Clinical Epidemiology最新文献

{"title":"Cardiovascular Data Quality in the Danish National Patient Registry (1977-2024): A Systematic Review.","authors":"Katrine Hjuler Lund, Cecilia Hvitfeldt Fuglsang, Sigrun Alba Johannesdottir Schmidt, Morten Schmidt","doi":"10.2147/CLEP.S471335","DOIUrl":"10.2147/CLEP.S471335","url":null,"abstract":"<p><strong>Background: </strong>The increasing use of routinely collected health data for research puts great demands on data quality. The Danish National Patient Registry (DNPR) is renowned for its longitudinal data registration since 1977 and is a commonly used data source for cardiovascular epidemiology.</p><p><strong>Objective: </strong>To provide an overview and examine determinants of the cardiovascular data quality in the DNPR.</p><p><strong>Methods: </strong>We performed a systematic literature search of MEDLINE (PubMed) and the Danish Medical Journal, and identified papers validating cardiovascular variables in the DNPR during 1977-2024. We also included papers from reference lists, citations, journal e-mail notifications, and colleagues. Measures of data quality included the positive predictive value (PPV), negative predictive value, sensitivity, and specificity.</p><p><strong>Results: </strong>We screened 2,049 papers to identify 63 relevant papers, including a total of 229 cardiovascular variables. Of these, 200 variables assessed diagnoses, 24 assessed treatments (10 surgeries and 14 other treatments), and 5 assessed examinations. The data quality varied substantially between variables. Overall, the PPV was ≥90% for 36% of variables, 80-89% for 26%, 70-79% for 16%, 60-69% for 7%, 50-59% for 4%, and <50% for 11% of variables. The predictive value was generally higher for treatments (PPV≥95% for 92%) and examinations (PPV≥95% for 100%) than for diagnoses (PPV≥80% for 71%). Moreover, the PPV varied for individual diagnoses depending on the algorithm used to identify them. Key determinants for validity were patient contact type (inpatient vs outpatient), diagnosis type (primary vs secondary), setting (university vs regional hospitals), and calendar year.</p><p><strong>Conclusion: </strong>The validity of cardiovascular variables in the DNPR is high for treatments and examinations but varies considerably between individual diagnoses depending on the algorithm used to define them.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"865-900"},"PeriodicalIF":3.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Prior Antithrombotic Drug Use with 90-Day Mortality After Intracerebral Hemorrhage.","authors":"Christian Mistegård Jørgensen, Nils Jensen Boe, Stine Munk Hald, Frederik Meyer-Kristensen, Mie Micheelsen Norlén, Christian Ovesen, Sören Möller, Birgit Bjerre Høyer, Jonas Asgaard Bojsen, Mohammad Talal Elhakim, Frederik Severin Gråe Harbo, Rustam Al-Shahi Salman, Larry B Goldstein, Jesper Hallas, Luis Alberto García Rodríguez, Magdy Selim, David Gaist","doi":"10.2147/CLEP.S493499","DOIUrl":"10.2147/CLEP.S493499","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the strength of association between use of antithrombotics (AT) drugs with survival after spontaneous intracerebral hemorrhage (s-ICH) comparing oral anticoagulant (OAC) or platelet antiaggregants (PA) with no AT use and in active comparator analyses OAC vs PA, direct oral anticoagulant (DOAC) vs vitamin K antagonist (VKA), and clopidogrel vs aspirin.</p><p><strong>Patients and methods: </strong>We identified patients ≥55 years with a first-ever s-ICH between 2015 and 2018 in Southern Denmark (population 1.2 million). From this population, patients who had used an AT at the time of ICH were identified and classified as OAC or PA vs no AT (reference group), and for active comparator analyses as OAC vs PA (reference group), DOAC vs VKA (reference group), or clopidogrel vs aspirin (reference group). We calculated adjusted relative risks (aRRs) and corresponding [95% confidence intervals] for 90-day all-cause mortality with adjustments for potential confounders.