scholarly journals Risk of vestibulocochlear disorders in patients with migraine or non-migraine headache

Author(s):  
Sang-Hwa Lee ◽  
Jong-Ho Kim ◽  
Young-Suk Kwon ◽  
Jae-June Lee ◽  
Jong-Hee Sohn

Abstract Background Headache, especially migraine, has been associated with various vestibular symptoms and several vestibular syndromes. In addition, cochlear disorders, such as tinnitus and hearing loss, have recently been reported to be more prevalent among migraine patients. However, whether headaches, including migraine or non-migraine headaches, are associated with vestibular and cochlear disorders remains unclear. Thus, the possible associations between headaches, including migraine and non-migraine headaches, and vestibulocochlear disorders were investigated in the present study. Methods Clinical data were analyzed from the Smart Clinical Data Warehouse of Hallym University Medical Center from 2011–2021. In patients with migraine and non-migraine headaches, data on Meniere`s disease (MD), benign paroxysmal positional vertigo (BPPV), vestibular neuronitis (VN), and cochlear disorders such as sensorineural hearing loss (SNHL) and tinnitus, were collected and compared with clinical data from controls without headache who had health check-ups. In addition, the presence of comorbidities were defined according to the International Classification of Diseases, tenth revision codes in the database and analyzed. Results The study included 15,128 participants with migraines and 76,773 with non-migraine headaches. Controls were identified based on propensity score matching (PSM). After PSM, the adjusted odds ratios (ORs) in subjects with migraine versus controls were 2.597 for MD (95% CI, 2.047–3.295; p < 0.001), 2.045 for BPPV (95% CI, 1.816–2.302; p < 0.001), 2.976 for VN (95% CI, 2.636–3.360; p < 0.001), 1.739 for SNHL (95% CI, 1.404–2.156; p < 0.001), and 1.970 for tinnitus (95% CI, 1.658–2.341; p < 0.001). The adjusted ORs for MD (1.771; 95% CI, 1.560–2.011; p < 0.001)), BPPV (1.731; 95% CI, 1.637–1.831; p < 0.001), VN (2.048; 95% CI, 1.935–2.168; p < 0.001), SNHL (1.396; 95% CI, 1.273–1.531; p < 0.001), and tinnitus (1.693; 95% CI, 1.569–1.826; p < 0.001) in patients with non-migraine headache versus controls were also high after PSM. Conclusion The present study findings indicated that migraine and non-migraine headaches are associated with an increased risk of cochlear disorders, such as SNHL and tinnitus, in addition to vestibular disorders.

2021 ◽  
Vol 11 (12) ◽  
pp. 1331
Author(s):  
Sang-Hwa Lee ◽  
Jong-Ho Kim ◽  
Young-Suk Kwon ◽  
Jae-June Lee ◽  
Jong-Hee Sohn

Headaches, especially migraines, have been associated with various vestibular symptoms and syndromes. Tinnitus and hearing loss have also been reported to be more prevalent among migraineurs. However, whether headaches, including migraine or non-migraine headaches (nMH), are associated with vestibular and cochlear disorders remains unclear. Thus, we sought to investigate possible associations between headache and vestibulocochlear disorders. We analyzed 10 years of data from the Smart Clinical Data Warehouse. In patients with migraines and nMH, meniere’s disease (MD), BPPV, vestibular neuronitis (VN) and cochlear disorders, such as sensorineural hearing loss (SNHL) and tinnitus, were collected and compared to clinical data from controls who had health check-ups without headache. Participants included 15,128 with migraines, 76,773 patients with nMH and controls were identified based on propensity score matching (PSM). After PSM, the odds ratios (OR) in subjects with migraine versus controls were 2.59 for MD, 2.05 for BPPV, 2.98 for VN, 1.74 for SNHL, and 1.97 for tinnitus, respectively (p < 0.001). The OR for MD (1.77), BPPV (1.73), VN (2.05), SNHL (1.40), and tinnitus (1.70) in patients with nMH was also high after matching (p < 0.001). Our findings suggest that migraines and nMH are associated with an increased risk of cochlear disorders in addition to vestibular disorders.


Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  

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.


