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Pedersen M, Rørth R, Andersen M, Sessa M, Polcwiartek C, Riddersholm S, Gislason G, Kristensen S, Andersen N, Køber L, Søgaard P, Torp-Pedersen C, Kragholm K. One-year incidence of depression, anxiety, or stress disorders following a first-time heart failure diagnosis: A Danish nationwide registry-based study. Am Heart J Plus 2023; 25:100240. [PMID: 38510497 PMCID: PMC10945984 DOI: 10.1016/j.ahjo.2022.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/14/2022] [Accepted: 12/06/2022] [Indexed: 03/22/2024]
Affiliation(s)
- M.W. Pedersen
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
| | - R. Rørth
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - M.P. Andersen
- Department of Clinical Research, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - M. Sessa
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - C. Polcwiartek
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
| | - S.J. Riddersholm
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
| | - G. Gislason
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hospitalsvej 1, 2900 Hellerup, Denmark
- The Danish Heart Foundation, Vognmagergade 7,3, 1120 Copenhagen K, Denmark
| | - S.L. Kristensen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - N.H. Andersen
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
| | - L. Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - P. Søgaard
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
| | - C. Torp-Pedersen
- Department of Clinical Research, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - K.H. Kragholm
- Department of Cardiology, Aalborg University Hospital, Hobrovej18-22, 9000 Aalborg, Denmark
- Unit of Clinical Biostatistics and Epidemiology, Aalborg University Hospital, Sdr. Skovvej 15, 9000 Aalborg, Denmark
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2
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Johansson I, Balasubramanian K, Bangdiwala S, Mielniczuk L, Hage C, Sharma SK, Branch K, Yonga G, Kragholm K, Sliwa K, Roy A, Stork S, McMurray JJV, Conen D, Yusuf S. Factors associated with health-related quality of life in heart failure in 23,000 patients from 40 countries: results of the global congestive heart failure research program. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Poor health-related quality of life (HRQL) is common in heart failure (HF) and strongly predicts death and HF hospitalization in all regions of the world. Understanding facors associated with HRQL could therefore lead to improved prognosis in HF patients. Despite that the majority of HF occurs in low- and middle-income countries, there are limited data characterizing self-perceived health HRQL and its correlates in these settings.
Purpose
To examine clinical and social correlates of HRQL in patients with HF from high- (HIC), upper middle- (UMIC), lower middle-(LMIC) and low-income (LIC) countries.
Methods
Between 2017 and 2020, we enrolled 23,292 patients with HF (32% inpatients, 61% men) from 40 countries in the Global Congestive Heart Failure Study. We recorded HRQL at baseline using Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0–100, higher=better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimates expressed as β-coefficients) of KCCQ-12-SS with sociodemographic-, comorbidity-, treatment- and symptom-covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. We used partial R2-estimates to understand the contribution to the variability in KCCQ-12-SS of 4 different groups of covariates. (sociodemographic, comorbidities, treatments and signs and symptoms of congestion).
Results
Mean age was 63 years and 40% were in NYHA class III–IV. Average HRQL was 55± SD 0.5. It was 62.5 (95% CI 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p<0.0001). Strong correlates (β-coefficient [95% CI]) of KCCQ-12-SS were NYHA class III vs class I/II (−12.1 [−12.8 to −11.4] and class IV vs. class I/II (−16.5 [−17.7 to −15.3]), effort dyspnea (−9.5 [−10.2 to −8.8]) and living in LIC vs. HIC (−5.8 [−7.1 to −4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R2=0.32 of total adjusted R2=0.51), followed by sociodemographic factors (R2=0.12). Results were consistent in populations across income levels.
Conclusion
The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country-income level. Improved symptom control may have a big impact on HRQL, especially in LICs.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer AG
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Affiliation(s)
- I Johansson
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - K Balasubramanian
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - S Bangdiwala
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - L Mielniczuk
- Ottawa Heart Institute, Division of Cardiology , Ottawa , Canada
| | - C Hage
- Karolinska Institute, Cardiology Unit, Department of Medicine K2 , Stockholm , Sweden
| | - S K Sharma
- B P Koirala Institute of Health Sciences , Dharan , Nepal
| | - K Branch
- University of Washington Medical Center, Division of Cardiology , Seattle , United States of America
| | - G Yonga
- University of Nairobi , Nairobi , Kenya
| | - K Kragholm
- Aalborg University Hospital , Aalborg , Denmark
| | - K Sliwa
- University of Cape Town, Department of Medicine and Cardiology , Cape Town , South Africa
| | - A Roy
- All India Institute of Medical Sciences (AIIMS), Department of Cardiology , New Delhi , India
| | - S Stork
- Comprehensive Heart Failure Center (CHFC) , Wurzburg , Germany
| | - J J V McMurray
- BHF Glasgow Cardiovascular Research Centre , Glasgow , United Kingdom
| | - D Conen
- Population Health Research Institute, McMaster University , Hamilton , Canada
| | - S Yusuf
- Population Health Research Institute, McMaster University , Hamilton , Canada
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3
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Dam Lauridsen M, Rorth R, Butt JH, Schmidt M, Kristensen SL, Kragholm K, Johnsen SP, Moller JE, Hassager C, Kober LV, Fosbol EL. Home care provision and nursing home admission after myocardial infarction in relation to cardiogenic shock and out-of-hospital cardiac arrest status. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Autonomy is of great importance for quality of life. There is a paucity of data on autonomy for those who survive myocardial infarction (MI) with and without cardiogenic shock (CS) and out-of-hospital arrest (OHCA).
Purpose
To examine the association between CS, OHCA, and need for home care provision or nursing home admission as a proxy for impaired autonomy in a first-time MI population.
Methods
Danish nationwide registries were used to identify patients with first-time MI (2009–2019), who prior to the event were living at home without home care and discharged alive. The patients were stratified according to CS and OHCA status. We report 1-year cumulative incidence of a composite outcome of home care provision or nursing home admission with competing risk of death and as a secondary outcome all-cause mortality. Cause specific Cox regression models were used to estimate adjusted hazard ratios (HR) with patients without CS or OHCA as reference.
Results
We identified 61,451 patients in the period with MI (by groups: −OHCA/−CS: 59,316, −OHCA/+CS: 1,597, +OHCA/−CS: 913, and +OHCA/+CS: 669). The 1-year cumulative incidences of home care/nursing home were 6.9% for patients with −OHCA/−CS, 21.1% for −OHCA/+CS, 5.2% for +OHCA/−CS, and 8.1% for those with +OHCA/+CS. With the −OHCA/−CS as reference, the adjusted HRs for home care/nursing home were 3.12 (95% CI: 2.78–3.49) for patients with −OHCA/+CS, 1.27 (95% CI: 0.95–1.70) for +OHCA/−CS, and 2.31 (95% CI: 1.76–3.03) for +OHCA/+CS (Figure). The 1-year cumulative incidences of mortality were 4.8% for patients with −OHCA/−CS, 10.0% for −OHCA/+CS, 2.8% for +OHCA/−CS, and 3.7% for those with +OHCA/+CS (adjusted HRs: 2.81 (95% CI: 2.55–3.10), 1.09 (95% CI: 0.85–1.39) and 1.81 (95% CI: 1.42–2.30) (Figure 1).
Conclusion
In a selected cohort of patients with MI, without previous need for home care/nursing home and surviving until discharge date, patients with CS were independent of OHCA status associated with less autonomy after discharge with a more than two-fold higher 1-year incidence of home care provision or nursing home admission. Further, patients with CS were associated with a two-fold higher 1-year mortality compared with MI patients without CS independent of OHCA status.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): The work was supported by Rigshospitalets Research Foundation, Master cabinetmaker Sophus Jacobsen and Wife Astrid Jacobsen Foundation, and Director Jacob Madsen and Wife Olga Madsens Foundation. The funding source had no role in the design, conduct, analysis, or reporting of the study.
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Affiliation(s)
- M Dam Lauridsen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - R Rorth
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - J H Butt
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - M Schmidt
- Aarhus University Hospital, Department of Clinical Epidemiology , Aarhus , Denmark
| | - S L Kristensen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology , Aalborg , Denmark
| | - S P Johnsen
- Aalborg University, Danish Center for Clinical Health Services Research, Department of Clinical Medicine , Aalborg , Denmark
| | - J E Moller
- Odense University Hospital , Odense , Denmark
| | - C Hassager
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L V Kober
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - E L Fosbol
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
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Byrne C, Barcella C, Krogager ML, Pareek M, Ringgren KB, Wissenberg M, Folke F, Gislason G, Kober L, Lippert F, Kjaergaard J, Hassager C, Torp-Pedersen C, Lip GYH, Kragholm K. External validation of the simple NULL-PLEASE clinical score in predicting outcomes in men and women with out-of-hospital cardiac arrest. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The NULL-PLEASE score (Nonshockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/L, End-stage renal disease on dialysis, Age ≥85 years, Still resuscitation, and Extracardiac cause) was developed to help identify patients with out-of-hospital cardiac arrest (OHCA) who are unlikely to survive. Although survival after OHCA differs between sexes, the performance of the NULL-PLEASE score according to sex has not been tested previously.
Purpose
To validate the NULL-PLEASE score separately in men and women in a nationwide setting.
Methods
Using Danish nationwide registry data from 2001–2019, we retrospectively identified male and female OHCA survivors with return of spontaneous circulation (ROSC) or ongoing cardiopulmonary resuscitation at hospital arrival. The primary outcome was 1-day mortality. Secondary outcomes were defined as 30-day mortality and the combination of 1-year mortality or anoxic brain damage. Logistic regression with a NULL-PLEASE score of 0 as reference was used for outcome risk estimation. The predictive ability of the score was assessed using area under the receiver operating characteristics (AUCROC) curves.
Results
A total of 2,601 men (median age 67 years (interquartile range (IQR) 56–76 years), and 1,280 women (median age 69 years (IQR 58–79 years) were included. One-day mortality was 31% in men and 42% in women; 30-day mortality was 56% and 71% in men and women, respectively; and 63% of men and 78% of women experienced the combined outcome. For patients with a NULL-PLEASE score ≥9, absolute risks were: 1-day mortality: 82.0% (95% confidence interval [CI]: 75.6–88.4%) for men and 79.1% (95% CI: 71.3–86.8%) for women; 30-day mortality: 98.6% (95% CI: 96.6–100.0) for men and 97.1% (95% CI: 94.0–100.0%) for women; and the combined outcome: 99.3% (95% CI: 97.9–100.0%) for men and 97.1% (95% CI: 94.0–100.0%) for women. AUCROC values for 1-day mortality were 0.827 (95% CI: 0.811–0.844) for men and 0.736 (95% CI: 0.710–0.763) for women. Results were similar for 30-day mortality and for the combined outcome. ROC curves for all outcomes are shown in Figure 1 (men) and Figure 2 (women). For a NULL-PLEASE score cut-point ≥3 to predict 1-day mortality, the positive predictive value was 91.8% in men and 91.1% in women, with a sensitivity of detecting patients who die of 47.3% in men and 51.8% in women. The corresponding negative predictive value for surviving more than 1 day was 54.6% in men and 37.7% in women, and the specificity of detecting patients who survive was 93.7% in men and 85.3% in women.
