scholarly journals Influenza Vaccination Is Associated With Lower Incidental Asthma Risk in Patients With Atopic Dermatitis: A Nationwide Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Kun Hong Li ◽  
Pui-Ying Leong ◽  
Chung-Fang Tseng ◽  
Yu Hsun Wang ◽  
James Cheng-Chung Wei
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Influenza Vaccination ◽  
Allergic Sensitization ◽  
Later Life ◽  
Incidence Density ◽  
Research Database ◽  
Recurrent Wheezing ◽  
Asthma Risk ◽  
Age And Sex

BackgroundAtopic march refers to the natural history of atopic dermatitis (AD) in infancy followed by subsequent allergic rhinitis and asthma in later life. Respiratory viruses interact with allergic sensitization to promote recurrent wheezing and the development of asthma. We aimed to evaluate whether influenza vaccination reduces asthma risk in people with AD.MethodsThis cohort study was conducted retrospectively from 2000 to 2013 by the National Health Insurance Research Database (NHIRD). Patients with newly diagnosed AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 691) were enrolled as the AD cohort. We matched each vaccinated patient with one non-vaccinated patient according to age and sex. We observed each participant until their first asthma event, or the end of the study on December 31, 2013, whichever came first.ResultsOur analyses included 4,414 people with a mean age of 53 years. Of these, 43.8 were male. The incidence density of asthma was 12.6 per 1,000 person-years for vaccinated patients, and 15.1 per 1000 person-years for non-vaccinated patients. The adjusted hazard ratio (aHR) of asthma in the vaccinated cohort relative to the non-vaccinated cohort was 0.69 (95% CI = 0.55–0.87). Vaccinated patients had a lower cumulative incidence of asthma than unvaccinated patients. Vaccinated participants in all age and sex groups trended toward a lower risk of asthma. People will reduce more asthma risk when taking shots every year.ConclusionInfluenza vaccination was associated with lower asthma risk in patients with AD.

scholarly journals Predicting the Long-Term Course of Asthma in Wheezing Infants Is Still a Challenge

ISRN Allergy ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Flore Amat ◽  
Amandine Vial ◽  
Bruno Pereira ◽  
Isabelle Petit ◽  
André Labbe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atopic Dermatitis ◽  
Allergic Sensitization ◽  
Persistent Asthma ◽  
Inclusion Criteria ◽  
Recurrent Wheezing ◽  
History Of ◽  
Airborne Allergens ◽  
Term Management

Background. In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective. To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods. Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results. Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9–11.2) ), initial atopic dermatitis (OR 3.4, CI-95% (1.9–6.3) ), severe recurrent wheezing (OR 2.3, CI-95% (1.3–4.2) ), and hypereosinophilia ≥470/mm3 (OR 2.2, CI-95% (1.07–4.7) ). Conclusion. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.

Risk of Incident Psychiatric Disorders in Sexual Assault Victims: A Nationwide Population-Based Cohort Study

2017 ◽  
Vol 55 (2) ◽  
pp. 147-157
Author(s):  
Tao-Hsin Tung ◽  
Sheng-Ang Shen ◽  
Chih-Hao Chen ◽  
Chien Huang
Keyword(s):  
Cohort Study ◽  
Sexual Assault ◽  
Psychiatric Disorders ◽  
Clinical Care ◽  
Population Based ◽  
Incidence Density ◽  
Control Group ◽  
Research Database ◽  
Sexual Offenses ◽  
Assault Victims

AbstractSexual offenses cause harm to the victims’ physical and psychological functions. This study was conducted to evaluate the risk of incident psychiatric disorders in sexual assault victims. Taiwan’s National Health Insurance Research Database was used to conduct a nationwide population-based cohort study to assess the risk of incident psychiatric disorders in sexual assault victims and to further evaluate the respective risk estimates on the basis of diagnostic patterns. A total of 81 sexual assault victims and 324 controls matched by sex, age and residential area were included. The mean age of the sexual assault victims was 18.39 (sd10.23) years, and 93.83% (76/81) of the sample were females. Sexual assault victims had a higher incidence density of psychiatric disorders than did the control group (9.2% per year, 95% confidence interval [CI] 1.1–33.2% per yearv.1.1% per year, 95% CI .4–15.7% per year;p=.037). Sexual assault was an independent risk factor for incident psychiatric disorders, with an incidence rate ratio of 3.40 (95% CI 1.04–26.41) after adjustment for potential confounding factors. Assessment of psychiatric disorders should be implemented in the integrative care of sexual assault victims. Physicians providing clinical care to the sexual assault victims should receive more all-round training to understand and manage this type of violence.

