Association of hearing loss with land transport accidents: a nationwide population-based study.

OBJECTIVE: This study aimed to investigate the association of prior hearing loss with land transport accidents using a nationwide population-based dataset. DESIGN: A case-control study. STUDY SAMPLE: Data for this study were obtained from Taiwan's National Health Insurance Dataset. We retrieved data on 2066 patients who had received a diagnosis of a land transport accident as cases. We used a propensity score-matched method to select 6198 controls. RESULTS: A Chi-squared test revealed that there was a significant difference in the prevalence of prior hearing loss between cases and controls (6.8% vs. 5.6%, p = 0.046). The odds ratio (OR) of prior hearing loss for cases was 1.128 (95% confidence interval [CI]: 1.003 ∼ 1.503) compared to controls. After adjusting for demographic variables and comorbidities, the OR of hearing loss for cases was 1.238 (95% CI: 1.008 ∼ 1.522) that of controls. CONCLUSIONS: Our finding suggests that pre-existing hearing loss may be associated with land transport accidents among adults aged 50 years and older. Further study is needed to elucidate the mechanism(s) through which hearing loss may contribute to land transport accidents and examine how the use of hearing rehabilitation devices, for example, hearing aids impacts the observed associations.

Ten-year trends in the incidence of microtia: a nationwide population-based study from Taiwan.

PURPOSE: Few studies have explored population-based incidence rates of microtia using nationwide data. The aim of this study was to analyze the 10-year secular trends in the incidence of microtia and/or anotia in Taiwan from 2008 to 2017 using nationwide population-based data. METHODS: Patient data were retrieved from Taiwan's National Health Insurance Dataset, after identifying 1152 children aged ≤ 1 year with a first-time diagnosis of microtia or anotia between January 2008 and December 2017. The annual microtia-anotia incidence rate was the sum of new microtia-anotia cases in a year divided by total infant population in the year. Furthermore, we used the annual percent change (APC) to study the secular trend in microtia-anotia incidence rate. RESULTS: The annual incidence rate of microtia-anotia averaged across the 10-year period was 57.7 per 100,000 infants (standard deviation = 8.6). The annual incidence rates of microtia and anotia were 53.3 and 4.4 per 100,000 infants, respectively, during this period. Furthermore, female infants had a higher incidence than males (63.3 vs. 52.4 per 100,000). The incidence of microtia-anotia gradually decreased between 2008 and 2017 with an APC of - 5.64% (95% CI - 9.31 ~ - 1.18%, p = 0.004). Since 2011, females had a significantly higher annual incidence rate of microtia-anotia than males. CONCLUSIONS: The incidence of microtia-anotia was 57.7 per 100,000 infants in Taiwan, which declined during the study period 2008-2017. The female-to-male incidence ratio was 1.21:1.

A population-based case-control study of the association between cervical spondylosis and tinnitus.

OBJECTIVE: This population-based study aimed to study the association between tinnitus and cervical spondylosis. DESIGN: A case-control study. STUDY SAMPLE: We retrieved data from the Taiwan Longitudinal Health Insurance Database. We identified 2465 patients with tinnitus (cases) and 7395 comparison patients by propensity score matching. Multivariable logistic regressions were conducted to estimate the odds (OR) of a diagnosis of cervical spondylosis preceding the tinnitus diagnosis relative to controls. RESULTS: We found that 1596 (16.19%) of 9860 sample patients had received a diagnosis of cervical spondylosis before the index date, significantly different between the tinnitus group and control group (17.20% vs. 15.85%, p < 0.001). Logistic regression analysis showed an adjusted OR for prior cervical spondylosis of 1.235 for cases vs. controls (95% confidence interval [CI]: 1.088-1.402). Further, the adjusted ORs were 1.246 (95% CI: 1.041-1.491) and 1.356 (95% CI: 1.016-1.811), respectively, among patients aged 45 ∼ 64 and >64 groups. No difference in cervical spondylosis likelihood between cases and controls was found among patients aged 18 ∼ 44 groups. CONCLUSIONS: In conclusion, the study shows a positive association between cervical spondylosis and tinnitus. The findings call for greater awareness among physicians about a possible somatosensory component of cervical spine function which may contribute to tinnitus.