</p><p><strong>Results: </strong>Among 1043 patients who had s-ICH, 206 had used an OAC, 270 a PA, and 428 had no AT use. The adjusted 90-day mortality was higher in OAC- (aRR 1.68 [1.39-2.02]) and PA-users (aRR 1.21 [1.03-1.42]), compared with no AT. Mortality was higher in OAC- (aRR 1.19 [1.05-1.36]) vs PA-users. In analyses by antithrombotic drug type, 88 used a DOAC, 136 a VKA, 111 clopidogrel, and 177 aspirin. Mortality was lower among DOAC- vs VKA-users (aRR 0.82 [0.68-0.99]), but similar between clopidogrel vs aspirin users (aRR 1.04 [0.87-1.24]).</p><p><strong>Conclusion: </strong>In this unselected cohort from a geographically defined Danish population, 90-day mortality after s-ICH was higher in patients with prior use of an OAC compared with no AT use or patients using a PA. Mortality was slightly lower for patients using a DOAC than a VKA. Mortality was also higher in PA- vs no AT-users, but there were no differences in mortality between clopidogrel vs aspirin.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"837-848"},"PeriodicalIF":3.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Western Denmark Myocardial Perfusion Imaging Registry: A Review and Validation Study.","authors":"Jacob Hartmann Søby, Morten Schmidt, Louise Nissen, June Anita Ejlersen, Lars Christian Gormsen, Kasper Tholstrup Pedersen, Paw Christian Holdgaard, Jesper Mortensen, Laust Dupont Rasmussen, Søren Ravn, Rika Horvat, Simon Winther, Morten Böttcher","doi":"10.2147/CLEP.S469538","DOIUrl":"10.2147/CLEP.S469538","url":null,"abstract":"<p><strong>Purpose: </strong>Myocardial perfusion imaging (MPI) procedures from single photon emission computed tomography and positron emission tomography imaging have been registered in the Western Denmark Heart Registry (WDHR) since 2017 as a sub-registry (WDHR-MPI). The aim was to review the content, quality, and research potential of the WDHR-MPI and assess the completeness and validity of its key variables.</p><p><strong>Patients and methods: </strong>Using the Danish National Patient Registry (DNPR) as a reference, we calculated the completeness of procedure registration as the proportion of procedures registered in the WDHR-MPI from 2017 to 2021. We defined completeness of variable registration as the proportion of non-missing values for a given variable and examined it for 38 key variables. We assessed validity by estimating the positive predictive values (PPV) and negative predictive values (NPV) with 95% confidence intervals (CI) for 26 selected key variables using corresponding extracted information from 300 randomly selected patient records.</p><p><strong>Results: </strong>We identified 19,084 procedures in 17,871 patients from all seven cardiac centers performing nuclear cardiology procedures in the WDHR uptake area. The registry accumulated 4000-6000 procedures each year from 2019 to 2021. The overall completeness of procedure registration was 72% (95% CI 72-73), increasing from 14% (95% CI 13-15) in 2017 to 98% (95% CI 98-98) in 2021. The mean completeness of variable registration was 89%. The validity of entered data was high, with an overall PPV for the selected key variables of 95% (95% CI 94-95) and NPV of 94% (95% CI 93-96).</p><p><strong>Conclusion: </strong>The WDHR-MPI is one of the largest systematic MPI cohorts. The overall high completeness and validity of the data support its potential for cardio-epidemiological research.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"849-863"},"PeriodicalIF":3.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Western Denmark Heart Registry and Population-Based National Health Registries.","authors":"Christine Gyldenkerne, Kevin Kris Warnakula Olesen, Pernille Gro Thrane, Malene Kærslund Hansen, Nina Stødkilde-Jørgensen, Malene Højgaard Andersen, Martin Bødtker Mortensen, Jesper Møller Jensen, Bjarne Linde Nørgaard, Henrik Toft Sørensen, Michael Maeng","doi":"10.2147/CLEP.S488498","DOIUrl":"https://doi.org/10.2147/CLEP.S488498","url":null,"abstract":"<p><p>The Western Denmark Heart Registry (WDHR) is a semi-national, multicenter-based clinical registry with unique potential for cardiovascular research. The registry has provided detailed prospectively registered information on patient and procedure characteristics since 1999. WDHR data can be linked to additional data in other healthcare registries in