Conclusions
In a nationwide OHCA-cohort, the NULL-PLEASE score consistently appeared to perform better in men than in women for all outcomes. Nevertheless, its predictive ability was high among both sexes. Sex-specific differences should not be overlooked in clinical decision-making in patients surviving OHCA.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Danish Heart FoundationThe Danish Foundation TrygFonden
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Affiliation(s)
- C Byrne
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - C Barcella
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | | | - M Pareek
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | | | - M Wissenberg
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | - F Folke
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | - G Gislason
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - F Lippert
- University of Copenhagen , Copenhagen , Denmark
| | - J Kjaergaard
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - C Hassager
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - G Y H Lip
- Liverpool Heart and Chest Hospital , Liverpool , United Kingdom
| | - K Kragholm
- Aalborg University Hospital , Aalborg , Denmark
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Frydenlund J, Valentin J, Norredam M, Riahi S, Kragholm K, Boggild H, Johnsen S. Incidence in atrial fibrillation in Denmark in relation to country of origin: a nationwide register-based study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Immigrants' healthcare needs can be a considerable challenge, as their risk profile can differ from the native population, and they may experience barriers to accessing health services in recipient countries. Immigration is projected to increase further due to conflicts and climate changes, and awareness on immigrants' health status is therefore warranted. Atrial fibrillation (AF) is the most common sustained arrhythmia with an estimated prevalence of approximately 2%. However, there is a paucity of data on AF epidemiology among immigrants.
Purpose
The aim of this study is to examine incidence of AF hospital diagnoses according to country of origin and to study if there is a difference in risk between immigrants and Danish born individuals.
Methods
The study period included 1st of January 1998 to 31st of December 2017 and the population consisted of all Danish citizens aged 45 or older. We included individuals as they turned 45 during the study period. Individuals who had been diagnosed with AF were excluded. Data was obtained from the Danish National Patient Registry and the Civil Registration System. Country of origin was based on the ten most represented counties in the population. Immigrants were defined as people born outside Denmark with none of the parents being both Danish citizens and born in Denmark. AF was defined as a hospital diagnosis according to international Classification of Diseases (ICD) version 8 and 10. Poisson regression were used to compute relative risk (RR) and associated 95% confidence intervals (CI). RRs were adjusted for sex, age, socioeconomic status, visits to general practitioner and comorbidity.
Results
The study population consist of 3,596,234 Danish-Born and 215,401 immigrants. A total of 334,636 had an incident AF diagnosis during the study period. Compared to Danish-born individuals, migrants from the Nordic countries had a higher adjusted RR of being diagnosed with AF: Norway 1.21 [95% CI: 1.05; 1.40], Sweden 1.16 [95% CI: 0.99; 1.35] and Germany 1.17 [95% CI: 1.06; 1.28]. In contrast, lower adjusted RRs were observed for individuals from Poland (0.82 [95% CI: 0.67; 1.01]), UK (0.89 [95% CI: 0.73; 1.08]), and the US (0.95 [95% CI: 0.72; 1.25]), respectively, and in particular for individuals from the non-Western countries: Turkey (0.49 [95% CI: 0.40; 0.59], Iran (0.48 [95% CI: 0.36; 0.65]), Iraq (0.32 [95% CI: 0.22; 0.45] and Bosnia-Herzegovina (0.63 [95% CI: 0.49; 0.79]).
Conclusion
Substantial variation in the incidence rate of incident AF hospital diagnoses according to country of origin. Further studies are warranted in order to clarify to what extent these differences reflets true differences in AF incidence or ethnic inequalities in the detection of AF in the health care system.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Karen Elise Jensen Foundation
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Affiliation(s)
- J Frydenlund
- Aalborg University, Department of Clinical Medicine , Aalborg , Denmark
| | - J Valentin
- Aalborg University, Department of Clinical Medicine , Aalborg , Denmark
| | - M Norredam
- Copenhagen University Hospital, Department of Public Health , Copenhagen , Denmark
| | - S Riahi
- Aalborg University Hospital , Aalborg , Denmark
| | - K Kragholm
- Aalborg University Hospital , Aalborg , Denmark
| | - H Boggild
- Aalborg University, Department of Health Science and Technology , Aalborg , Denmark
| | - S Johnsen
- Aalborg University, Department of Clinical Medicine , Aalborg , Denmark
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Sorensen E, Moller A, Lippert F, Kober L, Kragholm K, Folke F, Blomberg S, Christensen H, Torp-Pedersen C, Bang C. Patient reported symptoms in emergency health care service in patients with complete atrioventricular block. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
To examine initial symptoms in emergency and medical helpline calls of patients prior to hospital admission and pacemaker implantation due to recent onset of complete atrioventricular block.
Methods
In the capital region of Denmark, Copenhagen, citizens who require medical assistance can contact either the regional 24h non-urgent medical helpline 1813 or the emergency number 1–1-2 (equivalent to 9–1–1). In both services, the symptoms/purposes of the calls are registered by health professionals. We identified calls from patients who received a pacemaker due to recent onset complete AV block. Prior to analysis, symptoms were categorized as fainting, dizziness, other CNS symptoms, chest pain, other cardiac symptoms, breathing problems, trauma/exposure, unconsciousness, unclear problems, and other atypical symptoms.
Results
We identified 451 calls (261 emergency calls and 190 non-emergency calls) which included information on symptom presentation prior to hospital admission due to first time diagnosis of complete atrioventricular block, that resulted in pacemaker implantation (Figure). Typical symptoms such as fainting and dizziness accounted for only 12.6% (57/451) and 13.3% (60/451), respectively. Chest pain (13.6%, 61/451) and other cardiac symptoms (5.3%, 24/451) accounted for roughly one in five patient complaints. Across both service types, patients >80 years (median age) was more likely to call for help due to trauma/exposure, while complaints of fainting trended towards younger patients and the 1-1-2 emergency number. Median time from first call to pacemaker implantation was 2–3 days for fainting, dizziness, and chest pain, compared to 6–8 days for other CNS symptoms and other atypical symptoms (Table).
Conclusion
Typical symptoms such as fainting and dizziness accounted for only 13% in patients with complete atrioventricular block. Instead, these patients presented with a wide variety of initial symptoms, including chest pain, breathing problems, unclear problems, or trauma. Finally, symptom presentation seemed to affect the time to pacemaker implantation.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Danish Heart Foundation
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Affiliation(s)
- E Sorensen
- Bispebjerg University Hospital, Cardiology , Copenhagen , Denmark
| | - A Moller
- Hillerod Hospital , Hillerod , Denmark
| | - F Lippert
- University of Copenhagen, Copenhagen Emergency Medical Services , Copenhagen , Denmark
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Heart Centre, Department of Cardiology , Copenhagen , Denmark
| | - K Kragholm
- Aalborg University Hospital, Cardiology , Aalborg , Denmark
| | - F Folke
- Herlev-Gentofte University Hospital, Cardiology , Gentofte , Denmark
| | - S Blomberg
- University of Copenhagen, Copenhagen Emergency Medical Services , Copenhagen , Denmark
| | - H Christensen
- University of Copenhagen, Copenhagen Emergency Medical Services , Copenhagen , Denmark
| | | | - C Bang
- Bispebjerg University Hospital, Cardiology , Copenhagen , Denmark
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Gundlund A, Koeber L, Hoefsten DE, Vester-Andersen M, Pedersen MW, Torp-Pedersen C, Kragholm K, Soegaard P, Fosboel EL. Rehospitalizations, repeated aortic surgery, and death in initial survivors of surgery for Stanford type A aortic dissection and the significance of age – a nationwide registry-based cohort study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
All patients with type A aortic dissections, regardless of age, are recommended urgent aortic surgery. However, studies exploring long term outcomes in survivors are sparse, and especially, the significance of age on long-term outcomes remain unclear.
Purpose
We described and compared incidences across age groups of post-discharge readmission, repeated aortic surgery, and death in patients who survived surgery and hospitalization for type A aortic dissection.
Methods
Using data from Danish nationwide registries, we identified patients hospitalized with Stanford type A aortic dissections from 2006–2018. Survivors of hospitalization and surgery on the ascending aorta and/or aortic arch comprised the study population (Figure 1). Using cumulative incidence plots taking death into account as a competing risk and Cox regression analysis, we described long-term outcomes (rehospitalizations, repeated aortic surgery, and death) and compared different age groups. The diagnosis of type A aortic dissection in the registries used, was validated from 191 clinical records to have a positive predictive value of 94.8%.
Results
Of 606 initial survivors of surgery and hospitalization with type A aortic dissection, 236 (38.9%) were <60 years old (group I), 194 (32.0%) were 60–69 years old (group II), and 176 (29.1%) were >69 years old (group III). Figure 2 shows cumulative incidences of outcomes according to age. During the first year, 62.5% were re-hospitalized (median number of days hospitalized was 2 days (IQR 1–8 days) and 1.4% underwent repeated aortic surgery with no significant differences across age groups (P=0.68 and P=0.39, respectively). Further, 5.9% died (group I: 3.0%, group II: 8.3%, group III: 7.4%, P=0.04). After 10 years of follow up, 8.0% had undergone repeated aortic surgery (group I: 11.5%, group II: 8.5%, group III: 1.6%, P=0.04) and 10.2% (group I), 17.0% (group II), and 22.2% (group III) had died (P=0.01). In adjusted analyses, no age differences were found in one-year outcomes, while age >69 years (group III) compared with age <60 years (group I) was associated with a lower rate of repeated aortic surgery (hazard ratio 0.17, 95% confidence interval 0.04–0.78) and a higher rate of all-cause mortality (hazard ratio 2.44, 95% confidence interval 1.37–4.34) in the 10-years analysis.
Conclusion
Among survivors of type A aortic dissections, rehospitalizations the first year after discharge were common among all age groups, but survival was high. Repeated aortic surgery was rare, and significantly more common among younger than older patients. Evaluations of quality of life in survivors of type A aortic dissections are needed.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Gundlund
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - D E Hoefsten
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - M Vester-Andersen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - M W Pedersen
- Aalborg University Hospital, Department of cardiology , Aalborg , Denmark
| | - C Torp-Pedersen
- Nordsjaellands Hospital, Department of cardiology , Hilleroed , Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of cardiology , Aalborg , Denmark
| | - P Soegaard
- Aalborg University Hospital, Department of cardiology , Aalborg , Denmark
| | - E L Fosboel
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
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Storgaard Noerskov A, Lykkemark Moeller A, Torp-Pedersen C, Folke F, Collatz Christensen H, Blomberg SN, Kragholm K, Loenborg J, Dominguez H, Bang C. Opioid administered prior to onset of myocardial infarction is associated with atypical symptoms of acute coronary ischemia in emergency calls. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acute identification and treatment of myocardial infarction (MI) is crucial for survival. MI symptom presentation is typically characterized by chest pain. Regular use of opioids to relief pain of chronic diseases is common. However, it has not been investigated whether opioid administered prior to onset of MI is associated more with atypical presentation of ischemia compared to non-opioid users.
