BackgroundTN is one of the most common causes of facial pain. A higher prevalence of psychiatric co-morbidities, especially depressive disorder, has been proven in patients with TN; however, a clear temporal-causal relationship between TN and specific psychiatric disorders has not been well established. We performed a nationwide population-based retrospective cohort study to explore the relationship between TN and the subsequent development of psychiatric disorders, including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder.MethodsWe identified subjects who were newly diagnosed with TN between January 1, 2000 and December 31, 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed for patients without TN who were matched according to age and sex. All TN and control patients were observed until diagnosed with psychiatric disorders, death, withdrawal from the National Health Institute system, or until December 31, 2010.ResultsThe TN cohort consisted of 3273 patients, and the comparison cohort consisted of 13,092 matched control patients without TN. The adjusted hazard ratio (aHR) of depressive disorder, anxiety disorder and sleep disorder in subjects with TN was higher than that of the controls during the follow-up [aHR: 2.85 (95 % confidence interval: 2.11–3.85), aHR: 2.98 (95 % confidence interval: 2.12–4.18) and aHR: 2.17 (95 % confidence interval: 1.48–3.19), respectively].ConclusionsTN might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder, but not schizophrenia or bipolar disorder. Additional prospective studies are required to confirm these findings.
The number of patients with cancer being admitted to intensive care units (ICUs)
is increasing worldwide, and these patients are vulnerable to infection. This
study aimed to address the long-term impact of positive cultures during
admission on 1-year mortality among patients with cancer who received
perioperative intensive care. This retrospective cohort study enrolled adult
patients with cancer who were admitted to ICUs and received surgery during 2011
to 2016 at a tertiary hospital in central Taiwan. Cancer-related data were
retrieved from the cancer registry, and data during ICU admissions were obtained
from the electronic medical records. We compared the survival curves between
patients with and without positive clinical cultures using log-rank test and
used a multivariable Cox proportional hazards regression model to evaluate the
influence of positive clinical cultures on 1-year mortality. A total of 638
patients were included for analyses, and 37.9% of them had positive cultures
during the index admission. In-hospital mortality was 9.1%, while 1-year
mortality was 21.0%. Compared with patients who survived, patients who died were
significantly more likely to have positive cultures (59.7% vs 32.1%), to have a
higher Acute Physiology and Chronic Health Evaluation II scores (median 21.8 vs
19.0), and to receive mechanical ventilation (86.6% vs 77.4%). Survival analysis
found that positive cultures of blood, the respiratory tract, the urinary tract,
or the skin and soft tissue were associated with an increased 1-year mortality.
Multivariable Cox proportional hazards regression analysis found that positive
cultures of blood, the respiratory tract, the urinary tract, or the skin and
soft tissue (hazard ratio: 1.621; 95% confidence interval: 1.087-2.419) were
significantly associated with 62.1% increased hazards of death within 1 year
after the ICU admission. A positive culture during admission was associated with
a worsened long-term survival among patients with cancer who received
perioperative intensive care. Further studies are needed to confirm this
association.
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