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30-day mortality after peptic ulcer perforation among users of newer selective COX-2 inhibitors and traditional NSAIDs: a population-based study.

https://arctichealth.org/en/permalink/ahliterature80303
Source
Am J Gastroenterol. 2006 Dec;101(12):2704-10
Publication Type
Article
Date
Dec-2006
Author
Thomsen Reimar W
Riis Anders
Munk Estrid M
Nørgaard Mette
Christensen Steffen
Sørensen Henrik T
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark.
Source
Am J Gastroenterol. 2006 Dec;101(12):2704-10
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
Anti-Ulcer Agents - administration & dosage
Cohort Studies
Cyclooxygenase 2 Inhibitors - administration & dosage
Denmark
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Peptic Ulcer Perforation - complications - mortality
Registries
Survival Rate
Abstract
OBJECTIVES: Nonsteroidal anti-inflammatory drug (NSAID) use is a strong risk factor for peptic ulcer perforation, yet little is known about the outcome of this condition among NSAID users. We examined 30-day mortality after peptic ulcer perforation associated with the use of traditional NSAIDs and newer selective cyclo-oxygenase-2 (COX-2) inhibitors. METHODS: We conducted a cohort study of patients with the first hospitalization for peptic ulcer perforation, identified in discharge registries of three Danish counties between 1991 and 2003. Data on preadmission NSAID use, other ulcer-related drugs, and comorbidity were likewise from population-based registries. Mortality was ascertained from the Civil Registration System. We compared 30-day mortality in NSAID users and nonusers while adjusting for age, gender, comorbidity, previous uncomplicated peptic ulcer, and ulcer medication use. RESULTS: Of the 2,061 patients hospitalized with peptic ulcer perforation, 38% were current NSAID users. The 30-day mortality was 25% overall, and 35% among current NSAID users. Compared with never-use, the adjusted 30-day mortality rate ratios (MRRs) were 1.8 (95% CI 1.4-2.3) for current use of NSAIDs alone and 1.6 (95% CI 1.2-2.2) for current use combined with other ulcer-associated drugs. The mortality increase associated with the use of COX-2 inhibitors was similar to that of traditional NSAIDs: adjusted MRR for users of COX-2 inhibitors alone and in combination, 2.0 (1.3-3.1) and 1.4 (0.8-2.5), and for users of traditional NSAIDs alone or in combination, 1.7 (1.3-2.3) and 1.6 (1.2-2.3). CONCLUSION: Current use of NSAIDs, including COX-2 inhibitors, is associated with a poor prognosis for patients hospitalized with peptic ulcer perforation.
PubMed ID
17026569 View in PubMed
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[Coarctation of the aorta: 40-year follow-up after surgical repair--secondary publication]

https://arctichealth.org/en/permalink/ahliterature89098
Source
Ugeskr Laeger. 2009 Apr 6;171(15):1266-8
Publication Type
Article
Date
Apr-6-2009
Author
Høimyr Hilde
Pedersen Thais A L
Christensen Thomas D
Emmertsen Kristian
Johnsen Søren P
Riis Anders
Hansen Ole Kromann
Hjortdal Vibeke E
Author Affiliation
Arhus Universitetshospital, Skejby, DK-8200 Arhus N.
Source
Ugeskr Laeger. 2009 Apr 6;171(15):1266-8
Date
Apr-6-2009
Language
Danish
Publication Type
Article
Keywords
Adolescent
Antihypertensive Agents - administration & dosage
Aortic Coarctation - mortality - surgery
Child
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Infant
Male
Prognosis
Reoperation
Survival Rate
Treatment Outcome
Young Adult
Abstract
Coarctation of the aorta (CoA) was previously considered cured after surgical repair. Among 229 patients operated for CoA in Aarhus between 1965 and 1985, 14 died at surgery and 35 died during 20-40 years of follow-up, mainly due to cardiovascular disease. The mortality among CoA patients was 4.3 times higher than in a control population. Among 178 survivors, 35 had been reoperated and another 11 had received medical treatment for heart disease. Antihypertensive drugs were used by 25% of the survivors. Thus, CoA is not cured by surgery and long term follow-up is necessary.