Purpose
To investigate if opioid therapy is associated with atypical symptoms of MI.
Methods
The study is registry-based. MI is defined as patients with the ICD-10 discharge diagnoses I20.0 and I21 as primary diagnosis <24 hours after a call to the Capital Emergency Medical Services, including the Emergency Number (1–1-2) and Out-of-hours Service (OOHS). MI patients with opioid treatment prior to onset of MI are compared with a control group of MI patients without opioid treatment. The primary symptom of MI is registered in calls to the Capital Emergency Medical Services, from 2014 to 2018. Opioid treatment includes opioid prescribed and picked up <30 days prior to onset of MI.
Results
In total, 866 MI patients with opioid treatment and 10,061 MI patients without opioid treatment were included. The median age was 72.0 vs 67.8 years, 50.5% vs 34.5% were women, 61.0% vs 54.7% called the Emergency Number (1–1-2), ischemic heart disease was present in 48.5% vs 34.3% and type 2 diabetes in 23.1% vs. 16.2%. Atypical symptoms of MI were associated with opioid treatment and most prevalent in calls to OOHS, in women and by higher age. Acute symptoms of MI are visualized in Figure 1 and 2.
Conclusion
Opioid treatment prior to onset of MI was associated with increased atypical symptoms of MI, especially dyspnea, and increased in calls to the OOHS, in women and by higher age. This might challenge the clinician in early diagnose of MI in patients with opioid treatment and thereby delay acute lifesaving treatment.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation
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Affiliation(s)
| | | | | | - F Folke
- Herlev-Gentofte University Hospital , Gentofte , Denmark
| | | | - S N Blomberg
- Copenhagen Emergency Medical Services , Copenhagen , Denmark
| | - K Kragholm
- Aalborg University Hospital , Aalborg , Denmark
| | - J Loenborg
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - C Bang
- Bispebjerg Hospital , Copenhagen , Denmark
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9
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Jacobsen PA, Kragholm K, Andersen MP, Lindgren FL, Ringgren KB, Torp-Pedersen C, Weinreich UM. Voluntary early retirement and mortality in patients with and without chronic diseases: a nationwide Danish Registry study. Public Health 2022; 211:114-121. [PMID: 36088807 DOI: 10.1016/j.puhe.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/26/2022] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE This study explores how the choice of voluntary early retirement (VER) affects mortality in a population where VER is available 5 years before regular retirement age. STUDY DESIGN This retrospective cohort study uses a registry-based follow-up design with access to Nationwide Danish Registry Data. METHODS The study includes all Danish individuals who between 2000 and 2015 were part of an unemployment insurance fund and working at the time of their 60th (P60) or 62nd (P62) birthday. Those alive 1 year from their 60th or 62nd birthday were included in the mortality analysis. Individuals were registered as VER recipients if they chose the benefit within 1 year from P60 or P62. Three-year mortality likelihood following the first year from inclusion was explored for both cohorts separately. Multiple subgroups were explored in the mortality analysis, including individuals with chronic obstructive pulmonary disease (COPD), heart failure, and diabetes. RESULTS P60 included 627,278 individuals, and VER was chosen by 22.5%. P62 included 379,196 individuals, and VER was chosen by 33.4%. The likelihood of VER in the P60 was lower in healthy individuals (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88) and higher in COPD (OR 1.15, CI 1.07-1.22) and heart failure patients (OR 1.15, CI 1.05-1.25). Three-year mortality was significantly higher in those choosing VER in P60 (OR 1.28, CI 1.22-1.34), which was also found for all health subgroups (healthy, OR 1.18, CI 1.07-1.30; COPD, OR 1.55, CI 1.16-2.07; heart failure, OR 1.42, CI 1.02-1.98; diabetes, OR 1.36, CI 1.12-1.65). The increased mortality risk was not found in the P62 cohort. CONCLUSION The choice of VER is more likely in patients with COPD and heart failure. VER in the P60 cohort is associated with an increased mortality likelihood, which was not found in the P62 cohort, which may be explained by health selection bias.
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Affiliation(s)
- P A Jacobsen
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark.
| | - K Kragholm
- The Clinical Institute, Aalborg University, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - M P Andersen
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | - F L Lindgren
- The Clinical Institute, Aalborg University, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - K B Ringgren
- The Clinical Institute, Aalborg University, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - C Torp-Pedersen
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | - U M Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark
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10
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Jacobsen PA, Andersen MP, Gislason G, Phelps M, Butt JH, Køber L, Schou M, Fosbøl E, Christensen HC, Torp-Pedersen C, Gerds T, Weinreich UM, Kragholm K. Return to work after COVID-19 infection - A Danish nationwide registry study. Public Health 2022; 203:116-122. [PMID: 35038630 PMCID: PMC8786635 DOI: 10.1016/j.puhe.2021.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/05/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to explore return to work after COVID-19 and how disease severity affects this. STUDY DESIGN This is a Nationwide Danish registry-based cohort study using a retrospective follow-up design. METHODS Patients with a first-time positive SARS-CoV-2 polymerase chain reaction test between 1 January 2020 and 30 May 2020, including 18-64 years old, 30-day survivors, and available to the workforce at the time of the first positive test were included. Admission types (i.e. no admission, admission to non-intensive care unit [ICU] department and admission to ICU) and return to work was investigated using Cox regression standardised to the age, sex, comorbidity and education-level distribution of all included subjects with estimates at 3 months from positive test displayed. RESULTS Among the 7466 patients included in the study, 81.9% (6119/7466) and 98.4% (7344/7466) returned to work within 4 weeks and 6 months, respectively, with 1.5% (109/7466) not returning. Of the patients admitted, 72.1% (627/870) and 92.6% (805/870) returned 1 month and 6 months after admission to the hospital, with 6.6% (58/870) not returning within 6 months. Of patients admitted to the ICU, 36% (9/25) did not return within 6 months. Patients with an admission had a lower chance of return to work 3 months from positive test (relative risk [RR] 0.95, 95% confidence interval [CI] 0.94-0.96), with the lowest chance in patients admitted to an ICU department (RR 0.54, 95% CI 0.35-0.72). Female sex, older age, and comorbidity were associated with a lower chance of returning to work. CONCLUSION Hospitalised patients with COVID-19 infection have a lower chance of returning to work with potential implications for postinfection follow-up and rehabilitation.
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Affiliation(s)
- P A Jacobsen
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark.
| | - M P Andersen
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | - G Gislason
- Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark
| | - M Phelps
- The Danish Heart Foundation, Copenhagen, Denmark
| | - J H Butt
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - L Køber
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - M Schou
- Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Copenhagen, Denmark
| | - E Fosbøl
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | | | - C Torp-Pedersen
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - T Gerds
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - U M Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark
| | - K Kragholm
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
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11
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Yonis H, Winkel B, Andersen MP, Wissenberg M, Kober L, Gislason G, Larsen JM, Folke F, Pedersen CT, Sogaard P, Kragholm K. Duration of resuscitation efforts and long-term prognosis following in-hospital cardiac arrest (IHCA). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The decision to terminate resuscitation efforts can be challenging. Notably, the association between duration of resuscitation and long-term survival and functional outcomes after in-hospital cardiac arrest (IHCA) is unknown.
Purpose
To examine 30-day and 1-year survival stratified by duration of resuscitation efforts. Further, to report long term outcome (1-year survival) without anoxic brain damage or nursing home admission among 30-day IHCA survivors.
Methods
We included all patients with IHCA from 13 Danish hospitals between January 1st, 2013 to December 31st, 2015. Patients were only included if there was clinical indication for a resuscitation attempt. Data on IHCA was obtained from the DANARREST database, which was linked to national registries to retrieve information on patient characteristics, survival, anoxic brain damage and nursing home admission. Patients were stratified into four groups (A-D) according to quartiles of duration of resuscitation efforts: Group A (<5 minutes), group B (5–11 minutes), group C (12–20 minutes) and group D (≥21 minutes).
Using multivariable regression analysis, outcomes were standardized for patient age, sex, Charlson Comorbidity Index, witnessed arrest, monitored arrest, cardiopulmonary resuscitation (CPR) prior to arrival of the in-hospital cardiac arrest team and defibrillation.
Results
The study population comprised of 1868 patients, median age was 74 (1st-3rd quartile [Q1-Q3] 65–81 years) and 65.0% were men. In total, 52.1% (n=973) of the patients achieved return of spontaneous circulation (ROSC). The overall median duration of resuscitation was 12 min (Q1-Q3 5–21 min).
The standardized absolute chance of 30-day survival was 63.6% (95% CI 58.0%-69.0%) for group A, 34.0% (95% CI 29.7%-38.2%) for group B, 14.1% (95% CI 10.7%-17.5%) for group C and 9.0% (95% CI 6.8%-11.8%) for group D. Similarly, the chance of 1-year survival was highest for group A (51.5%; 95% CI 46.3%-56.7%) gradually decreasing to 7.0% (95% CI 4.5%-9.5%) in group D (Fig. 1).
Among 30-day survivors of an IHCA, the standardized absolute chance of survival without anoxic brain damage or nursing home admission within one-year post-arrest was highest for patients resuscitated in group A (83.2%; 95% CI 78.4%-88.1%), decreasing to 72.3% (95% CI 64.5%-80.0%) in group B, 68.3% (95% CI 55.3%-81.2%) in group C and 71.1% (95% CI 54.2%-88.0%) in group D (Fig. 2).
Conclusion
Short time to ROSC after in-hospital cardiac arrest is associated with better long-term prognosis. However, the majority of 30-day survivors are alive 1-year post-arrest without anoxic brain damage and without need for nursing home admission despite prolonged resuscitation.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- H Yonis
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - B Winkel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Heart Center, Copenhagen, Denmark
| | - M P Andersen
- Nordsjællands Hospital, Department of Cardiology, Hillerød, Denmark
| | - M Wissenberg
- Copenhagen University Hospital, Department of Cardiology, Herlev and Gentofte, Denmark
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Heart Center, Copenhagen, Denmark
| | - G Gislason
- Copenhagen University Hospital, Department of Cardiology, Herlev and Gentofte, Denmark
| | - J M Larsen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - F Folke
- Copenhagen University Hospital, Department of Cardiology, Herlev and Gentofte, Denmark
| | - C T Pedersen
- Nordsjællands Hospital, Department of Cardiology, Hillerød, Denmark
| | - P Sogaard
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
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12
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Gnesin F, Moeller A, Mills E, Zylyftari N, Jensen B, Boeggild H, Ringgren K, Kragholm K, Lippert F, Folke F, Gislason G, Torp-Pedersen C. Rapid recognition of out-of-hospital cardiac arrest by emergency medical dispatchers is associated with improved survival. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Emergency medical dispatchers' (EMD) recognition of out-of-hospital cardiac arrest (OHCA) is an essential part of the first link in the Chain of Survival. However, it is unknown whether the time-to-recognition of OHCA by EMD during an emergency call is associated with survival.