Denmark. Therefore, the WDHR is a valuable data resource for cardiovascular research, providing a foundation for numerous research projects and publications. This review describes three currently available cohorts from the WDHR containing individual-level information on: i) 200,647 first-time coronary angiographies from 2003 to 2021, ii) 88,630 first-time percutaneous coronary interventions from 1999 to 2022, and iii) 85,512 first-time coronary computed tomography angiographies from 2008 to 2021. Furthermore, we describe other frequently cross-linked Danish healthcare registries containing information on various patient characteristics and outcomes, such as vital status, cause of death, hospitalizations, medications, and laboratory test results. The comprehensive overview of these cohorts aims to assist researchers, collaborators, and other interested parties in understanding the scope and potential applications of the available data. All cohorts are regularly updated, thereby supporting continuing research on cardiovascular clinical practice and prognosis in Denmark.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"825-836"},"PeriodicalIF":3.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Safety Climate in Danish Primary Care: Adaption and Validation of the Danish Safety Attitudes Questionnaire (SAQ-DK-PRIM) [Letter].","authors":"Tien Zubaidah, Norlaila Sofia","doi":"10.2147/CLEP.S506133","DOIUrl":"10.2147/CLEP.S506133","url":null,"abstract":"","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"823-824"},"PeriodicalIF":3.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of New-Onset Atrial Fibrillation on Mortality in Critically Ill Patients.","authors":"Hong-Da Zhang, Lei Ding, Li-Jie Mi, Ai-Kai Zhang, Yuan-Dong Liu, Xiang-Nan Li, Xin-Xin Yan, Yu-Jing Shen, Min Tang","doi":"10.2147/CLEP.S485411","DOIUrl":"10.2147/CLEP.S485411","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in critically ill patients and significantly impacts mortality. This study sought to evaluate the impact of new-onset AF on mortality in a critically ill population.</p><p><strong>Methods: </strong>This study identified 48018 adult patients admitted to the ICU from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Patients were categorized as no AF, pre-existing AF, or new-onset AF. We analyzed mortality at 3 months, 6 months, and 1 year.</p><p><strong>Results: </strong>Overall, 31,562 (65.73%) patients had no AF, 4877 (10.16%) had pre-existing AF, and 11,579 (24.11%) had new-onset AF. Median ages were 61.47 years (no AF), 76.12 years (pre-existing AF), and 75.26 years (new-onset AF). New-onset AF was associated with the highest mortality rates: 25.16% at 3 months, 29.23% at 6 months, and 34.04% at 1 year, compared to 17.94%, 22.55%, and 28.52% for pre-existing AF, and 14.54%, 17.25%, and 20.69% for no AF respectively (p < 0.001 for all). Multivariate Cox regression indicated that new-onset AF significantly increased the risk of 1-year mortality by 15.5% compared to no AF (HR: 1.155, 95% CI: 1.101-1.212; p < 0.001) and by 23.9% compared to pre-existing AF (HR: 1.239, 95% CI: 1.164-1.318; p < 0.001). Kaplan-Meier analysis confirmed lower survival probabilities for new-onset AF over one year compared to the other groups (p < 0.001).</p><p><strong>Conclusion: </strong>In patients with critical illness, new-onset AF is associated with an increased risk of mortality compared with pre-existing AF or no AF.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"811-822"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Validation Study of the Danish ICD-10 Diagnosis Code K75.0 for Pyogenic Liver Abscess.","authors":"Margarita Dudina, Kirstine Kobberøe Søgaard, Søren Schou Olesen, Hans Linde Nielsen","doi":"10.2147/CLEP.S485678","DOIUrl":"10.2147/CLEP.S485678","url":null,"abstract":"<p><strong>Purpose: </strong>Routinely collected clinical data are a valuable resource for epidemiological research in infectious diseases. We examined the validity of the ICD-10 diagnosis code K75.0 for pyogenic liver abscess (PLA) from hospital discharge registries.