scholarly journals The Development of Keratopathy after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

2019 ◽  
Vol 16 (7) ◽  
pp. 1218 ◽  
Author(s):  
Hung-Jui Hsu ◽  
Chia-Yi Lee ◽  
Kun-Lin Yang ◽  
Hung-Chi Chen ◽  
Chi-Chin Sun ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Index Date ◽  
Population Based ◽  
Sinus Surgery ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Code ◽  
Research Database ◽  
Age And Sex

The aim of the present study was to evaluate the risk of developing keratopathy in patients with surgery-indicated chronic rhinosinusitis (CRS) via the National Health Insurance Research Database in Taiwan. Patients with a diagnostic code of CRS and who received functional endoscopic sinus surgery (FESS) were considered to have surgery-indicated CRS. The exclusion criteria were legal blindness, an ocular tumor, eyeball removal or previous keratopathy, and each individual in the study group was matched to four non-CRS patients by age and sex. The outcome was set as the occurrence of keratopathy according to the diagnostic codes after the index date. Cox proportional hazard regression was used for statistical analysis. A total of 6053 patients with surgery-indicated CRS and another 24,212 non-CRS individuals were enrolled after exclusions. The age and sex distributions were identical between the two groups due to matching, while comorbidities, including hypertension, diabetes mellitus, and other cardiovascular disorders, were significantly higher in the study group. There were 231 episodes of keratopathy in the study group, and 695 episodes of keratopathy in the control group after the index date, for which study group showed a significantly higher rate of developing keratopathy with an adjusted hazard ratio of 1.208 and a higher cumulative probability. In subgroup analysis, female sex with surgery-indicated CRS showed a significantly greater risk of developing keratopathy. In conclusion, surgery-indicated CRS that needs FESS to relieve symptoms is a potential risk factor for keratopathy.

scholarly journals The Development of Dry Eye Disease after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3829
Author(s):  
Chia-Yi Lee ◽  
Kun-Lin Yang ◽  
Chi-Chin Sun ◽  
Jing-Yang Huang ◽  
Hung-Chih Chen ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Sinus Surgery ◽  
Eye Disease ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Code ◽  
Research Database

We aim to evaluate the risk of dry eye disease (DED) occurrence in patients with surgery-indicated chronic rhinosinusitis (CRS) via the national health insurance research database in Taiwan. After exclusion, patients with a diagnostic code of CRS and had received functional endoscopic sinus surgery (FESS) were regarded as having surgery-indicated CRS and enrolled in the study group, then each patient in the study group was age- and gender-matched to four non-CRS patients that served as the control group. The outcome was considered as the development of DED and Cox proportional hazard regression was used for the statistical analysis, which involved multiple potential risk factors of DED. A total of 6076 patients with surgery-indicated CRS that received FESS and another 24,304 non-CRS individuals were enrolled after exclusion. There were 317 and 770 DED events in the study group and the control group during the 16-year follow-up interval, and the study group demonstrated a significantly higher adjusted hazard ratio (1490, 95% confidence intervals (CI): 1.303-1.702) of DED development compared to the control group in the multivariable analysis. In addition, the cumulative probability analysis illustrated a positive correlation of DED occurrence and the disease period of surgery-indicated CRS (p < 0.0001). In the subgroup analysis, both genders revealed a higher but not significant incidence of developing DED in the study group. In conclusion, the existence of surgery-indicated CRS will increase the risk of developing DED, which correlated to the disease interval.

scholarly journals The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

2019 ◽  
Vol 16 (22) ◽  
pp. 4456
Author(s):  
Siu-Fung Chau ◽  
Pei-Hsuan Wu ◽  
Chi-Chin Sun ◽  
Jing-Yang Huang ◽  
Chan-Wei Nien ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Conditional Logistic Regression ◽  
Sinus Surgery ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Code ◽  
Research Database ◽  
Age And Gender ◽  
And Gender

