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Total 64 results found since Jan 2013.
Cardiovascular risk of sitagliptin in ischemic stroke patients with type 2 diabetes and chronic kidney disease: A nationwide cohort study
Limited data are available about the cardiovascular (CV) safety and efficacy of sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, in ischemic stroke patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). Ischemic stroke patients with T2DM and CKD were selected from the Taiwan National Health Insurance Research Database (NHIRD) from March 1, 2009 to December 31, 2011. A total of 1375 patients were divided into 2 age- and gender-matched groups: patients who received sitagliptin (n = 275; 20%) and those who did not (n = 1,100). Primary major adverse cardiac and cerebrovascular events (M...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Effect of atrial fibrillation in Asian patients undergoing percutaneous coronary intervention with drug-eluting stents for stable coronary artery disease: Results from a Korean nationwide study
Although the prevalence of atrial fibrillation (AF) and percutaneous coronary intervention (PCI) are increasing in Asia, there is a paucity of data concerning the effect of AF in Asian patients undergoing PCI with drug-eluting stents (DESs). Furthermore, the majority of previous studies investigating the effect of AF on prognosis following PCI have exclusively evaluated patients with myocardial infarction (MI). We aimed to evaluate the effect of AF on clinical outcomes of Asian patients undergoing PCI with DES for coronary artery disease (CAD) excluding acute MI.
From national health insurance claims data in South Korea, ...
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Association between volume of surgery for acute hemorrhagic stroke and mortality
This study aimed to investigate the association between volume of surgery and mortality in relation to interventions for acute hemorrhagic stroke, namely craniotomy and trephination.
We obtained data on acute hemorrhagic stroke patients for a 5-year period (2009–2013) from the Health Insurance Review and Assessment Service. Hospitals were classified into 3 categories according to volume of surgery (low, medium, high). To avoid intentionally setting a cutoff, we placed the hospitals in order from those with high volume of surgery to those with low volume of surgery and divided them into 3 groups (tertile) according to th...
Source: Medicine - August 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Higher stroke incidence in the patients with pancreatic cancer: A nation-based cohort study in Taiwan
No study has investigated the role of pancreatic cancer in the stroke risk using population data. We used claims data obtained from a universal health insurance program of Taiwan to evaluate the stroke risk in pancreatic cancer patients.
From the catastrophic disease registry of the insurance, we identified 7479 patients with pancreatic malignancy without stroke history from 2000 to 2009. The comparison cohort consisted of 29,916 individuals identified from 1 million insured people without cancer and stroke history, matching with the cancer cohort by propensity score. We followed each selected individual until stroke was ...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Risk of major comorbidities among workers with hemophilia: A 14-year population-based study
In this study, we investigated the incidence of comorbidities and their risk factors among workers with hemophilia.
The study compared the incidence and risk factors of the major comorbidities of 411 workers with hemophilia enrolled in Taiwan's National Health Insurance Research Database between 1997 and 2010 with an age- and sex-matched general population.
Compared with the general population, workers with hemophilia had higher risks for hemorrhagic stroke, arthritis/arthropathy, and knee/hip replacement among workers with hemophilia after multivariate adjustment, with hazard ratios (95% CI) of 4.60 (2.81–7.53), 4.03 ...
Source: Medicine - February 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database
The Sentinel Distributed Database (SDD) is a large database of patient-level medical and prescription records, primarily derived from insurance claims and electronic health records, and is sponsored by the U.S. Food and Drug Administration for drug safety assessments. In this chart validation study, we report on the positive predictive value (PPV) of inpatient ICD-9-CM acute ischemic stroke (AIS) administrative diagnosis codes (433.x1, 434.xx, and 436) in the SDD.
As part of an assessment of the risk of thromboembolic adverse events following treatment with intravenous immune globulin (IGIV), charts were obtained for 131 ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study Source Type: research
The effectiveness and safety of angiotensin-converting enzyme inhibition or receptor blockade in vascular diseases in patients with hemodialysis
Abstract: Patients with end-stage renal disease (ESRD) who are on hemodialysis have high risk of vascular diseases. Our study sought to examine whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin type 1 receptor blockers (ARBs) could reduce the frequencies of cardiovascular and cerebrovascular events in patients receiving hemodialysis using the medication possession ratio (MPR) method of analysis.
This retrospective cohort study identified cases of ESRD with dialysis from the National Health Insurance Research Database between 1999 and 2006, and used Cox-regression methods to evaluate risk of poor outc...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Effect of statin use on clinical outcomes in ischemic stroke patients with atrial fibrillation
The objective of this study was to clarify whether statin therapy can influence the prognosis in recent ischemic stroke patients with atrial fibrillation.
