Risk of aortic dissection, congestive heart failure, pneumonia and acute respiratory distress syndrome in patients with clinical vertebral fracture: a nationwide population-based cohort study in Taiwan

Autor: Ching-Yuan Lai, Wei-Kung Chen, Tse-Yen Yang, Chia-Hung Kao, Cheng-Li Lin, Feng-You Lee
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
ARDS
Adolescent
Databases
Factual

Epidemiology
Taiwan
Acute respiratory distress
03 medical and health sciences
Young Adult
0302 clinical medicine
Risk Factors
Internal medicine
clinical vertebral fracture
medicine
pneumonia
Humans
030212 general & internal medicine
aortic dissection
Cardiopulmonary disease
Original Research
Aged
Proportional Hazards Models
Retrospective Studies
Aortic dissection
Aged
80 and over

Heart Failure
Respiratory Distress Syndrome
business.industry
Incidence (epidemiology)
Incidence
General Medicine
acute respiratory distress syndrome
Middle Aged
medicine.disease
Aortic Aneurysm
Pneumonia
congestive heart failure
Heart failure
Spinal Fractures
Female
business
030217 neurology & neurosurgery
national health insurance research database
Cohort study
Follow-Up Studies
Zdroj: BMJ Open
ISSN: 2044-6055
Popis: ObjectiveStudies on the association between clinical vertebral fractures (CVFs) and the subsequent risk of cardiopulmonary diseases, including aortic dissection (AD), congestive heart failure (CHF), pneumonia and acute respiratory distress syndrome (ARDS) are scarce. Therefore, we used the National Health Insurance Research Database to investigate whether patients with CVF have a heightened risk of subsequent AD, CHF, pneumonia and ARDS.DesignThe National Health Insurance Research Database was used to investigate whether patients with CVFs have an increased risk of subsequent AD, CHF, pneumonia and ARDS.ParticipantsThis cohort study comprised patients aged ≥18 years with a diagnosis of CVF and were hospitalised at any point during 2000–2010 (n=1 08 935). Each CVF patient was frequency-matched to a no-CVF hospitalised patients based on age, sex, index year and comorbidities (n=1 08 935). The Cox proportional hazard regressions model was used to estimate the adjusted effect of CVF on AD, CHF, pneumonia and ARDS risk.ResultsThe overall incidence of AD, CHF, pneumonia and ARDS was higher in the CVF group than in the no-CVF group (4.85 vs 3.99, 119.1 vs 89.6, 283.3 vs 183.5 and 9.18 vs 4.18/10 000 person-years, respectively). After adjustment for age, sex, comorbidities and Charlson comorbidity index score, patients with CVF had a 1.23-fold higher risk of AD (95% CI=1.03–1.45), 1.35-fold higher risk of CHF (95% CI=1.30–1.40), 1.57-fold higher risk of pneumonia (95% CI=1.54–1.61) and 2.21-fold higher risk of ARDS (95% CI=1.91–2.57) than did those without CVF. Patients with cervical CVF and SCI were more likely to develop pneumonia and ARDS.ConclusionsOur study demonstrates that CVFs are associated with an increased risk of subsequent cardiopulmonary diseases. Future investigations are encouraged to delineate the mechanisms underlying this association.
Databáze: OpenAIRE