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Tinnitus causes emotional stress that can be extreme, bringing on anxiety, depression, or sleep disorders. We used a nationwide, population-based database to study the risk of attempted suicide among adults with tinnitus.Data for this retrospective cohort study were extracted from the Taiwan National Health Insurance Research Database, on 386,055 patients with tinnitus and propensity score-matched controls. We performed Cox proportional hazards regression analysis to calculate the one-year hazard of a suicide attempt and 95 % confidence intervals (CI) following a first-time diagnosis of tinnitus.The results shows that the incidence of attempted suicide was 0.253 (95 % CI = 0.237-0.269) and 0.123 (95 % CI = 0.113-0.135) for the study cohort and comparison cohort, respectively. The log-rank test suggested that the study cohort had significantly lower suicide attempt-free survival at one year than the comparison cohort (p 0.001). Cox proportional analysis shows that the hazard ratio of attempted suicide within the one-year follow-up period was 2.04 (95 % CI = 1.83-2.28) for patients with tinnitus than those in the comparison cohort after adjusting for the patients' age, sex, monthly income, geographic region, urbanization level of the patient's residence, hyperlipidemia, diabetes, coronary heart disease, and hypertension.The database lacks information on socioeconomic problems, specific personal characteristics or traits, marital status, or other factors associated with attempts to commit suicide. Notably, our study addressed suicide attempts as detected from claims-based ICD codes which do not cover suicidal ideation or suicidal death.We found increased likelihood of attempted suicide among patients with tinnitus.

Background Colonic stent placement can avoid urgent surgery for large bowel obstruction in selected patients. Population-wide stent utilization patterns and outcomes are unknown. Materials and Methods Using retrospective, population-based, Nationwide Inpatient Sample data, we studied patients with colonic stents discharged during 2010-2015. The primary outcome was ostomy creation during the same hospitalization. Other outcomes were perforation or peritonitis, and in-hospital death. Associations of outcomes with stent indication were investigated, adjusting for patient-, admission-, and hospital characteristics. We estimated annual population-wide stent use volumes. Results Of 4257 patients with stent placement (52% male, mean age 64.6 years), 9.9% had non-metastatic colon cancer, 12.9% metastatic colon cancer, 37.8% extracolonic malignancy (ECM), and 39.3% had benign obstruction. In 8.1% of patients, ostomy creation surgery was performed. Perforation or peritonitis occurred in 16.7%, and in-hospital death in 4.5%. Relative to ECM, ostomy creation was several-fold more likely among nonmetastatic colon cancer (adjusted odds ratio (OR) 3.4; 95%CI, 2.1-5.5), metastatic colon cancer (adjusted OR 2.5; 95%CI, 1.7-3.7), and benign obstruction patients (adjusted OR 3.1; 95%CI, 2.1-4.7). Benign obstruction was associated with high risk of perforation/peritonitis (adjusted OR 3.1 relative to non-metastatic CC (95%CI, 2.1-4.5)). Perforation/peritonitis was highly associated with inpatient death (adjusted OR 6.8 (95%CI, 4.9-9.5)). Annually, about 3,580 patients underwent stent placement, with benign obstruction showing an increasing trend (P=0.0002). Conclusions Over 75% of stent placements were done for patients with benign disease and ECM obstruction. Subsequent ostomy creation during the hospitalization was least likely among ECM patients. Rates of perforation/peritonitis in benign obstructions were concerningly high. (22.2%).

