caesarean_section

1,801 women with caesarean section (CS) and 1,801 matched women with vaginal delivery (VD) from gynecological practices in Germany. Data set includes the patient-id, age, obesity, mode of delivery (CS versus VD) in the first pregnancy and in the second pregnancy, the most common pregnancy-induced diseases, pregnancy-associated disorders and complications prior to or during birth in the subsequent pregnancy. The index date (Indexdate) relates to the physician visit

Association Between Psoriasis and Dementia: A Retrospective Cohort Study

Background: To date, no large study has examined the relationship between psoriasis and dementia in Germany. Objective: The aim of this study was to assess the association between psoriasis and the risk of all-cause dementia in patients followed in general practices in Germany. Methods: This retrospective cohort study is based on longitudinal data from the IQVIATM Disease Analyzer database and included patients with an initial diagnosis of psoriasis between January 1995 and December 2014 in 1,173 general practices in Germany. Patients without psoriasis were matched individually (1:1) to psoriasis patients using propensity scores. The main outcome of the study was the cumulative incidence of dementia diagnoses within up to 15 years of the index date. Univariate Cox proportional regression models were used to assess the relationship between psoriasis or psoriatic arthritis and dementia. Results: The present study included 10,583 patients with a diagnosis of psoriasis and 10,583 controls without psoriasis. After 15 years of follow-up, 22.0% of the psoriasis patients and 19.1% (p < 0.001) of the non-psoriasis patients developed dementia. The incidence rate of dementia in 1,000 person-years was 15.0 in psoriasis patients and 11.9 in the non-psoriasis cohort. Psoriasis was significantly associated with a dementia risk (HR: 1.24; 95% CI: (1.14–1.35); p < 0.001). The association was stronger in patients with PsA (HR: 1.35; 95% CI: (0.98–1.86)) but this was not significant (p = 0.070). Conclusion: The present study found a positive association between psoriasis and all-cause dementia in patients in general practices in Germany.</p

Psychiatric disorder and its association with gastro-intestinal cancer: a retrospective cohort study with 45,842 patients in Germany

   Purpose: Psychiatric disorders and cancer are both common, and comorbidity has detrimental impacts on cancer outcomes. Previous studies focus on affective disorders which arise after cancer diagnosis, not on the impact of psychiatric disorders on cancer risk. We investigate the association between psychiatric disorders and subsequent gastro-intestinal cancer in a large cohort in Germany.  Methods:  Using secondary data (electronic medical records) from a national IQVIA Disease Analyzer database, we evaluated the association between previous psychiatric diagnosis in  44,582 matched patients with and without gastro-intestinal cancer .  Regression analyses were stratified by psychiatric diagnosis, and adjusted by chronic comorbidities and previous psychiatric treatments.  Results: No association between any previous psychiatric disease and GI cancers was found (OR=0.98 (0.95-1.02 95%CL, p=0.39). Previous psychosomatic disorder and GI - cancer showed a significant negative association (OR: 0.86, 0.81-0.90 95%CL, p Conclusion: Psychiatric disease was not associated with GI cancer risk. Further investigation into the pathways linking psychiatric disease and cancer needs to be conducted, taking into consideration psychiatric treatments administered, to enhance our understanding of the relationship between these two common and devastating diseases. No description supplied</p

Is there an association between post-traumatic stress disorder and the incidence of chronic low back pain?

Background: Preliminary research suggests post-traumatic stress disorder (PTSD) is a risk factor for chronic low back pain (CLBP). However, this literature displays some limitations. Therefore, this study aimed to investigate the association between PTSD and the 10-year cumulative incidence of CLBP in adults from Germany.  Methods: The present retrospective cohort study included adults diagnosed with PTSD in one of 1,284 general practices in Germany in 2005-2020 (index date). Individuals without PTSD were matched to those with PTSD (1:1) using a propensity score based on age, sex, index year, duration of follow-up, and the mean number of consultations during follow-up. In patients without PTSD, the index date was a randomly selected visit date.  Results: There were 60,664 patients included in the study. After adjusting for frequent comorbidities, there was a positive but non-significant association between PTSD and incident CLBP in the overall population (HR=1.07, 95% CI=0.99-1.15). Nonetheless, the relationship between PTSD and CLBP was statistically significant in the age group >60 years (HR=1.24, 95% CI=1.05-1.46). Conclusions: Conversely to previous research, PTSD was not associated with incident CLBP in this large German sample. Further longitudinal studies are warranted to corroborate these findings before drawing any firm conclusions. </p