Correction to: Increased risk of tinnitus following a trigeminal neuralgia diagnosis: a one-year follow-up study.

An amendment to this paper has been published and can be accessed via the original article.

Increased risk of tinnitus following a trigeminal neuralgia diagnosis: a one-year follow-up study.

BACKGROUND: Tinnitus due to hyperactivity across neuronal ensembles along the auditory pathway is reported. We hypothesized that trigeminal neuralgia patients may subsequently suffer from tinnitus. Using nationwide, population-based data and a retrospective cohort study design, we investigated the risk of tinnitus within 1 year following trigeminal neuralgia. METHODS: We used the Taiwan National Health Insurance Research Dataset, a claims database, to identify all patients diagnosed with trigeminal neuralgia from January 2001 to December 2014, 12,587 patients. From the remaining patients, we identified 12,587 comparison patients without trigeminal neuralgia by propensity score matching, using sex, age, monthly income, geographic region, residential urbanization level, and tinnitus-relevant comorbidities (hyperlipidemia, diabetes, coronary heart disease, hypertension, cervical spondylosis, temporomandibular joint disorders and injury to head and neck and index year). All study patients (n = 25,174) were tracked for a one-year period to identify those with a subsequent diagnosis of tinnitus over 1-year follow-up. RESULTS: Among total 25,174 sample patients, the incidence of tinnitus was 18.21 per 100 person-years (95% CI = 17.66 ~ 18.77), the rate being 23.57 (95% CI = 22.68 ~ 24.49) among patients with trigeminal neuralgia and 13.17 (95% CI = 12.53 ~ 13.84) among comparison patients. Furthermore, the adjusted Cox proportional hazard ratio for tinnitus in the trigeminal neuralgia group was 1.68 (95% CI = 1.58 ~ 1.80) relative to the comparison cohort. CONCLUSIONS: We found a significantly increased risk of tinnitus within 1 year of trigeminal neuralgia diagnosis compared to those without the diagnosis. Further studies in other countries and ethnicities are needed to explore the relationship between trigeminal neuralgia and subsequent tinnitus.

A case-control study of the association between sialolithiasis and osteoporosis.

OBJECTIVE: The purpose of this study was to evaluate the association between osteoporosis and salivary gland stone using a population-based claims database. DESIGN: A case-control design. SETTING: Taiwan. PARTICIPANTS: We retrieved the sample for this case-control study from the Taiwan "Longitudinal Health Insurance Database 2005." All 557 patients aged 40 years or older with a diagnosis of sialolithiasis were cases, and 1671 matched controls (without sialolithiasis) were selected. SUBJECTS AND METHODS: We used the chi-square test to explore differences between cases and controls on socio-demographic characteristics. Furthermore, conditional logistic regressions were used to examine the association of sialolithiasis with previously diagnosed osteoporosis. RESULTS: Of 2228 sampled patients, 171 (7.68%) had ever been previously diagnosed with osteoporosis; 58 (10.41%) among cases and 113 (6.76%) among controls (P = 0.005). Conditional logistic regression analysis found that the odds ratio (OR) of prior osteoporosis for cases was 1.79 (95% confidence interval [CI]: 1.24-2.59, P = 0.002) relative to controls after adjusting for urbanisation and the selected medical co-morbidities. Furthermore, we found that among patients aged ≥65 years, the adjusted OR of prior osteoporosis for cases was 1.89 (95% CI = 1.02-3.51). No significant relationship was observed among patients aged <65 years old. CONCLUSION: This study demonstrates an association between sialolithiasis and osteoporosis. Although the finding warrants further investigation, the results call for more awareness of the possible concurrence of osteoporosis among physicians and patients with salivary gland stones.

