Association Between Subconjunctival Hemorrhage and Acute Coronary Syndrome: A 14-Year Nationwide Population-Based Cohort Study

Purpose: Subconjunctival hemorrhage (SCH) is usually a benign ocular disorder that causes painless, redness under the conjunctiva. However, since SCH and acute coronary syndrome (ACS) share many vascular risk factors, studies have suggested that these two disorders may be significantly associated with each other, and evaluate the concomitance of ACS in patients with SCH.Methods: This population-based cohort study, enrolled 35,260 Taiwanese patients, and used the Taiwan National Health Insurance Research Database to identify patients with ACS and SCH. Outcomes were compared between the with and without SCH groups. The study population was followed until the date of ACS onset, the date of withdrawal, death, or December 31st 2013, whichever came first.Results: Of the 85,925 patients identified with SCH between 1996 and 2013, 68,295 were excluded based on the study's exclusion criteria, and a total of 17,630 patients with SCH who were diagnosed by ophthalmologists between 2000 and 2012 were eligible for analysis. After 1:1 propensity score matching for 5-year age groups, gender, and the index year, the results showed that SCH was more common in the 40–59 age group (53.82%) and females (58.66%). As for the ACS-related risk factors, patients with diabetes mellitus (aHR = 1.58, 95% CI = [1.38, 1.81]), hypertension (aHR = 1.71, 95% CI = [1.49, 1.96]) and patients taking aspirin (aHR = 1.67, 95% CI = [1.47, 1.90]) had a notably higher risk of ACS. However, it was found that there were no significant differences in the occurrence of ACS between the non-SCH and SCH patients.Conclusion: This results of this study regarding the risk factors and epidemiology of SCH and ACS were in keeping with previously reported findings. However, the results revealed no significant association between SCH and ACS.

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Incidence, Patient-Related Risk Factors, and Outcomes of Postoperative Pneumonia after Cholecystectomy: A Population-Based Cohort Study

BioMed Research International ◽

10.1155/2021/6614885 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yun-Hui Teng ◽

Fu-Chao Liu ◽

Keng-Hao Liu ◽

Jr-Rung Lin ◽

Huang-Ping Yu

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Large Population ◽

Population Based ◽

Clinical Population ◽

Postoperative Pneumonia ◽

Control Group ◽

Research Database ◽

Related Risk ◽

Age And Sex

Background. Cholecystectomy is one of the most common surgical procedures performed worldwide. The objective of this large, population-based cohort study is to explore the risk factors of pneumonia after cholecystectomy in Taiwan. Methods. From the Taiwanese National Health Insurance Research Database, we selected all patients who underwent cholecystectomy by using ICD-9-codes, from January 1, 1998, to December 31, 2016. The patients were separated into two groups based on the presence or absence of postoperative pneumonia. Basic information, comorbidities, and postoperative complications were evaluated using a t -test or chi-square test. There were 6056 patients in the pneumonia group and 24224 patients in the control group. These two groups were shown in a ratio of 1 : 4 and were matched by age and sex. The log-rank test was used to examine differences in postoperative mortality between patients with and without pneumonia. Preoperative risk factors were analyzed using logistic regression analysis, after adjusting for age and sex. Results. The final dataset included 282184 cholecystectomy patients. Of these patients, 6056 (2.15%) had postoperative new-onset pneumonia. The patient-related risk factors for pneumonia after cholecystectomy in the order of relevance were chronic obstructive pulmonary disease, congestive heart failure, cerebrovascular disease, diabetes mellitus, surgical type, hemodialysis, coronary artery disease, and liver cirrhosis. Compared to patients without postcholecystectomy pneumonia, those with postcholecystectomy pneumonia had higher rates of mortality (within first month, 1.72% vs. 2.28%, P < 0.005 ) and admission to intensive care unit (15.02% vs. 41.80%, P < 0.0001 ) and longer hospital stays (10.71 vs. 18.55 days, P < 0.0001 ). Conclusion. Our results show that postcholecystectomy associated with pneumonia had higher rates of morbidity and mortality in this clinical population. Early identification and possible management of risk factors for pneumonia could improve outcomes of cholecystectomy and lower the risk for patient comorbidities after surgery.

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Disorder-related risk factors for revision total hip arthroplasty after hip hemiarthroplasty in displaced femoral neck fracture patients: a nationwide population-based cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-016-0400-3 ◽

2016 ◽

Vol 11 (1) ◽

Cited By ~ 4

Author(s):

Chun-Hao Tsai ◽

Chih-Hsin Muo ◽

Chih-Hung Hung ◽

Tsung-Li Lin ◽

Ta-Ii Wang ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Total Hip Arthroplasty ◽

Femoral Neck ◽

Hip Arthroplasty ◽

Population Based ◽

Revision Total Hip Arthroplasty ◽

Hip Hemiarthroplasty ◽

Related Risk ◽

Neck Fracture

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Use of ticagrelor and the risks of pneumonia and pneumonia-specific death in patients with non-acute coronary syndrome conditions: a population-based cohort study

Scientific Reports ◽

10.1038/s41598-021-00105-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Qi Feng ◽

