harm: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
James A. Prior ◽  
Fay Crawford-Manning ◽  
Rebecca Whittle ◽  
Alyshah Abdul-Sultan ◽  
Carolyn A. Chew-Graham ◽  
...  
Keyword(s):  
Primary Care ◽  
Risk Factor ◽  
Cohort Study ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Self Harm

Abstract Background The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures. Methods Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95 % confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex. Results The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1 %), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95 %CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). Conclusions Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

scholarly journals Vertebral fracture as a risk factor for self-harm: A retrospective cohort study

2021 ◽  
Author(s):  
James A Prior ◽  
Fay Crawford-Manning ◽  
Rebecca Whittle ◽  
Alyshah Abdul-Sultan ◽  
Carolyn A. Chew-Graham ◽  
...  
Keyword(s):  
Primary Care ◽  
Risk Factor ◽  
Cohort Study ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Self Harm

Abstract Background The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures Methods Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex. Results The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). Conclusions Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

scholarly journals Trends in self-poisoning and psychotropic drug use in people aged 5–19 years: a population-based retrospective cohort study in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e026001 ◽  
Author(s):  
Rose Cairns ◽  
Emily A Karanges ◽  
Anselm Wong ◽  
Jared A Brown ◽  
Jeff Robinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Cohort Effect ◽  
Population Based ◽  
Psychotropic Medicine ◽  
Increased Risk ◽  
Self Harm

ObjectivesTo characterise trends in self-poisoning and psychotropic medicine use in young Australians.DesignPopulation-based retrospective cohort study.SettingCalls taken by the New South Wales and Victorian Poisons Information Centres (2006–2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).ParticipantsPeople aged 5–19 years.Main outcome measuresYearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).ResultsThere were 33 501 intentional poisonings in people aged 5–19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006–2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5–14 and 15–19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5–14 and 15–19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.ConclusionsOur results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

scholarly journals To Study Demographics as Risk Factor for Mortality Associated with COVID-19 : A retrospective cohort study

2021 ◽  
Vol 14 (3) ◽  
pp. 1519-1523
Author(s):  
Amandeep Singh Bakshi ◽  
Neetu Sharma ◽  
Jasbir Singh ◽  
Sandeep Batish ◽  
Vijay Sehga
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
P Value ◽  
Chi Square ◽  
Age And Gender ◽  
Risk Of Death ◽  
Males And Females ◽  
And Gender

Objectives : Novel coronavirus disease COVID-19 has emerged as a pandemic, claiming over 1,431,513 lives ( till Nov. 27,2020 ) worldwide involving 191 countries . The objective of the study is to evaluate age and gender as a risk factor for COVID -19 related mortality . Material and Methods : It is a retrospective cohort study , where the database of indoor COVID-19 positive patients was assessed for the study. Evaluation of the role of age and gender in mortality of COVID infection by comparing dataset of 2,142 indoor COVID positive patients with two outcome groups namely ,death and discharged groups was done. Results: The age comparison between two groups namely, death and discharged groups showed a median age of 60 years (IQR 50-70) for patients who died and 52 years (IQR 36–62) for the patients who recovered from COVID (p value-<0.001). There were 9 (0.65%) pediatric patients (<12 yrs) in the group of patients who recovered .For gender analysis (n=2129), COVID patients who died were 32.5%( n=692) ,out of which 63.6%(n=440) were males and 36.4%(n=252) were females. COVID positive patients in discharged group were 67.5%(n=1437),out of which 61.2%(n=880) were males and 38.8%(n=557) were females. There was no statistical difference between the two groups for mortality risk based on gender for COVID -19 infection (chi square value of 1.09, p value=.296) and the relative risk of death in males and females who died of COVID was 1.052 (95% CI=0.92-1.204). Conclusion: COVID-19 infection is showing predilection for male gender in both death and discharged group but the males and females are equally susceptible to the risk of death .

scholarly journals Sex Differences in Mortality after Myocardial Infarction: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Neda Shafiabadi Hassani ◽  
Reza Pirdehghan ◽  
Mohammadhossein Mozafarybazargany ◽  
Roya Sepahvandi ◽  
Zeynab Khodaprast ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Sex Differences ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Increased Risk

Abstract BACKGROUND: We aimed to examine sex differences in mortality after myocardial infarction. METHODS: This retrospective cohort study included all first admitted patients 50 years or older with acute myocardial infarction hospitalized in Rajaei hospital of Karaj city, Iran, between 23th March 2013 and 1th January 2020. Data was retrieved from the hospital information system (HIS) database, including patient’s demographic and socioeconomic characteristics, medical history, acute myocardial infarction (AMI) type, treatment and procedures, and outcome of hospitalization. Simple and multivariate cox regression models were used to assess the association of gender with in-hospital mortality after AMI. Results were presented as crude and adjusted hazard ratios along with their 95% confidence interval (HR (95% CI).RESULTS: Results from the multivariable Cox regression analysis revealed that females had a higher risk of death than males after ST segment Elevation MI (STEMI) (adjusted HR (95% CI): 1.64 (1.15 – 2.36), P=0.007). However, in subgroup analysis by age groups, this significant increased risk was observed only in female patients aged 50 to 64 years than their male counterparts. There was no significant differences between males and females after non-STEMI and unspecified MI.CONCLUSIONS: Based on our findings, women aged 50 to 64 years may be more likely to die during hospitalization after STEMI than men.