Endometriosis increased the risk of bladder pain syndrome/interstitial cystitis: A population-based study.

OBJECTIVE: Previous studies have suggested an association between bladder pain syndrome/interstitial cystitis (BPS/IC) and endometriosis. However, no nation-wide population study has yet reported an association between them. In this study, we examined the risk of BPS/IC among subjects with endometriosis during a 3-year follow-up in Taiwan using a population-based dataset. STUDY DESIGN: This study comprised 9191 subjects with endometriosis, and 27 573 subjects randomly selected as controls. We individually followed-up each subject (n = 36 764) for a 3-year period to identify subjects subsequently diagnosed with BPS/IC. A Cox proportional hazards regression model was employed to estimate the risk of subsequent BPS/IC following a diagnosis of endometriosis. RESULTS: Incidences of BPS/IC during the 3-year follow-up period was 0.2% and 0.05% for subjects with and without endometriosis, respectively. The hazard ratio for developing BPS/IC over a 3-year period for subjects with endometriosis compared to subjects without endometriosis was 4.43 (95% CI: 2.13-9.23). After adjusting for co-morbidities like diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, asthma, tobacco use, and alcohol abuse, the Cox proportional hazards regressions revealed that the hazard ratio for BPS/IC among subjects with endometriosis was 3.74 (95% CI = 1.76-7.94, P < 0.001) compared to that in controls. CONCLUSIONS: This study provides epidemiological evidence of an association between endometriosis and a subsequent diagnosis of BPS/IC.

Bladder pain syndrome/interstitial cystitis is associated with asthma: A case-control study.

OBJECTIVE: Although asthma and bladder pain syndrome/interstitial cystitis (BPS/IC) are considered to share similar pathophysiological pathways, the relationship between asthma and BPS/IC is uncertain. This case-control study aimed to investigate the relationship between prior asthma and BPS/IC using a large database in Taiwan. MATERIALS AND METHODS: This study used data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 500 female patients with BPS/IC as cases and 500 propensity score-matched females without BPS/IC as controls. We conducted logistic regressions to estimate the odds ratio (OR) and 95% confidence interval (CI) for prior asthma between cases and controls. RESULTS: Results indicated that 143 (14.30%) of the total sampled patients had received a prior diagnosis of asthma. Moreover, prior asthma was found in 86 (17.20%) cases and 57 (11.40%) controls. The OR of prior asthma for cases was 1.61 (95%CI: 1.13-2.32) compared to propensity score-matched controls. Additionally, the ORs of prior asthma for females with BPS/IC aged 18-59 and ≥60 years were 1.72 (95%CI: 1.11-2.69) and 1.40 (95%CI: 0.74-2.62), respectively, compared to controls. CONCLUSIONS: We concluded that prior asthma was significantly associated with BPS/IC in a female Taiwanese population.

Association of migraines with brain tumors: a nationwide population-based study.

BACKGROUND: Several studies examined headaches as a symptom of brain neoplasms. Nevertheless, very few studies attempted to specifically evaluate the role of headaches as a risk factor. This study aimed to investigate the risk of migraine occurrence in the preceding years among patients diagnosed with brain tumors and unaffected controls. METHODS: Data were obtained from the Taiwan National Health Insurance Research Database. In total, 11,325 adults with a first-time brain tumor diagnosis were included as cases, together with 11,325 unaffected matched controls. Each individual was traced in the healthcare claims dataset for a prior diagnosis of migraines. Conditional logistic regressions were performed to calculate the odds ratio (OR) and the corresponding 95% confidence interval (CI) to present the association between brain tumors and having previously been diagnosed with migraines. RESULTS: We found that among patients with and those without brain tumors, 554 (4.89%) and 235 (2.08%) individuals, respectively, were identified as having a prior migraine diagnosis. Compared to unaffected controls, patients with brain tumors experienced an independent 2.45-fold increased risk of having a prior migraine diagnosis. The risks were even higher among men (odds ratio (OR) = 3.04, 95% confidence interval (CI) = 2.29~ 4.04) and after patients who had received a prior migraine diagnosis within 3 years were excluded (OR = 1.91, 95% CI = 1.59~ 2.29). CONCLUSIONS: This is the first report demonstrating the occurrence of brain tumors to be associated with a prior migraine history, for both men and women, in a population-based study.

