AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

Abstract ObjectiveTo assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with Polymyositis/dermatomyositis associated interstitial lung disease (PM/DM-ILD).Patients and MethodsThis was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008 to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73 and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides or low density lipoprotein.ResultsHigher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up.ConclusionHigher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year—a retrospective cohort study with 522 cases

Arthritis Research & Therapy ◽

10.1186/s13075-020-02286-w ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Renjiao Li ◽

Wen-Jun Zhu ◽

Faping Wang ◽

Xiaoju Tang ◽

Fengming Luo

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Low Cost ◽

Density Lipoprotein ◽

Cox Regression Analysis ◽

Neutrophil Lymphocyte Ratio

Abstract Objective To assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). Patients and methods This was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008, to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73, and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides, or low-density lipoprotein. Results Higher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required the use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up. Conclusion Higher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation, and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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Associated Factories and Time to Occurrence of Tuberculosis Among Children on HIV/AIDS Care in Assosa and Pawe General Hospitals North West Ethiopia: A Retrospective Cohort Study 2020

10.21203/rs.3.rs-118270/v1 ◽

2020 ◽

Author(s):

Fassikaw kebede Bizuneh ◽

Tadese Tollosa Daba ◽

Belayneh Mengist Mitike ◽

Tamrat sheawno Fikretsion ◽

Belete Negese Negese

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Cox Model ◽

Incidence Density ◽

Human Immune Deficiency Virus ◽

Cox Regression Analysis ◽

Hiv Aids

Abstract Background: Tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied in Ethiopia, but among children on HIV/AIDS care is overlooked. Knowledge of the time when TB develops during successive follow up could be helpful for time relevant intervention strategies.Methods: health institution based retrospective cohort study conducted among 421 children on HIV/AIDS from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05.Result: Totally 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 8 years (IQR=2-15). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1).Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children.

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Time to develop tuberculosis and predictors of incidence among anti-retroviral therapy children on two selected hospitals at benishangule Gumuz region, North West Ethiopia: A retrospective cohort study

10.21203/rs.3.rs-18481/v1 ◽

2020 ◽

Author(s):

Fassikaw kebede Bizuneh ◽

Tadese Tolossa Daba ◽

Belayneh Mengist Mitiku ◽

Tamrat shewano Fikretsion

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Cox Model ◽

Incidence Density ◽

Human Immune Deficiency Virus ◽

Cox Regression Analysis ◽

North West

Abstract Background: Currently, tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied; the incidence of TB among children on ART is overlooked. Knowledge of the time when TB develops among children on ART could be helpful to develop time relevant intervention strategies.Methods: This was a hospital based retrospective cohort study conducted among 429 children on ART from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05Result: 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 9 years (SD=3.36). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1)Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children

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Trigger finger is associated with risk of incident cardiovascular disease in individuals with type 2 diabetes: a retrospective cohort study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-002070 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002070

Author(s):

Yusuke Mineoka ◽

Michiyo Ishii ◽

Yoshitaka Hashimoto ◽

Hiroki Yuge ◽

Machiko Toyoda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Regression Analysis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Trigger Finger ◽

Cox Regression Analysis

IntroductionTrigger finger is one of the complications affecting the upper extremity in patients with diabetes. Diabetes is also a well-known risk factor that predisposes individuals to cardiovascular diseases (CVDs). This retrospective cohort study aimed to establish the association between trigger finger and the patients with incident CVD with type 2 diabetes.Materials and methodsTrigger finger was diagnosed by palpating a thickened tendon during ﬂexion or on the manifestation of a locking phenomenon during extension or ﬂexion of either ﬁnger. The relationship between trigger finger and other clinical parameters or complications of diabetes was examined by a comparative analysis. Cox regression analysis was used to evaluate the association between trigger finger and incidence of CVD. We calculated the propensity scores using sex, body mass index, age, smoking status, duration of diabetes, estimated glomerular filtration rate, hypertension, dyslipidemia, and hemoglobin A1c as the number of patients with incident CVD during the follow-up period was low.ResultsAmong the 399 patients with type 2 diabetes, 54 patients had trigger finger. Patients with trigger finger were significantly older in age and had been suffering from diabetes for a longer duration. They also displayed worse renal function and glycemic control, along with a higher incidence of hypertension, neuropathy and nephropathy. During the average 5.66±1.12 years of follow-up, a total of 18 incidents occurred. According to the Cox regression analysis, trigger finger was shown to be associated with enhanced risk of the incidence of CVD after adjustment for the covariates (adjusted HR=3.33 (95% CI 1.25 to 8.66), p=0.017).ConclusionsTrigger finger is associated with the risk of incident CVD in patients with type 2 diabetes. Thus, clinicians must consider these factors at the time of diagnosis of such patients.

