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Age- and health-related quality of life after total hip replacement: decreasing gains in patients above 70 years of age.

https://arctichealth.org/en/permalink/ahliterature256755
Source
Acta Orthop. 2014 Jun;85(3):244-9
Publication Type
Article
Date
Jun-2014
Author
Max Gordon
Meridith Greene
Paolo Frumento
Ola Rolfson
Göran Garellick
André Stark
Author Affiliation
The Swedish Hip Arthroplasty Register , Gothenburg.
Source
Acta Orthop. 2014 Jun;85(3):244-9
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - psychology
Arthroplasty, Replacement, Hip - psychology
Cohort Studies
Female
Health status
Humans
Linear Models
Male
Osteoarthritis, Hip - surgery
Pain Measurement
Quality of Life - psychology
Questionnaires
Registries
Sweden
Abstract
While age is a common confounder, its impact on health-related quality of life (HRQoL) after total hip replacement is uncertain. This could be due to improper statistical modeling of age in previous studies, such as treating age as a linear variable or by using age categories. We hypothesized that there is a non-linear association between age and HRQoL.
We selected a nationwide cohort from the Swedish Hip Arthroplasty Register of patients operated with total hip replacements due to primary osteoarthritis between 2008 and 2010. For estimating HRQoL, we used the generic health outcome questionnaire EQ-5D of the EuroQol group that consits or 2 parts: the EQ-5D index and the EQ VAS estimates. Using linear regression, we modeled the EQ-5D index and the EQ VAS against age 1 year after surgery. Instead of using a straight line for age, we applied a method called restricted cubic splines that allows the line to bend in a controlled manner. Confounding was controlled by adjusting for preoperative HRQoL, sex, previous contralateral hip surgery, pain, and Charnley classification.
Complete data on 27,245 patients were available for analysis. Both the EQ-5D index and EQ VAS showed a non-linear relationship with age. They were fairly unaffected by age until the patients were in their late sixties, after which age had a negative effect.
There is a non-linear relationship between age and HRQoL, with improvement decreasing in the elderly.
Notes
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PubMed ID
24786908 View in PubMed
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Association of interleukin 8 with myocardial infarction: results from the Stockholm Heart Epidemiology Program.

https://arctichealth.org/en/permalink/ahliterature258580
Source
Int J Cardiol. 2014 Mar 1;172(1):173-8
Publication Type
Article
Date
Mar-1-2014
Author
Ilais Moreno Velásquez
Paolo Frumento
Katarina Johansson
Anita Berglund
Ulf de Faire
Karin Leander
Bruna Gigante
Source
Int J Cardiol. 2014 Mar 1;172(1):173-8
Date
Mar-1-2014
Language
English
Publication Type
Article
Keywords
Aged
Case-Control Studies
Coronary Artery Disease - epidemiology - genetics - metabolism
Female
Genetic Predisposition to Disease - epidemiology - genetics
HapMap Project
Humans
Interleukin-8 - blood - genetics
Logistic Models
Male
Middle Aged
Myocardial Infarction - epidemiology - genetics - metabolism
Odds Ratio
Polymorphism, Single Nucleotide
Receptors, Interleukin-8A - genetics - metabolism
Receptors, Interleukin-8B - genetics - metabolism
Risk factors
Sweden - epidemiology
Abstract
Interleukin 8 (IL8) has been contradictorily associated with the risk of myocardial infarction (MI).
To investigate the association of IL8 serum levels with the risk of MI and the association of the IL8 (IL8) and IL8 receptors (CXCR1 and CXCR2) genetic variants with IL8 levels and MI risk in a large case control study, the Stockholm Heart Epidemiology Program.
IL8 levels (pg/mL) were divided into quartiles and the MI risk was calculated by logistic regression and expressed as odds ratio (OR) and 95% CI. Two IL8 SNPs (rs4073A/T, rs2227306C/T) and three SNPs tagging CXCR1 and CXCR2 (rs4674258C/T, rs1008563C/T, rs6723449T/C) were analyzed for association with IL8 levels and with MI risk. Multivariate adjusted ORs for MI risk by IL8 levels in the highest quartiles indicated reduced point estimates in both women (OR 0.37; 95% CI 0.2-0.8) and men when compared to the lowest quartile. In female cases, IL8 levels decreased progressively in the six months after MI (p=0.03). IL8, CXCR1 and CXCR2 genetic variants were not associated with IL8 levels. In men, the T allele at the IL8 SNP rs4073 was associated with a slight increase in the MI risk under an additive and a recessive model of inheritance.