A case-control study of the association between ulcerative colitis and hyperthyroidism in an Asian population.

OBJECTIVE: Ulcerative colitis (UC) is a chronic relapsing inflammatory disease with significant clinical diversity. However, the aetiology, pathogenesis and optimal treatment of UC remain unclear. The purpose of this case-control study was to investigate the association between previously diagnosed hyperthyroidism and UC using a large population-based data set in Taiwan. METHODS: The data for this population-based case-control study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included 2709 patients with UC as cases and 8127 sex- and age-matched patients without UC as controls. A conditional logistic regression analysis was conducted to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between UC and prior hyperthyroidism. RESULTS: We found that, in total, 327 of the 10 836 sampled patients (3.02%) had previously been diagnosed with hyperthyroidism. There was a higher proportion of prior hyperthyroidism among cases than controls (4.10% vs 2.66%, P<.001). A conditional logistic regression showed that the OR of prior hyperthyroidism was 1.57 (95% CI=1.24-1.98) compared to controls. Similarly, after adjusting for monthly income, geographic location and urbanization level, cases were still more likely to have previously been diagnosed with hyperthyroidism than controls (OR=1.61, 95% CI=1.27-2.05). Furthermore, we analysed the ORs of prior hyperthyroidism between cases and controls according to age group. We found that of the youngest group of sampled patients (18-39 years), cases had the greatest adjusted OR for having previously been diagnosed with hyperthyroidism than controls (OR=1.98, 95% CI=1.04-3.79). CONCLUSIONS: This study demonstrated an association between UC and hyperthyroidism.

Decreased clinic visits for acute respiratory infections following an adult tonsillectomy: A population-based study.

PURPOSE: This study attempted to investigate the effects of a tonsillectomy on utilization of medical resources for acute respiratory infections by comparing numbers and costs of clinic visits within 1year before and after a tonsillectomy. MATERIALS AND METHODS: Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. The study includes 481 patients aged 18-80years who underwent a tonsillectomy and 481 comparison patients. A multivariate regression model employing difference-in-difference was carried out to assess the independent association between a tonsillectomy and the number and costs of clinic visits. RESULTS: We found that for patients who underwent a tonsillectomy, the mean number of clinic visits for acute respiratory care 1year before and after the index date significantly decreased from 7.3 to 4.2 (p<0.001). However, for the comparison group, there was no significant difference in the number (p=0.540) or costs (p=0.221) of clinic visits for acute respiratory care 1year before and after the index date. A multivariate regression model revealed that a tonsillectomy was associated with a reduction of 3.38 in the mean number of clinic visits for acute respiratory care (p<0.001). In other words, a tonsillectomy reduced by 46.3% (3.38/7.3) the number of clinic visits for acute respiratory care after adjusting for sociodemographic characteristics and medical comorbidities compared to comparison patients. CONCLUSIONS: This study demonstrated that a tonsillectomy was of substantial benefit to adult patients in that it provides decreased healthcare utilization for acute respiratory infections.

Increased risk for urological cancer associated with anxiety disorder: a retrospective cohort study.

