This study aimed to investigate whether patients with asthma have a higher risk of incident rheumatoid arthritis (RA) using systematic review and meta-analysis technique.
Potentially eligible studies ...were identified from Medline and EMBASE databases from inception to May 2020 using search strategy that comprised of terms for “Asthma” and “Rheumatoid arthritis”. Eligible cohort study must consist of one cohort of patients with asthma and another cohort of individuals without asthma. Then, the study must effect estimates with 95% confidence intervals (95% CIs) comparing incident RA between the groups. Eligible case-control studies must include cases with RA and controls without RA. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and RA must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.
A total of 22,442 articles were identified. After two rounds of independent review by three investigators, six cohort studies and fourteen case-control studies met the eligibility criteria and were included into the meta-analysis. Meta-analysis of cohort studies found that patients with asthma had a significantly higher risk of RA compared with individuals without asthma with the pooled hazard ratio of 1.42 (95% CI, 1.18 – 1.70). Meta-analysis of case-control studies revealed that patients with asthma had a higher risk of RA compared with individuals without asthma with the pooled odds ratio of 1.33 (95%CI, 0.97 – 1.83). Funnel plot for the meta-analysis of case-control studies was asymmetric, suggesting the presence of publication bias.
This systematic review and meta-analysis found a significant association between asthma and higher risk of incident RA.
Background: Recent studies have suggested that patients with chronic rhinosinusitis (CRS) may have a higher risk of stroke although the data are still limited. The current systematic review and ...meta-analysis was conducted with the aims to identify all studies that investigated this relationship and summarize their results together to better characterize the risk of stroke among patients with CRS. Methods: A comprehensive literature review was conducted by searching for published articles in MEDLINE and EMBASE databases from inception to October 2018 to identify all observational studies that compared the risk of stroke among patients with CRS to individuals without CRS. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using random-effect, generic inverse variance method of DerSimonian and Laird. Results: A total of 5 studies with 447,065 participants met the eligibility criteria and were included into the meta-analysis. The risk of stroke among patients with CRS was significantly higher than individuals without CRS with the pooled RR of 1.79 (95% CI, 1.34-2.40, I2 = 84%). Conclusions: The current study found that CRS is associated with higher risk stroke. Whether this relationship is causal and how it should be addressed in clinical practice require further investigations.
Chronic hepatitis C virus (HCV) infection is associated with increased risk of hepatobiliary tract cancer. However, whether chronic HCV infection is also associated with elevated risk of other types ...of cancer is still unknown. This systematic review and meta-analysis was conducted in order to investigate whether chronic HCV infection is positively associated with esophageal cancer.
A systematic review was conducted using Embase and MEDLINE databases from inception to November 2019, with a search strategy that comprised the terms for "hepatitis C virus" and "cancer." Eligible studies were cohort studies consisting of patients with chronic HCV infection and comparators without HCV infection, and followed them for incident esophageal cancer. Hazard risk ratio, incidence rate ratio, relative risk or standardized incidence ratio of this association were extracted from each eligible study along with their 95% confidence intervals and were combined to calculate the pooled effect estimate using the random effect, generic inverse variance method.
A total of 20,459 articles were identified using this search strategy. After 2 rounds of independent review, 7 studies satisfied the inclusion criteria and were included in the meta-analysis. Chronic HCV infection was significantly associated with a higher incidence of esophageal cancer with the pooled relative risk of 1.61 (95% confidence interval: 1.19-2.17; I2=39%). The funnel plot was relatively symmetric which was not suggestive of publication bias.
This systematic review and meta-analysis demonstrated that there is a modest association between chronic HCV and incident esophageal cancer. However, more studies are needed to investigate the causality of this association.
Abstract only Background: Abnormal kidney function is one of the risk factors for cardiovascular diseases. Whether the association between a wide range of kidney functions from normal to advanced ...chronic kidney disease and stroke risk is unclear. Methods: A cross-sectional study involving participants (≥ 18 years old) in the 2017 - 2020 NHANES was examined for the association between serum creatinine (SCr) and history of stroke informed by a doctor or other health professional by multiple logistic regression analysis. Results: Of 9,211 participants, the mean±SD age was 51±18 y/o and 52% were female. White accounts for 35% followed by Black (27%), Asian (12%), Mexican American (11%), Hispanic (10%), and others (5%). Up to 485 participants (5%) ever had a stroke. Median (IQR) SCr was 0.84 (0.71 - 1.01) mg/dL. Stratified SCr among 7,865 participants with SCr data into quartile (Q), mean SCr were 0.62, 0.78, 0.92, and 1.34 mg/dL, respectively (Figure 1A). Compared to participants in Q1, strokes were 1.72 and 3.45 times as likely to occur in those in Q3 and Q4, respectively (Q3: 95%CI 1.24, 2.39, P 0.001; Q4: 95%CI 2.55, 4.67, P <0.0001); while participants in Q2 were 1.41 times as likely to have strokes but not statically significant (95%CI 0.99, 2.00, P 0.055; Figure 1B). After adjusting for age, gender, race, BMI, only participants in Q4 were 1.64 times as likely to have a stroke compared to those in Q1 (95%CI 1.09, 2.45, P 0.017); while strokes were 1.158 and 1.21 times as likely to occur among participants in Q2 and Q3, respectively but not statically significant (Q2: 95%CI 0.78, 1.72, P 0.468; Q3: 0.81, 1.80, P 0.348). There were effect modifications between SCr in Q4 and some races (Hispanic, White, and others; P interaction 0.04, 0.013, and 0.011, respectively). Conclusions: SCr was positively associated with the likelihood to have a stroke. Longitudinal cohort studies are required to further elucidate the relationship.
