scholarly journals Effect of Sex on Clinical Outcomes in Patients with Coronavirus Disease: A Population-Based Study

2020 ◽  
Vol 10 (1) ◽  
pp. 38
Author(s):  
Kyu Hyang Cho ◽  
Sang Won Kim ◽  
Jong Won Park ◽  
Jun Young Do ◽  
Seok Hui Kang
Keyword(s):  
Clinical Outcomes ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Charlson Comorbidity Index Score ◽  
Population Based Study ◽  
Classification Of Diseases ◽  
Insurance Claims Data ◽  
Comorbidity Index ◽  
The Impact

Background: This study aimed to evaluate the association between sex and clinical outcomes in patients with coronavirus disease (COVID-19) using a population-based dataset. Methods: In this retrospective study, insurance claims data from the Korea database were used. Patients who tested positive for COVID-19 were included in the study. All diseases were defined according to the International Classification of Diseases 10th revision. During follow-up, the clinical outcomes, except mortality, were assessed using the electrical codes from the dataset. The clinical outcomes noted were: hospitalization, the use of inotropics, high flow nasal cannula, conventional oxygen therapy, mechanical ventilation, extracorporeal membrane oxygenation, development of acute kidney injury, cardiac arrest, myocardial infarction, acute heart failure, pulmonary embolism, and disseminated intravascular coagulation after the diagnosis of COVID-19. Results: A total of 7327 patients were included; of these, 2964 patients (40.5%) were men and 4363 patients (59.5%) were women. There were no significant differences in the Charlson comorbidity index score between men and women in the same age group. The incidence of mortality and clinical outcomes was higher among men than among women. The mortality rate was the highest for the populations aged 50–64 or ≥65 years. The subgroup analyses for age, diabetes mellitus, or hypertension showed favorable results for patient survival or clinical outcomes for women compared to men. Conclusion: Our population-based study showed that female patients with COVID-19 were associated with favorable outcomes. Furthermore, the impact of sex was more evident in patients aged 50–64 or ≥65 years.

scholarly journals Effect of sex on clinical outcomes in COVID-19 patients: a population-based study

2020 ◽  
Author(s):  
Seok Hui Kang ◽  
Sang Won Kim ◽  
Jong Won Park ◽  
Jun Young Do ◽  
Kyu Hyang Cho
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Age Groups ◽  
Population Based ◽  
Electronic Data Interchange ◽  
Charlson Comorbidity Index Score ◽  
Cardiac Events ◽  
Population Based Study ◽  
Icd 10 ◽  
The Impact

Abstract Background Previous studies have reported the association between sex and clinical outcomes; however, the most relevant results were obtained as part of analyses evaluating other prognostic factors. This study aimed to evaluate the association between sex and clinical outcomes in patinets with COVID-19 using a population-based dataset. Methods This retrospective study utilized claims data from the Health Insurance Review & Assessment Service of Korea. Confirmed patients were included among all participants who underwent COVID-19 testing. Diseases including COVID-19 were defined using International Classification of Diseases, 10th revision (ICD-10). During follow-up, clinical outcomes except death were defined using Electronic Data Interchange or ICD-10 codes from the dataset. Results A total of 234,427 patients underwent laboratory testing for COVID-19. Finally, 7327 patients were included; of these, 2964 were men and 4363 were women. The proportions of patients with diabetes mellitus or hypertension as major comorbidities were higher among men than among women of the some age groups, but there were no significant differences in the Charlson comorbidity index score between men and women in same age group. Survival and clinical outcomes including acute kidney injury, the use of inotropes, mechanical ventilator, and cardiac events were greater in men than women. The mortality rate was the highest for the populations aged 50–64 or ≥ 65 years. Subgroup analyses for age, diabetes mellitus, or hypertension showed favorable results for patient survival or clinical outcomes in women compared to men. Conclusion Our population-based study showed that female patients with COVID-19 were associated with favorable outcomes, including survival. The impact of sex was more evident in population aged 50–64 or ≥ 65 years.

Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study

2017 ◽  
Vol 42 (7) ◽  
pp. 673-677 ◽  
Author(s):  
J. Nordenskjöld ◽  
M. Englund ◽  
C. Zhou ◽  
I. Atroshi
Keyword(s):  
General Population ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Dupuytren’S Disease ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Population Based Study ◽  
Classification Of Diseases ◽  
First Time

The prevalence and incidence of doctor-diagnosed Dupuytren’s disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren’s disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren’s disease; the prevalence among men was 1.35% and among women 0.5%. Of all people diagnosed, 56% had received treatment (87% fasciectomy). In 2013, the incidence of first-time doctor-diagnosed Dupuytren’s disease among men was 14 and among women five per 10,000. The annual incidence among men aged ⩾50 years was 27 per 10,000. Clinically important Dupuytren’s disease is common in the general population. Level of evidence: III

scholarly journals Epidemiology and the Impact of Acute Kidney Injury on Outcomes in Patients with Rhabdomyolysis

2021 ◽  
Vol 10 (9) ◽  
pp. 1950
Author(s):  
Chien-Wen Yang ◽  
Si Li ◽  
Yishan Dong ◽  
Nitpriya Paliwal ◽  
Yichen Wang
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Wald Test ◽  
Categorical Variables ◽  
Charlson Comorbidity Index Score ◽  
Care Utilization ◽  
Chi Squared ◽  
Hospital Stays ◽  
The Impact

Background: Currently, no large, nationwide studies have been conducted to analyze the demographic factors, underlying comorbidities, clinical outcomes, and health care utilization in rhabdomyolysis patients with and without acute kidney injury (AKI). Methods: We queried the National Inpatient Sample of Healthcare Cost and Utilization Project (HCUP) with patients with rhabdomyolysis from 2016 to 2018. The chi-squared test was used to compare categorical variables, and the adjusted Wald test was employed to compare quantitative variables. The logistic regression model was applied to calculate adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) to estimate the impact of AKI on outcomes in patients with rhabdomyolysis. Results: Among 111,085 rhabdomyolysis-related hospitalizations, a higher prevalence of AKI was noticed in older patients (mean age ± SD, 58.2 ± 21.6 vs. 53.8 ± 22.2), Medicare insurance (48.5% vs. 43.2%,), and patients with a higher Charlson Comorbidity Index score (CCI 3–5, 15.1% vs. 5.5%). AKI was found to be independently associated with higher mortality (adjusted odds ratio [aOR].3.33, 95% CI 2.33–4.75), longer hospital stays (adjusted difference 1.17 days, 95% CI: 1.00−1.34), and higher cost of hospital stay (adjusted difference $11,315.05, 95% CI: $9493.02–$13,137.07). Conclusions: AKI in patients hospitalized with rhabdomyolysis is related to adverse clinical outcomes and significant economic and survival burden.

Cancer Complications At the Time of Multiple Myeloma Diagnosis and the Impact of Monoclonal Gammopathy of Undetermined Significance (MGUS) Follow-up: A Population-Based Study

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3996-3996
Author(s):  
Jacob D Gundrum ◽  
Joan M Neuner ◽  
Ronald S. Go
Keyword(s):  
Multiple Myeloma ◽  
Kidney Injury ◽  
Cord Compression ◽  
Population Based ◽  
Complication Rates ◽  
Population Based Study ◽  
Major Complications ◽  
The Impact ◽  
Over Time