Purpose
To investigate the effect of time-to-recognition on 30-day survival among patients with recognised OHCA.
Methods
We linked data on OHCAs occurring in the Capital Region of Denmark from 2016 through 2017 to records of corresponding emergency calls. We defined recognition as dispatching an ambulance with an appropriate priority level and subsequently defined time-to-recognition as the time from start of the call to the time of dispatching the ambulance. Among patients with recognised OHCA, we performed uni- and multivariate logistic regression to investigate the association of time-to-recognition and 30-day survival and reported odds ratios (OR) with 95% confidence intervals (CI).
Results
Among 2,382 patients with OHCA, 94.2% were recognised, in which median age was 73.6 years, 61.6% were males and median time-to-recognition was 0.8 minutes (interquartile range 0.7 minutes). Patients for whom time-to-recognition was up to (but not including) one minute had more than three-fold higher probability of surviving 30 days (15.5%) compared to patients for whom time-to-recognition was three or more minutes (4.5%) (Figure 1). Time-to-recognition was significantly associated with 30-day survival: OR 0.75 per minute (95% CI 0.62–0.91, P<0.005), and results were similar in the adjusted analysis: OR 0.72 per minute (95% CI 0.58–0.90, P<0.005).
Conclusion
Rapid recognition of OHCA by EMD resulted in improved survival rate of patients. This was particularly evident when time-to-recognition was three or more minutes.
Figure 1
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Hjerteforeningen
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Affiliation(s)
- F Gnesin
- Nordsjaellands Hospital, Hilleroed, Denmark
| | | | - E.H.A Mills
- Aalborg University Hospital, Aalborg, Denmark
| | - N Zylyftari
- Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - B Jensen
- Aalborg University, Aalborg, Denmark
| | | | | | - K Kragholm
- Aalborg University Hospital, Aalborg, Denmark
| | - F Lippert
- University of Copenhagen, Copenhagen, Denmark
| | - F Folke
- University of Copenhagen, Copenhagen, Denmark
| | - G Gislason
- Herlev and Gentofte Hospital, Copenhagen, Denmark
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13
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Lauridsen MD, Butt JH, Østergaard L, Møller JE, Hassager C, Gerds T, Kragholm K, Phelps M, Schou M, Torp-Pedersen C, Gislason G, Køber L, Fosbøl EL. Incidence of acute myocardial infarction-related cardiogenic shock during corona virus disease 19 (COVID-19) pandemic. Int J Cardiol Heart Vasc 2020; 31:100659. [PMID: 33072848 PMCID: PMC7553065 DOI: 10.1016/j.ijcha.2020.100659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/03/2020] [Indexed: 12/13/2022]
Abstract
Aims The hospitalization of patients with MI has decreased during global lockdown due to the COVID-19 pandemic. Whether this decrease is associated with more severe MI, e.g. MI-CS, is unknown. We aimed to examine the association of Corona virus disease (COVID-19) pandemic and incidence of acute myocardial infarction with cardiogenic shock (MI-CS). Methods On March 11, 2020, the Danish government announced national lock-down. Using Danish nationwide registries, we identified patients hospitalized with MI-CS. Incidence rates (IR) and incidence rate ratios (IRR) were used to compare MI-CS before and after March 11 in 2015–2019 and in 2020. Results We identified 11,769 patients with MI of whom 696 (5.9%) had cardiogenic shock in 2015–2019. In 2020, 2132 MI patients were identified of whom 119 had cardiogenic shock (5.6%). The IR per 100,000 person years before March 11 in 2015–2019 was 9.2 (95% CI: 8.3–10.2) and after 8.9 (95% CI: 8.0–9.9). In 2020, the IR was 7.5 (95% CI: 5.8–9.7) before March 11 and 7.7 (95% CI: 6.0–9.9) after. The IRRs comparing the 2020-period with the 2015–2019 period before and after March 11 (lockdown) were 0.81 (95% CI: 0.59–1.12) and 0.87 (95% CI: 0.57–1.32), respectively. The IRR comparing the 2020-period during and before lockdown was 1.02 (95% CI: 0.74–1.41). No difference in 7-day mortality or in-hospital management was observed between study periods. Conclusion We could not identify a significant association of the national lockdown on the incidence of MI-CS, along with similar in-hospital management and mortality in patients with MI-CS.
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Key Words
- CABG, Coronary artery bypass grafting
- CAG, Coronary angiography
- COVID-19
- COVID-19, Corona Virus disease
- Cardiogenic shock
- Corona virus
- ECMO, Extra-corporeal membrane oxygenation
- IABP, Intra-aortic balloon pump
- ICD, International Classification of Diseases
- Incidence
- MI, Acute myocardial infarction
- MI-CS, Acute myocardial infarction-related cardiogenic shock
- Myocardial infarction
- PCI, Percutaneous coronary intervention
- STEMI, ST-segment elevation myocardial infarction
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Affiliation(s)
- M D Lauridsen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J H Butt
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Østergaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J E Møller
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - C Hassager
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - T Gerds
- Department of Biostatistics, Copenhagen University, Copenhagen, Denmark.,The Danish Heart Foundation, Copenhagen, Denmark
| | - K Kragholm
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - M Phelps
- The Danish Heart Foundation, Copenhagen, Denmark
| | - M Schou
- Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| | - C Torp-Pedersen
- Department of Cardiology and Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark
| | - G Gislason
- The Danish Heart Foundation, Copenhagen, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| | - L Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - E L Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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14
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Mohr GH, Barcella CA, Kragholm K, Rajan S, Sondergaard KB, Pallisgaard JL, Wissenberg M, Lindhardsen J, Ahlehoff O, Skov L, Lippert FK, Torp-Pedersen C, Gislason G. P4439Increased risk of out-of-hospital cardiac arrest in patients with psoriasis - a nationwide case-control study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Chronic inflammatory disorders such as psoriasis have been associated with cardiovascular diseases and linked to proarrhythmogenic electrocardiographic changes, including QT-prolongation. However, evidence regarding the risk of out-of-hospital cardiac arrest with a history of psoriasis is lacking.
Purpose
To investigate the association between psoriasis and out-of-hospital cardiac arrest.
Methods
Through the nationwide Danish Cardiac Arrest Registry, we identified adult out-of-hospital cardiac arrest patients of presumed cardiac cause with and without psoriasis between June 2001 and December 2014. The odds of cardiac arrest were estimated using conditional logistic regression in a case-control design where we matched up to nine controls per case on age, sex and ischemic heart disease. The models were adjusted for comorbidities, concomitant pharmacotherapy and socioeconomic position.
Results
A total of 32,447 out-of-hospital cardiac arrest cases were included and matched with 291,999 controls from the general population. The median age was 72 years, 67% were male and 29% had ischemic heart disease. A total of 607 (1.9%) cases and 4662 (1.6%) controls had psoriasis. Compared with cardiac arrest cases without psoriasis, cases with psoriasis had same age (p=0.718) and gender distribution (p=0.794), higher prevalence of comorbidities such as congestive heart failure (25.7% vs 20.2%, p=0.001), chronic kidney disease (8.9% vs 6.2%, p=0.008) and chronic obstructive pulmonary disease (19.0% vs 14.7%, p=0.005) but had same prevalence of cerebral vascular disease (15.8% vs 14.5%, p=0.351) and peripheral vascular disease (13.3% vs 11.1%, p=0.078). In unadjusted and adjusted analyses, psoriasis was significantly associated with increased odds of cardiac arrest (odds ratio (OR) 1.18 [95% confidence interval (CI) 1.08–1.28] and OR 1.13 [95% CI 1.04–1.23], respectively) (Figure 1).
Conclusion
In this nationwide case-control study, psoriasis was significantly associated with increased odds of out-of-hospital cardiac arrest. Focus on risk factors and prevention of cardiovascular disease in patients with psoriasis is warranted.
Acknowledgement/Funding
None
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Affiliation(s)
- G H Mohr
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - C A Barcella
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - K Kragholm
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics,, Aalborg, Denmark
| | - S Rajan
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - K B Sondergaard
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - J L Pallisgaard
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - J Lindhardsen
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - O Ahlehoff
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - L Skov
- Gentofte University Hospital, Department of Dermatology and Allergy, Gentofte, Denmark
| | - F K Lippert
- University of Copenhagen, Emergency Medical Services Copenhagen, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics,, Aalborg, Denmark
| | - G Gislason
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
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15
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Mills EHA, Aasbjerg K, Hansen SM, Ringgren KB, Dahl M, Rasmussen BS, Torp-Pedersen C, Soegaard P, Kragholm K. P3347Pre-hospital time and 30-day mortality in patients with presumed heart conditions or dyspnea: a registry-based cohort study of patients requiring a highest priority emergency medical response. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Centralization of emergency care is expected to increase average pre-hospital time for patients, leading to concerns about possible adverse outcomes for patients. Prior studies have found increased mortality for patients with prolonged transport following acute myocardial infarction.
Purpose
Examine the association between total pre-hospital time (from dispatch to hospital arrival) and mortality for patients, depending on the condition presumed by the emergency dispatcher (presumed heart condition, dyspnea or non-specific medial conditions).
Methods
Pre-hospital registry data from a Danish region from 2006–2012 was used. This contained information on ambulance dispatch priority, ambulance times, and patient condition, as well if procedures consistent with cardiac arrest (CPR or shock) were performed. We included patients with both highest priority dispatch and transport to the hospital. Linkage to nationwide registries of hospital admissions, comorbidities and mortality was performed. Logistic regression was used for analysis.