2017 ◽  
Vol 34 (11) ◽  
pp. 1054-1057
Author(s):  
Kayli Senz ◽  
Whitney Humphrey ◽  
Vanessa Lee ◽  
Aaron Caughey ◽  
Sarah Dotters-Katz

Objective Characterize the impact of a trisomy 18 (T18) fetus on maternal and obstetric outcomes in a cohort including T18-affected deliveries. Study Design Retrospective cohort study of singleton deliveries in California from 2005 to 2008 using linked vital statistics and the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) data to compare deliveries affected by T18 to those without known aneuploidy. Outcomes of interest included gestational diabetes mellitus (GDM), preterm delivery (PTD), preeclampsia, cesarean delivery (CD), and intrauterine fetal demise (IUFD). The χ2 and paired t-tests were used to compare the outcomes. Multiple logistic regression was used to further characterize these risks and control potential confounders. Results Of 2,029,000 deliveries, 298 involved T18. Compared with unaffected deliveries, T18 was associated with GDM (10.7 vs. 6.5%, p = 0.003), PTD < 37 (40.6 vs. 9.9%, p < 0.001) and < 32 weeks (14.8 vs. 1.4%, p < 0.001), and cesarean section (56 vs. 30.2%, p < 0.001), but not preeclampsia. In adjusted analyses, T18 pregnancies were associated with an increased risk of PTD < 37 and < 32 weeks (adjusted odds ratio [AOR]: 5.48, 95% confidence interval [CI]: 4.29, 6.99; AOR: 10.4, 95% CI: 7.26, 14.8), and an increased odd of CD for primiparous and multiparous women (AOR: 2.41, 95% CI: 1.48, 3.91; AOR: 5.42, 95% CI: 3.90, 7.53). Risk of GDM did not persist. Conclusion Unlike trisomy 13 (T13), pregnancies complicated by fetal T18 did not appear to result in an increased risk of preeclampsia. However, there is an increased risk of a range of other obstetric complications.


2018 ◽  
Vol 160 (3) ◽  
pp. 559-566 ◽  
Author(s):  
Ying-Shuo Hsu ◽  
Wei-Chung Hsu ◽  
Jenq-Yuh Ko ◽  
Te-Huei Yeh ◽  
Chia-Hsuan Lee ◽  
...  

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tsung-Ying Lin ◽  
Chieh Hsin Wu ◽  
Wei-Che Lee ◽  
Chao-Wen Chen ◽  
Liang-Chi Kuo ◽  
...  

Subarachnoid hemorrhage (SAH) is a critical illness that may result in patient mortality or morbidity. In this study, we investigated the outcomes of patients treated in medical center and nonmedical center hospitals and the relationship between such outcomes and hospital and surgeon volume. Patient data were abstracted from the National Health Insurance Research Database of Taiwan in the Longitudinal Health Insurance Database 2000, which contains all claims data of 1 million beneficiaries randomly selected in 2000. The International Classification of Diseases, Ninth Revision, subarachnoid hemorrhage (430) was used for the inclusion criteria. We identified 355 patients between 11 and 87 years of age who had subarachnoid hemorrhage. Among them, 32.4% (115/355) were men. The median Charlson comorbidity index (CCI) score was 1.3 (SD ± 0.6). Unadjusted logistic regression analysis demonstrated that low mortality was associated with high hospital volume (OR = 3.21; 95% CI: 1.18–8.77). In this study, we found no statistical significances of mortality, LOS, and total charges between medical centers and nonmedical center hospitals. Patient mortality was associated with hospital volume. Nonmedical center hospitals could achieve resource use and outcomes similar to those of medical centers with sufficient volume.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027896 ◽  
Author(s):  
Aminur Rahman ◽  
Jagnoor Jagnoor ◽  
Kamran ul Baset ◽  
Dan Ryan ◽  
Tahera Ahmed ◽  
...  