Objectives: Whether tinnitus is associated with pre-existing hypertension remains uncertain. This study explored the association between tinnitus and pre-existing hypertension. Methods: We obtained data on a retrospective cohort of 542 884 cases ≥18 years old with a first-time tinnitus diagnosis from Taiwan’s National Health Insurance Research Database. We used propensity-score matching to select 542 884 matched controls and performed multiple logistic regression analyses to estimate the adjusted odds of prior hypertension among patients with tinnitus versus controls. Results: Bivariate analysis showed no significant difference in the prevalence of prior hypertension between the tinnitus and no-tinnitus groups (35.58% vs 35.5%, P = .617). Univariable logistic regression analysis confirmed the bivariate analysis finding, unadjusted odds of prior hypertension among the tinnitus group relative to controls, 1.002, 95% CI: 0.994-1.010, P = .617). After adjusting for age, sex, monthly income, geographic location and urbanization level, hyperlipidemia, diabetes, hearing loss, obesity, anemia, rheumatoid arthritis, alcohol abuse, nicotine dependence, anxiety disorder, depressive disorder and idiopathic intracranial hypertension, the odds of prior hypertension were similar among the tinnitus and no-tinnitus groups (OR = 1.006, 95% CI: 0.997-1.016, P = .178). Conclusions: Our population-based study found no evidence for an association between tinnitus and pre-existing hypertension.

Previous studies of healthcare organizations’ workforces and their performance have focused on burnout and its impact on care. The aim of this research is to expand on this and examine the association of positive organizational states, engagement and recommendation of employer as a place to work, in comparison to burnout on Hospital performance. Methods: This was a panel study of the respondents to the 2012–2019 yearly Staff Surveys of the English National Health Service (NHS) hospital Trusts with hospital performance measured by the adjusted inpatient Summary Hospital-level Mortality Indicator (SHMI). Results: In univariable regression, all three organizational states significantly and negatively correlated with SHMI, with recommendation and engagement showing a nonlinear effect. In multivariable analysis, all three states remained significant predictors of SHMI. Engagement and recommendation showed mutual correlation, with engagement being a more prevalent state than recommendation. Conclusion: Our study indicates that organizations could benefit from monitoring multiple workforce variables to preserve or enhance workforce well-being, while optimizing organizational performance. The surprising finding that higher burnout was associated with improved short-term performance requires further investigation, as does the finding of less frequent staff recommendation of work compared to staff engagement with their work.

BACKGROUND This study aimed to evaluate whether peripheral vestibular disorders (PVD) are associated with subsequent injury. METHODS Data for this follow-up study were retrieved from the Taiwan's National Health Insurance (NHI) Dataset. A total of 251,355 patients with newly diagnosed PVD during January 2015 to December 2016 was identified as the study cohort, the diagnosis date being their index date. Comparison patients were identified by propensity score-matching (one per case, n = 251,355 controls) from the remaining NHI beneficiaries in 2015 with their index date being the date of their first health service claim in 2015. We tracked each subject's claims history for 1 year from the index date to identify those who suffered an injury. Cox proportional hazards regressions were performed to calculate the injury hazard ratio of cases versus controls. RESULTS The incidence of injury during 1-year follow-up was 128.6 (95% CI = 127.6-129.5) per 1,000 person-years, 158.2 (95% CI = 156.8-159.6) and 97.5 (95% CI = 96.3-98.7) among the study and comparison cohorts, respectively. After adjusting for demographic variables, the hazard ratio (HR) for injury during 1-year was 1.663 (95% CI: 1.636-1.690) for cases relative to controls. CONCLUSIONS Patients with PVD were at a higher risk for a wide range of injuries, most of all, joint dislocation and sprain. LEVEL OF EVIDENCE 3 Laryngoscope, 131:1633-1638, 2021.

Prior studies suggest a possible association between thyroid disease and the subsequent development of age-related macular degeneration (AMD), although it remains inconclusive. This study aimed to evaluate the association of AMD with prior hyper-/hypothyroidism based on nationwide population-based data. We retrieved records of the study patients from the National Health Insurance Research Database, 7522 patients with a first-time diagnosis of AMD and 7522 propensity score-matched controls. Multiple logistic regression analyses were performed to explore the association of neovascular AMD with previously diagnosed hyperthyroidism or hypothyroidism. The Chi-square test shows that there was a statistically significant difference in the prevalence of prior hyperthyroidism between cases and controls (1.18 vs. 0.13%, p < 0.001). Furthermore, there was a statistically significant difference the prevalence of prior hypothyroidism between cases and controls (0.44 vs. 0.69%, p < 0.001). Multiple logistic regression analysis reveals that AMD was statistically and significantly associated with prior hyperthyroidism after adjusting for age, sex, monthly income, geographical location, urbanization level, hypertension, hyperlipidemia, diabetes, and coronary heart disease (odds ratio (OR) = 9.074, 95% CI = 4.713–17.471). The adjusted OR of prior hypothyroidism in patients with AMD was 3.794 (95% CI: 2.099~6.858) when compared to the controls. We conclude that patients with thyroid dysfunction are at higher risk of developing AMD Results suggest that these patients could benefit from proactive regular eye checkups to detect evolving eye pathology, even while vision remains normal during the initial phases.