Effects of smoking severity and moderate and severe periodontitis on serum C-reactive protein levels: an age- and gender-matched retrospective cohort study

Biomarkers ◽  
2015 ◽  
Vol 20 (5) ◽  
pp. 306-312 ◽  
Author(s):  
Arash Azizi ◽  
Fatemeh Sarlati ◽  
Mohsen Bidi ◽  
Leila Mansouri ◽  
Seyed Mohammad Mehdi Azaminejad ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
C Reactive Protein ◽  
Age And Gender ◽  
Protein Levels ◽  
Reactive Protein ◽  
Severe Periodontitis ◽  
And Gender

scholarly journals Proton pump inhibitors versus histamine-2 receptor blockers for stress ulcer prophylaxis in patients with sepsis: a retrospective cohort study

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110251
Author(s):  
Minqiang Huang ◽  
Ming Han ◽  
Wei Han ◽  
Lei Kuang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Proton Pump ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Stress Ulcer ◽  
Increased Risk ◽  
Ulcer Prophylaxis

Objective We aimed to compare the efficacy and risks of proton pump inhibitor (PPI) versus histamine-2 receptor blocker (H2B) use for stress ulcer prophylaxis (SUP) in critically ill patients with sepsis and risk factors for gastrointestinal bleeding (GIB). Methods In this retrospective cohort study, we used the Medical Information Mart for Intensive Care III Clinical Database to identify critically ill adult patients with sepsis who had at least one risk factor for GIB and received either an H2B or PPI for ≥48 hours. Propensity score matching (PSM) was conducted to balance baseline characteristics. The primary outcome was in-hospital mortality. Results After 1:1 PSM, 1056 patients were included in the H2B and PPI groups. The PPI group had higher in-hospital mortality (23.8% vs. 17.5%), GIB (8.9% vs. 1.6%), and pneumonia (49.6% vs. 41.6%) rates than the H2B group. After adjusting for risk factors of GIB and pneumonia, PPI use was associated with a 1.28-times increased risk of in-hospital mortality, 5.89-times increased risk of GIB, and 1.32-times increased risk of pneumonia. Conclusions Among critically ill adult patients with sepsis at risk for GIB, SUP with PPIs was associated with higher in-hospital mortality and higher risk of GIB and pneumonia than H2Bs.

scholarly journals Adverse Pregnancy Outcomes by Degree of Maternal Serum Analyte Elevation: A Retrospective Cohort Study

2020 ◽  
Vol 10 (04) ◽  
pp. e369-e379
Author(s):  
Amanda Yeaton-Massey ◽  
Rebecca J. Baer ◽  
Larry Rand ◽  
Laura L. Jelliffe-Pawlowski ◽  
Deirdre J. Lyell
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Screening Program ◽  
Maternal Serum ◽  
Obstetric Complication ◽  
Patient Counseling ◽  
Increased Risk ◽  
Antenatal Management ◽  
Adverse Pregnancy

Abstract Objective The aim of this study was to evaluate rates of preterm birth (PTB) and obstetric complication with maternal serum analytes > 2.5 multiples of the median (MoM) by degree of elevation. Study Design Retrospective cohort study of singleton live-births participating in the California Prenatal Screening Program (2005–2011) examining PTB and obstetric complication for α-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (INH) by analyte subgroup (2.5 to < 6.0, 6.0 to < 10.0, and ≥ 10.0 MoM vs. < 2.5 MoM). Results The risk of obstetric complication increased with increasing hCG, AFP, and INH MoM, and were greatest for AFP and INH of 6.0 to <10.0 MoM. The greatest risk of any adverse outcome was seen for hCG MoM ≥ 10.0, with relative risk (RR) of PTB < 34 weeks of 40.8 (95% confidence interval [CI]: 21.7–77.0) and 13.8 (95% CI: 8.2–23.1) for obstetric complication. Conclusions In euploid, structurally normal fetuses, all analyte elevations > 2.5 MoM confer an increased risk of PTB and, except for uE3, obstetric complication, and risks for each are not uniformly linear. These data can help guide patient counseling and antenatal management.

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