scholarly journals Keloid risk in patients with atopic dermatitis: a nationwide retrospective cohort study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022865 ◽  
Author(s):  
Ying-Yi Lu ◽  
Chun-Ching Lu ◽  
Wei-Wen Yu ◽  
Li Zhang ◽  
Qing-Rui Wang ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Secondary Outcome ◽  
Severe Atopic Dermatitis ◽  
Secondary Outcome Measure ◽  
Research Database ◽  
Cox Proportional Hazard Regression

ObjectiveThe pathogenesis of keloid is largely unknown. Because keloid and atopic dermatitis have overlapping pathophysiological mechanisms, we aimed to evaluate keloid risk in patients with atopic dermatitis.Study designPopulation-based retrospective cohort study.SettingThe Taiwan National Health Insurance Research Database was used to analyse data for people who had been diagnosed with atopic dermatitis.ParticipantsWe identified 8371 patients with newly diagnosed atopic dermatitis during 1996–2010. An additional 33 484 controls without atopic dermatitis were randomly identified and frequency matched at a one-to-four ratio.Primary and secondary outcome measureThe association between atopic dermatitis and keloid risk was estimated using Cox proportional hazard regression models.ResultsAfter adjustment for covariates, the atopic dermatitis patients have a 3.19-fold greater risk of developing keloid compared with the non-atopic dermatitis group (3.19vs1.07 per 1000 person-years, respectively). During the study period, 163 patients with atopic dermatitis and 532 patients without atopic dermatitis developed keloid. Notably, keloid risk increased with severity of atopic dermatitis, particularly in patients with moderate to severe atopic dermatitis.ConclusionsOur results indicate that patients with atopic dermatitis had a higher than normal risk of developing keloid and suggest that atopic dermatitis may be an independent risk factor for keloid.

scholarly journals Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study

2013 ◽  
Vol 35 (1) ◽  
pp. E10 ◽  
Author(s):  
Jau-Ching Wu ◽  
Chin-Chu Ko ◽  
Yu-Shu Yen ◽  
Wen-Cheng Huang ◽  
Yu-Chun Chen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cohort Study ◽  
Cervical Spondylotic Myelopathy ◽  
Incidence Density ◽  
Control Group ◽  
Cord Injury ◽  
National Cohort ◽  
Age And Sex

Object This study aimed to determine the age- and sex-specific incidence of cervical spondylotic myelopathy (CSM) and its associated risk of causing subsequent spinal cord injury (SCI). Methods Using the National Health Insurance Research Database (NHIRD), a 12-year nationwide database in Taiwan, this retrospective cohort study analyzed the incidence of hospitalization caused by CSM. All patients diagnosed with and admitted for CSM were identified during the study period. The CSM patients were divided into 2 groups, a control group and an operated group. An incidence density method was used to estimate age- and sex-specific incidence rates of CSM. The Kaplan-Meier method and Cox regression analyses were performed to compare the risk of SCI between the 2 groups. Results From 1998 to 2009, covering 349.5 million person-years, 14,140 patients were hospitalized for CSM. The overall incidence of CSM-related hospitalization was 4.04 per 100,000 person-years. Specifically, males and older persons had a higher incidence rate of CSM. During the follow-up of these patients for 13,461 person-years, a total of 166 patients were diagnosed with SCI. The incidence of SCI was higher in the control group than the operated group (13.9 vs 9.4 per 1000 person-years, respectively). During the follow-up, SCI was more likely to occur in CSM patients who were treated conservatively (crude HR 1.48, p = 0.023; adjusted HR 1.57, p = 0.011) than in those who underwent surgery for CSM. Conclusions In a national cohort of eastern Asia, the incidence of CSM-caused hospitalization was 4.04 per 100,000 person-years, with higher incidences observed in older and male patients. Subsequent SCI was more likely to develop in patients who received nonoperative management than in those who underwent surgery. Therefore, patients with CSM managed without surgery should be cautioned about SCI. However, further investigations are still required to clarify the risks and complications associated with surgery for CSM.

