Incidence Rates Of Comorbidities Research Articles

Comorbidity Burden Among Patients with Vitiligo in the United States: A Large-Scale Retrospective Claims Database Analysis.

Vitiligo is often associated with comorbid conditions that may increase economic burden and affect patients' health-related quality of life. No large-scale study has been published to date using claims databases to evaluate the burden of comorbidities among patients with vitiligo. Herein, we evaluate the comorbidity burden among patients diagnosed with vitiligo from the US. This retrospective cohort analysis used the Merative MarketScan Commercial Database. Eligible patients were diagnosed with vitiligo between January 2008 and December 2020 and matched 1:4 (vitiligo:control) with control subjects with no diagnosis of vitiligo between January 2007 and December 2021. Study outcomes were the incidence of comorbidities after matching, adjusted hazard ratios of comorbidity incidence among patients with vitiligo relative to matched control subjects, and time to comorbidity diagnosis or incidence. Baseline demographics were well balanced between matched vitiligo (n = 13,687) and control cohorts (n = 54,748). Incidence rates of comorbidities were higher among patients compared with control subjects (psychiatric, 28.4% vs 22.8%; autoimmune, 13.4% vs 5.1%; and non-autoimmune, 10.0% vs 7.0%). The most common psychiatric and autoimmune comorbidities in patients with vitiligo compared with control subjects included anxiety (14.3% vs 11.0%, respectively), sleep disturbance (9.1% vs 7.1%), depression (8.0% vs 6.3%), atopic dermatitis (3.1% vs 1.1%), psoriasis (2.7% vs 0.6%), and linear morphea (1.5% vs 0.1%). The risk of developing any psychiatric (hazard ratio 1.31; P < 0.01), autoimmune (hazard ratio 2.77; P < 0.01), or non-autoimmune (hazard ratio 1.45; P < 0.01) comorbidity was significantly higher among patients with vitiligo. Time to diagnosis of most vitiligo comorbidities was 1-3years, although linear morphea was diagnosed at < 1year. Results of this retrospective analysis demonstrated that patients were much more likely to be diagnosed with autoimmune or psychiatric comorbidities following a vitiligo diagnosis, which likely contributed to increased economic burden and lower quality of life.

Manifestation of Heart Failure and Chronic Kidney Disease are Associated with Increased Mortality Risk in Early Stages of Type2 Diabetes Mellitus: Analysis of a Japanese Real-World Hospital Claims Database.

IntroductionTo assess the initial manifestation of comorbidities and their impact on mortality risk in patients with type 2 diabetes mellitus (T2DM) without a history of cardiovascular or renal complications (i.e., in the early stages of T2DM) compared with patients without T2DM.MethodsWe performed a retrospective cohort study using a Japanese hospital claims database. The incidence rates of comorbidities (chronic kidney disease [CKD], heart failure [HF], myocardial infarction [MI], peripheral arterial disease [PAD], and stroke) and mortality risk were compared between patients with T2DM and age-/sex-matched patients without T2DM (matched 1:2).ResultsAmong the comorbidities assessed in this study, CKD and/or HF was the most frequent initial manifestation in the patients with T2DM (n = 426,186) with an incidence rate 2.02 times greater than that in matched patients without T2DM (n = 1,018,609). The mortality risk was also greater in patients with T2DM than in patients without T2DM with a hazard ratio of 1.73. In both patients with and without T2DM, the presence of CKD or HF was associated with greater mortality risks compared with the presence of MI, PAD, or stroke.ConclusionsThe high incidence of CKD or HF manifestation can contribute to the augmented mortality risk in patients in the early stages of T2DM compared with patients without T2DM. These findings highlight the importance of early interventions for preventing/treating CKD and HF to improve the prognosis of patients with T2DM.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-021-01191-y.

Clinical features of very-low-birthweight infants with congenital heart disease.

