Stine Schou Mikkelsen

Preoperative smoking status and postoperative complications: a systematic review and meta-analysis.

Objective:To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type. Background:The conclusions of studies examining the association between preoperative smoking and postoperative complications are inconsistent, thus there is a need for a review and meta-analysis to summarize the existing evidence. Methods:A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO. Included were original studies of the association between smoking status and postoperative complications occurring within 30 days of operation. In total, 9354 studies were identified and reviewed for eligibility and data were extracted. Forest plots and summarized relative risks (RR) including 95% confidence intervals (CIs) were estimated for various complication types. Results:Of the 9354 identified studies, 107 studies were included in the meta-analyses and based on these, 157 data sets were extracted. Preoperative smoking was associated with an increased risk of various postoperative complications including general morbidity (RR = 1.52, 95% CI: 1.33–1.74), wound complications (RR = 2.15, 95% CI: 1.87–2.49), general infections (RR = 1.54, 95% CI: 1.32–1.79), pulmonary complications (RR = 1.73, 95% CI: 1.35–2.23), neurological complications (RR = 1.38, 95% CI: 1.01–1.88), and admission to intensive care unit (RR = 1.60, 95% CI: 1.14–2.25). Preoperative smoking status was not observed to be associated with postoperative mortality, cardiovascular complications, bleedings, anastomotic leakage, or allograft rejection. Conclusions:Preoperative smoking was found to be associated with an increased risk of the following postoperative complications: general morbidity, wound complications, general infections, pulmonary complications, neurological complications, and admission to the intensive care unit.

A cohort study of leisure time physical activity and depression.

OBJECTIVE The objective of the study was to examine the role of leisure time physical activity on the risk of developing depression in a large longitudinal setting. METHODS A prospective cohort study was used, comprising three updated measures of leisure time physical activity and covariates and 26 years of follow-up data on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to two Danish hospital registers for information on depression. Data were collected in three rounds, namely, 1976-1978, 1981-1983, and 1991-1994, and analyses were conducted in 2010. RESULTS Compared to women with a high physical activity level, women with a moderate level had a hazard ratio of 1.07 (95% confidence interval: 0.80-1.44) for developing depression while women with a low level had a hazard ratio of 1.80 (95% confidence interval: 1.29-2.51). Compared to men with a high physical activity level, men with a moderate level had a hazard ratio of 1.11 (95% confidence interval: 0.73-1.68) for developing depression, while men with a low level had a hazard ratio of 1.39 (95% confidence interval: 0.83-2.34). CONCLUSION Among women, a low level of physical activity was significantly associated with a greater risk of depression.

Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis.

Objective: To systematically review and summarize the evidence of the association between preoperative alcohol consumption and postoperative complications elaborated on complication type. Background: Conclusions in studies on preoperative alcohol consumption and postoperative complications have been inconsistent. Methods: A systematic review and meta-analysis based on a search in MEDLINE, EMBASE, CINAHL, and PsycINFO citations. Included were original studies of the association between preoperative alcohol consumption and postoperative complications occurring within 30 days of the operation. In total, 3676 studies were identified and reviewed for eligibility, and data were extracted. Forest plots and pooled relative risks (RRs), including 95% confidence intervals (CIs), were estimated for several complication types. Results: Fifty-five studies provided data for estimates. Preoperative alcohol consumption was associated with an increased risk of various postoperative complications, including general morbidity (RR = 1.56; 95% CI: 1.31–1.87), general infections (RR = 1.73; 95% CI: 1.32–2.28), wound complications (RR = 1.23; 95% CI: 1.09–1.40), pulmonary complications (RR = 1.80; 95% CI: 1.30–2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18–1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03–1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50–4.78). Low to moderate preoperative alcohol consumption and postoperative complications did not seem to be associated; however, very few studies were included in the analyses hereof. Conclusions: Preoperative alcohol consumption was associated with an increased risk of general postoperative morbidity, general infections, wound complications, pulmonary complications, prolonged stay at the hospital, and admission to intensive care unit.

A longitudinal cohort study of intelligence and later hospitalisation with mental disorder

OBJECTIVE Few studies on the associations between pre-morbid IQ and mental disorders are based on comprehensive assessment of intelligence in both women and men and include a wide range of confounding variables. Thus, the objective of the present study was to examine the association between pre-morbid IQ and hospitalisation with any mental disorder, including possible gender differences in the association. METHODS The study population was born in 1959-61 and premorbid IQ was assessed with the WAIS between 1982 and 1994. Information on mental disorders was obtained from Danish hospital registers with a mean follow-up interval of 21.1years. A total of 1106 participants were analysed. RESULTS Those with a mental disorder had a significantly lower mean pre-morbid IQ score than those without. For women, the adjusted IQ difference was 8.5 points, and for men it was 5.1 points. A decrease of one standard deviation in pre-morbid IQ was associated with 83% greater risk of developing a mental disorder among women (HR=1.83, 95% CI: 1.41-2.36), and 36% among men (HR=1.36, 95% CI: 1.07-1.73). The interaction between gender and IQ was not statistically significant. Associations did not differ noteworthy between verbal and non-verbal IQ. CONCLUSIONS Pre-morbid IQ was found to be significantly associated with the development of mental disorder.

