This nationwide registry-based study in Denmark revealed a higher 10-year cumulative incidence of amyloidosis among 79,443 coronary artery disease-negative patients compared to matched controls, with an adjusted hazard ratio of 7.43 (95% CI 4.01-13.7). These findings warrant prospective studies to investigate the prevalence of amyloidosis in patients negative for coronary artery disease after coronary examination.

Multimorbidity, defined as two or more chronic conditions in an individual, is increasing in prevalence and is associated with polypharmacy. Polypharmacy can lead to increased out-of-pocket payments for prescription medicines. This, in turn, can be associated with cost-related non-adherence and impoverishment. Healthcare in Denmark is mostly free at the point-of-use; prescription medicines are one of the only exceptions.

To examine the association between multimorbidity and annual out-of-pocket prescription medicine expenditure for adults in Denmark.

A population-based register study was conducted. The study population included all adults residing in Denmark in 2020. Frequencies and descriptive statistics were used and regression analyses were conducted to assess the association between multimorbidity and annual out-of-pocket prescription medicine expenditure, while controlling for demographic and socioeconomic covariates.

Overall, 1,212,033 (24.2 %) individuals had multimorbidity. Individuals with five or more conditions spent, on average, €320 in out-of-pocket prescription medicines expenditure compared to €187 for those with two conditions and €44 for those with no conditions. Amongst those with any out-of-pocket prescription medicine expenditure, having multimorbidity was associated with 2-4 times greater out-of-pocket prescription medicine expenditure than those with zero conditions. Amongst those in the quantile with the highest expenditure, those with five or more conditions spent €408 more than those with no conditions, and those with two conditions spent €185 more than those with no conditions.

For adults in Denmark, multimorbidity was associated with significantly higher out-of-pocket prescription medicine expenditure, even after controlling for demographic and socioeconomic covariates. This is similar to patterns in other countries and likely affects those with lowest income the most, given the known socioeconomic patterning of multimorbidity, and raises concerns about cost related non-adherence. Potential protective mechanisms could include subsidies for certain vulnerable patient groups (e.g. those with severe mental illness) and low-income groups.

While mitral reoperation has been assumed to carry higher surgical risk than first-time mitral surgery, outcomes of this procedure remain uncertain.

To examine characteristics and outcomes associated with mitral valve reoperation and first-time surgery for mitral regurgitation.

Patients undergoing surgery for mitral regurgitation were identified using Danish nationwide registries. The population was categorized into 1) patients undergoing first-time mitral surgery, 2) patients undergoing mitral reoperation. Mortality rates were examined during 180-day follow-up using Reverse Kaplan-Meier and Multivariable Cox-analysis.

In total, 7734 patients underwent surgery for mitral regurgitation. Of these, 428 patients also underwent mitral reoperation. Compared to first-time surgery, reoperated patients were younger (median 64.9 and 66.7 years) and had more cardiovascular comorbidities including atrial fibrillation (61.6 % and 38.8 %) and heart failure (48.7 % and 29.9 %). Median time to reoperation was 2.3 years. Prosthetic replacement was performed in 34.0 % of first-time surgeries and 78.7 % of reoperations. Mortality was 7.1 % following first-time surgery and 10.1 % following reoperation. Following first-time surgery, factors associated with increased mortality rate was prior myocardial infarction (HR = 1.98, 95 %CI 1.62-2.41), heart failure (HR = 1.59, 95 %CI 1.33-1.90), concomitant aortic valve surgery (HR = 1.61-1.27, 95 % CI 1.27-2.02) and bypass grafting (HR = 1.58, 95 %CI 1.31-1.91). Following reoperation, heart failure was associated with increased mortality rate (HR = 2.23, 95 %CI 1.17-4.60).

Patients undergoing mitral reoperation are young but have developed high burden of comorbidities at the time of reoperation. In spite of this, outcomes of mitral reoperation were acceptable, reflecting that this procedure can be performed safely in selected patients.

Heart failure with reduced ejection fraction (HFrEF) and metabolic dysfunction-associated steatotic liver disease (MASLD) are both associated with liver fibrosis. HFrEF patients may develop liver fibrosis due to hepatic congestion, MASLD, or a combination of both. The Fibrosis-4 (FIB-4) score calculated using age, aspartate aminotransferase, alanine aminotransferase, and platelet count, serves as a screening tool for advanced liver fibrosis. This study examines the association between the FIB-4 score and all-cause mortality, cardiovascular mortality, and major adverse liver outcomes (MALO) in patients with HFrEF.