A few population-based studies have reported an association between prior age-related macular degeneration and senile dementia. No study has explored a possible link between prior macular degeneration and young-onset dementia (YOD). This case–control study aimed to evaluate the association of YOD with prior macular degeneration diagnosed in the 5-year period before their index date. Data for this retrospective observational study were retrieved from Taiwan’s National Health Insurance (NHI) dataset. A total of 36,577 patients with newly diagnosed YOD from January 2010 to December 2017 were identified as the study cohort, assigning their diagnosis date as their index date. Comparison patients were identified by propensity score-matching (three per case, n = 109,731 controls) from the remaining NHI beneficiaries of the period, their index date being the date of their first ambulatory care claim in the year of diagnosis of their matched YOD case. Chi-square test revealed no significant difference in the prevalence of prior macular degeneration between cases and controls (1.1% vs. 1.0%, p = 0.111). Conditional logistic regression analysis also showed an unadjusted odds ratio (OR) for prior macular degeneration of 1.098 among cases relative to controls (95% CI: 0.9797–1.232). Adjusted analysis confirmed that YOD was not associated with prior macular degeneration, adjusted odds ratio 1.098 (95% CI = 0.979–1.232). We conclude that patients with macular degeneration are not at increased risk for YOD.

BACKGROUND: Healthcare workforce engagement may represent a proactive approach against provider burnout, a widely prevalent condition that is associated with poor patient outcomes. OBJECTIVE: We examine whether workforce engagement is associated with better hospital performance, measured as lower inpatient mortality, in English National Health Services (NHS) acute Trusts. DESIGN: Panel study using cross-lagged regression, applying an optimally time-lagged value of the dependent variable as covariate to account for unmeasured Trust characteristics. PARTICIPANTS: NHS acute Trusts and respondents to the NHS Staff Surveys, 2012–2018. MAIN MEASURES: We measured engagement using three survey questions corresponding to validated engagement factors, and hospital performance using the Summary Hospital-level Mortality Indicator (SHMI). In the first analyses, associations of SHMI (dependent variable) with workforce engagement in the current, prior, and subsequent years were studied to find the optimum lag period for lagged regression analysis. In the subsequent cross-lagged regression analysis, bi-directional associations between SHMI and engagement were studied. Heterogeneity in engagement components across Trusts was studied in detail for the year 2017. KEY RESULTS: In the first analyses, current SHMI was negatively associated with engagement in the current year (ß = − 0.044; p = 0.035) more than with the prior year (ß = − 0.037; p = 0.049). In the second analysis, (a) engagement predicted same-year SHMI after controlling for prior-year SHMI (ß = − 0.044; p = 0.035). A 1-unit higher engagement score was associated with 4.4% lower SHMI. (b) SHMI predicted engagement in the same year (ß = − 0.066; p = 0.001) after controlling for prior-year engagement. More in-depth analysis showed high inter-trust heterogeneity on all three engagement factors (I(2) > 85%). CONCLUSION: Higher workforce engagement predicts lower mortality which in turn predicts engagement. Heterogeneity in workforce well-being suggests an opportunity to foster mutual learning across Trusts. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06045-0) contains supplementary material, which is available to authorized users.