Results
95% of total pre-hospital times were below 84 minutes. 30-day mortality was highest among patients with dyspnea (36.6%). Compared to pre-hospital times of 0–30 min, odds ratios of 30-day mortality for times >60 min were: for presumed heart conditions 0.54 [95% CI 0.38–0.77] (p<0.001), for dyspnea 0.98 [95% CI 0.65–1.47] and for other medical conditions 1.14 [95% CI 0.98–1.32]
Patient characteristics and outcomes according to the presumed aetiology of the priority 1 emergency dispatch Presumed heart condition Dyspnea Other medical conditions N 1836 1101 11538 Age, median {IQR} 66.4 {55.3, 76.8} 70.5 {56.8, 80.8} 61.5 {40.3, 75.8} Male, n (%) 1194 (65.0) 585 (53.1) 6172 (53.5) 10-year Charlson comorbidity index score ≥3, n (%) 744 (40.5) 613 (55.7) 4311 (37.6) Response time, median {IQR} 9 {5, 13} 9 {5, 13} 8 {5, 13} Total pre-hospital time, median {IQR} 49{37,61} 45{34, 58} 46{34,58} Cardiac arrest procedures during transport, n (%) 266 (14.5) 133 (12.1) 844 (7.3) Cardiovascular diagnosis (DI00-DI99), n (%) 962 (52.4) 282 (25.6) 3285 (28.5) Respiratory diagnosis (DJ00-DJ99), n (%) 82 (4.5) 430 (39.1) 1036 (9.0) 1-day mortality, n (%) 289 (15.7) 225 (20.4) 1311 (11.4) 30-day mortality, n (%) 402 (21.9) 403 (36.6) 2264 (19.6)
Logistic regression, 30-day mortality
Conclusion
No overall association between total pre-hospital time and mortality, however for presumed heart conditions longer times may improve survival.
Acknowledgement/Funding
Program for clinical research infrastructure (PROCRIN) established by the Lundbeck and Novo Nordisk foundations & The Danish Heart Foundation
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Affiliation(s)
- E H A Mills
- Aalborg University Hospital, Aalborg, Denmark
| | - K Aasbjerg
- Aalborg University Hospital, Aalborg, Denmark
| | - S M Hansen
- Aalborg University Hospital, Aalborg, Denmark
| | | | - M Dahl
- Aalborg University Hospital, Aalborg, Denmark
| | | | | | - P Soegaard
- Aalborg University Hospital, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Aalborg, Denmark
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16
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Christensen DM, Rajan S, Kragholm K, Sondergaard KB, Hansen OM, Gerds TA, Torp-Pedersen C, Gislason GH, Lippert FK, Barcella CA. 5225Bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest of non-cardiac origin. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Knowledge about the effect of bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) of non-cardiac origin is lacking. We aimed to investigate the association between bystander CPR and survival in OHCA of presumed non-cardiac origin.
Methods
From the Danish Cardiac Arrest Registry and through linkage with national Danish healthcare registries we identified all adult patients with OHCA of presumed non-cardiac origin in Denmark (2001–2014). These were categorized further into OHCA of medical and non-medical cause. We analyzed temporal trends in bystander CPR and 30-day survival during the study period. Multiple logistic regression was used to examine the association between bystander CPR and 30-day survival and reported as standardized 30-day survival chances with versus without bystander CPR standardized to the prehospital OHCA-factors and patient characteristics of all patients in the study population.
Results
We identified 10,761 OHCAs of presumed non-cardiac origin. Bystander CPR was associated with an increased 30-day survival chance of 3.4% (95% confidence interval [CI]: 2.9–3.9) versus 1.8% (95% CI: 1.4–2.2) with no bystander CPR, corresponding to a significant difference of 1.6% (95% CI: 0.9–2.3). During the study period, the overall bystander CPR rates increased from 13.6% (95% CI: 11.2–16.5) to 62.7% (95% CI: 60.2–65.2). 30-day survival increased overall from 1.3% (95% CI: 0.7–2.6) to 4.0% (95% CI: 3.1–5.2). Similar findings were observed in subgroups of medical and non-medical OHCA.
Table 1. Patient and arrest characteristics according to cause of out-of-hospital cardiac arrest Overall Medical OHCA Non-medical OHCA Patient characteristics Total patients 10761 7625 3136 Median age,y 67 70 50 Male, n (%) 6357 (59.1) 4154 (54.5) 2204 (70.4) OHCA factors Witnessed arrest, n (%) 4306 (40.0) 3574 (46.9) 732 (23.3) Public location, n (%) 6979 (64.9) 5494 (72.1) 1485 (47.4) OHCA, out-of-hospital cardiac arrest; CPR, cardiopulmonary resuscitation.
Figure 1. Temporal trends
Conclusion
Bystander CPR was associated with a higher chance of 30-day survival among OHCA of presumed non-cardiac origin regardless of the underlying cause (medical/non-medical). Rates of bystander CPR and 30-day survival improved during the study period.
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Affiliation(s)
- D M Christensen
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - S Rajan
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - K B Sondergaard
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - O M Hansen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - T A Gerds
- University of Copenhagen, Department of Biostatistics, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - G H Gislason
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - F K Lippert
- Emergency Medical Services, The Capital Region of Denmark, Copenhagen, Denmark
| | - C A Barcella
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
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17
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Andersen D, Petersen L, Kragholm K, Graff C, Soerensen P, Nielsen J, Pietersen A, Soegaard P, Atwater B, Torp-Pedersen C, Polcwiartek C. P2568Larger vectorcardiographic QRS area is associated with increased risk of heart failure development among left bundle branch block patients: a register-based cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
QRS morphology including left bundle branch block (LBBB) and duration remain the most widely used surrogate markers in the 12-lead electrocardiogram (ECG) for assessing ventricular dyssynchrony and predicting future burden of heart failure (HF) and cardiovascular mortality. However, the vectorcardiographic QRS area has recently been proposed and evidence suggest that this marker may more accurately predict HF development.
Purpose
The aim of this study was to investigate the association between vectorcardiographic QRS area and risk of HF development in LBBB patients.
Methods
From 2001–2015, the Copenhagen General Practitioners' Laboratory was used to identify patients with a first-time LBBB ECG (QRS>120 ms; LBBB morphology), from which QRS area was derived using the Kors transformation method and grouped into quartiles. Outcome was a composite of HF diagnosis, redeemed prescriptions of loop diuretics, or death from HF. Death from other causes was accounted for as a competing risk.
Results
We included a total of 2843 LBBB patients who were free of heart failure (median age, 70 years; female, 58%; ischemic heart disease, 9%). QRS area quartiles comprised Q1, 67–158 μVs; Q2, 159–189 μVs; Q3, 190–228 μVs; and Q4, 229–739 μVs. During 6-month, 1-year, and 5-year follow-up, 9%, 12%, and 28% of patients reached the combined HF endpoint, and 1%, 2%, and 8% of patients died from other causes, respectively (Figure 1). After multivariable adjustment, the highest QRS area quartile, Q4, was associated with increased HF risk (adjusted hazard ratio, 1.64; 95% confidence interval, 1.35–2.00) compared with the lowest quartile, Q1. We did not observe any significant increase in HF risk for remaining quartiles (Q2 or Q3 vs. Q1).
Figure 1
Conclusions
Among primary care patients with newly discovered LBBB, a large vectorcardiographic QRS area (229–739 μVs) is associated with increased risk of developing the incident, combined HF endpoint. This indicates that the QRS area derived using the Kors method may serve as a valuable prognostic marker when assessing risk of HF in patients with LBBB.
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Affiliation(s)
- D Andersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - L Petersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - C Graff
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - P Soerensen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - J Nielsen
- Rigshospitalet - Copenhagen University Hospital, Laboratory for Molecular Cardiology, The Heart Center, Copenhagen, Denmark
| | - A Pietersen
- Copenhagen General Practitioners' Laboratory (KPLL), Copenhagen, Denmark
| | - P Soegaard
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - B Atwater
- Duke University Medical Center, Division of Cardiology, Durham, United States of America
| | - C Torp-Pedersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - C Polcwiartek
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
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18
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Barcella CA, Mohr GH, Kragholm K, Christensen DM, Polcwiartek C, Wissenberg M, Lippert FK, Torp-Pedersen C, Kessing LV, Gislason GH, Soendergaard KB. 2285Increased risk of out-of-hospital cardiac arrest associated with psychiatric disorders. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Patients with psychiatric disorders are at high risk of cardiovascular morbidity and mortality; yet, the risk of out-of-hospital cardiac arrest (OHCA) compared to the general population remains unknown.
Purpose
We investigated whether the presence and severity of different psychiatric disorders were associated with a higher risk of OHCA.
Methods
We conducted a case-control study matching all adult patients with OHCA of presumed cardiac cause between 2001 and 2014 with up to nine controls from the entire Danish population on age, sex and ischemic heart disease (IHD). Patients with psychiatric disorders were identified using in- and out-patient hospital diagnoses – both primary and secondary - before index date. We identified six mutually exclusive psychiatric disorders that were separately examined: personality disorders, anxiety, substance-related mental disorders, depression, bipolar disorder and schizophrenia. The risk of OHCA associated with the six psychiatric disorders was evaluated by conditional logistic regression adjusting for comorbidities, concomitant pharmacotherapy, socioeconomic status and marital status.
Results
We included 32,447 OHCA cases matched with 291,999 controls from the general population. Overall, the median age was 72 years, 67% were male and 29% had IHD prior to index date. All the six psychiatric disorders examined were more common among cases than controls; depression was the most common psychiatric disorders in both groups: 5.0% among cases and 2.8% among controls. Concurrently, all six psychiatric disorders were associated with significantly higher odds of OHCA: personality disorders (odds ratio (OR) 1.30 [95% confidence interval (CI) 1.06–1.60], anxiety OR 1.26 [95% CI 1.15–1.39], substance induced-mental disorders OR 2.36 [95% CI 2.17–2.57], depression OR 1.27 [95% CI 1.19–1.35], bipolar disorder OR 1.32 [95% CI 1.16–1.50] and schizophrenia OR 1.80 [95% CI 1.58–2.05] (Figure). The association persisted unaffected when we studied psychiatric patients neither exposed to antipsychotics nor to antidepressants. We observed a trend towards a stronger association when we stratified according to the severity of the psychiatric disorder (Figure). Severe disorders where classified as at least one hospitalization for the specific psychiatric illness as primary diagnosis during the five years prior to index date.
Conclusions
Common psychiatric disorders including personality disorders, anxiety, substance-related mental disorders, depression, bipolar disorder and schizophrenia are significantly associated with higher odds of OHCA. These findings provide a rationale for early cardiovascular risk factor screening and, potentially, management among psychiatric patients to identify patients at high risk of OHCA.
Acknowledgement/Funding
ESCAPE-NET project
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Affiliation(s)
- C A Barcella
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - G H Mohr
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - D M Christensen
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - C Polcwiartek
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - F K Lippert
- University of Copenhagen, Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University, Institute of Health, Science and Technology, Aalborg, Denmark
| | - L V Kessing
- Rigshospitalet - Copenhagen University Hospital, Department of Psychiatry, Copenhagen, Denmark
| | - G H Gislason
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K B Soendergaard
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
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19
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Barcella CA, Mohr G, Kragholm K, Gerds TA, Jensen SE, Polcwiartek C, Wissenberg M, Lippert FK, Torp-Pedersen C, Kessing LV, Gislason GH, Sondergaard KB. P4135Patients with psychiatric disorders have reduced chances of receiving optimal post-arrest cardiovascular management. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Healthcare disparities between patients with and without a known psychiatric disorder have been documented worldwide. Whether these inequalities also apply to a life-threatening condition such as out-of-hospital cardiac arrest (OHCA) is unknown
Purpose
We aimed to investigate differences in selected in-hospital cardiovascular procedures following OHCA between patients with and without psychiatric disorders.