PubMed ID
19422155 View in PubMed
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Diabetes and 30-day mortality from peptic ulcer bleeding and perforation: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature82572
Source
Diabetes Care. 2006 Apr;29(4):805-10
Publication Type
Article
Date
Apr-2006
Author
Thomsen Reimar W
Riis Anders
Christensen Steffen
Nørgaard Mette
Sørensen Henrik T
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, DK-9100 Aalborg, Denmark. uxreth@aas.nja.dk
Source
Diabetes Care. 2006 Apr;29(4):805-10
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Complications - mortality
Female
Humans
Male
Middle Aged
Peptic Ulcer - complications - mortality
Peptic Ulcer Hemorrhage - mortality
Peptic Ulcer Perforation - mortality
Retrospective Studies
Abstract
OBJECTIVE: Diabetes may influence the outcome of complicated peptic ulcer disease, due to angiopathy, blurring of symptoms, and increased risk of sepsis. We examined whether diabetes increased 30-day mortality among Danish patients hospitalized with bleeding or perforated peptic ulcers. RESEARCH DESIGN AND METHODS: This population-based cohort study took place in the three Danish counties of North Jutland, Viborg, and Aarhus between 1991 and 2003. Patients hospitalized with a first-time diagnosis of peptic ulcer bleeding or perforation were identified using the counties' hospital discharge registries. Data on diabetes, other comorbidities, and use of ulcer-associated drugs were obtained from discharge registries and prescription databases. The Danish Civil Registry System allowed complete follow-up for mortality. The outcome under study was 30-day mortality in diabetic versus nondiabetic patients, adjusted for potential confounders. RESULTS: We identified 7,232 patients hospitalized for bleeding ulcers, of whom 731 (10.1%) had diabetes. The 30-day mortality among diabetic patients was 16.6 vs. 10.1% for other patients with bleeding ulcers. The adjusted 30-day mortality rate ratio (MRR) for diabetic patients was 1.40 (95% CI 1.15-1.70). We also identified 2,061 patients with perforated ulcers, of whom 140 (6.8%) had diabetes. The 30-day mortality among diabetic patients was 42.9 vs. 24.0% in other patients with perforated ulcers, corresponding to an adjusted 30-day MRR of 1.51 (1.15-1.98). CONCLUSIONS: Among patients with peptic ulcer bleeding and perforation, diabetes appears to be associated with substantially increased short-term mortality.
PubMed ID
16567819 View in PubMed
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Diabetes, glycemic control, and risk of hospitalization with pneumonia: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature86704
Source
Diabetes Care. 2008 Aug;31(8):1541-5
Publication Type
Article
Date
Aug-2008
Author
Kornum Jette B
Thomsen Reimar W
Riis Anders
Lervang Hans-Henrik
Schønheyder Henrik C
Sørensen Henrik T
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark. j.kornum@rn.dk
Source
Diabetes Care. 2008 Aug;31(8):1541-5
Date
Aug-2008
Language
English
Publication Type
Article
Abstract
OBJECTIVE: To examine whether diabetes is a risk factor for hospitalization with pneumonia and to assess the impact of A1C level on such risk. RESEARCH DESIGN AND METHODS: In this population-based, case-control study we identified patients with a first-time pneumonia-related hospitalization between 1997 and 2005, using health care databases in northern Denmark. For each case, 10 sex- and age-matched population control subjects were selected from Denmark's Civil Registration System. We used conditional logistic regression to compute relative risk (RR) for pneumonia-related hospitalization among subjects with and without diabetes, controlling for potential confounding factors. RESULTS: The study included 34,239 patients with a pneumonia-related hospitalization and 342,390 population control subjects. The adjusted RR for pneumonia-related hospitalization among subjects with diabetes was 1.26 (95% CI 1.21-1.31) compared with nondiabetic individuals. The adjusted RR was 4.43 (3.40-5.77) for subjects with type 1 diabetes and 1.23 (1.19-1.28) for subjects with type 2 diabetes. Diabetes duration >or=10 years increased the risk of a pneumonia-related hospitalization (1.37 [1.28-1.47]). Compared with subjects without diabetes, the adjusted RR was 1.22 (1.14-1.30) for diabetic subjects whose A1C level was or=9%. CONCLUSIONS: Type 1 and type 2 diabetes are risk factors for a pneumonia-related hospitalization. Poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization with pneumonia.
