Appendectomy and Non-Typhoidal Salmonella Infection: A Population-Based Matched Cohort Study

The potential association between appendectomy and non-typhoidal Salmonella (NTS) infection has not been elucidated. We hypothesized that appendectomy may be associated with gut vulnerability to NTS. The data were retrospectively collected from the Taiwan National Health Insurance Research Database to describe the incidence rates of NTS infection requiring hospital admission among patients with and without an appendectomy. A total of 208,585 individuals aged ≥18 years with an appendectomy were enrolled from January 2000 to December 2012, and compared with a control group of 208,585 individuals who had never received an appendectomy matched by propensity score (1:1) by index year, age, sex, occupation, and comorbidities. An appendectomy was defined by the International Classification of Diseases, Ninth Revision, Clinical Modification Procedure Codes. The main outcome was patients who were hospitalized for NTS. Cox proportional hazards models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Two sensitivity analyses were conducted for cross-validation. Of the 417,170 participants (215,221 (51.6%) male), 208,585 individuals (50.0%) had an appendectomy, and 112 individuals developed NTS infection requiring hospitalization. In the fully adjusted multivariable Cox proportional hazards regression model, the appendectomy group had an increased risk of NTS infection (adjusted HR (aHR), 1.61; 95% CI, 1.20–2.17). Females and individuals aged 18 to 30 years with a history of appendectomy had a statistically higher risk of NTS than the control group (aHR, 1.92; 95% CI, 1.26–2.93 and aHR, 2.67; 95% CI, 1.41–5.07). In this study, appendectomy was positively associated with subsequent hospitalization for NTS. The mechanism behind this association remains uncertain and needs further studies to clarify the interactions between appendectomy and NTS.

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Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15081601 ◽

2018 ◽

Vol 15 (8) ◽

pp. 1601

Author(s):

Hao-Ming Li ◽

Shi-Zuo Liu ◽

Ying-Kai Huang ◽

Yuan-Chih Su ◽

Chia-Hung Kao

Keyword(s):

Water Supply ◽

Proportional Hazards ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Sensitivity Analyses ◽

Study Cohort ◽

Research Database ◽

Piped Water ◽

Increased Risk

Appendicitis is a common surgical condition for children. However, environmental effects, such as piped water supply, on pediatric appendicitis risk remain unclear. This longitudinal, nationwide, cohort study aimed to compare the risk of appendicitis among children with different levels of piped water supply. Using data from Taiwan Water Resource Agency and National Health Insurance Research Database, we identified 119,128 children born in 1996–2010 from areas of the lowest piped water supply (prevalence 51.21% to 63.06%) as the study cohort; additional 119,128 children of the same period in areas of the highest piped water supply (prevalence 98.97% to 99.63%) were selected as the controls. Both cohorts were propensity-score matched by baseline variables. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of appendicitis in the study cohort compared to the controls by Cox proportional hazards regression. The study cohort had a raised overall incidence rates of appendicitis compared to the control cohort (12.8 vs. 8.7 per 10,000 person-years). After covariate adjustment, the risk of appendicitis was significantly increased in the study cohort (adjusted HR = 1.46, 95% CI: 1.35, 1.58, p < 0.001). Subgroup and sensitivity analyses showed consistent results that children with low piped water supply had a higher risk of appendicitis than those with high piped water supply. This study demonstrated that children with low piped water supply were at an increased risk of appendicitis. Enhancement of piped water availability in areas lacking adequate, secure, and sanitized water supply may protect children against appendicitis.