IL8 serum levels were associated with a reduced occurrence of MI among women, whereas IL8 was associated with a slightly increased risk among men, possibly through different mechanisms. These data suggest that the biological effects of IL8 on MI risk may vary over time and warrant further cohort studies with repetitive IL8 measurements.
PubMed ID
24462138 View in PubMed
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Elevated ApoB serum levels strongly predict early cardiovascular events.

https://arctichealth.org/en/permalink/ahliterature122892
Source
Heart. 2012 Aug;98(16):1242-5
Publication Type
Article
Date
Aug-2012
Author
Bruna Gigante
Karin Leander
Max Vikstrom
Paolo Frumento
Axel C Carlsson
Matteo Bottai
Ulf de Faire
Author Affiliation
Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, IMM, Nobelsväg 13, Karolinska Institutet, 17177 Stockholm, Sweden. bruna.gigante@ki.se
Source
Heart. 2012 Aug;98(16):1242-5
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Apolipoproteins B - blood
Biological Markers - blood
Cardiovascular Diseases - blood - epidemiology
Chi-Square Distribution
Female
Humans
Incidence
Male
Middle Aged
Prognosis
Proportional Hazards Models
Prospective Studies
Registries
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Up-Regulation
Abstract
ApoB exerts a pro-thrombotic and pro-atherogenic effect and promotes the progression of atherosclerotic lesions. In the present study, we investigated if elevated ApoB serum levels predicted the risk of premature cardiovascular events in a prospective Swedish cohort study of 60-year-old men and women from Stockholm.
A cohort consisting of every third man and woman turning 60 years of age in the large Stockholm area during the years 1997-1998 (n=4232).
Incident cases of cardiovascular diseases have been recorded yearly by matching national registries. Exposure to high ApoB serum levels (=0.9 g/l) was used to calculate the risk of cardiovascular diseases, and the time to the first cardiovascular event using Cox regression and Laplace regression, respectively.
Individuals exposed to high ApoB serum levels showed an increased risk of cardiovascular diseases over the 11 years of follow-up. The HR decreased over time from 2.49 at 4 years of study entry (95% CI 1.31 to 4.69) to 1.36 at 11 years (95% CI 1.01 to 1.83), after adjusting for gender, diabetes, hypertension, smoking, obesity, HDL and triglyceride serum levels. The first 5% of the individuals had a cardiovascular event nearly 2 years earlier among those with ApoB =0.9 g/l than among those with ApoB
PubMed ID
22760866 View in PubMed
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Evolution of chronic renal impairment and long-term mortality after de novo acute kidney injury in the critically ill; a Swedish multi-centre cohort study.

https://arctichealth.org/en/permalink/ahliterature267907
Source
Crit Care. 2015;19:221
Publication Type
Article
Date
2015
Author
Claire Rimes-Stigare
Paolo Frumento
Matteo Bottai
Johan MÃ¥rtensson
Claes-Roland Martling
Sten M Walther
Göran Karlström
Max Bell
Source
Crit Care. 2015;19:221
Date
2015
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - mortality - therapy
Aged
Cohort Studies
Critical Illness - mortality - therapy
Databases, Factual - trends
Female
Humans
Male
Middle Aged
Mortality - trends
Prospective Studies
Registries
Renal Insufficiency, Chronic - diagnosis - mortality - therapy
Sweden - epidemiology
Time Factors
Abstract
Acute Kidney Injury (AKI) is common in critical ill populations and its association with high short-term mortality is well established. However, long-term risks of death and renal dysfunction are poorly understood and few studies exclude patients with pre-existing renal disease, meaning outcome for de novo AKI has been difficult to elicit. We aimed to compare the long-term risk of Chronic Kidney Disease (CKD), End Stage Renal Disease (ESRD) and mortality in critically ill patients with and without severe de novo AKI.