This study investigates the development of glaucoma in subjects with surgery-indicated chronic rhinosinusitis (CRS) by the use of the National Health Insurance Research Database in Taiwan. Individuals that received the functional endoscopic sinus surgery (FESS) with a diagnostic code of CRS were regarded as surgery-indicated CRS and enrolled in the study group. Four non-CRS patients were age- and gender-matched to each patient in the study group. The exclusion criteria included legal blindness, ocular tumor, history of eyeball removal, and previous glaucoma. The outcome was regarded as the development of glaucoma, and conditional logistic regression was used for the statistical analysis, which involved multiple potential risk factors in the multivariate model. A total of 6506 patients with surgery-indicated CRS that received FESS and another 26,024 non-CRS individuals were enrolled after exclusion. The age and gender distributions were identical between the two groups due to matching. There were 108 and 294 glaucoma events in the study group and control group, respectively, during the follow-up period, and the study group had a significantly higher adjusted hazard ratio (1.291, 95% confidential interval: 1.031–1.615). The cumulative probability analysis also revealed a correlation between the occurrence of glaucoma and the CRS disease interval. In the subgroup analysis, the chance of developing open-angle glaucoma and normal-tension glaucoma was significantly higher in the study group than in the control group. In conclusion, the existence of surgery-indicated CRS is a significant risk factor for the development of glaucoma, which correlated with the disease interval.

scholarly journals The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan-Wei Nien ◽  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Shih-Chun Chao ◽  
Hung-Jui Hsu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Abstract Background The effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan. Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation. Results A total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group. Conclusion The presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

Congenital collagenopathies increased the risk of inguinal hernia developing and repair: analysis from a nationwide population-based cohort study

2021 ◽  
Author(s):  
Hao Han Chang ◽  
Yung Shun Juan ◽  
Ching Chia Li ◽  
Hsiang Ying Lee ◽  
Jian Han Chen
Keyword(s):  
Inguinal Hernia ◽  
Population Based ◽  
Collagen Disease ◽  
Control Group ◽  
Study Cohort ◽  
Diagnostic Code ◽  
Research Database ◽  
Asian Men ◽  
Male Patients

Abstract Introduction: The aim of this study is to explore whether male patients diagnosed of congenital collagen diseases had higher risk of occurrence inguinal hernia than patients who do not had these diseases.Method: Data were collected from National Health Insurance Research Database (NHIRD) of Taiwan retrospectively. 1801 male patients who diagnosed of congenital collagen disease by using ICD-9 CM diagnostic code was the study cohort, and in the other hand, after propensity score matching, 6493 man without congenital collagen disease were enrolled as control group. The primary endpoint was receiving inguinal hernia repair during observation period.Result: During median 133.9 months follow-up period, the risk of inguinal hernia in collagen cohort was significantly higher than the control group (HR = 2.237, 95% CI:1.646–3.291, p < 0.001). Furthermore, this phenomenon also presented in patient younger than 18 (HR:3.040 95% CI: 1.819–5.083, p < 0.001) and in age 18–80 (HR: 1.909, 95% CI: 1.186–3.073, p < 0.001).Conclusion: Asian men, regardless of age, with congenital collagen disease are at the risk of developing inguinal hernia. Detailed physical examination and well patient education should be performed while facing these patients.

scholarly journals Dermatologic Vasculature Diseases as a Risk Factor of Subconjunctival Hemorrhage

2019 ◽  
Vol 16 (16) ◽  
pp. 2865
Author(s):  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Jing-Yang Huang ◽  
Chi-Chin Sun ◽  
Chao-Bin Yeh ◽  
...  
Keyword(s):  
Risk Factor ◽  
Survival Analysis ◽  
Cox Regression ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Subconjunctival Hemorrhage ◽  
The Relationship