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Increased risk of trigeminal neuralgia in patients with migraine: A nationwide population-based study

Cephalalgia ◽

10.1177/0333102415623069 ◽

2016 ◽

Vol 36 (13) ◽

pp. 1218-1227 ◽

Cited By ~ 12

Author(s):

Kuan-Hsiang Lin ◽

Yung-Tai Chen ◽

Jong-Ling Fuh ◽

Shuu-Jiun Wang

Keyword(s):

Trigeminal Neuralgia ◽

Proportional Hazards ◽

Underlying Mechanism ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Sensitivity Analyses ◽

Research Database ◽

Increased Risk ◽

Using Data

Objectives The objectives of this article are to evaluate the association between migraine and trigeminal neuralgia and to investigate the effects of age, sex, migraine subtype, and comorbid risk factors on trigeminal neuralgia development. Methods This population-based cohort study was conducted using data from Taiwan’s National Health Insurance Research Database. Individuals aged ≥ 20 years with neurologist-diagnosed migraine between 2005 and 2009 were included. A non-headache age-, sex-, and propensity score-matched control cohort was selected for comparison. All participants were followed until the end of 2010, death, or the occurrence of trigeminal neuralgia. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for comparison of the risk of trigeminal neuralgia between groups. Results Both cohorts ( n = 137,529 each) were followed for a mean of 3.1 years. During the follow-up period, 575 patients (421,581 person-years) in the migraine cohort and 88 matched controls (438,712 person-years) were newly diagnosed with trigeminal neuralgia (incidence rates, 136.39 and 20.06/100,000 person-years, respectively). The HR for trigeminal neuralgia was 6.72 (95% CI, 5.37–8.41; p < 0.001). The association between migraine and trigeminal neuralgia remained significant in sensitivity analyses. Among migraine subtypes, patients with migraine with aura were at greater risk of trigeminal neuralgia development. No other significant interaction was identified in subgroup analyses. Conclusions Migraine is a previously unidentified risk factor for trigeminal neuralgia. The association between these conditions suggests a linked underlying mechanism, which is worthy of further exploration.

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Long-term cardiovascular and cerebrovascular morbidity in Israeli thyroid cancer survivors

Endocrine Connections ◽

10.1530/ec-19-0038 ◽

2019 ◽

Vol 8 (4) ◽

pp. 398-406 ◽

Cited By ~ 1

Author(s):

Elena Izkhakov ◽

Joseph Meyerovitch ◽

Micha Barchana ◽

Yacov Shacham ◽

Naftali Stern ◽

...

Keyword(s):

Thyroid Cancer ◽

Thyroid Disease ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Control Group ◽

Study Group ◽

American Thyroid Association ◽

Cox Proportional Hazards Models ◽

Increased Risk

Objective Thyroid cancer (TC) survivors may be at risk of subsequent cardiovascular and cerebrovascular (CaV&CeV) morbidity. The 2009 American Thyroid Association (ATA) guidelines recommended less aggressive treatment for low-risk TC patients. The aim of this study was to assess the atherosclerotic CaV&CeV outcome of Israeli TC survivors compared to individuals with no thyroid disease, and the atherosclerotic CaV&CeV outcome before (2000–2008) and after (2009–2011) implementation of the 2009 ATA guidelines. Methods All members of the largest Israeli healthcare organization who were diagnosed with TC from 1/2000 to 12/2014 (study group) and age- and sex-matched members with no thyroid disease (controls) were included. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards models. Results The mean follow-up was 7.6 ± 4.2 and 7.8 ± 4.1 years for the study (n = 5,677, 79% women) and control (n = 23,962) groups, respectively. The former had an increased risk of new atherosclerotic CaV&CeV events (adjusted HR 1.26, 95% CI 1.15–1.39). The 5-year incidence of CaV&CeV was lower (adjusted HR 0.49, 95% CI 0.38–0.62) from 2009 to 2011 compared to 2000 to 2008, but remained higher in the study group than in the control group (adjusted HR 1.5, 95% CI 1.14–1.69). Conclusions This large Israeli population-based cohort study showed greater atherosclerotic CaV&CeV morbidity in TC survivors compared to individuals with no thyroid diseases. There was a trend toward a decreased 5-year incidence of atherosclerotic CaV&CeV events among TC survivors following the implementation of the 2009 ATA guidelines, but it remained higher compared to the general population.