</p><p><strong>Patients and methods: </strong>This validation study was conducted in the North Denmark Region, using data from Aalborg University Hospital and the North Denmark Regional Hospital, along with their smaller regional satellite hospitals. The study period extended from January 1, 2010, to June 30, 2022, covering a catchment population of approximately 590,000 inhabitants. We identified patients with a first diagnosis (primary or secondary) of PLA (ICD-10 code K75.0) recorded in the Danish National Patient Registry and estimated the positive predictive value (PPV) of the PLA diagnosis using medical records as the reference standard. Subanalyses of PPV were conducted based on the department setting (emergency, medical, or surgical).</p><p><strong>Results: </strong>A total of 297 patients received an ICD-10 diagnosis code of K75.0 during the study period. Five (2.0%) patients were excluded due to initial hospitalization outside the North Denmark Region, and 67 (23%) were misclassified. The overall PPV for the K75.0 diagnosis code during the study period was 77% (95% CI: 72-82%). The highest PPV, 88% (95% CI: 81-93%), was observed in patients diagnosed in medical departments, while the lowest PPV, 56% (95% CI: 30-80%), was observed in patients diagnosed in emergency wards. The PPV for surgical departments was 69% (95% CI: 61-77%).</p><p><strong>Conclusion: </strong>The overall PPV of the ICD-10 diagnosis code K75.0 for PLA was 77%. Variability in PPVs across departments suggested differences in diagnostic accuracy, with medical departments demonstrating the highest PPV.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"803-810"},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibuprofen for Acute Pericarditis and Associated Cardiovascular Risks: A Danish Nationwide, Population-Based Cohort Study.","authors":"Jakob Kjølby Eika, Kasper Bonnesen, Lars Pedersen, Vera Ehrenstein, Henrik Toft Sørensen, Morten Schmidt","doi":"10.2147/CLEP.S483553","DOIUrl":"10.2147/CLEP.S483553","url":null,"abstract":"<p><strong>Purpose: </strong>Ibuprofen is used to treat acute pericarditis, but high-dose ibuprofen has also been associated with increased cardiovascular risks. We examined the cardiovascular safety of using ibuprofen for acute pericarditis.</p><p><strong>Patients and methods: </strong>A Danish nationwide, population-based cohort study including patients <i>≥</i>18 years with first-time acute pericarditis (n=12,381) during 1996-2020 was conducted. Ibuprofen use was modelled in two ways: First, we considered patients exposed based on the tablet strength of their first ibuprofen filling (a proxy for an <i>intention-to-treat</i> analysis). Second, we considered patients exposed in a time-varying manner (a proxy for an <i>as-treated</i> analysis). The primary outcome of major adverse cardiovascular events (MACE) was a composite of myocardial infarction, ischemic stroke, congestive heart failure, and cardiovascular death.</p><p><strong>Results: </strong>In the <i>intention-to-treat</i> analysis, the 1-year risk of MACE was 1.37% (95% confidence interval [CI]: 1.03-1.79) for ibuprofen initiators and 4.32% (95% CI: 3.89-4.78) for non-initiators. Compared with non-initiators within 1-year follow-up, the adjusted hazard ratio for MACE was 0.75 (95% CI: 0.67-0.85) for initiators overall, 0.38 (95% CI: 0.28-0.52) for initiators of >400 mg tablets, and 0.87 (95% CI: 0.76-0.99) for initiators of ≤400 mg tablets. In the <i>as-treated</i> analysis, compared with no use, the hazard ratio associated with ibuprofen use was 0.69 (95% CI: 0.54-0.89) for MACE, 0.82 (95% CI: 0.54-1.26) for myocardial infarction, 0.74 (95% CI: 0.45-1.22) for ischemic stroke, 0.67 (95% CI: 0.47-0.96) for congestive heart failure, and 0.60 (95% CI: 0.31-1.17) for cardiovascular death.</p><p><strong>Conclusion: </strong>Ibuprofen use for acute pericarditis was not associated with increased cardiovascular risks, supporting its safety in current practice.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"793-802"},"PeriodicalIF":3.