To examine the association between systemic hypertension (HTN) and primary open-angle glaucoma (POAG) using Taiwan's nationwide health insurance claims data.A case-control study.Data for this case-control study were retrieved from the Taiwan National Health Insurance Research Database for all 112,929 newly diagnosed patients with POAG from January 2010 through December 2015 (cases), and 449,840 propensity score-matched controls from Taiwan's National Health Insurance system. We performed multiple logistic regression analysis to estimate the odds (ORs) of prior HTN among cases vs controls.Of total 562,300 study patients, 296,975 (52.81%) had HTN prior to the index date, 63,528 (56.49%) among cases and 233,447 (51.90%) among controls (P.001). POAG was significantly associated with prior HTN (OR 1.31, 95% CI 1.29-1.33) after adjusting for age, sex, monthly income, geographic location and residential urbanization level, hyperlipidemia, diabetes, coronary heart disease, migraine, hypotension, and obstructive sleep apnea syndrome.POAG is associated with pre-existing HTN, suggesting that internal medicine/family medicine physicians should refer patients with hypertension periodically for regular ophthalmological examinations and ophthalmologists should alert patients with glaucoma to have their blood pressure regularly monitored.

BACKGROUND: Whether emergency medical services (EMS) transport improves disability outcomes compared with other transport among acute ischemic stroke (AIS) patients is unknown. OBJECTIVE: To study severity-adjusted associations of hospital arrival mode (EMS vs. other transport) with in-hospital and discharge disability outcomes. DESIGN: Prospective observational study. PARTICIPANTS: AIS patients discharged April 2016 to October 2017 from a safety-net hospital in South Carolina. MAIN MEASURES: National Institutes of Health Stroke Scale (NIHSS) change at discharge (admission NIHSS score minus discharge NIHSS, continuous variable), 24-h NIHSS change (attaining high improvement, admission NIHSS minus 24-h NIHSS being 75th percentile or higher), door to neuroimaging (DTI) time, and IV alteplase receipt. NIHSS change was assessed within stroke severity groups, mild, moderate, and severe (admission NIHSS 0–5, 6–14, and ≥ 15, respectively). KEY RESULTS: Of 1168 patients, 838 were study-eligible (52% male, 52.4% Black, 72.2% EMS arrivals, 56.6% mild strokes). Severe and moderate stroke patients were more likely than mild stroke patients to use EMS (adjusted odds ratios, AOR [95% CI] 11.7 [5.0, 27.4] and 4.0 [2.6, 6.3], respectively). EMS arrival was associated with shorter DTI time (adjusted difference − 88.4 min) and higher likelihood of alteplase administration (AOR 5.3 [2.5, 11.4]), both key mediating variables in disability outcomes. High 24-h NIHSS improvement was more likely for EMS arrivals vs. other arrivals among moderate strokes (AOR 3.4 [1.1, 10.9]) and severe strokes (AOR > 999). EMS arrivals had substantially higher NIHSS improvement at discharge within the severe stroke group (adjusted NIHSS change at discharge, 5.9 points higher, p = 0.01). Alteplase recipients showed higher discharge NIHSS improvement than non-recipients (by 2.8 and 1.9 points among severe and moderate strokes, respectively; p = 0.01, 0.02). CONCLUSIONS: The findings offer evidence for including stroke education as a standard of care in the primary care management of patients with stroke-risk comorbidities/lifestyle in order to minimize post-stroke disability.

The study objective was to evaluate the association between cervical spondylosis (CS) and a subsequent diagnosis of obstructive sleep apnea (OSA) in light of the expected constricting impact of CS-associated cervical spine changes on the pharyngeal airway space, a key contributor to OSA.Data were retrieved from the Taiwan National Health Insurance Research Dataset. A total of 98,234 patients who newly received a diagnosis of OSA were identified. We identified four propensity score-matched controls per OSA patient (n = 392,936). Chi-square tests were used to compare cases and controls on sociodemographic characteristics, and multivariable logistic regression modelling to examine the association of OSA with prior CS.Of the 98,234 sampled patients, 18,070 (18.4%) patients had a prior CS diagnosis, significantly different among cases compared to controls, being 18.4% and12.1%, respectively, p 0.001. Logistic regression analysis showed an adjusted odds ratio (OR) of prior CS of 1.778 (95% confident interval (CI): 1.744-1.814) relative to controls. The adjusted odds of prior CS without myelopathy was 1.764 for cases relative to controls (95% CI: 1.727-1.801), and for prior CS with myelopathy (adjusted OR: 1.778, 95% CI: 1.721-1.837). Analysis stratified by age showed that in the 45-64- and64-year age groups, the adjusted ORs of CS were 1.803 (95% CI: 1.758-1.850) and 1.634 (95% CI: 1.568-1.703), respectively, for cases relative to controls.Our results suggest that OSA is associated with prior CS. The results call for professionals to be alert to the possibility of subsequent development of OSA among patients with CS.

