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Wang TY, Chen HH, Su CH, Hsu SP, Ho CW, Hsieh MC, Lin CL, Kao CH. The Association Between Pleural Empyema and Peripheral Arterial Disease in Younger Patients: A Retrospective National Population-Based Cohort Study. Front Med (Lausanne) 2021; 8:621330. [PMID: 33869244 PMCID: PMC8044994 DOI: 10.3389/fmed.2021.621330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To investigate the relationship between pleural empyema (PE) and peripheral arterial disease (PAD). Methods: We conducted a retrospective cohort study using data from the National Health Institute Research Database. Univariable and multivariable Cox's proportional hazard regressions were performed to investigate the association between PE and the risk of PAD. Kaplan–Meier method and the differences were assessed using a log-rank test. Results: The overall incidence of PAD was higher in the PE cohort than in the non-PE cohort (2.76 vs. 1.72 per 1,000 person-years) with a crude hazard ratio (HR) of 1.61 [95% confidence interval (CI) = 1.41–1.83]. After adjustment for age, gender, and comorbidities, patients with PE were noted to be associated with an increased risk of PAD compared with those without PE [adjusted HR (aHR) = 1.18, 95% CI = 1.03–1.35]. Regarding the age-specific comparison between the PE and non-PE cohorts, PAD was noted to be significantly high in the ≤ 49 years age group (aHR = 5.34, 95% CI = 2.34–10.1). The incidence of PAD was higher in the first 2 years, with an aHR of 1.35 (95% CI = 1.09–1.68) for patients with PE compared with those without PE. Conclusion: The risk of PAD was higher if patients with PE were younger than 49 years and within the 2-year diagnosis of PE.
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Affiliation(s)
- Tzu-Yuan Wang
- Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Endocrinology and Metabolism, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Hung Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan.,School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University, Taichung, Taiwan.,Chung Sheng Clinic, Nantou, Taiwan
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Medicine, Everan Hospital, Taichung, Taiwan
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan.,Division of Clinical Nutrition, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences Science, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
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Shen TC, Chen CH, Huang YJ, Lin CL, Chang TC, Tu CY, Hsia TC, Shih CM, Hsu WH, Sung FC. Risk of pleural empyema in patients with schizophrenia: a nationwide propensity-matched cohort study in Taiwan. BMJ Open 2018; 8:e021187. [PMID: 29982211 PMCID: PMC6042618 DOI: 10.1136/bmjopen-2017-021187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/30/2018] [Accepted: 05/14/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Thoracic infection and pneumonia are prevalent in patients with schizophrenia; however, it is unclear whether patients with schizophrenia are at an increased risk of developing pleural empyema. DESIGN A retrospective cohort study with propensity-matched cohorts with and without schizophrenia. SETTING Using the National Health Insurance Research Database of Taiwan. PARTICIPANTS We identified 55 888 patients with schizophrenia newly diagnosed in 2000-2011 and same number of individuals without schizophrenia as the comparison cohort, frequency matched by propensity scores estimated using age, sex, occupation, income, urbanisation, year of diagnosis and comorbidities. PRIMARY OUTCOME MEASURES We assessed incident pleural empyema by the end of 2011 and used the Cox proportional hazards model to calculate the schizophrenia cohort to comparison cohort HR of pleural empyema. RESULTS The overall incidence of pleural empyema was 2.44-fold greater in the schizophrenia cohort than in the comparison cohort (4.39vs1.80 per 10 000 person-years), with an adjusted HR of 2.87(95% CI 2.14 to 3.84). Stratified analyses by age, sex, occupation, income, urbanisation and comorbidity revealed significant hazards for pleural empyema associated with schizophrenia in all subgroups. CONCLUSIONS Patients with schizophrenia are at an increased risk of developing pleural empyema and require greater attention and appropriate support.