Bidirectional Association between Psoriasis and Atopic Dermatitis: A Nationwide Population-Based Cohort Study

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ying-Xiu Dai ◽  
Ying-Hsuan Tai ◽  
Yun-Ting Chang ◽  
Tzeng-Ji Chen ◽  
Mu-Hong Chen
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
Cox Regression ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Biological Mechanisms ◽  
Bidirectional Association

Background: There have been some reports on the coexistence of psoriasis and atopic dermatitis; however, the longitudinal relationship between these two diseases remains unclear. Objective: This study aimed to investigate the bidirectional association between psoriasis and atopic dermatitis. Methods: This cohort study recruited patients from the National Health Insurance Research Database in Taiwan. We included 8,206 patients with psoriasis and 32,824 matched controls to assess the risk of atopic dermatitis and 25,743 patients with atopic dermatitis and 102,972 matched controls to assess the risk of psoriasis. Cox regression model was used for the analyses. Results: After adjusting for potential confounders, patients with psoriasis had a higher risk of atopic dermatitis (adjusted hazard ratio [aHR] 13.01; 95% CI 10.23–16.56) than the controls. Patients with atopic dermatitis had a higher risk of psoriasis (aHR 10.37; 95% CI 6.85–15.69) than the controls. Stratified analyses revealed similar results in both sexes and all age groups. Conclusion: Our study demonstrated a bidirectional association between psoriasis and atopic dermatitis, suggesting that psoriasis and atopic dermatitis are not mutually exclusive and may share some biological mechanisms.

scholarly journals Early Bronchiolitis Contributes to Preschool Asthma

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1176
Author(s):  
Jih-Chin Chang ◽  
Jeng-Yuan Chiou ◽  
Jiunn-Liang Ko ◽  
Jing-Yang Huang ◽  
Ko-Huang Lue
Keyword(s):  
Atopic Dermatitis ◽  
Health Insurance ◽  
Childhood Asthma ◽  
Synergistic Effects ◽  
Medical Data ◽  
Study Group ◽  
Research Database ◽  
Asthma Risk ◽  
One Year ◽  
And Control

This study aims to analyze whether bronchiolitis in children younger than one-year-old contributes to subsequent asthma. Medical data were retrieved from the National Health Insurance Research Database of Taiwan. Participants were divided into study (N = 65,559) and control (N = 49,656) groups, depending on whether they had early bronchiolitis. Incidences of asthma, potential comorbidities, and associated medical conditions were compared. The incidence of childhood asthma was significantly higher in the study group (aHR = 1.127, 95% CI: 1.063–1.195). Children with bronchiolitis hospitalization displayed higher asthma risk in the period between two and four years of age. The risk diminished as the children grew up. No relevant synergistic effects were found between bronchiolitis and atopic dermatitis. In conclusion, bronchiolitis before one year of age exhibits predictive value for development of preschool asthma, especially in children with bronchiolitis hospitalizations.

scholarly journals Protective Effect of Seasonal Influenza Vaccination in Elderly Individuals with Disability in Taiwan: A Propensity Score–Matched, Nationwide, Population-Based Cohort Study

Vaccines ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 140
Author(s):  
Yu-Chia Chang ◽  
Huang Yu-Tung ◽  
Long-Sheng Chen ◽  
Ho-Jui Tung ◽  
Kuang-Hua Huang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Propensity Score ◽  
Protective Effect ◽  
Influenza Vaccination ◽  
Population Based ◽  
Medical Expenditure ◽  
Research Database ◽  
Elderly Individuals ◽  
All Cause Mortality

This is the first and largest population-based cohort study to demonstrate that influenza vaccination reduced all-cause mortality and influenza-related hospitalization in elderly individuals with a disability. Purpose: To estimate the protective effect of influenza vaccination in elderly individuals with a disability by conducting a propensity score-matched (PSM), nationwide, population-based cohort study. Methods: Data from Taiwan’s National Health Insurance Research Database were used in this study. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. The GEE logit was used to estimate the relative risks of death and hospitalization after influenza vaccination. Adjusted odds ratios (aORs) were used to estimate relative risk. Results: The matching process yielded a final cohort of 272 896 elderly individuals with a disability (136 448 individuals in each cohort). In multivariate GEE analyses, aOR (vaccinated vs. unvaccinated) and 95% confidence interval (CI) of death were 0.70 (0.68–0.72). The aORs (95% CIs) of hospitalization for influenza and pneumonia, respiratory diseases, respiratory failure, heart disease, hemorrhagic stroke, and ischemic stroke were 0.98 (0.95–1.01), 0.96 (0.94–0.99), 0.85 (0.82–0.89), 0.96 (0.93–0.99), 0.85 (0.75–0.97), and 0.89 (0.84–0.95), respectively. The length of stay and medical expenditure exhibited greater reduction in vaccinated elderly individuals with a severe and very severe disability than in unvaccinated elderly individuals. Conclusions: Influenza vaccination reduced all-cause mortality, influenza-related hospitalization, length of stay, and medical expenditure in elderly individuals with a disability. The decrease in the length of stay and medical expenditure because of influenza vaccination was proportional to the severity of disability.