This cohort study was conducted between 2005 and 2011 in Swedish intensive care units (ICU). Data from 130134 adult patients listed on the Swedish intensive care register-database was linked with other national registries. Patients with pre-existing CKD (4192) and ESRD (1389) were excluded, as were cases (26771) with incomplete data. Patients were classified according to AKI exposure during ICU admission. Outcome in the de novo AKI group was compared to the non-exposed (no-AKI) intensive care control group. Primary outcome was all-cause mortality. Follow-up ranged from one to seven years (median 2.1 years). Secondary outcomes were incidence of CKD and ESRD and median follow-up was 1.3 years.
Of 97 782 patients, 5273 (5.4%) had de novo AKI. These patients had significantly higher crude mortality at one (48.4% vs. 24.6%) and five years (61.8% vs. 39.1%) compared to the control group. The first 30% of deaths in AKI patients occurred within 11 days of ICU admission whilst the 30-centile in the no-AKI group died by 748 days. CKD was significantly more common in AKI survivors at one year (6.0% vs. 0.44%) than in no-AKI group (adjusted incidence rate ratio (IRR) 7.6). AKI patients also had significantly higher rates of ESRD at one (2.0% vs. 0.08%) and at five years (3.9% vs. 0.3%) than those in the comparison group (adjusted IRR 22.5).
This large cohort study demonstrated that de novo AKI is associated with increased short and long-term risk of death. AKI is independently associated with increased risk of CKD and ESRD as compared to an ICU control population. Severe de novo AKI survivors should be routinely followed-up and their renal function monitored.
Notes
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PubMed ID
25944032 View in PubMed
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Increased Mortality of Patients With Childhood-Onset Inflammatory Bowel Diseases, Compared With the General Population.

https://arctichealth.org/en/permalink/ahliterature298924
Source
Gastroenterology. 2019 02; 156(3):614-622
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2019
Author
Ola Olén
Johan Askling
Michael C Sachs
Paolo Frumento
Martin Neovius
Karin E Smedby
Anders Ekbom
Petter Malmborg
Jonas F Ludvigsson
Author Affiliation
Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: ola.olen@ki.se.
Source
Gastroenterology. 2019 02; 156(3):614-622
Date
02-2019
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Age Factors
Age of Onset
Cause of Death
Child
Cohort Studies
Colitis, Ulcerative - diagnosis - epidemiology - therapy
Crohn Disease - diagnosis - epidemiology - therapy
Female
Humans
Inflammatory Bowel Diseases - diagnosis - epidemiology - therapy
Kaplan-Meier Estimate
Male
Middle Aged
Mortality - trends
Prognosis
Proportional Hazards Models
Risk assessment
Severity of Illness Index
Sex Factors
Sweden
Abstract
Childhood-onset inflammatory bowel disease (IBD) is believed to be a more severe disease than adult-onset IBD, but there is little information on all-cause and cause-specific mortality in patients with childhood-onset IBD. We performed a population-based cohort study, with 50 years of follow-up, to estimate absolute and relative risks for overall and cause-specific mortality in patients with childhood-onset IBD, during childhood and adulthood.
We identified children with a diagnosis of IBD (younger than 18 years) in the Swedish nationwide health registers (1964-2014; n = 9442) and individuals from the general population matched for sex, age, calendar year, and place of residence (reference group; n = 93,180). Hazard ratios (HR) for death were estimated using Cox regression separately in patients with ulcerative colitis (n = 4671), Crohn's disease (n = 3780), and IBD unclassified (n = 991). HRs were compared among calendar periods.
During 138,690 person-years of follow-up, 294 deaths (2.1/1000 person-years) occurred among the patients with IBD compared with 940 deaths in the reference group (0.7/1000 person-years; adjusted HR, 3.2; 95% confidence interval [CI] 2.8-3.7). Mean age at end of follow-up was 30 years. HRs were increased for patients with ulcerative colitis 4.0, 95% CI 3.4-4.7; Crohn's disease 2.3, 95% CI 1.8-3.0; and IBD unclassified 2.0, 95% CI 1.2-3.4. Among patients younger than 18 years, there were 27 deaths from IBD 4.9, 95% CI 3.0-7.7. Among young adults with IBD, we found no evidence that HRs for death decreased from 1964 through 2014 (P = .90).
Children with IBD have a 3-fold increase in risk of death when followed through adulthood. The relative risk for death has not decreased with development of new drugs for treatment of IBD.