ObjectivesThis study aimed to determine the fatal drowning burden and associated risk factors in Southern Bangladesh.SettingsThe survey was conducted in 39 subdistricts of all 6 districts of the Barisal division, Southern Bangladesh.ParticipantsAll residents (for a minimum 6 months prior to survey) of the Barisal division, Southern Bangladesh.Intervention/methodsA cross-sectional, divisionally representative household survey was conducted in all six districts of the Barisal division between September 2016 and February 2017, covering a population of 386 016. Data were collected by face-to-face interview with adult respondents using handheld electronic tablets. International Classification of Diseases (ICD)-v. 10 (ICD-10) Chapter XX: External causes of morbidity and mortality codes for drowning, W65–W74, X36–X39, V90, V92, X71 or X92, were used as the operational definition of a drowning event.ResultsThe overall fatal drowning rate in Barisal was 37.9/100 000 population per year (95% CI 31.8 to 43.9). The highest fatal drowning rate was observed among children aged 1–4 years (262.2/100 000/year). Mortality rates among males (48.2/100 000/year) exceeded that for females (27.9/100 000/year). A higher rate of fatal drowning was found in rural (38.9/100 000/year) compared with urban areas (29.3/100 000/year). The results of the multivariable logistic regression identified that the factors significantly associated with fatal drowning were being male (OR 1.7, 95% CI 1.2 to 2.3), aged 1–4 years (OR 3.0, 95% CI 1.4 to 6.4) and residing in a household with four or more children (four or more children OR 1.8, 95% CI 1.1 to 2.9; and five or more children OR 2.1, 95% CI 1.2 to 3.7).ConclusionDrowning is a public health problem, especially for children, in the Barisal division of Southern Bangladesh. Male gender, children 1–4 years of age and residing in a household with four or more children were associated with increased risk of fatal drowning events. The Barisal division demands urgent interventions targeted at high-risk groups identified in the survey.


Hand ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Rachel R. Yorlets ◽  
Kathleen Busa ◽  
Kyle R. Eberlin ◽  
Mohammad Ali Raisolsadat ◽  
Donald S. Bae ◽  
...  

Background: Although fingertip injuries are common, there is limited literature on the epidemiology and hospital charges for fingertip injuries in children. This descriptive study reports the clinical features of and hospital charges for fingertip injuries in a large pediatric population treated at a tertiary medical center. Methods: Our hospital database was queried using International Classification of Diseases, Revision 9 (ICD-9) codes, and medical records were reviewed. Frequency statistics were generated for 1807 patients with fingertip injuries who presented to the emergency department (ED) at Boston Children’s Hospital (BCH) between 2005 and 2011. Billing records were analyzed for financial data. Results: A total of 1807 patients were identified for this study; 59% were male, and the mean age at time of injury was 8 years. Most commonly, injuries occurred when a finger was crushed (n = 831, 46%) in a door or window. Average length of stay in the ED was 3 hours 45 minutes, 25% of cases needed surgery, and, on average, patients had more than 1 follow-up appointment. About one-third of patients were referred from outside institutions. The average ED charge for fingertip injuries was $1195 in 2014, which would amount to about $320 430 each year (in 2014 dollars) for fingertip injuries presenting to BCH. Conclusion: Fingertip injuries in children are common and result in significant burden, yet are mostly preventable. Most injuries occur at home in a door or window. Although these patients generally heal well, fingertip injuries pose a health, time, and financial burden. Increased awareness and education may help to avoid these injuries.


2018 ◽  
Author(s):  
Patrick Wu ◽  
Aliya Gifford ◽  
Xiangrui Meng ◽  
Xue Li ◽  
Harry Campbell ◽  
...  

AbstractBackgroundThe PheCode system was built upon the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) for phenome-wide association studies (PheWAS) in the electronic health record (EHR).ObjectiveHere, we present our work on the development and evaluation of maps from ICD-10 and ICD-10-CM codes to PheCodes.MethodsWe mapped ICD-10 and ICD-10-CM codes to PheCodes using a number of methods and resources, such as concept relationships and explicit mappings from the Unified Medical Language System (UMLS), Observational Health Data Sciences and Informatics (OHDSI), Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT), and National Library of Medicine (NLM). We assessed the coverage of the maps in two databases: Vanderbilt University Medical Center (VUMC) using ICD-10-CM and the UK Biobank (UKBB) using ICD-10. We assessed the fidelity of the ICD-10-CM map in comparison to the gold-standard ICD-9-CM→PheCode map by investigating phenotype reproducibility and conducting a PheWAS.ResultsWe mapped >75% of ICD-10-CM and ICD-10 codes to PheCodes. Of the unique codes observed in the VUMC (ICD-10-CM) and UKBB (ICD-10) cohorts, >90% were mapped to PheCodes. We observed 70-75% reproducibility for chronic diseases and <10% for an acute disease. A PheWAS with a lipoprotein(a) (LPA) genetic variant, rs10455872, using the ICD-9-CM and ICD-10-CM maps replicated two genotype-phenotype associations with similar effect sizes: coronary atherosclerosis (ICD-9-CM: P < .001, OR = 1.60 vs. ICD-10-CM: P < .001, OR = 1.60) and with chronic ischemic heart disease (ICD-9-CM: P < .001, OR = 1.5 vs. ICD-10-CM: P < .001, OR = 1.47).ConclusionsThis study introduces the initial “beta” versions of ICD-10 and ICD-10-CM to PheCode maps that will enable researchers to leverage accumulated ICD-10 and ICD-10-CM data for high-throughput PheWAS in the EHR.