e16622 Background: Bladder cancer constitutes a notable etiological factor in kidney disease, precipitating acute kidney injuries (AKI) through mechanisms such as post-renal obstruction, with the ...potential for progression to chronic kidney disease (CKD) over time. The objective of this study is to systematically evaluate the correlation between bladder cancer and the manifestation of acute or chronic kidney disease across various stages, with a focus on hospitalized patients undergoing treatment for bladder cancer. Methods: The 2020 United States National Inpatient Sample (NIS) database was subjected to analysis in this study. We focused on adult patients (≥18 years) with a primary discharge diagnosis of bladder cancer, specifically those who were hospitalized for cancer and presented with a diagnosis of acute kidney injury or diverse stages of chronic kidney disease, as identified through pertinent ICD-10 CM codes. Utilizing survey multivariable logistic and linear regression analysis, we calculated adjusted odds ratios (ORs) to assess the outcomes of interest. A p-value of <0.05 was deemed statistically significant in this analytical framework. Results: In 2020, 81,995 eligible patients were identified, with 75.62% being male. The ethnic distribution was 81% Caucasian, 8% Black, 5% Mexican American, and 2% Asian. Using a multivariable regression model adjusting for patient and hospital-level factors, bladder cancer showed a significant association with acute kidney injury (OR 1.92, 95% CI: 1.85-2.00, P < 0.001) and all stages of chronic kidney disease (OR 1.66, 95% CI: 1.58-1.74, P < 0.001). Further analysis revealed no significant association with early CKD stages 1 and 2 (P = 0.25 and 0.26), but a notable association with increased risk for CKD stages 3 and 4 (OR 1.45, 95% CI: 1.37-1.52, P < 0.001) and (OR 1.69, 95% CI: 1.56-1.83, P < 0.001), respectively. Intriguingly, bladder cancer displayed a negative association with CKD stage 5 (OR 0.76, 95% CI: 0.63-0.78, P < 0.001). Conclusions: In summary, our study reveals that bladder cancer in hospitalized cancer patients is linked to increased risks of acute kidney injury (AKI), CKD stages 3 and 4, and a decreased risk of CKD stage 5. Vigilant kidney function monitoring is crucial during cancer hospitalization, given the elevated risk of worsening function. Proactive interventions are necessary to address kidney-related complications. Further longitudinal cohort studies are warranted to enhance our understanding and devise strategies to reduce the risk of CKD in individuals with bladder cancer.
11160 Background: Lung cancer is the leading cause of cancer related deaths in the United States. Patients with advanced lung cancer tend to have varying degrees of protein energy malnutrition (PEM), ...due to multiple reasons including cancer related cachexia, sarcopenia, and adverse effect of chemotherapy. However, the impact of PEM on clinical outcomes in this subgroup needs further exploration. Methods: We utilized the 2020 National Inpatient Sample (NIS) Database in conducting this retrospective cohort study. We identified patients with lung cancer and PEM using appropriate ICD-10 diagnostic codes. We stratified patients with lung cancer based on the presence or absence of PEM. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (ORs) for the primary and secondary outcomes. A p value of <0.05 was considered statistically significant. The aim of this study was to investigate the impact of PEM on in-hospital mortality, hospital length of stay (LOS), and total hospitalization charge among hospitalized patients with lung cancer. Results: We identified a total of 92425 hospitalized patients with lung cancer, of which 10.53% (9739/92425) had comorbid PEM. The overall in-hospital mortality among patients with lung cancer was 5.79% (5360/92425). Among those with concomitant PEM, the mortality rate was significantly higher at 13.13% (1279/9739, p<0.001). Utilizing a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, PEM was found to be an independent predictor of increased in-hospital mortality (adjusted OR 2.11; 95% (confidence interval CI 1.77-2.51; p<0.001), longer LOS (coefficient 3.02; CI 2.62-3.42; p<0.001), and higher total hospitalization charge (coefficient $22105; CI $13423- $30786; p<0.001). Conclusions: Our analysis demonstrated that PEM was widely prevalent in hospitalized patients with lung cancer and associated with worse outcomes. Efforts should be made to promote nutritional assessment and screening mechanisms with the aim to initiate early nutritional support as indicated. Further prospective studies are warranted to better understand these associations and guide management.