What characterises smokers who quit without using help? A study of users and non-users of cessation support among successful ex-smokers

Background A variety of smoking cessation aids are available; however, the majority of smokers quit unaided. We know little of the differences between users and non-users of cessation support. Methods A cross-sectional study based on the Danish Health Examination Survey (DANHES) conducted in 2007–2008. In all, 6445 persons reporting quitting successfully within the last 5 years were included in analyses. Users and non-users of cessation aid (medical or behavioural support) were compared with regards to age, education, years smoked, tobacco amount, tobacco type and smoking-related disease using logistic regression analysis. Results Quitting unaided was reported by 63%. Adjusted analyses showed that men were more likely to quit unaided than women, and younger compared with older were more likely to quit unaided (eg, OR among women age 45–59 versus age 14–29 were 0.18, 95% CI 0.12 to 0.20). Additionally, those who had smoked for 15 years or more also had lower odds of quitting unaided. Smoking 15 or more grams of tobacco daily was inversely associated with quitting unaided (eg, OR among men were 0.38, 95% CI 0.31 to 0.46). Conclusions Quitting smoking without the use of formalised aid was the most common cessation approach. Quitting unaided was more likely among men, younger age groups, those with a shorter history of smoking and those who were light smokers. These results indicate that awareness of unaided cessation in general and to those for whom it is especially relevant should be increased. This could lead to a more efficient use of resources for cessation support.

The Danish National Youth Study 2014: Study design, population characteristics and non-response analysis:

Aims: This paper aims to give a description of the Danish National Youth Study 2014 in terms of study design, study population and questionnaire content. The differences between participants and non-participants regarding socioeconomic characteristics are also described. Methods: The Danish National Youth Study 2014 was a web-based survey with data collected through self-completion questionnaires administered in the classroom. There were two questionnaires: one for students, with >250 core questions; and one for school leaders on the school environment. Data collection took place at 119 high schools and 10 vocational schools. Results: A total of 75,853 students participated (70,674 high school students and 5179 vocational school students). In the participating schools, 85% of high school students and 69% of vocational school students took part in the survey. A total of 166 school leaders responded. Among the high school students, 61% were girls, and among vocational school students, 24% were girls. The average age was 17.9 years for high school students and 20.9 years for vocational school students. Participants were more likely than non-participants to be of Danish origin and to have parents with higher educational levels and a higher disposable income. Conclusions: The Danish National Youth Study 2014 contributes to knowledge on adolescent health behaviour, health and well-being. It is unique in its size, diversity of questionnaire content, high participation rate and possibility of linkage to various national registers through the Danish Civil Registration System. The study offers great opportunities for health planning and a wide range of future research projects.

A prospective cohort study of quality of life and ischemic heart disease.

Aims: To examine the role of self-rated quality of life, as a whole, on the risk of developing ischemic heart disease. Methods: Information on self-rated quality of life and covariates was obtained from 4497 people from the Copenhagen Perinatal Cohort. The study population, consisting of both men and women aged 31–33 years at baseline, was followed for registration of ischemic heart disease in national registers. Two different follow-up periods were examined. Results: Using a follow-up of 13 years, the basis-adjusted hazard ratio among women who rated their quality of life as poor was 2.93 (95% CI: 1.09–7.86), compared with women who rated their quality of life as very good. The hazard ratio of women who rated their quality of life as good, compared to very good, was 2.99 (95% CI: 1.22–7.29). When analyzing 16 years of follow-up, estimates among women were lower and some of the hazard ratios were insignificant. All hazard ratios among men were below two and none were statistically significant. Conclusions: Among women, the risk for ischemic heart disease was two to four times greater for those who rated their quality of life as poor or good, than for women with the most positive rating. For men, the association was not statistically significant.

Social network as predictor for onset of alcohol use disorder: A prospective cohort study

OBJECTIVE Social network has been linked to alcohol use disorder in several studies. However, since the majority of such findings are cross-sectional, causal interpretation is difficult. The aim of the present study was to test if social network characteristics predict alcohol use disorder in a prospective design. METHODS Information on social network and covariates was obtained from 9589 men and women aged 21-99 years in the Copenhagen City Heart Study, followed for registration of alcohol use disorder in the Danish National Patient Registry and the WINALCO database. RESULTS Men who lived alone, were separated or divorced or widowers had a higher risk of developing alcohol use disorder: HR among men living alone vs. men not living alone was 2.28 (95% CI: 1.59-3.27), and HR among separated/divorced men vs. married men was 2.55 (95% CI: 1.33-4.89). No such associations were found among women. Frequency of contact with friends was associated with risk of developing alcohol use disorder among both sexes. For example, the HRs were 1.72 (CI 95%: 0.99-3.01) and 2.59 (95% CI: 1.42-4.71) among women who had contact with friends a couple of times per week and daily, respectively, compared with more rarely. Frequency of contact with family was not associated with risk of developing alcohol use disorder among either sex. CONCLUSION Living alone and not being married or cohabiting with a partner were predictors of developing alcohol use disorder among men. Further, frequent contact with friends was associated with higher risk of alcohol use disorder among both sexes.