We identified ischemic stroke patients with atrial fibrillation between 2001 and 2011 from Taiwan National Health Insurance Database. Patients not treated with statins during the first 90 days after the index stroke were matched to patients treated with statins in the first 90 days in a 2:1 ratio on the basis of age, sex, hypertension, diabetes mellitus, ischemic heart disease, heart failure, estimated National Institutes of Health Stroke Scale, use of anticoagulant, an...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Increased risk of Parkinson disease with diabetes mellitus in a population-based study
Abstract: This nationwide population-based study investigated the risk of Parkinson disease (PD) in relation to diabetes mellitus (DM) through the National Health Insurance Research Database in Taiwan.
A retrospective study was conducted, consisting of 36,294 patients who were newly diagnosed with DM between January 1, 2000 and December 31, 2006 and 108,882 individuals without DM as healthy controls from insurance claims data from Taiwan's National Health Research Institutes Dataset. The subjects were followed up until December 31, 2011 or until the first manifestation of PD. The hazard ratio (HR) of DM for PD incidence w...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Usefulness of HATCH score in the prediction of new-onset atrial fibrillation for Asians
Abstract: The HATCH score (hypertension , age>75 years , stroke or transient ischemic attack , chronic obstructive pulmonary disease , and heart failure ) was reported to be useful for predicting the progression of atrial fibrillation (AF) from paroxysmal to persistent or permanent AF for patients who participated in the Euro Heart Survey. The goal of the current study was to investigate whether the HATCH score was a useful scheme in predicting new-onset AF. Furthermore, we aimed to use the HATCH scoring system to estimate the individual risk in developing AF for patients with different comorbidities. We used the “Taiwan...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Risk of sudden sensorineural hearing loss in stroke patients: A 5-year nationwide investigation of 44,460 patients
This study employed a nationwide population-based dataset to investigate the relationship between stroke and SSNHL.
The Taiwan Longitudinal Health Insurance Database was used to compile data from 11,115 stroke patients and a comparison cohort of 33,345 matched nonstroke enrollees. Each patient was followed for 5 years to identify new-onset SSNHL. Stratified Cox proportional-hazard regression analysis was used to examine the association of stroke with subsequent SSNHL.
Among the 44,460 patients, 66 patients (55,378 person-years) from the stroke cohort and 105 patients (166,586 person-years) from the comparison cohort were...
Source: Medicine - September 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Physiatrist referral preferences for postacute stroke rehabilitation
This study was intended to determine if there is variation among physiatrists in referral preferences for postacute rehabilitation for stroke patients based on physician demographic characteristics or geography.
A cross-sectional survey study was developed with 5 fictional case vignettes that included information about medical, social, and functional domains. Eighty-six physiatrist residents, fellows, and attendings were asked to select the most appropriate postacute rehabilitation setting and also to rank, by importance, 15 factors influencing the referral decision. Chi-square bivariate analysis was used to analyze the d...
Source: Medicine - August 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Risk analysis of carotid stent from a population-based database in Taiwan
Abstract: Because stroke is the third leading disease that causes mortality in the world, the prevention of stroke from advanced carotid stenosis is an important issue. The carotid stent (CAS) is a less invasive to treat advanced carotid stenosis, but for high-risk patients it may cause some events after the procedure that reduces the benefit of stroke prevention. Because patients and their families have less information about risk of events after CAS and are easy concerned, this study calculates the individual probability of major adverse cardiovascular events including any stroke, myocardial infarction, or death after pr...
Source: Medicine - August 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Presence of diabetic microvascular complications does not incrementally increase risk of ischemic stroke in diabetic patients with atrial fibrillation: A nationwide cohort study
Abstract: Conventional stroke risk prediction tools used in atrial fibrillation (AF) incorporate the presence of diabetes mellitus (DM) as a risk factor. However, it is unknown whether this risk is homogenous or dependent on the presence of diabetic microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy. The present study examined the risk of ischemic stroke in diabetic patients with and without microvascular complications. The present study used the National Health Insurance Research Database in Taiwan with detailed healthcare data on all-comers to the Taiwanese medical system from January ...
Source: Medicine - July 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
The use of proton pump inhibitors decreases the risk of diabetes mellitus in patients with upper gastrointestinal disease: A population-based retrospective cohort study
Conclusions: Our results demonstrated a decreased risk of DM in UGID patients who used PPIs; the risk appeared to be significantly dose-dependent.
Source: Medicine - July 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