To evaluate the relationship between subconjunctival hemorrhage (SCH) and dermatologic vasculature diseases (DVDs) via the national health insurance research database (NHIRD) of Taiwan. This retrospective cohort study used data from the NHIRD for the 2009 to 2013 period. Patients diagnosed with DVDs were enrolled in the study group, and a propensity score-matching population was selected as the control group after exclusion. The main outcome was set as the development of SCH in both groups. Multivariable Cox regression analysis and survival analysis were performed to estimate the adjusted hazard ratio (aHR) and cumulative probability of SCH. A total number of 3426 patients were enrolled and split equally into the study and the control groups. There was no prominent difference between the age, gender, urbanization, income level, systemic co-morbidities, and ocular diseases between the two groups after matching. During the whole study period, 131 patients in the study group and 98 patients in the control group developed SCH with a significant higher aHR of 2.69 in the study group (p < 0.05). In the survival analysis, the study group also demonstrated a higher cumulative probability of developing SCH than the control group throughout the study period (p = 0.02). In conclusion, the presence of DVDs may be a risk factor for the development of SCH.

scholarly journals Gout as a Risk Factor for Dry Eye Disease: A Population-Based Cohort Study

2019 ◽  
Vol 8 (1) ◽  
pp. 62 ◽  
Author(s):  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Chi-Chin Sun ◽  
Hung-Yu Lin ◽  
Ko-Hsiu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Age Related Macular Degeneration ◽  
Eye Disease ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Increased Risk

This study evaluated the effect of gout on the risk of dry eye disease (DED) by using the National Health Insurance Research Database (NHIRD). Data for 30,192 gout patients (21,081 men and 9111 women) and 30,192 non-gout patients (21,005 men and 9187 women) were analyzed. Approximately 1 million patients were randomly sampled from the NHIRD registry. After applying exclusion criteria, patients diagnosed with gout were enrolled in the study group. Thereafter, each individual in the study group underwent the matching process via the propensity score with another non-gout individual, which constituted the control group. The main outcome was defined as the development of DED in accordance with the corresponding International Classification of Diseases, Ninth Revision. In addition to DED, other risk factors including age, sex, and urbanization, and several co-morbidities were included in the multivariate model. The incidence of DED with the adjusted hazard ratio (aHR) and cumulative probability were evaluated in the gout and non-gout patients. A total of 2913 DED events were observed in the study group, whereas 2631 DED events were observed in the control group. A higher incidence rate ratio was found in the study group after adjustment (aHR: 1.065). Moreover, the cumulative probability indicated a significantly increased risk of DED in the study group (p = 0.001). The other potential risk factors of DED according to the multivariate analysis include older age, female gender, higher degree of urbanization, keratopathy, age-related macular degeneration, glaucoma, cataract, ischemic heart disease, hyperlipidemia, peripheral vascular disease, chronic pulmonary disease, rheumatic disease, peptic ulcer disease, liver disease, and malignancy. In conclusion, gout increased the risk of DED after adjustment, and the risk is positively correlated to a longer disease period.

scholarly journals Impact of the Severities of Glaucoma on the Incidence of Subsequent Dementia: A Population-Based Cohort Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2426
Author(s):  
Fu-Hsuan Kuo ◽  
Jui-Fu Chung ◽  
Min-Yen Hsu ◽  
Chia-Yi Lee ◽  
Jing-Yang Huang ◽  
...  
Keyword(s):  
Glaucoma Patient ◽  
Exclusion Process ◽  
Population Based ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Medical Treatments ◽  
Hazard Ratios ◽  
Potential Risk Factors ◽  
Cox Proportional Hazard Regression

