Bullöses Pemphigoid getriggert durch Schlaganfall

2018 ◽  
Vol 6 (1) ◽  
pp. 19-20
Author(s):  
Markus Braun-Falco
Keyword(s):  
Health Insurance ◽  
Parkinson Disease ◽  
Bullous Pemphigoid ◽  
Blood Brain Barrier ◽  
Cox Regression ◽  
Population Based ◽  
Control Group ◽  
Stroke Patients ◽  
Bullöses Pemphigoid ◽  
Insurance Database

Background: We hypothesize that autoantibodies are induced after the blood-brain barrier is damaged by stroke and the risk of bullous pemphigoid (BP) is increased after stroke. We assess the risk of BP after first-ever stroke in a nationwide population-based cohort of first-ever stroke patients. Methods: We extracted data from the Longitudinal Health Insurance Database 2005 and identified patients with first-ever stroke as well as control patients matched for age, gender, and year of enrollment. The risk of BP in first-ever stroke patients in comparison with that in control patients was analyzed using Cox regression. Results: Of 12,607 patients with first-ever stroke, 38 (0.3%) patients developed BP in a median of 3.5 years. In the control patients, 8 persons (0.06%) had BP in a median of 3.7 years. The crude hazard ratio (HR) of BP in first-ever stroke patients was 4.83 (95% CI 2.25-10.34, p < 0.001) compared to the control group. The adjusted HR was 4.20 (95% CI 1.94-9.08, p < 0.001) after adjustments for age, gender, hypertension, diabetes, dementia, epilepsy, Parkinson disease, furosemide, and neuroleptics for stroke patients. Conclusions: The risk of BP is increased in first-ever stroke patients in a nationwide population-based cohort and this association is independent of well-known confounders of BP.

scholarly journals Inflammatory markers and risk of cardiovascular mortality in relation to diabetes status in the HUNT study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Løfblad ◽  
Gunhild Garmo Hov ◽  
Arne Åsberg ◽  
Vibeke Videm
Keyword(s):  
Cardiovascular Mortality ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Population Based ◽  
Control Group ◽  
Bottom Quartile ◽  
Diabetes Status ◽  
Increased Risk ◽  
General Populations ◽  
Log Linear

AbstractInflammatory markers have been associated with increased risk of cardiovascular mortality in general populations. We assessed whether these associations differ by diabetes status. From a population-based cohort study (n = 62,237) we included all participants with diabetes (n = 1753) and a control group without diabetes (n = 1818). Cox regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for possible associations with cardiovascular mortality of 4 different inflammatory markers; C-reactive protein (CRP), calprotectin, neopterin and lactoferrin. During a median follow-up of 13.9 years, 728 (20.4%) died from cardiovascular disease (CVD). After adjustment for age, sex and diabetes, the associations of all inflammatory markers with risk of cardiovascular mortality were log-linear (all P ≤ 0.017 for trend) and did not differ according to diabetes status (all P ≥ 0.53 for interaction). After further adjustments for established risk factors, only CRP remained independently associated with cardiovascular mortality. HRs were 1.22 (1.12–1.32) per standard deviation higher loge CRP concentration and 1.91 (1.50–2.43) when comparing individuals in the top versus bottom quartile. The associations of CRP, calprotectin, lactoferrin and neopterin with cardiovascular mortality did not differ by diabetes, suggesting that any potential prognostic value of these markers is independent of diabetes status.

Increased risk of cancer in patients with retinal vein occlusion: a 12-year nationwide cohort study

2020 ◽  
pp. bjophthalmol-2020-316947
Author(s):  
Min Seok Kim ◽  
Joon Hee Cho ◽  
Seong Jun Byun ◽  
Chang-Mo Oh ◽  
Kyu Hyung Park ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Control Group ◽  
Time Varying ◽  
Vein Occlusion ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
Subsequent Cancer

AimsTo investigate the association between incident retinal vein occlusion (RVO) and the subsequent development of cancer.MethodsIn this nationwide population-based retrospective study using 2002–2013 National Health Insurance Service database which covers the entire South Korean population, 186 701 incident RVO patients and their 1:1 propensity-score matched controls were included. We defined the fixed cohort from January 1st, 2004 to December 31st, 2013; the cohort included patients who suffered incident RVO after entering the cohort and their matched controls, and excluded patients having any cancer history before entering the cohort. The association of RVO and cancer was assessed by time-varying covariate Cox regression models; Model 1 included RVO as a time-varying covariate, Model 2 included Model 1 plus demographic information and Model 3 included Model 2 and comorbidities.ResultsRVO was associated with an increased risk of subsequent cancer (HR=1.29; 95% CI, 1.26–1.31 in Model 1), which was consistent in Models 2 and 3. The incidence rate of overall cancer during the study period was 25.55 (95% CI, 25.19–25.91) per 1000 person-years in the RVO group and 18.62 (95% CI, 18.46–18.79) per 1000 person-years in the control group. In the subgroup analysis, haematological malignancies showed the highest association with RVO (HR=1.65; 95% CI, 1.49–1.83).ConclusionPatients with RVO have an increased risk of subsequent cancer development even after adjusting for demographic factors and comorbidities. Further study is warranted to elucidate these associations to provide proper recommendations for RVO patients regarding the cancer screening.