BACKGROUND: Anxiety disorders (ADs) are common with a high rate of medical comorbidities. Although the association between ADs and the overall cancer risk remains controversial, patients with ADs were found to be more likely to develop specific cancer types. Herein, we estimated the risk of developing urological cancers among patients with ADs in a 5-year follow-up period using a population-based database. METHODS: Two study cohorts were identified from the Taiwan Longitudinal Health Insurance Database 2005: patients with ADs, and comparison subjects selected by one-to-one matching for sex, age, and the year of recruitment. Follow-up was undertaken to determine whether sampled patients and comparison subjects had developed urological cancers in the subsequent 5 years. RESULTS: We found that urological cancers occurred among 0.54% of patients with ADs and 0.13% of comparison subjects. After adjusting for sociodemographic characteristics, medical comorbidities, and alcohol and tobacco use disorder, the stratified Cox proportional hazard regression suggested that patients with ADs were more likely to develop urological cancers relative to comparison subjects (adjusted hazard ratio, 3.67; 95% confidence interval, 2.85 ~ 4.72). The adjusted HR for males with ADs was 3.82 (95% CI: 2.79 ~ 5.23) in comparison to males without ADs. In addition, the adjusted HR for females with ADs was 3.47 (95% CI: 2.26 ~ 5.31) than those females without ADs. CONCLUSIONS: We concluded that during the 5-year follow-up period, there was a significantly increased risk of urological cancers among patients with ADs.

Obstructive sleep apnea and urological comorbidities in males: a population-based study.

PURPOSE: This study aimed to investigate associations between obstructive sleep apnea (OSA) and urological comorbidities using a large population-based dataset. METHODS: This cross-sectional study used the Taiwan Longitudinal Health Insurance Database 2005. We included 1236 males with OSA in the study group and 4944 males without OSA in the comparison group. Conditional logistic regressions were performed to examine relationships between OSA and urological comorbidities. RESULTS: We found that patients with OSA had significantly greater prevalences of hypertrophy of the prostate (15.13 vs. 7.28 %), chronic prostatitis (4.37 vs. 2.16 %,), urinary incontinence (3.32 vs. 0.87 %), nocturia (2.02 vs. 0.61 %), erectile dysfunction (2.91 vs. 0.97 %), urinary calculi (12.06 vs. 6.80 %), and prostate cancer (0.97 vs. 0.40 %) than the comparison group. Additionally, the adjusted odds ratios in males with OSA for hypertrophy of prostate, chronic prostatitis, urinary incontinence, nocturia, erectile dysfunction, urinary calculi, and prostate cancer were 2.54 (95 % confidence interval (CI) 2.05~3.15), 1.95 (95 % CI 1.38~2.74), 4.13 (95 % CI 2.63~6.50), 3.54 (95 % CI 2.03~6.18), 2.95 (95 % CI 1.89~4.61), 1.89 (95 % CI 1.53~2.33), and 2.14 (95 % CI 1.03~4.43) than those without OSA, respectively. CONCLUSIONS: This study concluded that males with OSA had higher odds ratios of hypertrophy of the prostate, chronic prostatitis, urinary incontinence, nocturia, erectile dysfunction, urinary calculi, and prostate cancer than comparison group.

Statin use and thyroid cancer: a population-based case-control study.

OBJECTIVE: Several observational studies raised the possibility that the use of statins may decrease the overall risk of cancer and of specific cancers. This study aimed to evaluate the association of statin use with thyroid cancer based on a population-based data set. DESIGN: The data for this case-control study were sourced from the Taiwan Longitudinal Health Insurance Database 2000. We included 500 subjects with thyroid cancer as cases and 2500 gender- and age-matched subjects without thyroid cancer as controls. We used a conditional logistic regression to calculate the odds ratio (OR) and its corresponding 95% confidence interval (CI) for having previously used statins between cases and controls. RESULTS: The OR of prior statin use for cases was 1.39 (95% CI = 1.08-1.78) compared to controls, and thyroid cancer was significantly associated with previous regular statin use (OR = 1.40, 95% CI = 1.05-1.86). However, thyroid cancer was not significantly associated with previous irregular statin use (OR = 1.35; 95% CI = 0.88-2.07). Furthermore, the significant association between thyroid cancer and previous statin use only existed for females (OR: 1.43; 95% CI: 1.07-1.90) but not for males (OR: 1.28; 95% CI: 0.75-2.17). CONCLUSIONS: We concluded that statin use was associated with thyroid cancer in female patients.

