Effect of COPD on the Hospital Outcomes and Mortality among Hemorrhagic Stroke Patients. Sex Differences in a Population-Based Study

(1) Background: It is not well known whether there is an association between COPD and hemorrhagic stroke (HS). We aim to analyze the incidence, clinical characteristics, procedures, and outcomes of HS in patients with and without COPD and to assess sex differences. Secondly, to identify factors associated with in-hospital mortality (IHM). (2) Methods: Patients aged ≥40 years hospitalized with HS included in the Spanish National Hospital Discharge Database (2016–2018) were analyzed. Propensity score matching (PSM) was used to compare patients according to sex and COPD status. (3) Results: We included 55,615 patients (44.29% women). Among men with COPD the HS adjusted incidence was higher (IRR 1.31; 95% CI 1.24–1.57) than among non-COPD men. COPD men had higher adjusted incidence of HS than COPD women (IRR 1.87; 95% CI 1.85–1.89). After matching, COPD men had a higher IHM (29.96% vs. 27.46%; p = 0.032) than non-COPD men. Decompressive craniectomy was more frequently conducted among COPD men than COPD women (6.74% vs. 4.54%; p = 0.014). IHM increased with age and atrial fibrillation, while decompressive craniectomy reduced IHM. (4) Conclusions: COPD men had higher incidence and IHM of HS than men without COPD. COPD men had higher incidence of HS than COPD women. Decompressive craniectomy was more frequently conducted in COPD men than COPD women and this procedure was associated to better survival.

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Sex-related disparities in the incidence and outcomes of hemorrhagic stroke among type 2 diabetes patients: a propensity score matching analysis using the Spanish National Hospital Discharge Database for the period 2016–18

Cardiovascular Diabetology ◽

10.1186/s12933-021-01334-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ana Lopez-de-Andres ◽

Rodrigo Jimenez-Garcia ◽

Valentín Hernández-Barrera ◽

Isabel Jiménez-Trujillo ◽

José M. de Miguel-Yanes ◽

...

Keyword(s):

Type 2 Diabetes ◽

Sex Differences ◽

Propensity Score ◽

Decompressive Craniectomy ◽

Hemorrhagic Stroke ◽

Antiplatelet Agents ◽

National Hospital ◽

Men And Women ◽

Discharge Database

Abstract Background To analyze incidence, use of therapeutic procedures, use of oral anticoagulants (OACs) and antiplatelet agents prior to hospitalization, and in-hospital outcomes among patients who were hospitalized with hemorrhagic stroke (HS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the role of sex differences among those with T2DM. Methods Using the Spanish National Hospital Discharge Database we estimated the incidence of HS hospitalizations in men and women aged ≥ 35 years with and without T2DM. Propensity score matching (PSM) was used to compare population subgroups according to sex and the presence of T2DM. Results HS was coded in 31,425 men and 24,975 women, of whom 11,915 (21.12%) had T2DM. The adjusted incidence of HS was significantly higher in patients with T2DM (both sexes) than in non-T2DM individuals (IRR 1.15; 95% CI 1.12–1.17). The incidence of HS was higher in men with T2DM than in T2DM women (adjusted IRR 1.60; 95% CI 1.57–1.63). After PSM, men and women with T2DM have significantly less frequently received decompressive craniectomy than those without T2DM. In-hospital mortality (IHM) was higher among T2DM women than matched non-T2DM women (32.89% vs 30.83%; p = 0.037), with no differences among men. Decompressive craniectomy was significantly more common in men than in matched women with T2DM (5.81% vs. 3.33%; p < 0.001). IHM was higher among T2DM women than T2DM men (32.89% vs. 28.28%; p < 0.001). After adjusting for confounders with multivariable logistic regression, women with T2DM had a 18% higher mortality risk than T2DM men (OR 1.18; 95% CI 1.07–1.29). Use of OACs and antiplatelet agents prior to hospitalization were associated to higher IHM in men and women with and without T2DM. Conclusions T2DM is associated with a higher incidence of HS and with less frequent use of decompressive craniectomy in both sexes, but with higher IHM only among women. Sex differences were detected in T2DM patients who had experienced HS, with higher incidence rates, more frequent decompressive craniectomy, and lower IHM in men than in women.