scholarly journals Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan

2018 ◽  
Vol 12 (4) ◽  
pp. 913-925 ◽  
Author(s):  
Yun-Ju Yang ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Kun-Ting Hong ◽  
Yi-Lin Yu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Erectile Dysfunction ◽  
Health Insurance ◽  
Brain Injury ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Confounding Factors

Introduction: In our study, we aimed to investigate the association between a traumatic brain injury (TBI) and subsequent erectile dysfunction (ED). This is a population-based study using the claims dataset from The National Health Insurance Research Database. Methods: We included 72,642 patients with TBI aged over 20 years, retrospectively, selected from the longitudinal health insurance database during 2000–2010, according to the ICD-9-CM. The control group consisted of 217,872 patients without TBI that were randomly chosen from the database at a ratio of 1:3, with age- and index year matched. Cox proportional hazards analysis was used to estimate the association between the TBI and subsequent ED. Results: After a 10-year follow-up, the incidence rate of ED was higher in the TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively). Patients with TBI had a higher risk of developing ED than the non-TBI cohort after the adjustment of the confounding factors, such as age, comorbidity, residence of urbanization and locations, seasons, level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95% CI [1.890, 3.492], p < .001). Conclusion: This is the first study using a comprehensive nationwide database to analyze the association of ED and TBI in the Asian population. After adjusted the confounding factors, patients with TBI have a significantly higher risk of developing ED, especially organic ED, than the general population. This finding might remind clinicians that it’s crucial in early identification and treatment of ED in post-TBI patients.

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

Bipolar disorder and risk of Parkinson disease

Neurology ◽  
2019 ◽  
Vol 92 (24) ◽  
pp. e2735-e2742 ◽  
Author(s):  
Mao-Hsuan Huang ◽  
Chih-Ming Cheng ◽  
Kai-Lin Huang ◽  
Ju-Wei Hsu ◽  
Ya-Mei Bai ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Parkinson Disease ◽  
Cox Regression ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Depressive Episodes

ObjectiveTo evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD).MethodsUsing the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified.ResultsPatients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74–8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89–6.93) or first 3 years (HR 4.42; 95% CI 3.63–5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD.ConclusionPatients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.

scholarly journals Type and severity of migraine determines long-term risk of atrial fibrillation in women: a nationwide population-based study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T.-M Rhee ◽  
E.-K Choi ◽  
K.-D Han ◽  
S.-R Lee ◽  
S Oh
Keyword(s):  
Atrial Fibrillation ◽  
Gender Difference ◽  
Migraine With Aura ◽  
National Health ◽  
Migraine Without Aura ◽  
Cox Regression ◽  
Smoking Status ◽  
Population Based ◽  
Control Group ◽  
Severe Migraine