This study included 4523 HFrEF patients from the Danish Heart Failure Registry. Based on FIB-4 score, 25.5 % were low-risk, 45.7 % were indeterminate-risk, and 28.8 % were high-risk for advanced liver fibrosis. After five years, the cumulative incidence of all-cause mortality was 43 % for the high-risk group, 36 % for the indeterminate-risk group, and 23 % for the low-risk group. The indeterminate-risk and high-risk group had an increased hazard ratio (HR) for all-cause mortality (HR 1.33, 95 % confidence interval [CI] 1.16-1.52; HR 1.51, 95 % CI 1.31-1.74) compared to the low-risk group. Similarly, HRs were elevated for cardiovascular mortality (HR 1.61, 95 % CI 1.27-2.05; HR 2.14, 95 % CI 1.67-2.74) and MALO (HR 1.77, 95 % CI 1.01-3.31; HR 2.54, 95 % CI 1.43-4.52).

A high FIB-4 score in patients with HFrEF is associated with increased mortality and MALO.

To investigate the putative association between semaglutide and non-arteritic anterior ischaemic optic neuropathy (NAION).

Data from national health registries in Denmark (2018-2024) and Norway (2018-2022) were used to compare NAION risk in individuals with type 2 diabetes initiating semaglutide versus sodium-glucose co-transporter 2 inhibitors (SGLT-2is). A supplementary self-controlled analysis examined NAION risk among all semaglutide users. National estimates were pooled using a fixed-effects model.

We identified 44 517 users of semaglutide for the management of type 2 diabetes in Denmark and 16 860 in Norway, with a total of 32 NAION events observed. The unadjusted incidence rate of NAION was 2.19/10 000 person-years among Danish semaglutide initiators, compared to 1.18 among SGLT-2i initiators. In Norway, the corresponding rates were 2.90 and 0.92, respectively. After adjustment, the pooled hazard ratio (HR) was 2.81 (95% confidence interval [CI] 1.67-4.75), and the incidence rate difference (IRD) was +1.41 (95% CI +0.53 to +2.29) per 10 000 person-years. Estimates were consistent across both countries but higher and less precise in Norway (HR 7.25; 95% CI 2.34-22.4) compared to Denmark (HR 2.17; 95% CI 1.20-3.92). Results remained consistent across sensitivity and supplementary analyses, with a stronger association observed in a post hoc per-protocol analysis (HR 6.35; 95% CI 2.88-14.0). In the supplementary self-controlled study, symmetry ratios (SRs) for NAION were 1.14 (95% CI 0.55-2.36) in Denmark and 2.67 (95% CI 0.91-8.99) in Norway.

The use of semaglutide for managing type 2 diabetes is associated with an increased risk of NAION compared with the use of SGLT-2is. However, the absolute risk remains low.

The aim of this study is to investigate associations between attending routine preventive child health examinations in general practice and the risk of obesity and overweight at age six, focusing on psychosocial risk factors.

Data from nationwide Danish registers on 725 926 children born between 2000 and 2012 were analysed. Information on examination attendance and BMI was obtained. Regression analyses assessed the association between examination attendance and obesity or overweight risk.

Non-attendance in preventive child health examinations was associated with a risk of obesity of 18%-31% at age six. The highest risk was observed in children of parents with low educational attainment who missed all examinations, a four- to five-fold increase compared to children of parents with high educational attainment who attended all or missed only one exam. A smaller association of one to 2% was found between missing examinations and risk of overweight in the general population. However, children of parents with low educational attainment who did not attend were 8%-9% more likely to have overweight.

Associations were found between obesity and overweight and not attending preventive child health examinations in general practice. Further research is needed to understand the mechanisms and develop targeted interventions to address health disparities in childhood obesity.

Periprosthetic knee fracture (PPKF) following total knee arthroplasty (TKA) can be difficult to treat. A PPKF can be treated both operatively and nonoperatively, and the treatment varies between fracture sites. This study aimed to assess the risk of reoperation according to the fracture site and treatment of the PPKF.

This study is a nationwide cohort study using register data from 1997 to 2022. Cruciate-retaining or posterior-stabilized primary TKA were identified from the Danish Knee Arthroplasty Register. Subsequent PPKFs, fracture treatments, and later reoperations were identified through the International Classification of Diseases, tenth edition (ICD-10) diagnosis and procedure codes in the Danish National Patient Register. In addition, indications for revision total knee arthroplasty (rTKA) in the Danish Knee Arthroplasty Register were used to identify PPKFs and the reason for reoperation.

We included 1,931 PPKFs (1,494 femoral, 207 patellae, and 230 tibial) with an overall two-year reoperation risk of 20% (95% confidence interval (CI): 18 to 23). Femoral PPKFs had a two-year reoperation risk of 16% (CI: 12 to 22) after nonoperative treatment and 21% (CI: 18 to 24) after operative treatment. Patellar PPKFs had a two-year reoperation risk in five to 17 after nonoperative treatment and 46% (CI: 30 to 69) after operative treatment. Tibial PPKFs had a two-year reoperation risk of 17% (CI: 11 to 27) after nonoperative treatment and 36% (25 to 53) after operative treatment.