Few studies have investigated the developmental prognosis of very-low-birthweight (VLBW) infants with congenital heart diseases (CHDs). This study aimed to determine the mortality and morbidity, including the developmental prognosis, of VLBW infants with CHD. This single-center, retrospective cohort study included VLBW infants admitted to the neonatal intensive care unit from January 2006 to December 2011. Perinatal records were reviewed for CHD diagnosis, treatment details, comorbidities, mortality, and long-term neurodevelopmental outcomes. The characteristics and neurological developmental quotients at around the age of 3years were compared among the following three groups of VLBW infants with CHDs: biventricular circulation without intervention (without surgery), biventricular circulation with intervention (catheter intervention or one-stage surgery), and single-ventricular circulation (Fontan-type multiple-stage surgery). Among a total of 449 VLBW infants admitted during this period, 45 (10.0%) infants had CHDs, including 25 infants with congenital abnormalities (chromosomal abnormalities and/or multiple anomalies). All 13 infants who died before discharge had congenital abnormalities. The incidence rates of comorbidities were not higher in VLBW infants with CHDs than in those without CHDs. The developmental quotients of the no-surgery, catheter intervention or one-stage surgery, and Fontan-type multiple-stage surgery groups were 87.2±10.9, 91.3±4.7, and 63.7±8.6, respectively. The neurological development at around the age of 3years in VLBW infants with biventricular circulation was in the borderline-to-normal range; however, that in infants with single-ventricular circulation was poor. Further studies are needed to comprehend the neurological development of VLBW infants with CHDs better.

Systematically comparing COVID-19 with the 2009 influenza pandemic for hospitalized patients

ObjectivesThis study aimed to comprehensively compare the clinical features of hospitalized COVID-19 patients with hospitalized 2009 influenza pandemic patients. MethodsMedline, Embase, Web of Science, Cochrane CENTRAL, and Google scholar were systematically searched to identify studies related to COVID-19 and the 2009 influenza pandemic. The pooled incidence rates of clinical features were estimated using the DerSimonian-Laird random-effects model with the Freeman-Tukey double arcsine transformation method. ResultsThe incidence rates of fever, cough, shortness of breath, sore throat, rhinorrhea, myalgia/muscle pain, or vomiting were found to be significantly higher in influenza patients when compared with COVID-19 patients. The incidence rates of comorbidities, including cardiovascular disease/hypertension and diabetes, were significantly higher in COVID-19 compared with influenza patients. In contrast, comorbidities such as asthma, chronic obstructive pulmonary disease, and immunocompromised conditions were significantly more common in influenza compared with COVID-19 patients. Unexpectedly, the estimated rates of intensive care unit admission, treatment with extracorporeal membrane oxygenation, treatment with antibiotics, and fatality were comparable between hospitalized COVID-19 and 2009 influenza pandemic patients. ConclusionsThis study comprehensively estimated the differences and similarities of the clinical features and burdens of hospitalized COVID-19 and 2009 influenza pandemic patients. This information will be important to better understand the current COVID-19 pandemic.

Obesity Fact Sheet in Korea, 2018: Data Focusing on Waist Circumference and Obesity-Related Comorbidities.

BackgroundThe global prevalence of obesity has increased steadily in recent years. Waist circumference (WC) reflects body composition better than body mass index. The Korean Society for the Study of Obesity released the 2018 Obesity Fact Sheet to address the incidence of obesity-related comorbidities according to WC levels.MethodsData from the Korean National Health Insurance Service health examination database from 2009 to 2016 were analyzed. Abdominal obesity was defined as a WC ≥90 cm in men and ≥85 cm in women. Incidence rates of comorbidities and all-cause mortality rates were calculated after standardizing by age and sex based on the 2010 census.ResultsFrom 2009 to 2015, the incidence rates of type 2 diabetes mellitus, hypertension, myocardial infarction, and ischemic stroke increased both in men and women. Individuals with the lowest WC levels had the highest all-cause mortality rates followed by those with the highest WC levels in men, women, and the total population. The incidence rates of total cancer increased as WC levels escalated between 2009 and 2016. In men, the incidence rates of colorectal, prostate, and liver cancers increased as WC levels increased. The incidence rates of thyroid, colorectal, and stomach cancers increased as WC levels rose in women. In addition, medical expenses continuously increased as WC increased in both men and women.ConclusionBased on the 2018 Obesity Fact Sheet, strategies for reducing the abdominal obesity and related comorbidities and medical expenses are a public health priority.