Influenza vaccination reduces dementia in patients with chronic obstructive pulmonary disease: a nationwide cohort study

2020 ◽  
Vol 68 (4) ◽  
pp. 838-845 ◽  
Author(s):  
Ching-Shan Luo ◽  
Ching-Chi Chi ◽  
Yu-Ann Fang ◽  
Ju-Chi Liu ◽  
Kang-Yun Lee
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cohort Study ◽  
Influenza Vaccination ◽  
Pulmonary Disease ◽  
Influenza Infection ◽  
Chronic Obstructive ◽  
Research Database ◽  
Dependent Manner ◽  
Obstructive Pulmonary Disease ◽  
Dose Response Effect

This study aimed to explore the protective potential of influenza vaccination against occurrence of dementia in patients with chronic obstructive pulmonary disease (COPD), who are expected to be more vulnerable to influenza infection. This nationwide retrospective cohort study enrolled patients with COPD (aged ≥60 years) from 1 January 2001 to 31 December 2012 by using the Taiwan National Health Insurance Research Database. By applying time-dependent Cox proportional hazard model, we used multivariate analysis to calculate the adjusted HR (aHR) with 95% CI of dementia in relation to influenza vaccination among patients with COPD. Besides, patients were partitioned into four groups according to the vaccination number (unvaccinated, 1, 2–3 and ≥4 total vaccinations) to investigate the dose-response effect of vaccinations on the dementia incidence. This cohort study included 19 848 patients with COPD, and 45% of them received influenza vaccination. The aHR of dementia was 0.68 (95% CI: 0.62 to 0.74, p<0.001) comparing vaccinated patients with unvaccinated ones. Furthermore, there was a trend of dementia risk reduction with the vaccination number. For patients who received 2–3 vaccinations, the aHR was 0.81 (95% CI: 0.73 to 0.90), and for those received 4 vaccinations, the aHR was 0.44 (95% CI: 0.40 to 0.50), with p for trend <0.001. In conclusion, annual influenza vaccination can reduce the risk of dementia in patient with COPD in a dose-dependent manner.

scholarly journals Association between benzodiazepine use and risks of chronic-onset poststroke pneumonia: a population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024180 ◽  
Author(s):  
Shu-Man Lin ◽  
Shih-Hsien Yang ◽  
Chung-Chao Liang ◽  
Huei-Kai Huang ◽  
Ching-Hui Loh
Keyword(s):  
Cohort Study ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Defined Daily Doses ◽  
Increased Risk ◽  
Benzodiazepine Use ◽  
Age And Sex

ObjectivesTo investigate the association between benzodiazepine (BZD) use and the risk of chronic-onset poststroke pneumonia.DesignPopulation-based propensity-matched retrospective cohort study.SettingTaiwan’s National Health Insurance Research Database.ParticipantsPatients newly diagnosed with stroke between 2000 and 2012 were identified and, after propensity score matching, 7516 patients were enrolled. Among these, 3758 patients received BZDs after stroke while 3758 did not.Outcome measuresHRs for developing pneumonia over 1 month after stroke according to BZD use were assessed using Cox proportional hazards regression models. Analyses according to cumulative defined daily doses (cDDDs) of BZDs and stratification for age and sex were also performed.ResultsDuring a mean follow-up time of 4.4 years, 1027 patients in the BZD cohort and 478 patients in the non-BZD cohort developed pneumonia over 1 month after stroke. Patients using BZDs after stroke had a higher pneumonia risk than did those not using BZDs (52.2vs32.6 per 1000 person-years, adjusted HR (aHR)=2.21, 95% CI (CI)=1.97 to 2.48, p<0.001). Analyses based on cumulative BZD dose revealed that all BZD user subgroups were associated with a higher risk of pneumonia. The aHRs for patients taking 1–90, 91–365 and >365 cDDDs of BZDs were 2.28 (95% CI=2.01 to 2.58; p<0.001), 2.09 (95% CI=1.77 to 2.47; p<0.001) and 2.08 (95% CI=1.72 to 2.52; p<0.001), respectively. The significant association between BZD use and increased pneumonia risk persisted even after stratifying subgroups by age and sex.ConclusionsBZD use is associated with an increased risk of chronic-onset poststroke pneumonia.

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

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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