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.

BACKGROUND This study aimed to evaluate the association between pioglitazone use and the occurrence of head and neck cancer. METHODS Data for this case-control study were retrieved from the Taiwan National Health Insurance Research Database. A total of 21 464 diabetic patients newly diagnosed with head and neck cancers were identified. We used propensity score matching to select 64 392 comparison patients (3:1 ratio). Multiple logistic regression modeling was used to examine the association of head and neck cancer with pioglitazone use in the 5 years preceding the cancer diagnosis. RESULTS Bivariate analysis showed a significant difference in the prevalence of prior using pioglitazone between cases and controls (19.3% vs 18.5%, P

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.

This population-based, case–control study aims to explore the relationship between prior tinnitus and the occurrence of chronic kidney disease (CKD) using a nationwide, population-based cohort study. We used data from the Taiwan National Health Insurance Research Database to explore the association of CKD with tinnitus. We identified 15,314 patients aged ≥40 years old with a first-time diagnosis of CKD as the cases. We used propensity-scored matching to select 45,942 controls (1:3 ratio). We performed multivariate logistic regression to estimate the odds ratio (OR) of a prior tinnitus diagnosis among the CKD group vs. the control group. Analysis showed that 770 (1.26%) out of the 61,256 sampled patients had previously diagnosed tinnitus. Chi-square testing revealed a significant difference in the rate of previously diagnosed tinnitus between cases and controls (3.86% vs. 0.93%, p < 0.001). Univariate logistic regression analysis showed an OR of prior tinnitus for cases of 10.249 (95% confidence interval (CI): (8.662~12.126)) relative to controls. In adjusted analysis, cases were more likely than controls to have a prior diagnosis of tinnitus (OR = 10.970, 95% CI = 9.255~13.004, p < 0.001) after adjusting for age, sex, monthly income, geographic location, urbanization level, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, and autoimmune disease. Our study shows that CKD patients have a higher likelihood of having suffered from tinnitus before CKD was diagnosed, but we have no data suggesting that tinnitus is a predictor of subsequent CKD. Patients diagnosed with tinnitus may benefit from proactive measures to prevent CKD and detect it early through lifestyle modifications and regular renal function examinations, regardless of CKD-related symptoms.

Hearing loss and the related otologic manifestations are receiving increased scrutiny as significant causes of morbidity in Fabry disease. However, the relative risks of auditory deficits among patients with Fabry disease relative to the general population without a diagnosis of Fabry disease have not been studied. This study aims to explore the associations between Fabry disease and hearing-related manifestations using a nationwide population-based dataset. We identified study patients for this cross-sectional study from the 2015–2017 claims databases of the Taiwan Longitudinal Health Insurance Database 2005. We first identified 2312 patients aged over 20 years with a diagnosis of Fabry disease. We used propensity score matching to select five comparison patients per patient with Fabry disease and 11,560 comparison patients without Fabry disease. We used multivariable logistic regressions to estimate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for tinnitus, hearing loss, and sudden deafness among Fabry disease patients vs. comparison patients. Chi-square tests showed statistically significant differences between patients with and without Fabry disease in the prevalence rates of tinnitus (16.7% vs. 11.7%, p < 0.001), hearing loss (7.5% vs. 6.2%, p = 0.014) and sudden deafness (1.7% vs. 1.0%, p = 0.005). Multiple logistic regression revealed that patients with Fabry disease were more likely to suffer from tinnitus, hearing loss and sudden deafness, with adjusted odds ratios of 1.513 (95% CI = 1.336–1.713), 1.246 (95% CI = 1.047–1.483), and 1.681 (95% CI = 1.166–2.423), respectively. We found that Fabry disease is significantly associated with certain auditory manifestations, including hearing loss, sudden deafness, and tinnitus.