The overall two-year reoperation risk was 20% (CI: 18 to 23). Operative-treated PPKFs had a higher risk of reoperation across all fracture locations. The highest reoperation risk was found after operatively treated patella and tibial PPKFs (46 and 36%, respectively), and the lowest reoperation risk was found after nonoperative-treated patella PPKFs.

To describe sociodemographic characteristics of women with hospital diagnosed endometriosis in Denmark and compare them with women without endometriosis.

Case-control study using Danish national registers. Cases were identified as women aged 14-84 years receiving a first-time hospital-based diagnosis of endometriosis in 1991-2021 (n = 37.709). Each case was matched based on date of diagnosis and birth year to five controls without endometriosis (n = 188.545). Information on diagnosis of endometriosis and sociodemographic factors was obtained from Danish registers. Descriptive statistics and unadjusted and adjusted conditional logistic regression analyses were used to investigate the association between a diagnosis of endometriosis and sociodemographic factors.

For family-based socioeconomic status, women in all groups other than the employed category (both higher and lower socioeconomic status) had lower odds of receiving a diagnosis (ORs ranging from 0.78 to 0.91). Women with primary education, master or equivalent, and PhD had lower odds of a diagnosis (ORs 0.79-0.93) compared to upper secondary education. Compared to couples, singles and "other" had slightly lower odds of a diagnosis (ORs 0.91-0.94). Women of Danish origin and immigrants had similar odds of a diagnosis whereas descendants had lower odds (0.85 (95% CI: 0.76-0.95)) when compared to the two other groups.

Sociodemographic factors were found to be associated with receiving a hospital diagnosis of endometriosis. However, only smaller differences and a mixed pattern were found.

Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care.

A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON).

The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40-49 years), having a high education level (>15 years) and having a cancer comorbidity.

Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.

Undergoing medically assisted reproduction (MAR) has been linked to mixed mental health outcomes in women. We investigated the risk of postpartum depression (PPD) among mothers conceiving with MAR compared to mothers conceiving spontaneously.

Register-Based Study.

Denmark.

125 870 mothers with a PPD screening record who gave birth between 2015 and 2019.

We linked mothers' PPD screening records to national health registers and defined MAR conception linking childbirths to MAR treatments.

We defined PPD as an Edinburgh Postnatal Depression Scale score of ≥ 11. We performed logistic regression on the risk of PPD among mothers who conceived with MAR compared to spontaneous conception and further assessed variations according to duration, type, and indication for MAR.

The study population included 10 977 mothers with MAR conception and 114 893 with spontaneous conception, of which 767 (7%) and 8767 (8%) had PPD. We found a lower risk (adjusted risk ratio 0.87, 95% CI [0.80-0.93]) of PPD among mothers with MAR conception compared to spontaneous conception, with smaller variations according to type, duration and indication for MAR.

We observed a lower risk of PPD among mothers with MAR conception compared to mothers with spontaneous conception. While it is unlikely that MAR itself is protective of PPD, women who seek MAR may have a strong desire and psychological preparedness for parenthood, which could explain the observed findings. Among mothers conceiving with MAR, PPD risk may vary depending on the type of MAR treatment and underlying reasons for seeking MAR.

Musculoskeletal pain is the biggest contributor to burden of disease, causing excessive use of pain-relief medication. Non-pharmaceutical measures are called on for handling this burden. Guidelines recommend physical activity as an effective non-pharmaceutical measure. However, it is unknown if occupational physical activity has the same preventive effects on redeeming pain-relief medication as when performed during leisure-time ("The Physical Activity Paradox"). We aimed to investigate if the paradox contributes to the redemption of prescribed pain relief-medication. 24-h device-measured physical activity data [sitting, standing, light physical activity, moderate-to-vigorous physical activity (MVPA) and time in bed)] were collected from 824 workers using a thigh-worn accelerometer during work and leisure-time. Redeemed pain-relief prescribed medication was retrieved from the Danish National Prescription Registry during a 4-year follow-up. The prospective association between occupational and leisure-time physical activity and number of redeemed pain-relief prescribed medication was analyzed using a generalized linear model, adjusted for potential confounders. During follow-up, 53% of the workers redeemed a pain-relief medication. In leisure-time, 30 min more of MVPA per day were associated with 23% lower risk (RR = 0.77; 95% CI 0.64 - 0.94) of redeeming pain-relief medication. In contrast, occupational physical activity was not associated with the risk of redeeming pain-relief medication [RR = 1.04 (95% CI 0.89 - 1.20)]. Leisure-time MVPA was associated with lower risk of redeeming pain-relief medication, while no beneficial association was found for occupational MVPA. These findings support the paradox that the domain of physical activity is important for redeeming pain-relief medication. PERSPECTIVE: Leisure-time MVPA differs from occupational MVPA in its association with redeeming pain-relief medication. Increasing leisure-time MVPA may serve as an effective non-pharmacological strategy to reduce pain-relief medication redemption. These findings could potentially inform guidelines for managing musculoskeletal pain, highlighting the need to differentiate between occupational and leisure-time physical activity.