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Associations between concussion and risk of diagnosis of psychological and neurological disorders: a retrospective population-based cohort study

Family Medicine and Community Health ◽

10.1136/fmch-2020-000390 ◽

2020 ◽

Vol 8 (3) ◽

pp. e000390

Author(s):

Marc P Morissette ◽

Heather J Prior ◽

Robert B Tate ◽

John Wade ◽

Jeff R S Leiter

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cohort Study ◽

Proportional Hazards ◽

Geographical Location ◽

International Classification Of Diseases ◽

Population Based ◽

Cox Proportional Hazards ◽

Control Group ◽

Increased Risk

ObjectiveTo investigate associations between concussion and the risk of follow-up diagnoses of attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.DesignA retrospective population-based cohort study.SettingAdministrative health data for the Province of Manitoba between 1990–1991 and 2014–2015.ParticipantsA total of 47 483 individuals were diagnosed with a concussion using International Classification of Diseases (ICD) codes (ICD-9-CM: 850; ICD-10-CA: S06.0). All concussed subjects were matched with healthy controls at a 3:1 ratio based on age, sex and geographical location. Associations between concussion and conditions of interest diagnosed later in life were assessed using a stratified Cox proportional hazards regression model, with adjustments for socioeconomic status and pre-existing medical conditions.Results28 021 men (mean age ±SD, 25±18 years) and 19 462 women (30±21 years) were included in the concussion group, while 81 871 men (25±18 years) and 57 159 women (30±21 years) were included in the matched control group. Concussion was associated with adjusted hazard ratios of 1.39 (95% CI 1.32 to 1.46, p<0.001) for ADHD, 1.72 (95% CI 1.69 to 1.76; p<0.001) for MADs, 1.72 (95% CI 1.61 to 1.84; p<0.001) for dementia and 1.57 (95% CI 1.41 to 1.75; p<0.001) for Parkinson’s disease.ConclusionConcussion was associated with an increased risk of diagnosis for all four conditions of interest later in life.

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Increased Risk of Ulcerative Colitis in Patients with Periodontal Disease: A Nationwide Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112602 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2602 ◽

Cited By ~ 6

Author(s):

Chien-Yu Lin ◽

Kuo-Sen Tseng ◽

Jui-Ming Liu ◽

Heng-Chang Chuang ◽

Chi-Hone Lien ◽

...

Keyword(s):

Ulcerative Colitis ◽

Periodontal Disease ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Control Group ◽

Research Database ◽

Immune Mediated ◽

Increased Risk ◽

Inflammatory Processes

Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94–1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13–2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC.

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Women with multiple gestations have an increased risk of development of hypertension in the future

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03992-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Geum Joon Cho ◽

Un Suk Jung ◽

Ho Yeon Kim ◽

Soo Bin Lee ◽

Minjeong Kim ◽

...

Keyword(s):

Proportional Hazards ◽

Smoking Status ◽

International Classification Of Diseases ◽

Population Based ◽

Cox Proportional Hazards ◽

Abnormal Liver Function Test ◽

Multiple Gestations ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Classification Of Diseases

Abstract Background Multiple gestations are associated with an increased incidence of preeclampsia. However, there exists no evidence for an association between multiple gestations and development of hypertension(HTN) later in life. This study aimed to determine whether multiple gestations are associated with HTN beyond the peripartum period. Methods In this retrospective nationwide population-based study, women who delivered a baby between January 1, 2007, and December 31, 2008, and underwent a national health screening examination within one year prior to their pregnancy were included. Subsequently, we tracked the occurrence of HTN during follow-up until December 31, 2015, using International Classification of Diseases-10th Revision codes. Results Among 362,821 women who gave birth during the study period, 4,944 (1.36%) women had multiple gestations. The cumulative incidence of HTN was higher in multiple gestations group compared with singleton group (5.95% vs. 3.78%, p < 0.01, respectively). On the Cox proportional hazards models, the risk of HTN was increased in women with multiple gestations (HR 1.35, 95% CI 1.19, 1.54) compared with those with singleton after adjustment for age, primiparity, preeclampsia, atrial fibrillation, body mass index, blood pressure, diabetes mellitus, high total cholesterol, abnormal liver function test, regular exercise, and smoking status. Conclusions Multiple gestations are associated with an increased risk of HTN later in life. Therefore, guidelines for the management of high-risk patients after delivery should be established.