Man Fung Tsoi ◽

Yue Fei ◽

Ching Lung Cheung ◽

Bernard M. Y. Cheung

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Hong Kong ◽

Lower Risk ◽

Population Based ◽

Public Hospitals ◽

Sensitivity Analyses ◽

Coronary Syndrome ◽

Matching Adjustment ◽

Analysis Models

AbstractPrevious studies have shown that ticagrelor reduced risk of pneumonia in patients with acute coronary syndrome (ACS) compared to clopidogrel, however, its effect in patients with non-ACS cardiovascular diseases remains uncertain. The aim was to investigate the effect of ticagrelor on pneumonia and pneumonia-specific death compared to clopidogrel in non-ACS patients in Hong Kong. This was a population-based cohort study. We included consecutive patients using ticagrelor or clopidogrel admitted for non-ACS conditions in Hong Kong public hospitals from March 2012 to September 2019. Patients using both drugs were excluded. The outcomes of interest were incident pneumonia, all-cause death, and pneumonia-specific death. Multivariable survival analysis models were used to estimate the effects [hazard ratio (HR) and 95% confidence interval (CI)]. Propensity score matching, adjustment and weighting were performed as sensitivity analyses. In total, 90,154 patients were included (mean age 70.66 years, males 61.7%). The majority of them (97.2%) used clopidogrel. Ticagrelor was associated with a lower risk of incident pneumonia [0.59 (0.46–0.75)], all-cause death [0.83 (0.73–0.93)] and pneumonia-specific death [0.49 (0.36–0.67)]. Sensitivity analyses yielded similar results. Ticagrelor was associated with lower risk of all-cause death, pneumonia-specific death, and incident pneumonia in patients with non-ACS cardiovascular conditions, consistent with previous evidence in patients with ACS. This additional effect of anti-pneumonia should be considered when choosing a proper P2Y12 inhibitor for patients with high risk of pneumonia.

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Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

Frontiers in Medicine ◽

10.3389/fmed.2021.757459 ◽

2022 ◽

Vol 8 ◽

Author(s):

Han Zhang ◽

Yingying Wu ◽

Yuqing He ◽

Xingyuan Liu ◽

Mingqian Liu ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Age Groups ◽

Clinical Manifestations ◽

Population Based ◽

Male Gender ◽

Poor Correlation ◽

Age Related ◽

Related Risk ◽

Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

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Sex Differences in the Risk of Developing Acute Coronary Syndrome in Patients With Sleep Disorders: A Population-Based Cohort Study

American Journal of Men s Health ◽

10.1177/1557988316651260 ◽

2016 ◽

Vol 11 (5) ◽

pp. 1560-1568

Author(s):

Wei-Sheng Chung ◽

Hsuan-Hung Lin

Keyword(s):

Acute Coronary Syndrome ◽

Sex Differences ◽

Cohort Study ◽

Sleep Disorders ◽

Population Based ◽

Coronary Syndrome ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression ◽

Middle Aged Adults

Studies that focus on the relationship between sex and the risk of acute coronary syndrome (ACS) are scant. The current study investigated the effects of sex differences in the risk of developing ACS in patients with sleep disorders (SDs). This longitudinal population-based cohort study evaluated the incidence and risk of ACS development in 40,232 men and 65,519 women newly diagnosed with SDs between 2002 and 2008 from the Longitudinal Health Insurance Database. The follow-up period began from the entry date and ended on the date of an ACS event or December 31, 2010. Univariable and multivariable Cox proportional hazard regression models were conducted to estimate the sex differences in the risk of ACS. Men with SDs exhibited an increased incidence of ACS compared with women with SDs in all age- and comorbidity-specific subgroups. After covariates were adjusted, the men with SDs exhibited a 1.48-fold adjusted hazard ratio (aHR) of ACS compared with the women with SDs (95% confidence interval [CI] = 1.36-1.60). After age group stratification, the men with SDs in the young adult group exhibited the highest risk of subsequent ACS development compared with the women with SDs (aHR = 2.07, 95% CI = 1.69-2.55), followed by those in middle-aged adults (aHR = 1.52, 95% CI = 1.32-1.76) and older adults groups (aHR = 1.24, 95% CI = 1.11-1.39). This study determined that men with SDs, particularly young men, are at a higher risk of subsequent ACS development compared with women with SDs.

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Frequency of risk factors in patients of acute coronary syndrome due to coronary ectasia

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492320937155 ◽

2020 ◽

Vol 28 (6) ◽

pp. 312-315

Author(s):

Noor Dastgir ◽

Arslan Masood ◽

Ahmed Muqeet ◽

Gul Zaman Khan Niazi

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Age Groups ◽

Coronary Risk Factors ◽

Coronary Risk ◽

Coronary Syndrome ◽

Coronary Ectasia ◽

Few Data

Background Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. Methods The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20–50 years and 82 (52.90%) were 51–80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. Results Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. Conclusion Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.

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S83. MORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.149 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S65-S66 ◽

Cited By ~ 1

Author(s):

Wing Chung Chang ◽

Joe Kwun Nam Chan ◽

Corine Sau Man Wong ◽

Philip Chi Fai Or ◽

JoJo Siu Han Hai

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Cardiovascular Complications ◽

Population Based ◽

Public Healthcare ◽

Complication Rates ◽

Short Term ◽

Coronary Syndrome

Abstract Background Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders. Methods This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription. Results Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (<65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted. Discussion Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.

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