Methods
We identified adult patients with OHCA of presumed cardiac cause admitted to hospital following OHCA (2001–2015). Patients with psychiatric disorders were identified using hospital diagnoses or redeemed prescriptions for psychotropic drugs and studied both as a single group and separately (three subgroups: severe mental illness [SMI], minor psychiatric disorders, patients who redeemed psychotropic drugs). We calculated age- and gender-standardized incidence rates (SIRs), and relative incidence-rate-ratio (IRR), of cardiovascular procedures during admission post-OHCA in patients with and without psychiatric disorders. Differences in 30-day and 1-year survival were assessed by multiple logistic regression in the overall population and among 2-day survivors who received acute coronary angiography (CAG).
Results
We included 7,288 hospitalized OHCA-patients: 1505 (22.8%) had a psychiatric disorder. Compared with patients without psychiatric disorders, patients with psychiatric disorders had lower SIRs for acute CAG (≤1 days post-OHCA) (IRR 0.51 [95% confidence interval, CI, 0.45–0.57]) (Figure), subacute CAG (2–30 days post-OHCA) (IRR 0.40, [95% CI 0.30–0.52]) and ICD-implantation (IRR 0.67, [95% CI 0.48–0.97]). Lower rates of acute and subacute CAG were still present in subanalyses only including patients with initial shockable rhythm, among those with return of spontaneous circulation upon hospital-arrival and regardless of Charlson score and socioeconomic status. Notably, the difference in CAG-rates between the two groups increased in the recent years. Conversely, we did not detect differences in coronary revascularization (encompassing coronary artery bypass graft and percutaneous coronary intervention) among CAG-patients (IRR 1.11 [95% CI 0.94–1.30]) (Figure). Patients with psychiatric disorders showed lower survival following OHCA, even among 2-day survivors who received acute CAG: odds (OR) of 30-day survival 0.63 (95% CI, 0.48–0.83) and 1-year survival 0.61 (95% CI 0.46–0.81).
Conclusions
Patients with psychiatric disorders had half the probability of receiving acute and subacute CAG and lower chances of ICD-implantation compared to non-psychiatric patients, but, among CAG-patients, same probability of coronary revascularization. Moreover, their survival was lower irrespective of acute angiographic procedures. Our findings show disparities that demand urgent action considering the large burden of cardiovascular morbidity and mortality in patients with psychiatric disorders.
Acknowledgement/Funding
ESCAPE-NET
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Affiliation(s)
- C A Barcella
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - G Mohr
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K Kragholm
- Aalborg University, Institute of Health, Science and Technology, Aalborg, Denmark
| | - T A Gerds
- University of Copenhagen, Department of Biostatistics, Copenhagen, Denmark
| | - S E Jensen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - C Polcwiartek
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - F K Lippert
- University of Copenhagen, Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - L V Kessing
- Rigshospitalet - Copenhagen University Hospital, Department of Psychiatry, Copenhagen, Denmark
| | - G H Gislason
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K B Sondergaard
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
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20
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Krogager ML, Mortensen RN, Lund PE, Boeggild H, Hansen SM, Kragholm K, Aasbjerg K, Soegaard P, Torp-Pedersen C. 1421Dyskalemias in hypertensive patients treated with combination of antihypertensive drugs: a nested case-control study using Danish national registries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Little is known about the occurrence of potassium disturbances in relation to combination therapy in hypertension. Using data from Danish electronic registries, we investigated the association between different combinations of antihypertensive therapy and potassium imbalances, in 22,060 individuals, between 1995–2012.
Methods
Using incidence density matching, two comparison patients without hypokalemia were matched to each corresponding patient with hypokalemia on age, gender, renal function, time from HTN date to date of potassium measurement. The same approach was applied to identify matches for patients with hyperkalemia. The ten most common antihypertensive drug combinations in our population were: (1) Beta-blockers + Angiotensin converting enzyme inhibitors, (2) Angiotensin converting enzyme inhibitors + Thiazides, (3) Angiotensin converting enzyme inhibitors + Thiazides + Potassium supplement, (4) Angiotensin receptor blockers + Other diuretics, (5) Beta-blockers + Angiotensin converting enzyme inhibitors + Potassium supplement (ATC: A12B), (6) Beta-blockers + Calcium channel blockers, (7) Beta-blockers + Thiazides + Potassium supplement, (8) Calcium channel blockers + Angiotensin converting enzyme inhibitors, (9) Calcium channel blockers + Thiazides + Potassium supplement, (10) Other antihypertensive drug combinations. We used conditional logistic regression analysis to examine the risk of developing hypo- and hyperkalemia in relation to different combinations of antihypertensive drugs within one year. The multivariable model was adjusted for serum sodium, malignancy, inflammatory bowel disease, diabetes, alcoholism and beta2-agonists.
Results
The multivariable analysis showed 10.5 times increased odds for developing hypokalemia if administered Calcium channel blockers + Thiazides + Potassium supplement (95% CI 4.97–22.06) compared to Angiotensin converting enzyme inhibitors + Beta blockers. Other drug combinations significantly associated with increased hypokalemia risk were: Angiotensin converting enzyme inhibitors + Thiazides (OR 5.01, 95% CI 2.32–10.79), Angiotensin converting enzyme inhibitors + Loop + Potassium supplement (A12B) (OR 4.03, 95% CI 1.69–9.62), Angiotensin converting enzyme inhibitors + Thiazides + Potassium supplement (OR 4.16, 95% CI 2.01–8.64) and Calcium channel blockers + Angiotensin converting enzyme inhibitors (OR 4.04, 95% CI 1.72–9.50). None of the ten groups were associated with increased odds for developing hyperkalemia in the multivariable analysis.
Cumulative incidence curves for hypokale
Conclusion
Thiazide diuretics in combination with angiotensin converting enzyme inhibitors or calcium channel blockers were strongly associated with hypokalemia risk within one year from treatment initiation.
Acknowledgement/Funding
None
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Affiliation(s)
- M L Krogager
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - R N Mortensen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - P E Lund
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - H Boeggild
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - S M Hansen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - K Aasbjerg
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | | | - C Torp-Pedersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
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21
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Kragholm K, Tayal B, Sejersen HM, Zaremba T, Noergaard BL, Boetker HE, Koeber L, Torp-Pedersen CT, Soegaard P, Freeman P. P2241Patients examined with coronary computed tomography angiography have comparable five-year outcomes to age- and sex-matched population controls. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
According to Danish national guidelines, coronary computed tomography angiography (CCTA) is the preferred frontline test in patients without known coronary artery disease (CAD) and stable symptoms indicative of CAD. Over the last decade in Denmark, we have seen a steadily and considerable increase in CCTA use. Data on long-term cardiovascular risk following CCTA remains limited, in particular in comparison to background population controls.
Purpose
To study individual and composite five-year outcomes of mortality, myocardial infarction (MI) and revascularization in CCTA-examined patients compared to background population controls.
Methods
Nationwide registry-based study including 58,176 patients with an incident CCTA examination during 2007–2014 in Denmark versus 116,352 age- and sex-matched population controls. Despite no detailed information on CCTA results were available, a landmark analysis including patients and corresponding controls alive six months post-CCTA enabled us to study five patient categories: 1) 19,135 patients with no relevant medical therapy (nitrates, cholesterol-lowering, antiplatelet and/or anticoagulant drugs) before or 180 days post-CCTA; 2) 6,073 patients on relevant medical therapy prior to but not 180 days post-CCTA; 3) 5,086 patients who initiated relevant medical therapy during 180 days post-CCTA; 4) 19,809 patients on relevant medical therapy both before and during 180 days post-CCTA; and 5) 8,073 patients with myocardial infarction (MI) or treated with percutaneous intervention (PCI) or coronary artery bypass surgery (CABG) within 180 days post-CCTA. Within each CCTA patient group, two controls matched on age and sex were identified for each CCTA patient. Neither CCTA-patients nor controls had prior ischemic heart disease.
Results
Outcomes of MI for CCTA patient groups 1)-5) versus controls were: 0.3%, 0.6%, 0.8%, 0.7%, and 11.4% versus 0.7%, 1.1%, 1.0%, 1.1%, and 1.5%. Corresponding figures for all-cause mortality were: 2.2%, 2.0%, 4.1%, 4.9%, and 6.8%, versus 2.1%, 2.8%, 4.2%, 4.3%, and 6.4%. For composite endpoint of MI, PCI or CABG, results for CCTA patients versus controls were: 0.3%, 0.6%, 0.8%, 0.7%, and 18.2% versus 0.9%, 1.3%, 1.2%, 1.4%, and 1.9%. Lastly, for composite endpoint of MI, PCI, CABG or death, results for CCTA patients versus controls were: 2.5%, 2.6%, 4.8%, 4.9%, and 24.2% versus 3.0%, 3.9%, 5.3%, 6.1%, and 8.0%.
Conclusions
Only the CCTA group treated with PCI or CABG or diagnosed with MI during the first 180 days post-CCTA had substantially higher five-year MI event rates and composite endpoints of MI, PCI or CABG and MI, PCI, CABG or death. In addition, no difference in five-year all-cause mortality was seen for all CCTA patient groups when compared to their respective controls. Altogether, the majority of CCTA-examined patients were event-free at five-year follow-up suggesting a potential overutilization of CCTA and a need for refinement of CCTA referral criteria.
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Affiliation(s)
- K Kragholm
- Aalborg University Hospital, Aalborg, Denmark
| | - B Tayal
- Aalborg University Hospital, Aalborg, Denmark
| | - H M Sejersen
- North Denmark Regional Hospital, Hjørring, Denmark
| | - T Zaremba
- Aalborg University Hospital, Aalborg, Denmark
| | | | | | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | | | - P Soegaard
- Aalborg University Hospital, Aalborg, Denmark
| | - P Freeman
- Aalborg University Hospital, Aalborg, Denmark
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22
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Krogager ML, Kragholm K, Skals RK, Mortensen RN, Polcwiartek C, Graff C, Nielsen JB, Kanters JK, Holst AG, Soegaard P, Pietersen AH, Torp-Pedersen C, Hansen SM. P6562The relationship between serum potassium concentrations and electrocardiographic characteristics in 163,547 individuals from primary care. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Potassium disturbances are common and associated with increased morbidity and mortality, even in patients without prior cardiovascular disease. We examined six electrocardiographic (ECG) measures and their association to serum potassium levels.