PubMed ID
18487479 View in PubMed
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Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry.

https://arctichealth.org/en/permalink/ahliterature84539
Source
Acta Orthop. 2007 Oct;78(5):622-8
Publication Type
Article
Date
Oct-2007
Author
Paulsen Aksel
Pedersen Alma B
Johnsen Søren P
Riis Anders
Lucht Ulf
Overgaard Søren
Author Affiliation
Department of Orthopaedic Surgery, Odense University Hospital, University of Southern Denmark, Denmark. akselpaulsen@gmail.com
Source
Acta Orthop. 2007 Oct;78(5):622-8
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Arthroplasty, Replacement, Hip - adverse effects - methods
Coated Materials, Biocompatible
Denmark
Female
Follow-Up Studies
Hip Prosthesis
Humans
Hydroxyapatites
Male
Middle Aged
Outcome Assessment (Health Care)
Prosthesis Design
Prosthesis Failure
Registries
Reoperation
Risk factors
Abstract
BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.2 years for stems. We estimated the relative risk (RR) of revision due to aseptic loosening or any cause, and adjusted for possible confounders (age, sex, fixation of opposite implant part, and diagnosis for primary THA) using multivariate Cox regression analysis. RESULTS: The adjusted RRs for revision of HA-coated cups and stems due to aseptic loosening were 0.89 (95%CI: 0.37-2.2) and 0.71 (95%CI: 0.27-1.9) with up to 9 years of follow-up, compared to non-HA-coated implants. When taking all causes of revision into consideration, the risk estimates were 0.85 (95%CI: 0.68-1.1) and 0.81 (95%CI: 0.61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.
PubMed ID
17966021 View in PubMed
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Perforated peptic ulcer and short-term mortality among tramadol users.

https://arctichealth.org/en/permalink/ahliterature86402
Source
Br J Clin Pharmacol. 2008 Apr;65(4):565-72
Publication Type
Article
Date
Apr-2008
Author
Tørring Marie L
Riis Anders
Christensen Steffen
Thomsen Reimar W
Jepsen Peter
Søndergaard Jens
Sørensen Henrik T
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, University of Aarhus, Aarhus, Denmark. mlt@alm.au.dk
Source
Br J Clin Pharmacol. 2008 Apr;65(4):565-72
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analgesics, Opioid - administration & dosage - adverse effects - immunology
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage - adverse effects
Denmark
Drug Administration Schedule
Duodenal Ulcer - chemically induced - mortality
Female
Humans
Male
Peptic Ulcer Perforation - chemically induced - mortality
Prognosis
Proportional Hazards Models
Stomach Ulcer - chemically induced - mortality
Survival Rate
Tramadol - administration & dosage - adverse effects - immunology
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a strong risk and prognostic factor for peptic ulcer perforation, and alternative analgesics are needed for high-risk patients. * Pain management guidelines propose tramadol as a treatment option for mild-to-moderate pain in patients at high risk of gastrointestinal side-effects, including peptic ulcer disease. * Tramadol may mask symptoms of peptic ulcer complications, yet tramadol's effect on peptic ulcer prognosis is unknown. WHAT THIS STUDY ADDS: * In this population-based study of 1271 patients hospitalized with peptic ulcer perforation, tramadol appeared to increase mortality at least as much as NSAIDs. * Among users of tramadol, alone or in combination with NSAIDs, adjusted 30-day mortality rate ratios were 2.02 [95% confidence interval (CI) 1.17, 3.48] and 1.32 (95% CI 0.89, 1.95), compared with patients who used neither tramadol nor NSAIDs. AIM: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown. The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. METHODS: The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993-2004 period, extracted from population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non-users, adjusting for use of other drugs and comorbidity. RESULTS: Of 1271 patients with perforated peptic ulcers included in the study, 2.4% used tramadol only, 38.9% used NSAIDs and 7.9% used both. Thirty-day mortality was 28.7% overall and 48.4% among users of tramadol alone. Compared with the 645 patients who used neither tramadol nor NSAIDs, the adjusted mortality rate in the 30 days following hospitalization was 2.02-fold [95% confidence interval (CI) 1.17, 3.48] higher for the 31 'tramadol only' users, 1.41-fold (95% CI 1.12, 1.78) higher for the 495 NSAID users and 1.32-fold (95% CI 0.89, 1.95) higher for the 100 patients who used both drugs. CONCLUSION: Among patients hospitalized for perforated peptic ulcer, tramadol appears to increase mortality at a level comparable to NSAIDs.
