Distributions of demographic variables and comorbidities in breast cancer patients with and without propensity score matching.

Background: Whether diabetes mellitus (DM) patients with chronic kidney disease (CKD) can glean individual renal benefit from dihydropyridine calcium channel blockers (DCCBs) remains to be determined. We conducted a nationwide, population-based, propensity score matching cohort study to examine the effect of DCCBs on CKD progression in DM patients with CKD.Methods: One million individuals were randomly sampled from Taiwan’s National Health Insurance Research Database. The study cohort consisted of DM patients with CKD who used DCCBs. The comparison cohort was propensity-matched for demographic characteristics and comorbidities. The endpoint was advanced CKD or end-stage renal disease (ESRD). The Cox proportional hazards model was used to calculate the risks.Results: In total, 9,761 DCCB users were compared with DCCB nonusers at a ratio of 1:1. DCCB users had lower risk of advanced CKD and ESRD than nonusers—with adjusted hazard ratio [aHR; 95% confidence interval (CI)] of 0.64 (0.53–0.78) and 0.59 (95% CI, 0.50–0.71) for advanced CKD and ESRD, respectively. DCCB users aged ≥65 years had the lowest incidence rates of advanced CKD and ESRD—with aHR (95% CI) of 0.47 (0.34–0.65) and 0.48 (0.35–0.65) for advanced CKD and ESRD, respectively. Finally, cumulative DCCB use for >1,100 days was associated with the lowest advanced CKD and ESRD risks [(aHR, 0.29 (95% CI, 0.19–0.44)].Conclusion: DM patients with CKD who used DCCBs had lower risk of progression to advanced CKD and ESRD than nonusers did.

Objective Ketamine, as a sedative, has been administered during mechanical ventilation in critically ill patients; however, its impact on survival outcomes in this patient population remains uncertain. Methods This retrospective cohort study extracted data from the Medical Information Mart for Intensive Care (MIMIC-IV) database, version 3.0. Patients were categorized into the ketamine group and the control group based on whether ketamine was administered during mechanical ventilation. Propensity score matching was performed to adjust for demographic variables and coexisting conditions. The primary outcome was 28-day mortality. Secondary outcomes included 14-day and 90-day mortality rates, as well as hospital and ICU lengths of stay. Results The study included a total of 8569 patients, with 330 in the ketamine group and 8239 in the control group. After propensity score matching, significant differences in mechanical ventilation duration and the proportion of patients with acute respiratory distress syndrome remained between groups. No significant differences were observed in 28-day and 90-day mortality rates between the groups. Subgroup analysis indicated that ketamine was associated with lower 14-day mortality rates among younger patients, those with acute respiratory distress syndrome, and norepinephrine users. Ketamine administration was also found to correlate with increased lengths of stay in both the hospital and ICU. Conclusions Ketamine was more frequently selected for patients requiring prolonged mechanical ventilation. The administration of ketamine was associated with reduced 14-day but not with 28-day or 90-day mortality rates.

Basic demography of admitted AKI-D patients in England grouped by day of admission in a propensity score matched cohort between 2003–2015.

Baseline demographic and clinical characteristics of the patients (unmatched and matched cohorts).

BackgroundAntibiotic-driven dysbiosis may impair immune function and reduce vaccine-induced antibody titers.ObjectivesThis study aims to investigate the impacts of early-life antibiotic exposure on subsequent varicella and breakthrough infections.MethodsThis is a nationwide matched cohort study. From Taiwan’s National Health Insurance Research Database, we initially enrolled 187,921 children born from 1997 to 2010. Since 2003, the Taiwan government has implemented a one-dose universal varicella vaccination program for children aged 1 year. We identified 82,716 children born during the period 1997 to 2003 (pre-vaccination era) and 48,254 children born from July 1, 2004, to 2009 (vaccination era). In the pre-vaccination era, 4,246 children exposed to antibiotics for at least 7 days within the first 2 years of life (Unvaccinated A-cohort) were compared with reference children not exposed to antibiotics (Unvaccinated R-cohort), with 1:1 matching for gender, propensity score, and non-antibiotic microbiota-altering medications. Using the same process, 9,531 children in the Vaccinated A-cohort and Vaccinated R-cohort were enrolled from the vaccination era and compared. The primary outcome was varicella. In each era, demographic characteristics were compared, and cumulative incidences of varicella were calculated. Cox proportional hazards model was used to examine associations.ResultsIn the pre-vaccination era, the 5-year cumulative incidence of varicella in the Unvaccinated A-cohort (23.45%, 95% CI 22.20% to 24.70%) was significantly higher than in the Unvaccinated R-cohort (16.72%, 95% CI 15.62% to 17.82%) (p

Participant demographics and clinical characteristics.