A retrospective cohort study to evaluate the development of comorbidities, including psychiatric comorbidities, among a pediatric psoriasis population.

Background/ObjectiveCompared with the adult psoriasis population, knowledge about the incidence of comorbidities in the pediatric psoriasis population is limited. The objective of this study was to assess the prevalence and incidence of comorbidities, including psychiatric comorbidities, in patients with pediatric psoriasis.MethodsIn this claims‐based, retrospective cohort study, patients with pediatric psoriasis were matched 1:3 with a nonpsoriasis cohort based on age, sex, and index date (the earliest of inpatient claims or the latter of two outpatient claims).ResultsObesity, serious infection, and juvenile idiopathic arthropathy had higher prevalence and incidence rates in the psoriasis cohort than the nonpsoriasis cohort. Psychiatric comorbidities were also more common in the psoriasis cohort than the nonpsoriasis cohort, as were ulcerative colitis and Crohn disease. Stratifying the psoriasis cohort by disease severity—mild and moderate‐to‐severe—found no differences in incidence rates of comorbidities between the two subsets.ConclusionThe incidence rates of many comorbid conditions were higher for patients with pediatric psoriasis compared with patients without pediatric psoriasis, and similar between patients with moderate‐to‐severe and mild pediatric psoriasis.

Incidence rates of comorbidities among patients with psoriasis in the United States

Psoriasis is associated with a substantial burden of comorbidities; however, incidence rates (IRs) of these comorbidities following psoriasis diagnosis are not well characterized. Using administrative claims data from the Truven Health Analytics MarketScan Commercial and Medicare Supplemental Databases between January 1, 2002 and September 30, 2015, we compared the incidence of newly diagnosed comorbidities among patients with psoriasis versus demographically matched (birth year, gender, and geographic region) control patients without psoriasis in the United States. Comorbidities of interest were identified using ICD-9-CM codes. A total of 114,824 matched pairs of patients with psoriasis and control patients were included. IRs of all selected comorbidities were significantly higher among patients with psoriasis compared with controls (P&lt;0.05). The most common newly diagnosed comorbidities in both groups were hyperlipidemia (psoriasis versus control, IR per 1,000 patient-years, 127.5 versus 102.8) and hypertension (94.3 versus 80.6). The greatest differences in IRs between patients with psoriasis and controls were observed for rheumatoid arthritis (9.7 versus 3.1; IR ratio [IRR], 3.15) and psoriatic arthritis (24.0 versus 0.2; IRR, 151.57). In this real-world study, patients with psoriasis were more likely to develop new selected comorbidities after diagnosis compared with demographically matched patients without psoriasis.

Incidence Of Comorbidities In Medicare Beneficiaries Diagnosed With Acute Lymphoblastic Leukemia