Author(s):  
Wei-Jun Lin ◽  
Tomor Harnod ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao

Aim: Use the National Health Insurance Research Database of Taiwan to determine whether patients with posttraumatic epilepsy (PTE) have an increased risk of mortality. Methods: Patients ≥20 years old ever admitted because of head injury (per International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 850–854 and 959.01) during 2000–2012 were enrolled into a traumatic brain injury (TBI) cohort. The TBI cohort was divided into with PTE (ICD-9-CM code 345) and posttraumatic nonepilepsy (PTN) cohorts. We compared the PTE and PTN cohorts in terms of age, sex, and comorbidities. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts. Results: Patients with PTE had a higher incidence rate (IR) of mortality than did patients with TBI alone (IR per 1000 person-years: 71.8 vs. 27.6), with an aHR 2.31 (95% CI = 1.96–2.73). Patients with PTE aged 20–49, 50–64, and ≥65 years had, respectively, 2.78, 4.14, and 2.48 times the mortality risk of the PTN cohort. Patients with any comorbidity and PTE had 2.71 times the mortality risk as patients in the PTN cohort. Furthermore, patients with PTE had 28.2 increased hospital days and 7.85 times as frequent medical visits per year compared with the PTN cohort. Conclusion: Taiwanese patients with PTE had approximately 2 times the mortality risk and an increased medical burden compared to patients with TBI only. Our findings provide crucial information for clinicians and the government to improve TBI outcomes.


2020 ◽  
Vol 179 (5) ◽  
pp. 791-799 ◽  
Author(s):  
Richard Thwaites ◽  
Scot Buchan ◽  
John Fullarton ◽  
Carole Morris ◽  
ElizaBeth Grubb ◽  
...  

AbstractNational data from Scotland (all births from 2000 to 2011) were used to estimate the burden associated with respiratory syncytial virus hospitalisation (RSVH) during the first 2 years of life. RSVHs were identified using the International Classification of Diseases 10th Revision codes. Of 623,770 children, 13,362 (2.1%) had ≥ 1 RSVH by 2 years, with the overall rate being 27.2/1000 (16,946 total RSVHs). Median age at first RSVH was 137 days (interquartile range [IQR] 62–264), with 84.3% of admissions occurring by 1 year. Median length of stay was 2 (IQR 1–4) days and intensive care unit (ICU) admission was required by 4.3% (727) for a median 5 (IQR 2–8) days. RSVHs accounted for 6.9% (5089/73,525) of ICU bed days and 6.2% (64,395/1,033,121) of overall bed days (5370/year). RSVHs represented 8.5% (14,243/168,205) of all admissions between October and March and 14.2% (8470/59,535) between December and January. RSVH incidence ranged from 1.7 to 2.5%/year over the study period. Preterms (RSVH incidence 5.2%), and those with congenital heart disease (10.5%), congenital lung disease (11.2%), Down syndrome (14.8%), cerebral palsy (15.5%), cystic fibrosis (12.6%), and neuromuscular disorders (17.0%) were at increased risk of RSVH.Conclusions: RSV causes a substantial burden on Scottish paediatric services during the winter months.What is known:• Respiratory syncytial virus (RSV) is a leading cause of childhood hospitalisation.What is new:• This 12-year study is the first to estimate the burden of RSV hospitalisation (RSVH) in Scotland and included all live births from 2000 to 2011 and followed > 600,000 children until 2 years old.• The overall RSVH rate was 27.2/1000 children, with 2.1% being hospitalised ≥ 1 times.• RSVHs accounted for 6.2% of all inpatient bed days, which rose to 14.2% during the peak months of the RSV season (December–January), equating to over 1400 hospitalisations and nearly 5500 bed days each year.


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