Methods and results
From the Copenhagen General Practitioners' Laboratory, we identified 163,547 individuals aged ≥16 years with a first available ECG and a concomitant serum potassium measurement during 2001–2011. Restricted cubic splines curves showed a non-linear relationship between potassium and the Fridericia corrected QT (QTcF) interval, T-wave amplitude, morphology combination score (MCS), PR interval, P-wave amplitude and duration. Therefore, potassium was stratified in two intervals K: 2.0–4.1 mmol/L and 4.2–6.0 mmol/L for further analyses. Within the low potassium range, we observed: QTcF was 12.5 ms longer for each mmol/L decrease in potassium (p<0.0001); T-wave amplitude was 55.1 μV lower for each mmol/L decrease in potassium (p<0.0001); and MCS was 0.09 higher per mmol/L decrease in potassium (p<0.001). Moreover, P-wave duration and PR interval were prolonged by 3.1 and 3.3 ms for each mmol/L decrease in potassium (p<0.0001), respectively. Within the lowest potassium range (2.0–4.1 mmol/L) P-wave amplitude was 10.7 μV higher for each mmol/L decrease in potassium (p<0.0001). Within the high potassium range associations with the above-mentioned ECG parameters were much weaker.
Restricted cubic splines on adjusted lin
Conclusion
The association of potassium with six commonly measured ECG parameters was non-linear. Strong associations between ECG abnormalities and potassium were seen among individuals with lower potassium levels (≤4.1 mmol/L).
Acknowledgement/Funding
None
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Affiliation(s)
- M L Krogager
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Aalborg, Denmark
| | - R K Skals
- Aalborg University Hospital, Aalborg, Denmark
| | | | | | - C Graff
- Aalborg University, Aalborg, Denmark
| | - J B Nielsen
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan, United States of America
| | - J K Kanters
- University of Copenhagen, Laboratory of experimental cardiology, Copenhagen, Denmark
| | - A G Holst
- Rigshospitalet - Copenhagen University Hospital, Cardiology, Copenhagen, Denmark
| | - P Soegaard
- Aalborg University Hospital, Aalborg, Denmark
| | | | | | - S M Hansen
- Aalborg University Hospital, Aalborg, Denmark
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23
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Christensen DM, Rajan S, Kragholm K, Søndergaard KB, Hansen OM, Gerds TA, Torp-Pedersen C, Gislason GH, Lippert FK, Barcella CA. Bystander cardiopulmonary resuscitation and survival in patients with out-of-hospital cardiac arrest of non-cardiac origin. Resuscitation 2019; 140:98-105. [PMID: 31129226 DOI: 10.1016/j.resuscitation.2019.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/30/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Knowledge about the effect of bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) of non-cardiac origin is lacking. We aimed to investigate the association between bystander CPR and survival in OHCA of presumed non-cardiac origin. METHODS From the Danish Cardiac Arrest Registry and through linkage with national Danish healthcare registries we identified all patients with OHCA of presumed non-cardiac origin in Denmark (2001-2014). These were categorized further into OHCA of medical and non-medical cause. We analyzed temporal trends in bystander CPR and 30-day survival during the study period. Multiple logistic regression was used to examine the association between bystander CPR and 30-day survival and reported as standardized 30-day survival chances with versus without bystander CPR standardized to the prehospital OHCA-factors and patient characteristics of all patients in the study population. RESULTS We identified 10,761 OHCAs of presumed non-cardiac origin. Bystander CPR was associated with a significantly higher 30-day survival chance of 3.4% (95% confidence interval [CI]: 2.9-3.9) versus 1.8% (95% CI: 1.4-2.2) without bystander CPR. A similar association was found in subgroups of both medical and non-medical OHCA. During the study period, the overall bystander CPR rates increased from 13.6% (95% CI: 11.2-16.5) to 62.7% (95% CI: 60.2-65.2). 30-day survival increased overall from 1.3% (95% CI: 0.7-2.6) to 4.0% (95% CI: 3.1-5.2). CONCLUSION Bystander CPR was associated with a higher chance of 30-day survival among OHCA of presumed non-cardiac origin regardless of the underlying cause (medical/non-medical). Rates of bystander CPR and 30-day survival improved during the study period.
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Affiliation(s)
- D M Christensen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.
| | - S Rajan
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - K Kragholm
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - K B Søndergaard
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - O M Hansen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - T A Gerds
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark
| | - C Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - G H Gislason
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark
| | - Freddy K Lippert
- Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark
| | - C A Barcella
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
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Winther‐Jensen M, Hassager C, Lassen JF, Køber L, Torp‐Pedersen C, Hansen SM, Lippert F, Kragholm K, Christensen EF, Kjaergaard J. Neurological prognostication tools in out-of-hospital cardiac arrest patients in Danish intensive care units from 2005 to 2013. Acta Anaesthesiol Scand 2018; 62:1412-1420. [PMID: 29947076 DOI: 10.1111/aas.13177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurological prognostication is an essential part of post-resuscitation care in out-of-hospital cardiac arrest (OHCA). This study aims to assess the use of computed tomography (CT) and magnetic resonance imaging (MR) of the head, electroencephalography (EEG), and somatosensory evoked potentials (SSEP) in neurological prognostication in resuscitated OHCA patients and factors associated with their use in Danish tertiary and non-tertiary centers from 2005 to 2013 and associations with outcome. METHODS We used the Danish Cardiac Arrest Registry to identify patients ≥18 years of age admitted to intensive care units due to OHCA of presumed cardiac etiology. CT 0-20 days and MR, SSEP, and EEG ≥2-20 days post OHCA were considered related to prognostication. Incidence and factors associated with procedures were assessed by multiple Cox regression with death as competing risk. RESULTS Use of CT, MR, EEG, and SSEP increased during the study period (CT: 51%-67%, HRCT : 1.06, CI: 1.03-1.08, MR: 2%-5%, P = .08, EEG: 6%-33%, HREEG : 1.25, CI: 1.19-1.30, SSEP: 4%-15%, HRSSEP : 1.23, CI: 1.15-1.32). EEG and SSEP were more used in tertiary centers than non-tertiary (HREEG : 1.86, CI: 1.51-2.29, HRSSEP : 4.44, CI: 2.86-6.89). Use of CT, SSEP, and EEG were associated with higher 30-day mortality, and MR was associated with lower (HRCT : 1.15, CI: 1.01-1.30, HRMR : 0.53, CI: 0.37-0.77, HRSSEP : 1.90, CI: 1.57-2.32, HREEG : 1.75, CI: 1.49-2.05). CONCLUSION Use of neurological prognostication procedures increased during the study period. EEG and SSEP were more used in tertiary centers. CT, EEG and SSEP were associated with increased mortality.
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Affiliation(s)
- M. Winther‐Jensen
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - C. Hassager
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - J. F. Lassen
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - L. Køber
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - C. Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Forskningens Hus Aalborg Denmark
| | - S. M. Hansen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Forskningens Hus Aalborg Denmark
| | - F. Lippert
- Emergency Medical Services Copenhagen University of Copenhagen Copenhagen Denmark
| | - K. Kragholm
- Department of Anesthesiology and Intensive Care Medicine Cardiovascular Research Centre Aalborg Denmark
| | - E. F. Christensen
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - J. Kjaergaard
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
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Havers-Borgersen E, Fosboel EL, Roerth R, Kragholm K, Oestergaard L, Aslam M, Valeur N, Gislason GH, Torp-Pedersen C, Koeber L, Butt JH. P3534Infective endocarditis is associated with an increased risk of nursing home admission and initiation of domiciliary care. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Havers-Borgersen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - E L Fosboel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - R Roerth
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K Kragholm
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - L Oestergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - M Aslam
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - N Valeur
- Bispebjerg University Hospital, Department of Cardiolgy, Copenhagen, Denmark
| | - G H Gislason
- Gentofte Hospital - Copenhagen University Hospital, Department of Cardiology, Hellerup, Denmark
| | - C Torp-Pedersen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - J H Butt
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
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Mohr GH, Barcella CA, Kragholm K, Sondergaard KB, Pallisgaard JL, Moller SG, Karlsson L, Wissenberg M, Hansen SM, Lippert FK, Folke F, Torp-Pedersen C, Gislason G, Rajan S. P1752Differences in post-resuscitation care between patients with and without diabetes following out-of-hospital cardiac arrest - a nationwide study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G H Mohr
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - C A Barcella
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - K Kragholm
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics,, Aalborg, Denmark
| | - K B Sondergaard
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - J L Pallisgaard
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - S G Moller
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - L Karlsson
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - S M Hansen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics,, Aalborg, Denmark
| | - F K Lippert
- University of Copenhagen, Emergency Medical Services Copenhagen, Copenhagen, Denmark
| | - F Folke
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics,, Aalborg, Denmark
| | - G Gislason
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - S Rajan
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
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27
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Tayal B, Sogaard P, Torp-Pedersen C, Kragholm K. 3403Risk of atrial fibrillation after pm implantation: a nationwide danish registry-based follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Tayal
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - P Sogaard
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of Clinical Epidemiology, Aalborg, Denmark
| | - K Kragholm
- Vendsyssel Hospital, Internal Medicine, Hjorring, Denmark
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28
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Tayal B, Fruelund P, Sogaard P, Riahi S, Torp-Pedersen C, Kober L, Kragholm K. 5304Risk of pacemaker-induced heart failure: a nationwide Danish registry-based follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Tayal
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - P Fruelund
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - P Sogaard
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - S Riahi
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | | | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - K Kragholm
- Vendsyssel Hospital, Internal Medicine, Hjorring, Denmark
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29
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Hagengaard L, Tayal B, Schou M, Gislason G, Riahi S, Torp-Pedersen C, Soegaard P, Kragholm K. P6587Return to work and maintenance of work after first time hospitalization for atrial fibrillation or flutter. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Hagengaard
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
| | - B Tayal
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
| | - M Schou
- Herlev Hospital, Department of Cardiology, Herlev, Denmark
| | - G Gislason
- Herlev Hospital, Department of Cardiology, Herlev, Denmark
| | - S Riahi
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
| | - P Soegaard
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiologi, Aalborg, Denmark
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30
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Polcwiartek C, Kragholm K, Hansen S, Graff C, Nielsen JB, Pietersen A, Nielsen J, Friedman D, Atwater B, Sogaard P, Torp-Pedersen C, Jensen S. P3455Common electrocardiogram abnormalities confer increased mortality in patients with schizophrenia exposed to antipsychotic drugs: a register-based cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Polcwiartek
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - S Hansen
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - C Graff
- Aalborg University, Health Science and Technology, Aalborg, Denmark
| | - J B Nielsen
- University of Michigan, Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, United States of America
| | - A Pietersen
- Rigshospitalet - Copenhagen University Hospital, Laboratory for Molecular Cardiology, The Heart Center, Copenhagen, Denmark
| | - J Nielsen
- Glostrup Hospital - Copenhagen University Hospital, Mental Health Center, Copenhagen, Denmark
| | - D Friedman