This study aims to investigate the association between primary open-angle glaucoma (POAG) and tinnitus. We found that tinnitus was significantly associated with preexisting POAG [adjusted odds ratio (OR)=1.298].The purpose of this study was to investigate the association between POAG and tinnitus using nationwide population-based data from Taiwan.Data for this case-control study were retrieved from the Taiwan National Health Insurance Research Database for all 542,682 patients with a first-time diagnosis of tinnitus (cases), and 1,628,046 propensity score-matched controls from Taiwan's National Health Insurance system. We performed multiple logistic regression analysis to estimate the odds (ORs) of prior POAG among cases versus controls.Of total 2,170,728 study patients, 85,257 (3.93%) had POAG before the index date of tinnitus, 25,496 (4.70%) among cases and 59,761 (3.67%) among controls (P0.001). Multiple logistic regression analysis showed a significant association between prior POAG and tinnitus (OR=1.298, 95% confidence interval: 1.278-1.318) after adjusting for age, sex, monthly income, geographic location and residential urbanization level, hyperlipidemia, diabetes, obesity, anemia, rheumatoid arthritis, alcohol abuse, nicotine dependence, anxiety disorder, depressive disorder, and hypertension.Patients with POAG have a higher risk of tinnitus compared with those without the disease. Ophthalmologists should be aware of this association and further studies are needed to understand underlying mechanisms.

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. 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. 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. 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.

This case–control study aimed to investigate the association of peripheral vestibular disorders (PVD) with subsequent land transport accidents. Data for this study were obtained from Taiwan’s National Health Insurance (NHI) dataset. We retrieved 8704 subjects who were newly found to have land transport accidents as cases. Their diagnosis date was used as their index date. Controls were identified by propensity score matching (one per case, n = 8704 controls) from the NHI dataset with their index date being the date of their first health service claim in 2017. Multiple logistic regressions were performed to calculate the prior PVD odds ratio of cases vs. controls. We found that 2.36% of the sampled patients had been diagnosed with PVD before the index date, 3.37% among cases and 1.36% among controls. Chi-square test revealed that there was a significant association between land transport accident and PVD (p &lt, 0.001). Furthermore, multiple logistic regression analysis suggested that cases were more likely to have had a prior PVD diagnosis when compared to controls (OR = 2.533, 95% CI = 2.041–3.143, p &lt, 0.001). After adjusting for age, gender, hypertension, diabetes, coronary heart disease, and hyperlipidemia, cases had a greater tendency to have a prior diagnosis of PVD than controls (OR = 3.001, 95% CI = 2.410–3.741, p &lt, 0.001). We conclude that patients with PVD are at twofold higher odds for land transport accidents.

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 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.

With many previous studies indicating a higher prevalence of sexual problems in patients with tinnitus, the association between tinnitus and erectile dysfunction (ED) has become an interesting topic that warrants further research. In our study, we hypothesized that tinnitus may be associated with ED and aimed to further explore the relationship between these two medical conditions using a nationwide population-based database. After retrieving data of 19,329 patients with ED and 19,329 propensity score-matched patients without ED (controls) from Taiwan’s National Health Insurance Dataset, we defined the diagnosis date (the date of the first ED claim) for patients with ED as the index date for cases, and the date of the first utilization of ambulatory care by patients without ED during the index year of their matched case as the index date for controls. We found that 1247 out of 38,658 sampled patients (3.23%) had received a tinnitus diagnosis within the year before the index date, with 792 (4.10%) from cases and 455 (2.35%) from controls. We then utilized multiple logistic regression analysis and observed that cases were more likely to have had a prior tinnitus diagnosis compared to controls (OR 1.772; 95% CI 1.577–1.992; p p

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.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.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.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.