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Elderly patients hospitalized in the ICU in France: a population-based study using secondary data from the national hospital discharge database

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.12497 ◽

2015 ◽

Vol 22 (3) ◽

pp. 378-386 ◽

Cited By ~ 8

Author(s):

Thomas Fassier ◽

Antoine Duclos ◽

Fatima Abbas-Chorfa ◽

Sandrine Couray-Targe ◽

T Eoin West ◽

...

Keyword(s):

Elderly Patients ◽

Hospital Discharge ◽

Secondary Data ◽

Population Based ◽

National Hospital ◽

Population Based Study ◽

Hospital Discharge Database ◽

Discharge Database

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Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

BMC Public Health ◽

10.1186/s12889-021-10442-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Giulia Cesaroni ◽

◽

Gian Francesco Mureddu ◽

Nera Agabiti ◽

Flavia Mayer ◽

...

Keyword(s):

Heart Failure ◽

Logistic Regression ◽

Sex Differences ◽

Ventricular Dysfunction ◽

Population Based ◽

Left Ventricular ◽

Cross Sectional ◽

Population Based Study ◽

Factors Associated ◽

Diastolic Left Ventricular Dysfunction

Abstract Background Although sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study. Methods A random sample of 2001 65–84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP. Results In 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women. Conclusions There were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors.

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Hypertension Among Hemorrhagic Stroke Patients in Northeast China: A Population-Based Study 2017–2019

Medical Science Monitor ◽

10.12659/msm.926581 ◽

2020 ◽

Vol 26 ◽

Author(s):

Haoran Dong ◽

Shuang Liu ◽

Li Jing ◽

Mengyuan Tian ◽

Jinglun Sun ◽

...

Keyword(s):

Northeast China ◽

Hemorrhagic Stroke ◽

Population Based ◽

Stroke Patients ◽

Population Based Study

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Risk factors associated with treatment of hyperactive postoperative delirium in elderly patients following hip fracture surgery under regional anesthesia: a nationwide population-based study

Brazilian Journal of Anesthesiology (English Edition) ◽

10.1016/j.bjane.2021.03.020 ◽

2021 ◽

Author(s):

Eun-Jin Ahn ◽

Si Ra Bang

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Regional Anesthesia ◽

Postoperative Delirium ◽

Population Based ◽

Population Based Study ◽

Factors Associated ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Sex differences in the association between serum lipids and depressive symptoms: a longitudinal population-based study

Journal of Affective Disorders ◽

10.1016/j.jad.2021.05.011 ◽

2021 ◽

Author(s):

Lu Xu ◽

Kai Wang ◽

Shengfeng Wang ◽

Lili Liu ◽

Xiaozhen Lv ◽

...

Keyword(s):

Sex Differences ◽

Depressive Symptoms ◽

Serum Lipids ◽

Population Based ◽

Population Based Study

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Inguinal hernia repair in Spain. A population-based study of 263,283 patients: factors associated with the choice of laparoscopic approach

Hernia ◽

10.1007/s10029-021-02402-y ◽

2021 ◽

Author(s):

S. Guillaumes ◽

C. Hoyuela ◽

N. J. Hidalgo ◽

M. Juvany ◽

I. Bachero ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Laparoscopic Approach ◽

Population Based ◽

Population Based Study ◽

Factors Associated

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Trends in oral corticosteroids use in severe asthma: a 14-year population-based study

Respiratory Research ◽

10.1186/s12931-021-01696-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mohsen Sadatsafavi ◽

Amir Khakban ◽

Hamid Tavakoli ◽

Solmaz Ehteshami-Afshar ◽

Larry D. Lynd ◽

...

Keyword(s):

Severe Asthma ◽

Poisson Regression ◽

Population Based ◽

Population Based Study ◽

Factors Associated ◽

Asthma Patients ◽

Oral Corticosteroids ◽

Administrative Health Databases ◽

Time Since Diagnosis

Abstract Background Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort. Methods We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥ 2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression. Results 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p < 0.001). The average number of episodes of OCS use was 0.89/year, which increased by 1.1%/calendar year (p < 0.001). Trends remained significant for both exposure types in adjusted analyses. Both maintenance and episodic use increased by age and time since diagnosis. Conclusions This population-based study documented a secular downward trend in maintenance OCS use in a period before widespread use of biologics. This might have been responsible for a higher rate of exacerbations that required episodic OCS therapy. Such trends in OCS use might be due to changes in the epidemiology of severe asthma, or changes in patient and provider preferences over time.

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