- Duke University Medical Center, Clinical Cardiac Electrophysiology Laboratories and Electrophysiology Clinical Research Unit, Durham, United States of America
| | - B Atwater
- Duke University Medical Center, Clinical Cardiac Electrophysiology Laboratories and Electrophysiology Clinical Research Unit, Durham, United States of America
| | - P Sogaard
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - S Jensen
- Aalborg University Hospital, Cardiology, Aalborg, Denmark
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31
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Sarajuddin J, Polcwiartek C, Tayal B, Kragholm K, Sogaard P, Dalsgaard A, Borup H, Arulanandam H, Aagaard J, Jensen S. P863Impact of the duration of schizophrenia in patients without known cardiac disease on myocardial function assessed by echocardiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Sarajuddin
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - C Polcwiartek
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - B Tayal
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - P Sogaard
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - A Dalsgaard
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - H Borup
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - H Arulanandam
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - J Aagaard
- Aalborg University Hospital, Department of Psychiatry, Aalborg, Denmark
| | - S Jensen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
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Sondergaard KB, Riddersholm S, Wissenberg M, Hansen SM, Gerds TA, Barcello C, Karlsson L, Lippert FK, Kjaergaard J, Gislason GH, Folke F, Torp-Pedersen C, Kragholm K. 470Out-of-hospital cardiac arrest: long-term outcomes according to status at hospital arrival. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - S Riddersholm
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - S M Hansen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - T A Gerds
- University of Copenhagen, Department of Biostatistics, Copenhagen, Denmark
| | - C Barcello
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - L Karlsson
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - F K Lippert
- Emergency Medical Services, Copenhagen, Denmark
| | - J Kjaergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - G H Gislason
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - F Folke
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - C Torp-Pedersen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - K Kragholm
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
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33
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Barcella CA, Mohr GH, Kragholm K, Wissenberg M, Hansen SM, Kessing LV, Gislason GH, Torp-Pedersen C, Sondergaard KB. 1148Out-of-hospital cardiac arrest in patients with psychiatric disorder - Characteristics and outcomes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C A Barcella
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - G H Mohr
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - M Wissenberg
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - S M Hansen
- Aalborg University, Institute of Health, Science and Technology, Aalborg, Denmark
| | - L V Kessing
- Rigshospitalet - Copenhagen University Hospital, Department of Psychiatry, Copenhagen, Denmark
| | - G H Gislason
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - K B Sondergaard
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
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34
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Kjeldsen S, Mohr G, Moeller S, Kragholm K, Wissenberg M, Hansen S, Koeber L, Lippert F, Folke F, Andersson C, Gislason G, Torp-Pedersen C, Weeke P. P3808Proarrhythmic pharmacotherapy and out-of-hospital cardiac arrest - a nationwide Danish study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Kjeldsen
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - G Mohr
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - S Moeller
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - K Kragholm
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - M Wissenberg
- University of Copenhagen, Emergency Medical Services Copenhagen, Copenhagen, Denmark
| | - S Hansen
- Aalborg University Hospital, Unit of Epidemiology and Biostatistics, Aalborg, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, The Heart Center, Copenhagen, Denmark
| | - F Lippert
- University of Copenhagen, Emergency Medical Services Copenhagen, Copenhagen, Denmark
| | - F Folke
- University of Copenhagen, Emergency Medical Services Copenhagen, Copenhagen, Denmark
| | - C Andersson
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - G Gislason
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University, Department of Health Science and Technology, Aalborg, Denmark
| | - P Weeke
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
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Kragholm K, Andersen MP, Mortensen RN, Bech LF, Polcwiartek C, Rohde C, Torp-Pedersen C, Videbech P, Nielsen J. Exposure to selective serotonin reuptake inhibitors in utero and early elementary school outcomes. Acta Psychiatr Scand 2018; 137:481-490. [PMID: 29479669 DOI: 10.1111/acps.12867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Data on special education in offspring exposed to selective serotonin reuptake inhibitors (SSRIs) in utero are lacking. We examined associations of in utero SSRI exposure with special education needs and delayed elementary school start. METHODS A population-based case-cohort study using Danish nationwide birth and prescription registry data from 2005 to 2008. Follow-up ends during 2011-2015 to capture special education needs during and delayed entry to the first elementary school year. Cases were in utero SSRI-exposed offspring. Cohort-controls were SSRI-unexposed offspring of mothers previously on SSRIs. We reported odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for relevant potential confounders. RESULTS Of 117 475 first-incident non-multiple pregnancy births, 3314 were SSRI-exposed, and 3536 were unexposed. Among SSRI-exposed offspring, 3.2% (n = 98) had special school needs vs. 2.4% (n = 77) in unexposed offspring, P-value=0.048. Correspondingly, 12.3% (n = 383) among SSRI-exposed children had delayed school entry vs. 9.4% (n = 308) in unexposed offspring, P-value < 0.001. Adjusted OR for the association with special school needs was 1.12 (95% CI 0.82-1.55; P-value = 0.48) and 1.38 (95% CI 0.90-2.13; P-value = 0.14) for exposure in all three trimesters. The corresponding adjusted ORs for delayed school entry were 1.17 (95% CI 0.99-1.38; P-value = 0.073) and 1.40 (95% CI 1.11-1.76; P-value = 0.004). CONCLUSION In utero SSRI exposure in all three trimesters was associated with delayed elementary school start but not special education needs.
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Affiliation(s)
- K Kragholm
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - M P Andersen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - R N Mortensen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - L F Bech
- Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark
| | - C Polcwiartek
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - C Rohde
- Mental Health Centre, Copenhagen University Hospital, Glostrup, Denmark
| | - C Torp-Pedersen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - P Videbech
- Mental Health Centre, Copenhagen University Hospital, Glostrup, Denmark
| | - J Nielsen
- Mental Health Centre, Copenhagen University Hospital, Glostrup, Denmark
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36
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Rohde C, Polcwiartek C, Kragholm K, Ebdrup BH, Siskind D, Nielsen J. Adverse cardiac events in out-patients initiating clozapine treatment: a nationwide register-based study. Acta Psychiatr Scand 2018; 137:47-53. [PMID: 29064084 DOI: 10.1111/acps.12827] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Using national Danish registers, we estimated rates of clozapine-associated cardiac adverse events. Rates of undiagnosed myocarditis were estimated by exploring causes of death after clozapine initiation. METHOD Through nationwide health registers, we identified all out-patients initiating antipsychotic treatment (January 1, 1996-January 1, 2015). Rates of clozapine-associated myocarditis and pericarditis within 2 months from clozapine initiation and rates of cardiomyopathy within 1-2 years from clozapine initiation were compared to rates for other antipsychotics. Mortality within 2 months from clozapine initiation was extracted. RESULTS Three thousand two hundred and sixty-two patients of a total 7932 patients initiated clozapine as out-patients (41.12%). One patient (0.03%) developed myocarditis, and no patients developed pericarditis within 2 months from clozapine initiation. Two (0.06%) and four patients (0.12%) developed cardiomyopathy within 1 and 2 years respectively. Rates were similar for other antipsychotics. Twenty-six patients died within 2 months from clozapine initiation. Pneumonia (23.08%) and stroke (11.54%) were the main causes of death. We estimated the maximum rate of clozapine-associated fatal myocarditis to 0.28%. CONCLUSION Cardiac adverse effects in Danish out-patients initiating clozapine treatment are extremely rare and these rates appear to be comparable to those observed for other antipsychotic drugs.
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Affiliation(s)
- C Rohde
- Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark.,Psychiatric Research Academy, Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - C Polcwiartek
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - K Kragholm
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - B H Ebdrup
- Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark.,Center for Neuropsychiatric Schizophrenia Research (CNSR), Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - D Siskind
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia.,University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - J Nielsen
- Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
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Pape M, Rajan S, Hansen S, Mortensen R, Riddersholm S, Folke F, Karlsson L, Lippert F, Kober L, Gislason G, Soholm H, Wissenberg M, Torp-Pedersen C, Kragholm K. P2744Low survival after out-of-hospital cardiac arrest in nursing homes despite early initiation of bystander cardiopulmonary resuscitation - a nationwide study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karlsson L, Sondergaard K, Malta Hansen C, Wissenberg M, Moller Hansen S, Lippert F, Rajan S, Kragholm K, Gislason G, Torp-Pedersen C, Folke F. P2767Straight line versus route distance to nearest automated external defibrillator - implications for cardiac arrest coverage. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Smedegaard L, Kragholm K, Charlot M, Gislason G, Hansen P. P2517Nursing home admission and mortality after myocardial infarction in the elderly: a nationwide cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sondergaard K, Rajan S, Wissenberg M, Karlsson L, Kragholm K, Pape M, Lippert F, Gislason G, Folke F, Torp-Pedersen C, Hansen S. P2766Bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest according to location of arrest. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Winther-Jensen M, Hassager C, Lassen J, Kober L, Torp-Pedersen C, Hansen S, Lippert F, Kragholm K, Christensen E, Kjaergaard J. P1356A nationwide study: Differences in use of neurological prognostication procedures in out-of-hospital cardiac arrest patients in intensive care units from 2004-2013. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Winther-Jensen M, Kjaergaard J, Lassen J, Kober L, Torp-Pedersen C, Hansen S, Lippert F, Kragholm K, Christensen E, Hassager C. P2740Use of dialysis in out-of-hospital cardiac arrest patients in Danish intensive care units from 2004-2013 and implications for outcome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rosendahl E, Carlson N, Kragholm K, Gislason G, Torp-Pedersen C, Christiansen C. P512Return to work following ischemic stroke in a working age population. a danish nationwide register-based cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Butt J, Kragholm K, Dalager-Pedersen M, Rorth R, Kristensen S, Chaudry M, Valeur N, Ostergaard L, Torp-Pedersen C, Gislason G, Kober L, Fosbol E. P4543Return to the workforce following infective endocarditis: a nationwide study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kragholm K, Skovmoeller M, Christensen AL, Fonager K, Tilsted HH, Kirkegaard H, De Haas I, Rasmussen BS. Employment status 1 year after out-of-hospital cardiac arrest in comatose patients treated with therapeutic hypothermia. Crit Care 2012. [PMCID: PMC3363706 DOI: 10.1186/cc10895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kragholm K, Odgaard A, Nielsen TK, Kolstad HA, Andersen JH. Poor outcome in patients with spine-related leg or arm pain who are involved in compensation claims: a prospective study of patients in the secondary care sector: comment on the article by Rasmussen et al. Scand J Rheumatol 2009; 38:398-9; author reply 399. [DOI: 10.1080/03009740902833389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nielsen TK, Kragholm K, Odgaard A, Sommerlund M, Kolstad HA. Recurrent cyclic hyperkeratotic eczema after occupational alkali burn: traumatic chronic irritant dermatitis. Contact Dermatitis 2009; 60:345-6. [DOI: 10.1111/j.1600-0536.2009.01549.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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