Abstract TMP52: Psychiatric Hospitalization Increases Short-Term Risk of Stroke: A Case-Crossover Analysis

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jonah P Zuflacht ◽  
Iris Y Shao ◽  
Mitchell S Elkind ◽  
Hooman Kamel ◽  
Amelia K Boehme ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Psychiatric Hospitalization ◽  
Conditional Logistic Regression ◽  
Small Sample ◽  
Psychiatric Condition ◽  
Short Term ◽  
Case Crossover ◽  
Crossover Analysis ◽  
Small Sample Sizes ◽  
The Relationship

Introduction: Recent evidence suggests that psychological distress, including symptoms of psychiatric illness, may acutely increase the risk of stroke. However, current studies are limited by small sample sizes, inherent recall bias, and poorly defined criteria for what constitutes psychological distress. Methods: We used a case-crossover design, where each patient serves as his/her own control, to assess the relationship between the diagnosis of a psychiatric condition (defined by ICD-9 codes) and stroke (combined hemorrhagic and ischemic events) in adults over the age of 18. Data were utilized from the Healthcare Cost and Utilization Project (HCUP) for the state of California from 2007 - 2009. Cases in which both stroke and psychiatric diagnoses were present on arrival were excluded from the analysis. The relationship between psychiatric hospitalization and stroke was assessed through conditional logistic regression, with separate analyses conducted for 15, 30, 90, 180, and 365-days pre-stroke. Results: A total of 52,068 strokes were identified. Psychiatric conditions diagnosed within 1 year of stroke were found in 3,337 (6.4%) patients. Compared to patients without (n = 48,731), patients with a recent psychiatric hospitalization had a higher proportion of women (59.67% vs. 50.11%) and longer hospital course (8.9 days vs. 6.9). The presence of a psychiatric condition leading to hospitalization was associated with increased odds of stroke within all five pre-defined time periods (Table 1), with the highest odds of stroke occurring in those who most recently experienced a psychiatric visit (15 day OR = 3.48, 95% CI; 2.68-4.52). Conclusions: Psychiatric hospitalization increases the short-term risk of stroke, particularly within the 15-day period following the diagnosis. This risk decreases but persists for at least 1 year.

scholarly journals The Value of Local Heatwave Impact Assessment: A Case-Crossover Analysis of Hospital Emergency Department Presentations in Tasmania, Australia

2019 ◽  
Vol 16 (19) ◽  
pp. 3715 ◽  
Author(s):  
Sharon L. Campbell ◽  
Tomas A. Remenyi ◽  
Grant J. Williamson ◽  
Christopher J. White ◽  
Fay H. Johnston
Keyword(s):  
Emergency Department ◽  
Capacity Planning ◽  
Conditional Logistic Regression ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Case Crossover ◽  
Crossover Analysis ◽  
The Impact ◽  
The Relationship ◽  
Local Research

Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.

Association of Short-term Particulate Matter Exposure with Suicide Death Among Major Depressive Disorder Patients: A Time-Stratified Case-Crossover Analysis

2021 ◽  
Author(s):  
In Young Hwang ◽  
Daein Choi ◽  
Jihoon Andrew Kim ◽  
Seulggie Choi ◽  
Jooyoung Chang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Particulate Matter ◽  
Depressive Disorder ◽  
Short Term ◽  
Major Depressive ◽  
Suicide Death ◽  
Case Crossover ◽  
Crossover Analysis ◽  
High Level ◽  
Particulate Matter Exposure

Abstract Objective: There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide.Methods: We investigated the risk of suicide among 1,046,169 newly-diagnosed MDD patients from 2004 to 2015 within the Korean National Health Insurance Service (NHIS) database. We identified 3,372 suicide cases from January 1, 2015, to December 31, 2017, within the death statistics database of the Korean National Statistical Office. PMs with diameter less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 2.5 μm to 10 μm (PM2.5-10) were considered, which were provided from the National Ambient Air Monitoring System in South Korea. Time-stratified case-crossover analysis was performed to investigate the association of particulate matter exposure to suicide events.Results: The risk of suicide was significantly high upon the high level of exposure to PM2.5-10, PM10 on lag 1 (p for trend = 0.044, 0.035, respectively). A similar association was observed in the multi-day lag model (lag 0-3). Increasing exposure to PM 2.5 was not associated with increased suicide risk.Conclusions: Short-term exposure to a high level of PM2.5-10 and PM10 was associated with an elevated risk for suicide among MDD patients, while PM2.5 did not. There is a clear dose-response relationship between short-term coarse particle exposures with suicide death among Major Depressive Disorder patients. This result will be used as an essential basis for consideration when establishing an air pollution alarm system and implementing a suicide prevention program for reducing adverse health outcomes by PM.

scholarly journals Case-crossover analysis of short-term particulate matter exposures and stroke in the health professionals follow-up study

2019 ◽  
Vol 124 ◽  
pp. 153-160 ◽  
Author(s):  
Jared A. Fisher ◽  
Robin C. Puett ◽  
Francine Laden ◽  
Gregory A. Wellenius ◽  
Amir Sapkota ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Health Professionals ◽  
Short Term ◽  
Follow Up Study ◽  
Case Crossover ◽  
Crossover Analysis

scholarly journals The clinical effect of smoking and environmental factors in spontaneous pneumothorax: a case-crossover study in an Inland province