Abstract Background Migraine, especially when accompanied by aura, increases the risk of ischemic stroke and has also shown a close relationship with the occurrence of atrial fibrillation (AF). Although the risk of stroke and cardiovascular diseases is higher in women with migraine than in men, there is a lack of evidence for gender differences in the risk of AF in migraineurs. Purpose We sought to evaluate the gender-specific risk of AF according to the type and severity of migraine. Methods The study population included all national health checkup examinees (2009) without a history of AF from the Korean National Health Insurance Service data. The diagnosis and type or severity of migraine were determined using claims data, including diagnostic, procedural, and medication prescription codes. Newly developed non-valvular AF was identified during 10 years of follow-up. Gender-difference in the effect of migraine on AF occurrence was evaluated according to the type and severity of migraine. A multivariate Cox regression model was used to adjust for baseline differences between comparison groups, including age, smoking status, drinking habit, regular physical activity, income level, diabetes mellitus, hypertension, dyslipidemia, body mass index, and glomerular filtration rate as covariates. Results Of a total of 4,020,488 subjects (men, n=2,213,147, women, n=1,807,341) enrolled, 4,986 had migraine with aura (mean age 50.6±14.0, men 29.3%) and 105,029 without aura (mean age 51.6±14.3, men 30.9%). The proportion of migraine with aura among migraine patients was 4% in both gender groups. In the total population, migraine or migraine with aura did not significantly increase the risk of AF. The risk of AF did not increase in a mild degree of migraine, irrespective of gender or the presence of aura. Severe migraine without aura modestly increased the risk of AF in both men and women compared to the control group. (Men, incidence rate [IR] 4.51 per 1,000 person-year, adjusted hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.12–1.31; Female, IR 3.00 per 1,000 person-year, adjusted HR 1.16, 95% CI 1.09–1.22) The increase of AF risk was the most prominent in women who had severe migraine with aura (IR 3.39 per 1,000 person-year, adjusted HR 1.48, 95% CI 1.18–1.85). In contrast, no significant association was observed between AF and migraine with aura in men. (IR 2.28, adjusted HR 0.63, 95% CI 0.39–1.01; P for interaction 0.011) Conclusions Mild migraine was not associated with an increase in AF risk regardless of gender or the presence of aura. Severe migraine without aura showed a mild increase in AF risk without gender-difference, while severe migraine with aura significantly increased the risk of AF only in women, not in men. Surveillance for incident AF and prompt stroke prevention would be beneficial, particularly for young-aged women suffering from severe migraine with aura. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Changes in metabolic syndrome and risk of psoriasis: a nationwide population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyun Ji Lee ◽  
Kyung Do Han ◽  
Hae Eun Park ◽  
Ju Hee Han ◽  
Chul Hwan Bang ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Health Insurance ◽  
Waist Circumference ◽  
Confidence Interval ◽  
Density Lipoprotein ◽  
Population Based ◽  
Control Group ◽  
Newly Diagnosed ◽  
Population Based Study ◽  
The Relationship

AbstractMetabolic syndrome (MetS) is associated with psoriasis, but it remains unclear whether risk of psoriasis remains in patients whose MetS diagnosis changes. To assess the relationship between risk of psoriasis and changes in MetS components. We obtained data from the National Health Insurance Service of Korea and divided the participants into four groups: individuals without MetS (control); individuals with MetS in 2009, but without MetS in 2012 (pre-MetS); individuals without MetS in 2009, but with newly diagnosed MetS in 2012 (post-MetS); and individuals with MetS during the 2009–2012, period (continuous-MetS). We calculated the risk of psoriasis for each group. Risk of psoriasis was similar in the control and pre-MetS groups but was significantly higher in the post-MetS group (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.04–1.12) and in the continuous-MetS group (HR, 1.11; 95% CI, 1.07–1.15) than in the control group. Among MetS components, waist circumference showed the strongest association with psoriasis, followed by high-density lipoprotein and triglyceride levels. Risk of psoriasis was higher in patients with continuous- or post-MetS than in those with pre-MetS (regardless of prior MetS status).

scholarly journals Clinical Efficacy of Ruxolitinib in Patients with Myelofibrosis: A Nationwide Population-Based Study in Korea

2021 ◽  
Vol 10 (20) ◽  
pp. 4774
Author(s):  
Byung-Hyun Lee ◽  
Hyemi Moon ◽  
Jae-Eun Chae ◽  
Ka-Won Kang ◽  
Byung-Soo Kim ◽  
...  
Keyword(s):  
Propensity Scores ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Previous History ◽  
Population Based ◽  
Population Based Study ◽  
Cox Regression Analysis ◽  
History Of ◽  
Korean National Health Insurance ◽  
Insurance Database

Previous studies have reported the survival benefit after ruxolitinib treatment in patients with myelofibrosis (MF). However, population-based data of its efficacy are limited. We analyzed the effects of ruxolitinib in MF patients with data from the Korean National Health Insurance Database. In total, 1199 patients diagnosed with MF from January 2011 to December 2017 were identified, of which 731 were included in this study. Patients who received ruxolitinib (n = 224) were matched with those who did not receive the drug (n = 507) using the 1:1 greedy algorithm. Propensity scores were formulated using five variables: age, sex, previous history of arterial/venous thrombosis, and red blood cell (RBC) or platelet (PLT) transfusion dependence at the time of diagnosis. Cox regression analysis for overall survival (OS) revealed that ruxolitinib treatment (hazard ratio (HR), 0.67; p = 0.017) was significantly related to superior survival. In the multivariable analysis for OS, older age (HR, 1.07; p < 0.001), male sex (HR, 1.94; p = 0.021), and RBC (HR, 3.72; p < 0.001) or PLT (HR, 9.58; p = 0.001) transfusion dependence were significantly associated with poor survival, although type of MF did not significantly affect survival. Considering evidence supporting these results remains weak, further studies on the efficacy of ruxolitinib in other populations are needed.

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