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1024. First Episode Infective Endocarditis in Persons Who Inject Drugs (PWIDs); A Retrospective Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.861 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S305-S305

Author(s):

Laura Rodger ◽

Dresden GlockerLauf ◽

Esfandiar Shojaei ◽

Adeel Sherazi ◽

Brian Hallam ◽

...

Keyword(s):

Cohort Study ◽

Infective Endocarditis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

First Episode ◽

Persons Who Inject Drugs ◽

Cox Regression Analysis ◽

Lower Survival ◽

Valvular Surgery

Abstract Background Persons who inject drugs (PWID) represent a distinct demographic of patients with infective endocarditis (IE). Many centers do not perform valvular surgery on these patients due to concerns about poor outcomes. Methods Retrospective cohort study comparing PWID patients to non-PWID patients presenting between February 2007 and March 2016 in London, Ontario, among adult (>18) inpatients with first episode IE. Results In 370 first episode IE cases, 53.9% occurred in PWIDs. PWID patients were younger (35.4 SD 10.0 vs. 59.4 SD 14.9) (P < 0.001), more likely to have right-sided infection [125/202 (62%), vs. 16/168 (9.5%) (P < 0.001)], and more often due to S. aureus (156/202 (77.3%) vs. 54/168 (32.1%), P < 0.001). Myocardial and aortic root abscesses were less common in PWIDs [17/202 (8.4%) vs. 50/168 (30%) (P < 0.01)]. There was no difference in the frequency of noncardiac complications. In total, 36.5% of patients were treated surgically with PWID patients less likely to undergo surgery [39/202 (19.3%) vs. 98/168 (58%) P < 0.001]. Cox regression analysis identified the protective effect of cardiac surgery with regards to survival in all patients, with a hazard ratio of 0.49 (95% CI 0.31–0.76, P < 0.001), as well as among PWIDs (HR 0.39, 95% CI 0.17–0.87, P = 0.02). Among all patients, lower survival was associated with older age (HR 1.03, 95% CI 1.00–1.05, P < 0.001), injection drug use (HR 2.72, 95% CI 1.52–4.88, P < 0.001), left-sided infection (HR 3.48, 95% CI 2.01–6.03, P < 0.001), and bilateral infection (HR 3.19, 95% CI 1.45–7.01, P = 0.004). The lower survival of left-sided infection (HR 4.01, 95% CI 1.97–8.18, P < 0.001) or bilateral infection (HR 6.94, 95% CI 2.39–20.2,P < 0.001) was re-demonstrated in PWIDs. Conclusion This study identifies important clinical differences between PWIDs and nondrug users with respect to valve involvement, causative organism, complications, and management strategies. Our results highlight the important role of surgical treatment in a carefully selected PWID patient population. Disclosures All authors: No reported disclosures.

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Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽

10.1177/0333102413513181 ◽

2013 ◽

Vol 34 (5) ◽

pp. 327-335 ◽

Cited By ~ 22

Author(s):

Knut Hagen ◽

Eystein Stordal ◽

Mattias Linde ◽

Timothy J Steiner ◽

John-Anker Zwart ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Cox Regression ◽

Subsequent Development ◽

Population Based ◽

Health Study ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

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Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-054098 ◽

2021 ◽

Vol 11 (10) ◽

pp. e054098

Author(s):

Jo-Hui Pan ◽

Chih-Hung Cheng ◽

Chao-Ling Wang ◽

Chia-Yen Dai ◽

Chau-Chyun Sheu ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Cumulative Incidence ◽

Retrospective Cohort ◽

Cox Regression ◽

Secondary Outcome ◽

Matched Cohort ◽

Cox Regression Analysis ◽

Control Subjects

ObjectivesThis study was conducted to explore the association between pneumoconiosis and pneumothorax.DesignRetrospective cohort study.SettingNationwide population-based study using the Taiwan National Health Insurance Database.ParticipantsA total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).Primary and secondary outcome measuresThe incidence and the cumulative incidence of pneumothorax.ResultsBoth incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients.ConclusionsOur study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.