BackgroundThe presence of comorbidities, including infections and neurological conditions, among older patients with acute lymphoblastic leukemia (ALL) may impact treatment decisions and influence patient prognosis. Thus, understanding the epidemiology of comorbidities among patients with ALL is useful for identifying subpopulations most likely to benefit from treatment. However, literature describing the epidemiology of comorbidities among older patients with ALL is sparse. ObjectiveTo characterize the incidence of comorbidities among older adults with ALL in routine clinical practice. MethodsUsing the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified a cohort of Medicare beneficiaries with a primary cancer diagnosis of ALL between 2000 and 2007. Individuals from a random 5% sample of cancer-free Medicare beneficiaries residing in SEER regions were matched (1:1) to ALL patients on year of diagnosis (i.e., the cancer-free individual was enrolled in Medicare Parts A and B during the same year), and county of residence. Individuals were required to be enrolled in Medicare Parts A and B for ≥ 4 months prior to diagnosis or index date (i.e., June 1st of the matched year for cancer-free individuals). Time-at-risk for each comorbidity began on the diagnosis or index date and continued until the first of the following events: a claim for the comorbidity, change in Medicare coverage, death, or end of follow-up. Patients were identified with a comorbidity if they had ≥ 2 outpatient claims at least 30 days apart, or 1 inpatient claim with an appropriate diagnosis code. Three- and 12-month crude incidence rates were estimated for a broad range of comorbidities. ResultsThere were 646 Medicare beneficiaries with a primary diagnosis of ALL and 646 cancer-free individuals. Incidence rates of comorbidities selected based on clinical relevance and/or large observed differences between patients with ALL and cancer-free individuals are presented (Table). In general, 3- and 12-month incidence rates were considerably higher among ALL patients than in cancer-free individuals. ConclusionsIn older adults with ALL, there is a high incidence of comorbidities, including infections and neurological conditions. The incidence rates of comorbidities are particularly high within the first 3 months of diagnosis, but remain elevated even when observation time is extended up to 12 months following diagnosis. High incidence rates of comorbidities may be attributable to ALL and/or toxicities associated with therapy, or may represent recognition of prevalent conditions at the time of ALL diagnosis.Table3-month and 12-month incidence of selected comorbidities3-month Incidencen / person-years (per 100 person-years)12-month Incidencen / person-years (per 100 person-years)ICD-9 Code(s)ALLCancer-freeALLCancer-freeSepticemia038155 / 99.61 / 160.2207 / 235.16 / 618.4(155.6)(0.6)(88.0)(1.0)Mycoses110-11854 / 107.81 / 159.483 / 268.73 / 614.9(50.1)(0.6)(30.9)(0.5)Psychoses290-29930 / 111.74 / 149.144 / 287.612 / 574.7(26.9)(2.7)(15.3)(2.1)Depressive disorder31122 / 112.61 / 157.739 / 291.13 / 609.2(19.5)(0.6)(13.4)(0.5)Other disorders of central nervous system340-34922 / 115.90 / 159.240 / 296.64 / 614.7(19.0)(0.0)(13.5)(0.7)Epilepsy / recurrent seizures3455 / 121.20 / 161.56 / 316.31 / 623.5(4.1)(0.0)(1.9)(0.2)Disorders of peripheral nervous system350-35918 / 114.12 / 158.332 / 286.18 / 610.1(15.8)(1.3)(11.2)(1.3)Hypertension40134 / 51.25 / 99.946 / 123.018 / 380.2(66.4)(5.0)(37.4)(4.7)Heart failure42845 / 105.26 / 145.761 / 268.919 / 560.2(42.8)(4.1)(22.7)(3.4)Other thromboembolic events45339 / 113.60 / 159.553 / 289.92 / 615.8(34.3)(0.0)(18.3)(0.3)Pneumonia, organism unspecified48676 / 101.42 / 151.2108 / 252.213 / 583.5(75.0)(1.3)(42.8)(2.2)Emphysema4925 / 120.90 / 161.010 / 317.01 / 621.8(4.1)(0.0)(3.2)(0.2)Acute renal failure58495 / 107.01 / 159.7119 / 266.811 / 614.9(88.8)(0.6)(44.6)(1.8)Chronic kidney disease58513 / 118.32 / 158.719 / 306.88 / 612.7(11.0)(1.3)(6.2)(1.3) Disclosures:Cetin:Amgen, Inc.: Employment. Danese:Amgen, Inc.: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; MedImmune: Consultancy, Research Funding. Katz:Amgen, Inc.: Employment. Kelsh:Amgen, Inc.: Employment. Gleeson:Amgen, Inc.: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; MedImmune: Consultancy, Research Funding. Alekar:Amgen, Inc.: Employment. Griffiths:Amgen, Inc.: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; MedImmune: Consultancy, Research Funding.