The aim of the present study was to survey the relationship between the severity of glaucoma and subsequent dementia using the National Health Insurance Research Database (NHIRD) in Taiwan. Subjects with glaucoma were selected into the study group after an exclusion process, and each subject in the study group was propensity score-matched to another non-glaucoma patient that constituted the control group. The Cox proportional hazard regression that considered multiple potential risk factors of dementia was used to yield the adjusted hazard ratios (aHR) of dementia in different severities of glaucoma. There were 1185 (5.63 percent) subjects in the study group and 1119 (5.32 percent) patients in the control group that developed dementia. After adjusting for multiple confounders, there were no differences in the rate of any dementia (aHR: 0.961, 95% CI: 0.886–1.043, p = 0.3443), vascular dementia (aHR: 0.928, 95% CI: 0.846–1.018, p = 0.1154), Alzheimer’s disease (aHR: 1.018, 95% CI: 0.761–1.362, p = 0.9025) or Parkinson’s disease (aHR: 1.021, 95% CI: 0.886–1.176, p = 0.7744) between the study and the control groups. Regarding the disease severity of glaucoma, no difference was found in any type of dementia whether the glaucoma patients received less than two medical treatments, received more than two medical treatments, received drainage surgeries or received destructive surgeries. In conclusion, the different severities of glaucoma do not alter the incidence of subsequent dementia.

scholarly journals The elevated risk of sight-threatening cataract in diabetes with retinopathy: a cohort study

2020 ◽  
Author(s):  
Chan-Wei Nien ◽  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Shih-Chun Chao ◽  
Hung-Jui Hsu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Multivariable Analysis ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
And Gender ◽  
Cox Proportional Hazard Regression

Abstract Background To survey the effect of diabetic retinopathy (DR) on the development of sight-threatening cataract via National Health Insurance Research Database of Taiwan.Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. The age and gender-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR with considering multiple factors of cataract formation.Results A total of 3,297 DR patients, 13,188 DM control patients and 13,188 non-DM controls were enrolled. There were 919 events (27.87 percent) of sight-threatening cataract in the study group while another 1,108 events (8.40 percent) in the DM control group and 957 events (7.26 percent) in the non-DM control group. After multivariable analysis, the study group showed a higher aHR of cataract surgery (2.93, 95% CI: 2.60-3.30) and a higher cumulative probability of cataract surgery compared to both the DM control and non-DM control groups (both Log rank P<0.001). Besides, both the proliferative DR (3.90, 95% CI: 3.42-4.45) and non-proliferative DR (2.35, 95% CI: 2.08-2.65) subgroups showed a higher aHR of cataract surgery than the DM control group.Conclusion The presence of DR will increase the risk for development of sight-threatening cataract that surgery is warranted, and the effect is prominent in both the proliferative DR and non-proliferative DR.

Postoperative Antibiotic Care after Functional Endoscopic Sinus Surgery

2008 ◽  
Vol 22 (6) ◽  
pp. 608-612 ◽  
Author(s):  
Rong-San Jiang ◽  
Kai-Li Liang ◽  
Kung-Yaun Yang ◽  
Jiun-Yih Shiao ◽  
Mao-Chang Su ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Postoperative Care ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Control Group ◽  
Study Group ◽  
Term Outcome ◽  
Before And After

Background Antibiotics are used routinely in the postoperative care of functional endoscopic sinus surgery (FESS), but their efficacy has not been well evaluated. Methods Patients with chronic rhinosinusitis who underwent FESS were enrolled in this study. They were randomly divided into two groups: a study group and a control group. In the study group, patients took amoxicillin/clavulante for 3 weeks after FESS. In the control group, no antibiotic was given after FESS. Before FESS, all patients filled out a symptom questionnaire and received nasal endoscopy. Swab specimens were taken from the middle meati for bacterial cultures. These procedures were done again 3 weeks after FESS. Results Seventy-one patients completed the study. Thirty-one patients were in the study group, and 40 patients were in the control group. The symptom scores significantly decreased after surgery in both groups, but bacteria identified before and after FESS were statistically different in both groups. There were no differences in the symptom and endoscopic scores, rates of bacterial culture, and drug sensitivity to amoxicillin/clavulante between the two groups after FESS. Conclusion This study showed that postoperative care with amoxicillin/clavulante did not improve the short-term outcome of FESS on chronic rhinosinusitis or decrease bacterial growth 3weeks after FESS, although the long-term influence was not evaluated in this study.

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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