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Danish National Hospital Medication Register: A Resource for Pharmacoepidemiology.","authors":"Oscar Rosenkrantz, Jannik Wheler, Mats Christian Westphal Thrane, Lars Pedersen, Henrik Toft Sørensen","doi":"10.2147/CLEP.S487838","DOIUrl":"10.2147/CLEP.S487838","url":null,"abstract":"<p><strong>Background: </strong>The Danish National Hospital Medication Register (DHMR), one of the first nationwide in-hospital medication registries in the world, contains detailed information on medication administration and dispensing.</p><p><strong>Objective: </strong>To provide an overview of the information recorded in the DHMR and to highlight its strengths and limitations as a pharmacoepidemiological research tool.</p><p><strong>Methods: </strong>We reviewed the registry´s geographic and clinical specialty coverage and medications recorded according to the main groups of the Anatomical Therapeutic Chemical classification system.</p><p><strong>Results: </strong>From May 2018 through December 2023, the DHMR recorded data on more than 1.9 million unique patients from all approximately 50 public hospitals and associated hospital outpatient clinics, totaling 105.3 million recordings of hospital medication use. The registry records detailed data on the indication for medication, medication type, pharmaceutical form, dosage, and administration time, collected through electronic medical record systems. Although the data quality has not yet been evaluated in a scientific context, some potential limitations are known. These include regional differences in the data collection and a lack of data from certain clinical specialties. Due to its recent establishment in 2018, the registered number of patients treated may still be limited for some rarely used medications.</p><p><strong>Conclusion: </strong>The DHMR is an important new resource for research in Denmark. Combined with the Danish National Prescription Registry, which covers all community pharmacies, it offers access to accurate data on medication exposure in the Danish population. Users should be aware of potential issues with lack of information before 2018.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"783-792"},"PeriodicalIF":3.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Survival of Nasopharyngeal Carcinoma in Endemic and Non-Endemic Areas Based on the US SEER Database and a Chinese Single-Institutional Registry.","authors":"Lin-Feng Guo, Ya-Qing Dai, Yi-Feng Yu, San-Gang Wu","doi":"10.2147/CLEP.S490023","DOIUrl":"10.2147/CLEP.S490023","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prognostic implications of gender in nasopharyngeal carcinoma (NPC) utilizing data from two independent cohorts: the Xiamen (XM)-NPC cohort (an endemic area in China) and the United States Surveillance, Epidemiology, and End Results (SEER)-NPC cohort (a non-endemic area).</p><p><strong>Methods: </strong>We included patients diagnosed with NPC from both the XM-NPC and SEER-NPC cohorts. Statistical analysis involved the chi-square test, Kaplan-Meier method, and multivariate Cox regression analyses.</p><p><strong>Results: </strong>The study identified 728 patients in the XM-NPC cohort and 2237 in the SEER cohort. In the XM-NPC cohort, 515 (70.7%) were male and 213 (29.3%) were female. In the SEER-NPC cohort, 1597 (71.4%) were male and 640 (28.6%) were female. The male-to-female ratio peaked at ≤25 years (2.33) and 46-55 years (2.79) in the XM-NPC cohort, and at ≤25 years (2.07) and 56-65 years (3.24) in the SEER-NPC cohort. The lowest ratios were observed among patients aged 26-35 years in both cohorts (XM-NPC: 1.64; SEER-NPC:1.38). In the XM-NPC cohort, females had significantly better overall survival (P=0.022) and distant metastasis-free survival (P=0.038) compared to males. Similarly, in the SEER-NPC cohort, gender was found to be an independent prognostic factor for overall survival, with females showing better outcomes (P=0.038). Consistent trends were observed in patients aged >45 years in both cohorts, while survival outcomes were comparable between genders in patients aged ≤45 years.</p><p><strong>Conclusion: </strong>Gender independently influences survival outcomes of NPC in both endemic and non-endemic areas.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"16 ","pages":"769-782"},"PeriodicalIF":3.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}