Incidence of newly-diagnosed dementia after COVID-19 infection vs. acute upper respiratory infection: a retrospective cohort study

Background: There is emerging evidence that coronavirus disease 2019 (COVID-19) is giving rise to seemingly unrelated clinical conditions long after the infection has resolved. Objective: The aim of this study is to examine whether COVID-19 is associated with an increased risk of dementia including Alzheimer’s disease. Methods: This retrospective cohort study is based on longitudinal data from the IQVIATM Disease Analyzer database and included patients aged≥65 with an initial diagnosis of COVID-19 or acute upper respiratory infection (AURI) from 1,293 general practitioner practices between January 2020 and November 2021. AURI patients were matched 1 : 1 with COVID-19 patients using propensity scores based on sex, age, index quarter, health insurance type, the number of doctor visits, and comorbidities associated with dementia risk. Incidence rates of newly-diagnosed dementia were calculated using the person-years method. Poisson regression models were used to compute the incidence rate ratios (IRR). Results: The present study included 8,129 matched pairs (mean age 75.1 years, 58.9% females). After 12 months of follow-up, 1.84% of the COVID-19 patients and 1.78% of the AURI patients had been diagnosed with dementia. The Poisson regression model resulted in an IRR of 1.05 (95% CI: 0.85–1.29). Conclusion: This study did not find any association between COVID-19 infection and one-year dementia incidence after controlling for all common risk factors for dementia. Because dementia is a progressive disease, which can be difficult to diagnose, a longer follow-up period might offer a better insight into a possible association between COVID-19 infection and an increased incidence of dementia cases in the future

Association between syncope and the 6-month incidence of ischemic stroke, arrhythmia, brain tumor, epilepsy, and anxiety disorder

Objectives: the aim of the present study is to investigate the associations between syncope and subsequent diagnoses of brain tumor, cardiac arrhythmia, stroke/transient ischemic attack (TIA), epilepsy, and anxiety disorder in a large outpatient population in Germany. Methods: This retrospective cohort study uses data from the Disease Analyzer database (IQVIA). Adults who received syncope diagnosis from one of 1284 general practices between January 2005 and December 2021 (index date) were included and matched (1:1) to individuals without syncope diagnosis using a propensity score based on age, sex, the number of consultations during the follow-up period (up to 6 months), and defined co-diagnoses documented within 12 months prior to and on the index date. Finally, associations between syncope and subsequent outcome diagnoses were investigated using multivariable logistic regression models. Results: Data related to 64,016 patients with and 64,016 patients without syncope (mean age 54.5 years, 56.5% female) were available. In total, 6.43% of syncope patients and 2.14% of non-syncope patients were diagnosed with one of the five outcome diagnoses within 6 months of the index date. There was a positive and significant association between syncope and incidences of ischemic stroke/TIA (OR = 2.83, 95% CI = 2.41–3.32), arrhythmia (OR = 3.81, 95% CI = 3.44–4.18), brain tumor (OR = 4.24, 95% CI = 2.50–7.19), epilepsy (OR = 5.52, 95% CI = 4.27–7.14), and anxiety disorder (OR = 1.99, 95% CI = 1.79–2.21). Conclusions: Syncope is significantly associated with an increased risk of subsequent ischemic stroke/TIA, cardiac arrhythmia, brain tumor, epilepsy, and anxiety disorder. Nevertheless, the cumulative incidences for all five diagnoses are very low

Falls increase the risk for incident anxiety and depressive symptoms among adults aged ≥50 years: an analysis of the Irish Longitudinal Study on Ageing

Background: Little is known about the potential impact of falls on the onset of common mental disorders in older adults. Thus, we aimed to investigate the longitudinal association between falls and incident anxiety and depressive symptoms in adults aged ≥50 years living in Ireland. Methods: Data from the Irish Longitudinal Study on Ageing were analyzed (Wave 1: 2009–2011; and Wave 2: 2012–2013). The presence of falls and injurious falls in the past 12 months was assessed at Wave 1. Anxiety and depressive symptoms were assessed at Wave 1 and Wave 2 using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) and the 20-item Center for Epidemiologic Studies Depression (CES-D), respectively. Covariates included sex, age, education, marital status, disability, and the number of chronic physical conditions. The association of falls at baseline with incident anxiety and depressive symptoms at follow-up was estimated by multivariable logistic regression. Results: This study included 6,862 individuals (51.5% women; mean [SD] age 63.1 [8.9] years). After adjusting for covariates, falls were significantly associated with anxiety (OR = 1.58, 95%CI = 1.06–2.35) and depressive symptoms (OR = 1.43, 95%CI = 1.06–1.92). These associations were no longer significant after including fear of falling in the models. Similar findings were obtained for injurious falls, although the relationship with anxiety symptoms was not statistically significant. Conclusions: This prospective study of older adults from Ireland found significant associations between falls and incident anxiety and depressive symptoms. Future research may focus on whether interventions to reduce fear of falling could also alleviate anxiety and depressive symptoms