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Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Nutrients ◽

10.3390/nu13093150 ◽

2021 ◽

Vol 13 (9) ◽

pp. 3150

Author(s):

Enrica Migliore ◽

Amelia Brunani ◽

Giovannino Ciccone ◽

Eva Pagano ◽

Simone Arolfo ◽

...

Keyword(s):

Bariatric Surgery ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Proportional Hazards ◽

Severe Obesity ◽

Hospital Admissions ◽

Cox Proportional Hazards ◽

Hazard Ratios

Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ≥ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95% CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

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Association of Rosacea With Cardiovascular Disease: A Retrospective Cohort Study

Journal of the American Heart Association ◽

10.1161/jaha.120.020671 ◽

2021 ◽

Author(s):

Daein Choi ◽

Sungjun Choi ◽

Seulggie Choi ◽

Sang Min Park ◽

Hyun‐Sun Yoon

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Cohort Study ◽

Heart Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Hazard Ratios ◽

Increased Risk

Background There is emerging evidence that rosacea, a chronic cutaneous inflammatory disease, is associated with various systemic diseases. However, its association with cardiovascular disease (CVD) remains controversial. We aimed to investigate whether patients with rosacea are at increased risk of developing CVD. Methods and Results This retrospective cohort study from the Korean National Health Insurance Service‐Health Screening Cohort included patients with newly diagnosed rosacea (n=2681) and age‐, sex‐, and index year–matched reference populations without rosacea (n=26 810) between 2003 and 2014. The primary outcome was subsequent CVD including coronary heart disease and stroke. Multivariable Cox regression analyses were used to evaluate adjusted hazard ratios for subsequent CVD adjusted for major risk factors of CVD. Compared with the reference population (13 410 women; mean [SD] age, 57.7 [9.2] years), patients with rosacea (1341 women; mean [SD] age, 57.7 [9.2] years) displayed an increased risk for CVD (adjusted hazard ratios, 1.20; 95% CI, 1.03–1.40) and coronary heart disease (adjusted hazard ratios, 1.29; 95% CI, 1.05–1.60). The risk for stroke was not significantly elevated (adjusted hazard ratios, 1.12; 95% CI, 0.91–1.37). Conclusions This study suggests that patients with rosacea are more likely to develop subsequent CVD. Proper education for patients with rosacea to manage other modifiable risk factors of CVD along with rosacea is needed.

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Association Between Serum Albumin and Mortality in Older People With Dysphagia: a Retrospective Cohort Study

10.21203/rs.3.rs-1057186/v1 ◽

2021 ◽

Author(s):

Gaigai Li ◽

Tongtao Fan ◽

Xun Zhou ◽

Xunrui Hou ◽

Yuheng Luo ◽

...

Keyword(s):

Regression Analysis ◽

Cohort Study ◽

Older People ◽

Serum Albumin ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Total Mortality ◽

High Group ◽

Cox Regression Analysis

Abstract Objective: To determine whether there is a link between serum albumin and mortality among participants in Japan older people.Methods: This is a single-center, retrospective cohort study analysis of 253 older patients with dysphagia from Japan, conducted from January 2014 and January 2017. The primary outcome was mortality. We performed Cox regression analysis to compare the mortality between the two groups (dividing by serum albumin=3g/dl).Results: A total of 253 patients were included in the analysis, of whom the number of serum albumin under 3g/dl was 93. The log-rank test showed a significantly longer mortality in the high group (serum albumin >=3g/dl) compared with the low group (median, 382 vs 176 days, P < 0.0001). Cox regression analysis showed that unadjusted HR for the high group relative to the low group was 0.40 (95% CI: 0.29–0.57; P <0.001). After adjustment 3 models in multivariable analyses, serum albumn was significantly associated with mortality. The adjusted HRs (95% CI) for total mortality rates were 0.46 (0.33~0.65) , 0.66 (0.44~0.99) and 0.64 (0.42~0.97), from model 2 to model 4.Conclusion: There is negative association between serum albumin and mortality in older people with dysphagia.

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