PubMed ID
17922882 View in PubMed
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Risk for hospital contact with infection in patients with splenectomy: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature94965
Source
Ann Intern Med. 2009 Oct 20;151(8):546-55
Publication Type
Article
Date
Oct-20-2009
Author
Thomsen Reimar W
Schoonen W Marieke
Farkas Dóra K
Riis Anders
Jacobsen Jacob
Fryzek Jon P
Sørensen Henrik Toft
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg Hospital Science and Innovation Centre, Søndre Skovvej 15, Aalborg, Denmark. r.thomsen@rn.dk
Source
Ann Intern Med. 2009 Oct 20;151(8):546-55
Date
Oct-20-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bacteremia - diagnosis - epidemiology - etiology
Child
Child, Preschool
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Hospitalization - statistics & numerical data
Humans
Infant
Infection - diagnosis - epidemiology - etiology
Male
Middle Aged
Pneumonia - diagnosis - epidemiology - etiology
Risk
Splenectomy - adverse effects
Time Factors
Young Adult
Abstract
BACKGROUND: Splenectomy has been associated with increased risk for infection. OBJECTIVE: To assess the magnitude and duration of risk for hospital contact with infection associated with splenectomy. DESIGN: Population-based cohort study. SETTING: Denmark. PATIENTS: All 3812 persons in Denmark who underwent splenectomy from 1996 to 2005. Splenectomized patients were matched to 3 comparison cohorts: the general population, appendectomized patients, and unsplenectomized patients with indications for splenectomy. MEASUREMENTS: Relative risks were assessed for hospital contact involving any infection, pneumonia, and microbiologically confirmed bacteremia among 3812 splenectomized patients and their matched comparisons, during different follow-up periods and after regression analysis for confounder adjustment. RESULTS: The adjusted relative risk for any hospital contact with infection was highest within 90 days of splenectomy: 10.2% vs. 0.6% among general population comparisons (adjusted odds ratio, 18.1 [95% CI, 14.8 to 22.1]) and 10.2% vs. 4.2% among appendectomized patients (adjusted odds ratio, 2.4 [CI, 2.1 to 2.8]). The hazard of infection was 4.6-fold (CI, 3.8 to 5.5) higher in splenectomized patients than in general population comparisons from 91 to 365 days after splenectomy and 2.5 times (CI, 2.2 to 2.8) higher more than 365 days after splenectomy. The risks were similar for pneumonia and were higher for bacteremia. Markedly increased risks were also found when compared with those of appendectomized patients. Modest increases in infection risk were seen with splenectomy matched-indication comparisons (adjusted 90-day odds ratio, 1.7 [CI, 1.5 to 2.1]; hazard ratios, 1.5 [CI, 1.2 to 1.8] from 91 to 365 days after splenectomy and 1.2 [CI, 1.1 to 1.4] beyond 365 days after splenectomy). Relative risks for infection were highest in patients who had splenectomy because of hematologic disorders. LIMITATION: Increased surveillance among splenectomized patients may have affected the findings. CONCLUSION: Splenectomy is associated with increased long-term risk for infections involving hospital contact.