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Is ankylosing spondylitis a risk factor for cardiovascular disease, and how do these risks compare with those in rheumatoid arthritis?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-209315 ◽

2016 ◽

Vol 76 (2) ◽

pp. 364-370 ◽

Cited By ~ 47

Author(s):

Jonas K Eriksson ◽

Lennart Jacobsson ◽

Karin Bengtsson ◽

Johan Askling

Keyword(s):

Rheumatoid Arthritis ◽

Ankylosing Spondylitis ◽

General Population ◽

Proportional Hazards ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Relative Risks ◽

Cox Proportional Hazards Models ◽

Increased Risk

AimsTo assess and compare the incidence of cardiovascular (CV) events, by CV phenotype, between patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA) and the general population.MethodsUsing linkages of national and population-based registers, we identified one cohort of prevalent patients with AS (n=5358), one with RA (n=37 245) and one with matched general population subjects (n=25 006). These cohorts were identified in 2006 through 2011 and were followed in 31 December 2012, for first ever occurrence of acute coronary syndromes (ACS), deep venous thromboembolism, pulmonary embolism and stroke, respectively. For each outcome, we calculated incidence rates standardised to the age and sex distribution of the AS cohort, as well as relative risks using Cox proportional hazards models.ResultsBased on 69 ACS events during 20 251 person-years of follow-up of the patients with AS, and 966 events during 127 014 person-years in the RA cohort, the age/sex-adjusted relative risks for ACS compared with the general population was 1.3 (95% CI 1.0 to 1.7) for AS and 1.7 (1.4 to 2.0) for RA. For thromboembolic events, the corresponding risks were 1.4 (1.1 to 1.9) in AS and 1.8 (1.5 to 2.1) in RA. Finally, for stroke, the relative risks were 1.5 (1.1 to 2.0) in AS and 1.5 (1.2 to 1.8) in RA, compared with the general population.ConclusionsPrevalent patients with AS are at a 30%–50% increased risk of incident CV events. When compared with patients with RA, this level of increase was similar for stroke, but only half as high for ACS and thrombotic events.

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Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2009.122770 ◽

2010 ◽

Vol 69 (6) ◽

pp. 1162-1164 ◽

Cited By ~ 83

Author(s):

Mary A De Vera ◽

M Mushfiqur Rahman ◽

Vidula Bhole ◽

Jacek A Kopec ◽

Hyon K Choi

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Proportional Hazards ◽

Elderly Women ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Prescription Drug Use ◽

Increased Risk

BackgroundMen with gout have been found to have an increased risk of acute myocardial infarction (AMI), but no corresponding data are available among women.ObjectiveTo evaluate the potential independent association between gout and the risk of AMI among elderly women, aged ≥65 years.MethodsA population-based cohort study was conducted using the British Columbia Linked Health Database and compared incidence rates of AMI between 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease. Cox proportional hazards models stratified by gender were used to estimate the relative risk (RR) for AMI, adjusting for age, comorbidities and prescription drug use.ResultsOver a 7-year median follow-up, 3268 incident AMI cases, were identified, 996 among women. Compared with women without gout, the multivariate RRs among women with gout were 1.39 (95% CI 1.20 to 1.61) for all AMI and 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI. These RRs were significantly larger than those among men (multivariate RRs for all AMI and non-fatal AMI, 1.11 and 1.11; p values for interaction, 0.003 and 0.005, respectively).ConclusionThese population-based data suggest that women with gout have an increased risk for AMI and the magnitude of excess risk is higher than in men.