Appendectomy increased the risk of ischemic heart disease.

BACKGROUND: Although the appendix may not be considered vital, recent studies have noted adverse health consequences after appendectomy. This study aimed to use a population-based data set to explore whether appendectomy increases the risk for subsequent ischemic heart disease (IHD) in a 3-y follow-up period. MATERIALS AND METHODS: This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. The study cohort included 5413 patients who underwent appendectomies. The comparison cohort was selected by randomly recruiting 16,239 enrollees matched with the study group in terms of sex, age, hypertension, hyperlipidemia, and diabetes. Each individual was tracked for 3 y to identify whether he and/or she developed IHD during the follow-up period. Cox proportional hazard regressions were performed for analysis. RESULTS: During a 3-y follow-up, 196 (3.62%) and 375 (2.31%) IHD incidents developed in the study and the comparison cohorts, respectively. For adults aged ≥18 y, experiencing an appendectomy was independently associated with a 1.54-fold increased risk of IHD during the 3 y of follow-up (95% CI = 1.29-1.84). The association persisted in further analyses stratified by age. CONCLUSIONS: There is an increased risk of subsequent IHD within 3 y after appendectomy, and this underscores the need for more serious clinical decision-making in removing the appendix. Regular monitoring for IHDs is also recommended for patients who have undergone an appendectomy.

Increased risk of ischemic stroke among women with bladder pain syndrome/interstitial cystitis: a cohort study from Taiwan.

AIM: Vascular factors are proposed in the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC). In this study, we investigated the risk of stroke among women following a diagnosis of BPS/IC over 3 years of follow-up, compared to controls without a BPS/IC diagnosis. METHODS: This retrospective cohort study used data retrieved from the Taiwan "Longitudinal Health Insurance Database 2000." We identified 847 women who received a diagnosis of BPS/IC between January 1, 2001 and December 31, 2008 (study group) and 4,235 comparison women (women without a BPS/IC diagnosis matched on age and other selected demographic variables. All subjects were tracked for 3 years following the index date to identify those who received a diagnosis of stroke during follow-up. RESULTS: The stroke incidence rate was 20.86 (95% confidence interval (CI): 15.78-27.07) and 11.65 (95% CI: 9.88-13.64) per 1,000 person-years among the study and comparison cohorts, respectively. Cox regression analysis showed a stroke hazard ratio (HR) of 1.52 (95% CI: 1.09-2.14) in the BPS/IC group relative to the comparison group over 3-year follow-up, after adjusting for hypertension, diabetes, coronary heart disease, atrial fibrillation, hyperlipidemia, and chronic kidney disease. The adjusted HR of ischemic stroke was 1.52 (95% CI: 1.02-2.27). However, there was no significant difference between the two groups in hemorrhagic stroke risk. CONCLUSIONS: Our study demonstrates an association between BPS/IC and a subsequent ischemic stroke diagnosis among women in Taiwan.

Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study.