Notes
SummaryForPatientsIn: Ann Intern Med. 2009 Oct 20;151(8):I4219841440
PubMed ID
19841456 View in PubMed
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Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature78037
Source
BMC Geriatr. 2007;7:8
Publication Type
Article
Date
2007
Author
Christensen Steffen
Riis Anders
Nørgaard Mette
Sørensen Henrik T
Thomsen Reimar W
Author Affiliation
Department of Clinical Epidemiology, Aalborg and Aarhus Hospital, Aarhus University Hospital, Denmark. sc@dce.au.dk
Source
BMC Geriatr. 2007;7:8
Date
2007
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Humans
Male
Peptic Ulcer Hemorrhage - complications - mortality
Peptic Ulcer Perforation - complications - mortality
Abstract
BACKGROUND: Mortality after perforated and bleeding peptic ulcer increases with age. Limited data exist on how the higher burden of comorbidity among elderly patients affects this association. We aimed to examine the association of age with short-term mortality after perforated and bleeding peptic ulcer and to determine the impact of comorbidity on this association. METHODS: In this population-based cohort study in three Danish counties between 1991 and 2003 we identified two cohorts of patients: those hospitalized with a first-time discharge diagnosis of perforated peptic ulcer and those with bleeding peptic ulcer. The diagnoses were ascertained from hospital discharge registries and mortality through the Danish Civil Registration System. Information on comorbidity and use of ulcer-related drugs was obtained through administrative medical databases. We computed age-, gender- and comorbidity-standardized 30-day mortality rates and used Cox's regression to estimate adjusted 30-day mortality rate ratios (MRR) for elderly compared with younger patients. RESULTS: Among 2,061 patients with perforated peptic ulcer, 743 (36%) were 65-79 years old and 513 patients (25%) were aged 80+ years. Standardized 30-day mortality was 8.9% among patients younger than 65 years rising to 44.6% among patients aged 80+ years, corresponding to an adjusted MRR of 5.3 (95% CI: 4.0-7.0). Among 7,232 patients with bleeding peptic ulcer 2,372 (33%) were aged 80+ years. Standardized 30-day mortality among patients younger than 65 was 4.3% compared with 16.9% among patients aged 80+ years, corresponding to an adjusted MRR of 3.7 (95% CI: 2.9-4.7). Analyses stratified by comorbidity consistently showed high MRRs among elderly patients, regardless of comorbidity level. CONCLUSION: Ageing is a strong predictor for a poor outcome after perforated and bleeding peptic ulcer independently of comorbidity.
PubMed ID
17439661 View in PubMed
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Short-term mortality in relation to age and comorbidity in older adults with community-acquired bacteremia: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature92571
Source
J Am Geriatr Soc. 2008 Sep;56(9):1593-600
Publication Type
Article
Date
Sep-2008
Author
Søgaard Mette
Schønheyder Henrik C
Riis Anders
Sørensen Henrik T
Nørgaard Mette
Author Affiliation
Department of Clinical Microbiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. mette.soegaard@rn.dk
Source
J Am Geriatr Soc. 2008 Sep;56(9):1593-600
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Bacteremia - mortality
Cohort Studies
Community-Acquired Infections - mortality
Comorbidity
Denmark
Escherichia coli Infections - mortality
Female
Health Surveys
Humans
Male
Marital status
Middle Aged
Pneumococcal Infections - mortality
Proportional Hazards Models
Pseudomonas Infections - mortality
Reference Values
Registries
Respiratory Tract Infections - mortality
Risk Assessment - statistics & numerical data
Staphylococcal Infections - mortality
Urinary Tract Infections - mortality
Young Adult
Abstract
OBJECTIVES: To assess 30-day mortality from bacteremia in relation to age and comorbidity and the association between age and mortality with increasing comorbidity. DESIGN: Population-based cohort study. SETTING: North Jutland County, Denmark. PARTICIPANTS: Adults in medical wards with community-acquired bacteremia, 1995 to 2004. MEASUREMENTS: Smoothed mortality curves and computed mortality rate ratios (MRRs) using Cox regression analysis. RESULTS: Two thousand eight hundred fifty-one patients, 851 aged 15 to 64, 1,092 aged 65 to 79, and 909 aged 80 and older were included. Mortality increased linearly with age. Compared with patients younger than 65, adjusted MRRs in patients aged 65 to 79 and 80 and older were 1.5 (95% confidence interval (CI)=1.2-2.0) and 1.8 (95% CI=1.4-2.3), respectively. Mortality also increased with level of comorbidity. Compared with patients with low comorbidity, adjusted MRRs in patients with medium and high comorbidity were 1.5 (95% CI=1.2-1.8) and 1.7 (95% CI=1.4-2.2), respectively. Regardless of the level of comorbidity, MRRs were consistently higher in older than in younger patients. CONCLUSION: Older age and greater comorbidity predicted mortality, and increasing age-related comorbidity did not explain the effect of age.
Notes
Comment In: J Am Geriatr Soc. 2008 Sep;56(9):1750-219166447
PubMed ID
18691276 View in PubMed
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11 records – page 1 of 2.