Abstract Abstract 3996 Background: We performed a population-based study to determine the rates of major complications related to multiple myeloma, lymphoplasmacytic lymphoma, and Waldenstrom's macroglobulinemia (hence abbreviated as MM) at the time of cancer diagnosis in the US, their trends over time, disparities among demographic subsets, and the impact of preceding follow-up for MGUS. Methods: Data were obtained from the Surveillance Epidemiology and End Results (SEER) database linked to Medicare claims. We considered patients age >/= 67 years with MM diagnosed from 1994–2007 (N = 28,879). We excluded those who were diagnosed by autopsy or death certificate only, had invasive cancers within 5 years prior to MM diagnosis, lacked date of either diagnosis or death, lacked complete Medicare parts A/B coverage 15 months prior to or 3 months after MM diagnosis date (or to date of death, if death was within 3 months), and receiving dialysis for other conditions (n = 11,450). Major complications including acute kidney injury (AKI), dialysis requirement, cord compression, fracture, and hypercalcemia presenting within 3 months before or after MM diagnosis were obtained from diagnosis and procedure claims. MGUS follow-up was defined as having a diagnosis claim 3–15 months prior to MM diagnosis. Results: Of the 17,429 MM patients included in our study, 50.6% were males and the median age was 77 years. Major complications were present at diagnosis in 31.9% of the patients in the following order of frequency: fracture (16.6%), acute kidney injury (13.5%), hypercalcemia (5.5%), dialysis (5.3%), and cord compression (2.4%). There was a significant increase in most complication rates (unadjusted) over time (P < .001) except for hypercalcemia and cord compression. Females were more likely to have hypercalcemia (6.0% vs 5.1%; P = .005) or fracture (19.4% vs 13.9%; P < .001), but men were more likely to have AKI (14.6% vs 12.3%; P < .001) and to require dialysis (5.8% vs 4.8%; P = .002). Blacks were more likely to have hypercalcemia (7.1%; P < .001), AKI (18.3%; P < .001), cord compression (3.1%; P = .009), or require dialysis (7.8%; P < .001), but were less likely to have fracture (14.6%; P < .001) compared to whites (5.4%, 12.9%, 2.3%, 5.0%, and 17.1%, respectively) or other races (4.6%, 12.5%, 1.0 %, 4.8%, and 16.0%, respectively). Overall, 6% of the patients had MGUS follow-up (n = 1,037) preceding MM diagnosis with an increasing trend from 2.6% in 1994 to 6.9% in 2007 (P < .001). Complication rates were lower in the group with MGUS follow-up compared to those without follow-up: any complication (20.8% vs 32.6%; P < .001), AKI (10.1% vs 13.7%; P < .001), cord compression (1.4% vs 2.4%; P < .001), dialysis (3.4% vs 5.4%; P = .004), fracture (11.0% vs 17.0%; P < .001), and hypercalcemia (2.4% vs 5.7%; P < .001). Conclusions: At the time of MM diagnosis, major cancer-related complications were present in a third of patients with increasing trends from 1994–2007 for fracture, AKI, and requirement for dialysis. Complication rates varied among gender and race. Patients being followed for MGUS had significantly lower complications rates compared to those who were not. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Trends in prevalence of pre-existing diabetes and perinatal outcomes: a large, population-based study in Catalonia, Spain, 2006–2015

2020 ◽  
Vol 8 (1) ◽  
pp. e001254
Author(s):  
Lucia Gortazar ◽  
Albert Goday ◽  
Juana Antonia Flores-Le Roux ◽  
Eugènia Sarsanedas ◽  
Antonio Payà ◽  
...  
Keyword(s):  
Gestational Age ◽  
Large Population ◽  
Perinatal Outcomes ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Large For Gestational Age ◽  
Data Set ◽  
Population Based Study ◽  
Classification Of Diseases ◽  
Using Data