BACKGROUND: This study aimed to compare clinical outcome between laparoscopic and open right hemicolectomy. METHODS: The data were sourced from Taiwan's National Health Insurance Research Database. This study included 14,320 and 1313 patients who underwent open and laparoscopic right hemicolectomies, respectively. The study outcome included "intensive care unit (ICU) admission," "over 2 h of general anesthesia," "use of mechanical ventilation," "acute respiratory failure," "in-hospital death," and "hospitalization for pneumonia." Separate conditional logistic regressions were performed for each clinical outcome. RESULTS: The results showed that patients who underwent an open right hemicolectomy had significantly higher likelihood of ICU admission (31.4 vs. 13.4%, p<0.001), acute respiratory failure (3.6 vs. 0.8%, p<0.001), mechanical ventilation (12.8 vs. 4.1%, p<0.001), in-hospital death (3.7 vs. 0.9%, p<0.001), over 2 h of general anesthesia (4.6 vs. 1.2%, p<0.001), and hospitalization for pneumonia (5.8 vs. 3.1%, p<0.001) than patients who underwent a laparoscopic right hemicolectomy. Adjusted conditional logistic regression analyses revealed that patients who underwent an open right hemicolectomy were 2.96, 4.98, 3.41, 4.01, 3.44, and 1.78 times more likely to be admitted to the ICU, to have acute respiratory failure, the use of mechanical ventilation, in-hospital death, over 2 h of general anesthesia, and hospitalization for pneumonia, respectively, than patients who underwent a laparoscopic right hemicolectomy. CONCLUSIONS: Laparoscopic right hemicolectomy reduced risk of post-operative pulmonary complications.

Association between sudden sensorineural hearing loss and anxiety disorder: a population-based study.

Anxiety disorder (AD) is commonly associated with a number of physical illnesses. No previous study has investigated the association between AD and sudden sensorineural hearing loss (SSNHL). In this study, we investigated the association between prior AD and SSNHL using a population-based dataset in Taiwan. Sampled subjects of this case-control study were retrieved from the Taiwan "Longitudinal Health Insurance Database". We identified 3,522 patients who had a diagnosis of SSNHL as cases and 10,566 age- and gender-matched subjects without SSNHL as controls. A conditional logistic regression was used to calculate the odds ratio (OR) for having previously been diagnosed with AD between cases and controls. We found that of 14,088 patients, 13.4% had a prior AD diagnosis, 17.8 and 11.9% for the SSNHL group and controls, respectively. After adjusting for patient socioeconomic characteristics and comorbid medical disorders, SSNHL patients were more likely to have prior AD than the controls (OR 1.49, 95% confidence interval (CI) 1.34-1.66, p < 0.001). Furthermore, we found that the significant relationship between SSNHL and prior AD decreased with age. The relationship was the most pronounced among those aged ≤44 years, with an adjusted OR of 1.86 (95% CI 1.48-2.33, p < 0.001) for cases compared to controls. We concluded that patients with SSNHL had a higher proportion of prior AD than non-SSNHL-diagnosed controls. Further study is needed to confirm our findings and explore the underlying pathomechanisms.

Obstructive sleep apnea increases the risk of bladder pain syndrome/interstitial cystitis: a population-based matched-cohort study.

AIMS: Previous studies indicated a possible association between bladder pain syndrome/interstitial cystitis (BPS/IC) and sleep disorders including sleep abnormalities with delayed onset of sleep, waking up before needed, and snoring. Nevertheless, no previous study has reported the association between obstructive sleep apnea (OSA) and BPS/IC. In this retrospective cohort study, we examined the risk of BPS/IC among subjects with OSA during a 3-year follow-up in Taiwan using a population-based dataset. METHODS: This study comprised 2,940 study subjects with OSA, and 29,400 randomly selected comparison subjects. We individually followed-up each sampled subject (n = 32,340) for a 3-year period to identify those subjects who subsequently received a diagnosis of BPS/IC. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent BPS/IC following a diagnosis of OSA. RESULTS: Incidences of BPS/IC during the 3-year follow-up period were 13.61 (95% confidence interval [CI] = 7.37-23.13) and 3.60 (95% CI = 2.06-4.39) for subjects with and those without OSA, respectively. After adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, asthma, tobacco use disorder, and alcohol abuse, the stratified Cox proportional hazards regressions revealed that the hazard ratio for BPS/IC among subjects with OSA was 3.71 (95% CI = 1.81-7.62, P < 0.001) that of comparison subjects. CONCLUSIONS: This study provides epidemiological evidence of a link between OSA and a subsequent BPS/IC diagnosis. We suggest that clinical practitioners treating subjects with OSA be alert to urinary complaints in this population.