Association between carpal tunnel syndrome and the five-year incidence of anxiety disorder and depression in adults followed in general practices in Germany

ObjectiveLittle is known about the longitudinal relationship between carpal tunnel syndrome (CTS) and mental health. Therefore, this retrospective cohort study investigated the association between CTS and the five-year incidence of anxiety disorder and depression in adults from Germany.MethodsData from the Disease Analyzer database (IQVIA) were used for the present study. Patients aged ≥18 years diagnosed for the first time with CTS in one of 1284 general practices in Germany in 2005–2020 were included (index date). Individuals without CTS were matched to those with CTS using a propensity score based on age, sex, the mean number of consultations per year during the follow-up, and the index year. In people without CTS, the index date was a randomly selected consultation in 2005–2020.ResultsThere were 75,135 patients with and 75,135 patients without CTS included in the study (mean [SD] age 57.2 [16.5] years; 59.7% women). Within five years of the index date, the incidence of anxiety disorder was 3.9% and 3.6% in the group with and the group without CTS, respectively (log-rank p-valueConclusionCTS was associated with an increased incidence of anxiety disorder and depression in Germany. Further research should identify the mediators involved in these relationships.</p

Is there an association between breast cancer and incident adhesive capsulitis of the shoulder? A retrospective cohort study from Germany

Purpose Preliminary data suggest that women with breast cancer are at particularly high risk of adhesive capsulitis of the shoulder. Therefore, this study aimed to investigate the potential association between breast cancer and adhesive capsulitis in adults from Germany. Methods This retrospective cohort study included all women aged ≥ 18 years who were diagnosed for the first time with breast cancer in one of 1,274 general practices in Germany between January 2000 and December 2018 (index date). Women without breast cancer were matched (1:1) to those with breast cancer using a propensity score based on age at the index date, index year, and the average number of medical consultations per year during the follow-up. In women without breast cancer, the index date was a randomly selected visit date between 2000 and 2018. The association between breast cancer and the 10-year incidence of adhesive capsulitis was studied using Kaplan–Meier curves and a Cox regression model adjusted for age and several comorbidities. Results There were 52,524 women included in this study (mean [SD] age 64.2 [12.9] years). The 10-year incidence of adhesive capsulitis was 3.6% in both the group with and the group without breast cancer (log-rank p-value = 0.317). The Cox regression analysis further showed no significant association between breast cancer and adhesive capsulitis (HR = 0.96, 95% CI = 0.86–1.08). Conclusion In this sample of women from Germany, breast cancer was not significantly associated with adhesive capsulitis. Although the present preliminary findings are reassuring, general practitioners should regularly assess shoulder function in breast cancer survivors

Chronic Low Back Pain and Incident Transient Ischemic Attack and Stroke in General Practices in Germany

The aim was to investigate the association between chronic low back pain (CLBP) and 18 incident transient ischemic attack (TIA) and stroke in Germany. The present retrospective cohort 19 study included adults aged ≥18 years who were diagnosed for the first time with CLBP in one of 20 1,198 general practices in Germany in 2005-2019 (index date). Patients without CLBP were matched 21 to those with CLBP (1:1) using a propensity score based on age, sex, the index year, the number of 22 medical consultations per year during the follow-up, and the number of years of follow-up. In pa-23 tients without CLBP, the index date was a randomly selected visit date. Both groups were followed 24 for up to 10 years. There were 159,440 patients included in the study [mean (SD) age 52.1 (16.5) 25 years; 51.5% women]. Within 10 years of the index date, 6.5% and 5.9% of patients with and without 26 CLBP were diagnosed with TIA or stroke, respectively (log-rank p-value<0.001). The Cox regression 27 analysis corroborated these results, as there was a significant association between CLBP and inci-28 dent TIA or stroke (HR=1.28, 95% CI=1.22-1.35). CLBP was positively and significantly associated 29 with incident TIA and stroke in Germany. More research is warranted to better understand this 30 relationship