IntroductionThis study aims to assess trends in the prevalence of pre-existing diabetes and whether the risk of adverse perinatal outcomes decreased in women between 2006 and 2015 in Catalonia, Spain.Research design and methodsA population-based study of 743 762 singleton deliveries between 2006 and 2015 in Catalonia, Spain, was conducted using data from the Spanish Minimum Basic Data Set. Cases of type 1 diabetes (T1DM) and ‘type 2 diabetes and other pre-existing diabetes’ (‘T2DM and other PGD’) were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Crude and age-adjusted annual prevalences were calculated. Poisson regression model was used to assess trends in prevalence and perinatal outcomes during the study period.ResultsOverall prevalences of pre-existing diabetes, T1DM and ‘T2DM and other PGD’ were 0.52% (95% CI 0.51 to 0.54), 0.17% (95% CI 0.17 to 0.18) and 0.35% (95% CI 0.33 to 0.36), respectively. From 2006 to 2015, rates increased for pre-existing diabetes (from 0.43 (95% CI 0.39 to 0.48) to 0.56% (0.50 to 0.62), p<0.001), T1DM (from 0.14 (0.11 to 0.17) to 0.20% (0.17 to 0.23), p<0.001) and ‘T2DM and other PGD’ (from 0.29 (0.25 to 0.33) to 0.36% (0.31 to 0.40), p<0.001). Pre-eclampsia rose in women with pre-existing diabetes (from 4.38% to 8.97%, adjusted p<0.001), T1DM (from 3.85% to 12.88%, p=0.005) and ‘T2DM and other PGD’ (from 4.63% to 6.78%, adjusted p=0.01). Prevalence of prematurity, cesarean section and small for gestational age remained stable in all diabetes groups. However, the prevalence of macrosomia fell in women with pre-existing diabetes (from 18.18% to 11.9%, adjusted p=0.011) and ‘T2DM and other PGD’ (from 14.71% to 11.06%, non-adjusted p=0.022, adjusted p=0.305) and large for gestational age decreased in all diabetes groups (from 39.73% to 30.25% in pre-existing diabetes, adjusted p=0.004).ConclusionsThe prevalence of pre-existing diabetes increased significantly in Catalonia between 2006 and 2015. Despite improvements in outcomes related to excessive birth weight, pre-eclampsia rates are rising and overall perinatal outcomes in women with pre-existing diabetes continue to be markedly worse than in the population without diabetes.

scholarly journals Comorbidities at Diagnosis, Survival, and Cause of Death in Patients with Chronic Lymphocytic Leukemia: A Population-Based Study

2021 ◽  
Vol 18 (2) ◽  
pp. 701
Author(s):  
Alicia Villavicencio ◽  
Marta Solans ◽  
Lluís Zacarías-Pons ◽  
Anna Vidal ◽  
Montse Puigdemont ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Relative Survival ◽  
Organ Damage ◽  
Population Based ◽  
Lymphocytic Leukemia ◽  
Common Disease ◽  
Population Based Study ◽  
Comorbidity Index ◽  
Clinical Records ◽  
The Impact

This study aimed to examine the prevalence of comorbidities in patients diagnosed with chronic lymphocytic leukemia (CLL), and to assess its influence on survival and cause-specific mortality at a population-based level. Incident CLL cases diagnosed in the Girona province (Spain) during 2008–2016 were extracted from the Girona Cancer Registry. Rai stage and presence of comorbidities at diagnosis, further categorized using the Charlson comorbidity index (CCI), were obtained from clinical records. Observed (OS) and relative survival (RS) were estimated and Cox’s proportional hazard models were used to explore the impact of comorbidity on mortality. Among the 400 cases included in the study, 380 (99.5%) presented at least one comorbidity at CLL diagnosis, with diabetes without end organ damage (21%) being the most common disease. 5-year OS and RS were 68.8 (95% CI: 64.4–73.6) and 99.5 (95% CI 3.13–106.0), respectively, which decreased markedly with increasing CCI, particularly in patients with CCI ≥ 3. Multivariate analysis identified no statistically significant association between the CCI and overall CLL-related or CLL-unrelated mortality. In conclusion, a high CCI score negatively influenced the OS and RS of CLL patients, yet its effect on mortality was statistically non-significant when also considering age and the Rai stage.

scholarly journals DOP18 Impact of adherence to anti-tumour necrosis factor therapy on clinical outcomes in Crohn’s disease: A nationwide population-based study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S058-S058
Author(s):  
J J Park ◽  
H Koo ◽  
Y Park ◽  
S J Park ◽  
T I Kim ◽  
...  
Keyword(s):  
Health Insurance ◽  
Clinical Outcomes ◽  
Tumour Necrosis Factor ◽  
National Health Insurance ◽  
National Health ◽  
Tumour Necrosis ◽  
Population Based ◽  
Population Based Study ◽  
The Impact ◽  
Necrosis Factor