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Association of Exposure to Hydrocarbons Air Pollution with Incidence of Atopic Dermatitis in Children

10.21203/rs.3.rs-93979/v1 ◽

2020 ◽

Author(s):

Chieh Wang ◽

Jeng-Dau Tsai ◽

Lei Wan ◽

Cheng-Li Lin ◽

Chang-Ching Wei

Keyword(s):

Air Pollution ◽

Atopic Dermatitis ◽

Proportional Hazards ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Air Pollutant ◽

Research Database ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Taiwan National Health Insurance

Abstract Background:There is growing evidence that air pollution may act as an important environmental risk factor in the development and aggravation of childhood atopic dermatitis (AD). Methods:We collected data from the Taiwan National Health Insurance research database and linked the data to the Taiwan Air Quality-Monitoring Database. Children younger than 18 years old between January 1st, 2000 and until the diagnosis of AD was made, or December 31st, 2012, were selected from the database. We measured the incidence rate and hazard ratios for AD, and stratified by quartiles (Q1-Q4) of air pollutant concentration. Multivariable Cox proportional hazards models were also applied by adjusting for age, sex, monthly income, and level of urbanization. Results:Compared with those exposed to the concentrations in the Q1 quartile, the adjusted hazard ratio (HR) for AD increased, and total hydrocarbon (THC), non-methane hydrocarbon (NMHC), and methane (CH4) exposure concentrations ranged from 1.65 to 10.6, from 1.14 to 2.47, and from 1.70 to 11.9, respectively. Patients exposed to higher levels of THC, NMHC, and CH4 had greater accumulative incidence rates of childhood AD. Conclusions:The current study demonstrated that exposure to higher concentrations of THC, NMHC, and CH4 were associated with an increased risk of childhood AD.

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Association of exposure to hydrocarbon air pollution with the incidence of atopic dermatitis in children

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01157-7 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Chieh Wang ◽

Chang-Ching Wei ◽

Lei Wan ◽

Cheng-Li Lin ◽

Jeng-Dau Tsai

Keyword(s):

Air Pollution ◽

Atopic Dermatitis ◽

Proportional Hazards ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Air Pollutant ◽

Research Database ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Taiwan National Health Insurance

Abstract Background There is growing evidence suggesting that air pollution may act as an important environmental risk factor in the development and aggravation of childhood atopic dermatitis (AD). Methods We collected data from the Taiwan National Health Insurance (NHI) research database and linked the data to the Taiwan Air Quality-Monitoring Database. From January 1, 2000 to December 31, 2012; children aged below 18 years were selected from the database and followed longitudinally until the diagnosis of AD, withdrawal from the NHI, or December 31, 2012. Children with missing data or those diagnosed with AD before enrolment in this study were excluded. We measured the incidence rate and hazard ratios (HRs) for AD and stratified them by quartiles (Q1–Q4) of air pollutant concentration. Multivariable Cox proportional hazards models were also applied by adjusting for age, sex, monthly income, and level of urbanization. Results When compared with the concentrations of pollutants in the Q1 quartile, the adjusted HR for AD increased with an increase in the exposure concentrations of total hydrocarbons (THCs), non-methane hydrocarbons (NMHCs), and methane (CH4) from 1.65 (95% confidence interval [CI]: 1.47–1.84) to 10.6 (95% CI: 5.85–7.07), from 1.14 (95% CI: 1.06–1.24) to 2.47 (95% CI: 2.29–2.66), and from 1.70 (95% CI: 1.52–1.89) to 11.9 (95% CI: 10.8–13.1), respectively. Patients exposed to higher levels of THCs, NMHCs, and CH4 exhibited greater incidence rates of childhood AD. Conclusions The present study demonstrated that exposure to higher concentrations of THCs, NMHCs, and CH4 were associated with an increased risk of childhood AD.

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