PubMed ID
30342031 View in PubMed
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Long-term mortality and risk factors for development of end-stage renal disease in critically ill patients with and without chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature271702
Source
Crit Care. 2015;19:383
Publication Type
Article
Date
2015
Author
Claire Rimes-Stigare
Paolo Frumento
Matteo Bottai
Johan Mårtensson
Claes-Roland Martling
Max Bell
Source
Crit Care. 2015;19:383
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Critical Illness - mortality - therapy
Female
Humans
Incidence
Intensive Care Units
Kidney Failure, Chronic - etiology - mortality - pathology
Male
Middle Aged
Renal Dialysis - adverse effects - mortality
Renal Insufficiency, Chronic - complications - mortality - pathology
Risk factors
Sweden
Abstract
Prevalence of chronic kidney disease (CKD) amongst intensive care unit (ICU) admissions is rising. How mortality and risk of end-stage renal disease (ESRD) differs between those with and without CKD and with acute kidney injury (AKI) is unclear. Determining factors that increase the risk of ESRD is essential to optimise treatment, identify patients requiring nephrological surveillance and for quantification of dialysis provision.
This cohort study used the Swedish intensive care register 2005-2011 consisting of 130,134 adult patients. Incomplete cases were excluded (26,771). Patients were classified (using diagnostic and intervention codes as well as admission creatinine values) into the following groups: ESRD, CKD, AKI, acute-on-chronic disease (AoC) or no renal dysfunction (control). Primary outcome was all-cause mortality. Secondary outcome was ESRD incidence.
Of 103,363 patients 4,192 had pre-existing CKD; 1389 had ESRD; 5273 developed AKI and 998 CKD patients developed AoC. One-year mortality was greatest in AoC patients (54 %) followed by AKI (48.7 %), CKD (47.6 %) and ESRD (40.3 %) (P?
Notes
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Cites: N Engl J Med. 2004 Sep 23;351(13):1296-30515385656
Cites: BMJ. 2013;346:f32423360717
Cites: JAMA. 2012 Dec 12;308(22):2349-6023111824
Cites: J Am Soc Nephrol. 2009 Jan;20(1):223-819020007
PubMed ID
26526622 View in PubMed
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Women in Charnley class C fail to improve in mobility to a higher degree after total hip replacement.

https://arctichealth.org/en/permalink/ahliterature102991
Source
Acta Orthop. 2014 Aug;85(4):335-41
Publication Type
Article
Date
Aug-2014
Author
Max Gordon
Paolo Frumento
Olof Sköldenberg
Meridith Greene
Göran Garellick
Ola Rolfson
Author Affiliation
Swedish Hip Arthroplasty Register , Gothenburg.
Source
Acta Orthop. 2014 Aug;85(4):335-41
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - classification - rehabilitation
Comorbidity
Female
Follow-Up Studies
Humans
Linear Models
Male
Middle Aged
Mobility Limitation
Motor Activity
Osteoarthritis, Hip - epidemiology - rehabilitation - surgery
Prospective Studies
Quality of Life
Recovery of Function
Registries
Severity of Illness Index
Sex Distribution
Sweden - epidemiology
Abstract
The Charnley comorbidity classification organizes patients into 3 classes: (A) 1 hip involved, (B) 2 hips involved, and (C) other severe comorbidities. Although this simple classification is a known predictor of health-related quality of life (HRQoL) after total hip replacement (THR), interactions between Charnley class, sex, and age have not been investigated and there is uncertainty regarding whether A and B should be grouped together.
We selected a nationwide cohort of patients from the Swedish Hip Arthroplasty Register operated with THR due to primary osteoarthritis between 2008 and 2010. For estimation of HRQoL, we used the generic health outcome questionnaire EQ-5D of the EuroQol group. This consists of 2 parts: the EQ-5D index and the EQ VAS estimates. We modeled the EQ-5D index and the EQ VAS against the self-administered Charnley classification. Confounding was controlled for using preoperative HRQoL values, pain, and previous contralateral hip surgery.
We found that women in class C had a poorer EQ-5D outcome than men. This effect was mostly due to the fact that women failed to improve in the mobility dimension; only 40% improved, while about 50% of men improved. Age did not interact with Charnley class. We also found that the classification performed best without splitting or aggregating classes.
Our results suggests that the self-administered Charnley classification should be used in its full capacity and that it may be interesting to devote special attention to women in Charnley class C.
Notes
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PubMed ID
24954483 View in PubMed
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7 records – page 1 of 1.