Abstract Background The impact of compliance with anti-tumour necrosis factor (TNF) on the clinical outcomes of Crohn’s disease (CD) is not well unknown. We performed a nationwide population-based study to investigate the impact of adherence to anti-TNF therapy on clinical outcomes in CD patients. Methods Using the National Health Insurance claims data, we collected data on newly diagnosed patients with CD between 2004 and 2015. Given that infliximab was listed in the National Health Insurance Service in 2006 and adalimumab in 2010, data only after the listing date were extracted. A total of 2784 patients were included according to inclusion criteria. Medication adherence was measured based on the following three criteria, including the ratio of delayed visit, the ratio of the number of visits, and the ratio of actual administration, and was assessed at four-point in time from the initial administration: 14, 22, 39, and 48 weeks. Results A total of 2179 patients received infliximab, and 605 patients received adalimumab. The mean cumulative actual to predetermined prescription ratio (CAPPR) at 14 and 48 weeks was 1.07 and 1.17, respectively. CAPPRs of infliximab users were higher than those of adalimumab users (1.06 and 1.21 vs. 1.02 and 1.04 at 14 and 48 weeks, respectively). As hospital visits were delayed one more day, risk of perianal surgery (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.089–1.333), corticosteroid use (OR = 1.008, 95% CI 1–1.016), and hospitalisation (OR = 1.05,95% CI 1.002–1.108) at 48 weeks were significantly increased. Moreover, as CAPPR decreased by 1 percent point, risk of bowel resection (OR = 1.589, 95% CI 0.713–3.542), perianal surgery (OR = 1.246, 95% CI 0.868–1.79), and hospitalisation (OR = 1.128, 95% CI 0.998–1.276) at 14 weeks were significantly increased. Conclusion Our data indicate that adherence to anti-TNF therapy affects major clinical outcomes of CD in the short- and mid-term period. Intervention to improving adherence to anti-TNF therapy is highly needed for better clinical outcomes in CD.

Impact of smoking status and smoking cessation after coronary revascularization on long-term clinical outcomes: from a nationwide population-based study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y.J Ki ◽  
J.K Han ◽  
H.S Lee ◽  
M.O Chang ◽  
J.H Kang ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Clinical Outcomes ◽  
Smoking Status ◽  
Coronary Revascularization ◽  
Population Based ◽  
Health Check ◽  
National Health Insurance System ◽  
Population Based Study ◽  
The Impact

Abstract Background There are many studies on emphasizing the importance of quitting smoking, but the smoking status was based on baseline status without subsequent status. Since a significant percentage of patients who have received coronary revascularization change their smoking status, it is necessary to confirm the clinical consequences of smoking status after revascularization. Purpose In this study, we aimed to investigate the impact of smoking status after revascularization on long-term clinical outcomes, using large population based study from the Korean National Health Insurance System. Methods Among 74,004 patients who received coronary revascularization (PCI or CABG) from 1 January 2007 to 21 December 2013 and underwent regular health check-up within 2 years after index PCI, examined for death, MI, revascularization and stroke. Results Within patients who underwent revascularization, 33,800 (45.7%) of patients were self-reported non-smoker, 28,603 (38.7%) were ex-smoker, 11601 (15.6%) were current smokers at first regular health check-up after revascularization. Current smokers were associated with higher risks for death (HR: 1.497; 95% CI: 1.366–1.641), MI (HR: 1.498; 95% CI: 1.302–1.723) and revascularization (HR: 1.088; 95% CI: 1.018–1.164) than non-smokers. Compared with non-smokers, more than 30PY ex-smokers and current smokers showed higher incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of death, MI, revascularization and stroke. Regarding smoking tendency, maintaining non-smokers were lower risk for MACCE than maintaining smokers (Figure 1). Quitters tended to lower MACCE compared to patients who continued to smoke (HR: 0.823; 95% CI: 0.762–0.888). Especially, maintaining non-smokers and quitters significantly showed lower mortality than patients who continued to smoke. Conclusion Smoking is associated with poor clinical outcomes after coronary revascularization especially more than 30PY ex-smokers and current smokers. These results also emphasized that smoking cessation after revascularization also important for mortality benefit. Figure 1 Funding Acknowledgement Type of funding source: None

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