The Swedish cause of death register

Brooke, Hannah L.; Talbäck, Mats; Hörnblad, Jesper; Johansson, Lars; Ludvigsson, Jonas F.; Druid, Henrik; Feychting, Maria; Ljung, Rickard

doi:10.1007/s10654-017-0316-1

Cited by 856 publications

(757 citation statements)

References 15 publications

(17 reference statements)

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“…Correcting for random error in exposure measurement and their true longterm variation further allowed for more accurate effect estimates. 42 However, validation specifically for BC as death cause is lacking, and we cannot exclude under-or overrepresentation of BC as death cause and therefore a potential influence on our results for BC mortality. However, aside from residual confounding, the association between metabolic factors and BC among current smokers might be underestimated due to potential random error in the measurement of smoking, which has been speculated to cause the consistently inverse association found for BMI and lung cancer.…”

Section: Discussionmentioning

confidence: 97%

Risk of bladder cancer by disease severity in relation to metabolic factors and smoking: A prospective pooled cohort study of 800,000 men and women

Teleka

Häggström

Nagel

et al. 2018

Intl Journal of Cancer

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Previous studies on metabolic factors and bladder cancer (BC) risk have shown inconsistent results and have commonly not investigated associations separately by sex, smoking, and tumor invasiveness. Among 811,633 participants in six European cohorts, we investigated sex-specific associations between body mass index (BMI), mid-blood pressure (BP, [systolic + diastolic]/2), plasma glucose, triglycerides, total cholesterol and risk of BC overall, non-muscle invasive BC (NMIBC) and muscle invasive BC (MIBC). Among men, we additionally assessed additive interactions between metabolic factors and smoking on BC risk. During follow-up, 2,983 men and 754 women were diagnosed with BC. Among men, triglycerides and BP were positively associated with BC risk overall (hazard ratio [HR] per standard deviation [SD]: 1.17 [95% confidence interval (CI) 1.06-1.27] and 1.09 [1.02-1.17], respectively), and among women, BMI was inversely associated with risk (HR: 0.90 [0.82-0.99]). The associations for BMI and BP differed between men and women (p ≤ 0.005). Among men, BMI, cholesterol and triglycerides were positively associated with risk for NMIBC (HRs: 1.09 [95% CI 1.01-1.18], 1.14 [1.02-1.25], and 1.30 [1.12-1.48] respectively), and BP was positively associated with MIBC (HR: 1.23 [1.02-1.49]). Among women, glucose was positively associated with MIBC (HR: 1.99 [1.04-3.81]). Apart from cholesterol, HRs for metabolic factors did not significantly differ between MIBC and NMIBC, and there were no interactions between smoking and metabolic factors on BC. Our study supports an involvement of metabolic aberrations in BC risk. Whilst some associations were significant only in certain sub-groups, there were generally no significant differences in associations by smoking or tumor invasiveness.

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Section: Discussionmentioning

confidence: 97%

Risk of bladder cancer by disease severity in relation to metabolic factors and smoking: A prospective pooled cohort study of 800,000 men and women

Teleka

Häggström

Nagel

et al. 2018

Intl Journal of Cancer

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“…The personal identity number is a unique 10‐digit code provided to all Swedish residents . Through this number, we linked the MBR to the NPR and the CDR . The NPR contains data on hospital discharge diagnoses since 1964, with full national coverage since 1987 and hospital‐based outpatient data since 2001.…”

Section: Methodsmentioning

confidence: 99%

Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population‐Based Cohort Study of 1.3 Million Pregnancies

Hagström

Höijer

Marschall

et al. 2018

Hepatology Communications

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There are limited data on pregnancy outcomes in women with cirrhosis. To address this gap, we examined the records of singleton births from Sweden’s National Patient Register (NPR), Cause of Death Register (CDR), and Medical Birth Register (MBR) between 1997 and 2011 to assess exposure and pregnancy‐related and liver‐related outcomes of pregnant women with cirrhosis. Exposure status was defined as having an International Classification of Diseases (ICD) code for cirrhosis obtained prior to or during pregnancy. Poisson regression with cluster‐robust standard errors was used to estimate relative risks (RRs) adjusted for maternal age, smoking, and body mass index (BMI). We identified 103 pregnancies in women with cirrhosis and compared these to 1,361,566 pregnancies in women without cirrhosis. Pregnancies in women with cirrhosis were at increased risk of caesarean delivery (36% versus 16%, respectively; adjusted RR [aRR], 2.00; 95% confidence interval [CI], 1.47‐2.73), low birth weight (15% versus 3%; aRR, 3.87; 95% CI, 2.11‐7.06), and preterm delivery (19% versus 5%; aRR, 3.51; 95% CI, 2.16‐5.72). Rates of maternal mortality during pregnancy (no cases), gestational diabetes, preeclampsia, small for gestational age, congenital malformations, and stillbirth were not increased when compared to the pregnant women without cirrhosis. There were 12 hospitalizations during pregnancy due to liver‐related events, including one case with bleeding esophageal varices. Conclusion: Women with cirrhosis are at increased risk for adverse pregnancy outcomes. However, severe maternal and fetal adverse events were rare in our study, and most pregnancies in women with cirrhosis ended without complications.

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“…The validity of hospital discharge diagnoses obtained from the NPR is between 85% and 95% depending on diagnosis . The CDR contains data regarding the causes of death of all deceased Swedish inhabitants …”

Section: Methodsmentioning

confidence: 99%

Cardiovascular risk factors in non‐alcoholic fatty liver disease

Hagström

Nasr

Ekstedt

et al. 2018

Liver International

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Background & Aims Patients with non‐alcoholic fatty liver disease (NAFLD) are at an increased risk for cardiovascular disease (CVD). It is unclear whether histological variables may help predict CVD risk. We evaluated histology and traditional CV risk factors as predictors of CVD outcomes in a large NAFLD cohort. Methods We included 603 biopsy‐proven NAFLD patients free of baseline CVD and matched these (1:10, by age, sex and municipality) to 6269 population controls. All individuals were cross‐linked to national registries to ascertain incident CVD events, defined as acute ischaemic heart disease or stroke. The presence of CV risk factors and liver histology were available in NAFLD patients only. Cox regression models were used to estimate hazard ratios (HR) for incident CVD. Results During a mean follow‐up of 18.6 years, 168 (28%) of NAFLD patients and 1325 (21%) of controls experienced a CVD event (HR 1.54, 95%CI 1.30‐1.83). Within the NAFLD cohort, age, male sex, type 2 diabetes, smoking and triglycerides were associated with risk of CVD. Taking these CV risk factors into account, no histological parameter, including presence of NASH and fibrosis stage, were associated with incident CVD. Conclusions Patients with NAFLD are at an increased risk for CVD compared to matched controls, but histological parameters do not seem to independently predict this risk.

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The Swedish cause of death register

Cited by 856 publications

References 15 publications

Risk of bladder cancer by disease severity in relation to metabolic factors and smoking: A prospective pooled cohort study of 800,000 men and women

Risk of bladder cancer by disease severity in relation to metabolic factors and smoking: A prospective pooled cohort study of 800,000 men and women

Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population‐Based Cohort Study of 1.3 Million Pregnancies

Cardiovascular risk factors in non‐alcoholic fatty liver disease

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