2020 ◽  
Vol 14 ◽  
pp. 175346662097740
Author(s):  
Dohun Kim ◽  
Sang-Yong Eom ◽  
Chang-Seob Shin ◽  
Yong-Dae Kim ◽  
Si-Wook Kim ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Relative Humidity ◽  
Air Pollutants ◽  
Spontaneous Pneumothorax ◽  
Conditional Logistic Regression ◽  
Air Pressure ◽  
Case Crossover ◽  
Matched Data ◽  
Stratified Analysis ◽  
The Relationship

Background: The factors that trigger spontaneous pneumothorax have not been sufficiently evaluated. The purpose of this study is to analyze the relationship between the development of spontaneous pneumothorax and meteorological parameters, including air pollutants. Methods: This is a retrospective study using the medical records of 379 patients who were admitted for spontaneous pneumothorax (SP) over a period of 4 years. Meteorological and air pollution data were obtained from the National Meteorological Office and the Ministry of Environment. We employed a case-crossover design to evaluate the short-term association between SP and meteorological factors including air pollutants. Conditional logistic regression was used to analyze bi-directional matched data. Results: Increase of relative humidity (RH) and of carbon monoxide (CO) were associated with the risk of pneumothorax, with odds ratio (OR) for RH = 1.18 (1.02–1.36), CO = 1.23 (1.02–1.48). Moreover, as air pressure (AP) decreased, risk of pneumothorax increased, with OR = 1.30 (1.05–1.59) but others did not. In the stratified analysis, the effect of RH was positive in ex-smokers (OR = 3.31) and non-smokers (OR = 1.32), but negative in current smokers (OR = 0.72). The effect of AP was significant in younger patients (OR = 1.33), males (OR = 1.40), and non-smokers (OR = 1.36). CO was related only with non-smokers (OR = 1.35) Conclusion: The triggering factors for spontaneous pneumothorax were relative humidity, carbon monoxide, and air pressure. The effect of the trigger was prominent in patients who were younger (<45 years), non- or ex-smokers, and male. The reviews of this paper are available via the supplemental material section.

scholarly journals Short-term exposure to ambient ozone and stroke hospital admission: A case-crossover analysis

2015 ◽  
Vol 26 (2) ◽  
pp. 162-166 ◽  
Author(s):  
Jessica A Montresor-López ◽  
Jeff D Yanosky ◽  
Murray A Mittleman ◽  
Amir Sapkota ◽  
Xin He ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Short Term ◽  
Ambient Ozone ◽  
Case Crossover ◽  
Short Term Exposure ◽  
Crossover Analysis

scholarly journals Association Between Short-Term Exposure to PM2.5and PM10and Mortality in Susceptible Subgroups: A Multisite Case-Crossover Analysis of Individual Effect Modifiers

2016 ◽  
Vol 184 (10) ◽  
pp. 744-754 ◽  
Author(s):  
Ester Rita Alessandrini ◽  
Massimo Stafoggia ◽  
Annunziata Faustini ◽  
Giovanna Berti ◽  
Cristina Canova ◽  
...  
Keyword(s):  
Individual Effect ◽  
Short Term ◽  
Case Crossover ◽  
Short Term Exposure ◽  
Crossover Analysis

scholarly journals The relationship between dose and serotonin transporter occupancy of antidepressants—a systematic review

2021 ◽  
Author(s):  
Anders Sørensen ◽  
Henricus G. Ruhé ◽  
Klaus Munkholm
Keyword(s):  
Serotonin Transporter ◽  
Antidepressant Treatment ◽  
Imaging Techniques ◽  
Small Sample ◽  
Short Treatment ◽  
Predicted Values ◽  
Small Sample Sizes ◽  
The Relationship ◽  
Short Treatment Duration

AbstractBrain imaging techniques enable the visualization of serotonin transporter (SERT) occupancy as a measure of the proportion of SERT blocked by an antidepressant at a given dose. We aimed to systematically review the evidence on the relationship between antidepressant dose and SERT occupancy. We searched PubMed and Embase (last search 20 May 2021) for human in vivo, within-subject PET, or SPECT studies measuring SERT occupancy at any dose of any antidepressant with highly selective radioligands ([11C]-DASB, [123I]-ADAM, and [11C]-MADAM). We summarized and visualized the dose-occupancy relationship for antidepressants across studies, overlaying the plots with a curve based on predicted values of a standard 2-parameter Michaelis–Menten model fitted using the observed data. We included seventeen studies of 10 different SSRIs, SNRIs, and serotonin modulators comprising a total of 294 participants, involving 309 unique occupancy measures. Overall, following the Michaelis–Menten equation, SERT occupancy increased with a higher dose in a hyperbolic relationship, with occupancy increasing rapidly at lower doses and reaching a plateau at approximately 80% at the usual minimum recommended dose. All the studies were small, only a few investigated the same antidepressant, dose, and brain region, and few reported information on factors that may influence SERT occupancy. The hyperbolic dose-occupancy relationship may provide mechanistic insight of relevance to the limited clinical benefit of dose-escalation in antidepressant treatment and the potential emergence of withdrawal symptoms. The evidence is limited by non-transparent reporting, lack of standardized methods, small sample sizes, and short treatment duration. Future studies should standardize the imaging and reporting procedures, measure occupancy at lower antidepressant doses, and investigate the moderators of the dose-occupancy relationship.

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