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Affiliation(s)
- Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Intensive Care Unit, Chu Shang Show Chwan Hospital, Nantou, Taiwan
| | - Chia-Hung Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Jhen Huang
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Chang Chang
- Department of Business Administration, Asia University, Taichung, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chuen-Ming Shih
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Wu-Huei Hsu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
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Abstract
Objective Pneumonia is one of the most common infectious diseases in patients with COPD. The risk of empyema in COPD is controversial, and its incidence has not been reported. The aim of our study was to determine the risk of empyema in COPD patients and to assess its risk factors. Patients and methods We used the National Health Insurance Research Database in Taiwan to conduct an observational cohort study. This study analyzed patients who were diagnosed with COPD between January 1, 2003 and December 31, 2009. The earliest date of COPD diagnosis was designated the index date. Patients who were younger than 40 years or had empyema before the index date were excluded. Results We analyzed 72,085 COPD patients in our study. The incidence of empyema was higher in the COPD group than in the non-COPD group (15.80 vs 4.34 per 10,000 person-years). The adjusted hazard ratio for empyema was 3.25 (95% CI =2.73–3.87) in patients with COPD compared with patients without COPD. COPD patients with only comorbidity of stroke, cancer, and chronic renal disease had adjusted hazard ratios of 1.88, 4.84, and 3.90, respectively. Conclusion The likelihood of developing empyema is higher in patients with COPD than in those without COPD. Some comorbidities, such as stroke, cancer, and chronic renal disease, are associated with an elevated risk for empyema in COPD patients.
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Affiliation(s)
- Hsueh-Yi Lu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan
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Sokouti M, Ghojazadeh M, Sokouti M, Sokouti B. Surgical and nonsurgical outcomes for treating a cohort of empyema thoracis patients: A monocenteric retrospective cohort study. Ann Med Surg (Lond) 2017; 24:19-24. [PMID: 29062481 PMCID: PMC5647471 DOI: 10.1016/j.amsu.2017.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/06/2017] [Accepted: 10/06/2017] [Indexed: 12/14/2022] Open
Abstract
Background There are several studies reporting high success rates for surgical and nonsurgical treatments of empyema separately. The aim of current retrospective cohort study is to find the best treatment in low socio-economic areas. Material and methods A total of 149 patients were treated in the referring hospital from January 2002 to December 2008. The current retrospective cohort study was carried out by nonsurgical (medically & thoracenthesis & chest tube drainage with or without fibrinolytic agents) and surgical (VATS &open thoracotomy decortication methods) procedures in single center performed in thoracic and respiratory medicine wards. The independent t-test on demographic data was the statistical test tool. Results The complete cure and mortality rates for 130 patients were 27% (35 out of 130 patients) and 0.3% (1 out of 130 patients), respectively. Thirteen out of 149 patients that were estimated to be at stage II underwent VATS decortication. The results showed zero success rates for this procedure which was then converted to open thoracotomy decortication. And, 113 patients who underwent thoracotomy decortication had a cure rate of 96.4% (109 patients) and mortality rate of 1.8% (2 patients). Four (3.5%) patients needed thoracoplasty, 2 died and 2 (1.8%) needed open window thoracostomy resulted in empyema necessitans that remained uncured. Total hospitalization lengths for the patients treated by tube thoracostomy and thoracotomy decortication were (15.4 ± 2.1) and (6.2 ± 1.8) days (P < 0.001), respectively. The success rates between surgical and nonsurgical treatments were 98.2% and 27.1%. And, the difference between them was significant (P < 0.001). Conclusion Because of the advanced stages of empyema in our patients, thoracotomy decortication procedure is often the first rank choice with success rates higher than nonsurgical techniques. However, nowadays, the success rates of nonsurgical and VATS management of empyema thoracis are mostly reported in the literature. Outcomes of surgical and nonsurgical management for treating empyema thoracis patients were presented based on STROCSS criteria. Due to advanced stages of empyema in low socioendemic areas, thoracotomy decortication procedure proposed higher success rates. Success and cure rates, and hospitalization time showed significant differences between surgical and nonsurgical procedures.
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Affiliation(s)
- Mohsen Sokouti
- Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Massoud Sokouti
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Babak Sokouti
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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