The COVID-19 pandemic has been on a downward trend since May, 2022, but it continues to cause substantial numbers of hospital admissions and deaths. We describe this burden in the 2 years since May, 2022, and compare it with the burden of influenza in Denmark.

This observational cohort study included residents in Denmark from May 16, 2022, to June 7, 2024. Data were obtained from national registries, including admissions with COVID-19 or influenza (ie, having a positive PCR test for either virus from 14 days before and up to 2 days after the hospital admission date), deaths, sex, age, COVID-19 and influenza vaccination status, comorbidities, and residence in long-term care facilities. Negative binomial regression was used to estimate adjusted incidence rate ratios (aIRRs) to compare rates of hospital admissions between COVID-19 and influenza. To compare the severity of COVID-19 versus influenza among patients admitted to hospital, we used the Kaplan-Meier estimator to produce weighted cumulative incidence curves and adjusted risk ratios (aRRs) of mortality at 30 days between COVID-19 and influenza admissions.

Among 5 899 170 individuals, COVID-19 admissions (n=24 400) were more frequent than influenza admissions (n=8385; aIRR 2·04 [95% CI 1·38-3·02]), particularly during the first year (May, 2022, to May, 2023) versus the second year (May, 2023, to June, 2024; p=0·0096), in the summer versus the winter (p<0·0001), and among people aged 65 years or older versus younger than 65 years (p<0·0001). The number of deaths was also higher for patients with COVID-19 (n=2361) than patients with influenza (n=489, aIRR 3·19 [95% CI 2·24-4·53]). Among patients admitted in the winter (n=19 286), the risk of mortality from COVID-19 was higher than for influenza (aRR 1·23 [95% CI 1·08-1·37]), particularly among those without COVID-19 and influenza vaccination (1·36 [1·05-1·67]), with comorbidities (1·27 [1·11-1·43]), and who were male (1·36 [1·14-1·59]).

COVID-19 represented a greater disease burden than influenza, with more hospital admissions and deaths, and more severe disease (primarily among non-vaccinated people, those with comorbidities, and male patients). These results highlight the continued need for attention and public health efforts to mitigate the impact of SARS-CoV-2.

Danish Government.

Intracranial devices may be used to treat or guide the treatment of increased intracranial pressure in patients with pneumococcal meningitis. European guidelines do not recommend the routine use of intracranial devices in the management of pneumococcal meningitis. However, in some countries, intracranial devices are used routinely, but the effect remains unknown. We aimed to examine whether mortality and sequelae were lower in patients with pneumococcal meningitis admitted to hospitals in regions where intracranial devices were routinely used compared with regions not utilizing intracranial devices routinely in pneumococcal meningitis management.

In a registry-based, nationwide, population-based cohort study, we examined patients with pneumococcal meningitis (Denmark, 2004-2021). Patients were categorized according to whether the individual was admitted to hospitals in regions where intracranial devices were routinely (exposed patients, n = 305 of whom 66 (22%) had an intracranial device) or not routinely used (non-exposed patients, n = 333 of whom 4 (1%) had intracranial devices). We used Cox regression to calculate adjusted mortality rate ratios (aMRR) and hazard ratios of sequelae for the short-term and long-term periods (<6 or ≥6 months after study inclusion).

The short-term cumulative incidence of death was 22% among exposed patients and 22% among non-exposed patients. We found no association between mortality and routine use of intracranial devices in the region in which patients with pneumococcal meningitis were admitted (short-term aMRR [95% CI], 0.9 [0.6-1.3]; long-term aMRR [95% CI], 1.0 [0.7-1.6]). Furthermore, our study did not demonstrate lower risks of diagnosis of epilepsy, hearing loss, diagnoses suggestive of brain damage, disability pension, or shorter length of stay in exposed compared with non-exposed patients with pneumococcal meningitis.

The routine use of intracranial devices is not associated with lower mortality or morbidity among patients with pneumococcal meningitis.

Anticipated risks of urinary tract infections (UTI) and genital tract infections (GTI) associated with sodium-glucose cotransporter 2 inhibitors (SGLT2is) may prevent their use in clinical practice. We investigated whether initiation of SGLT2is, compared with glucagon-like peptide 1 receptor agonists (GLP-1RAs), was associated with an elevated risk of UTI and GTI in people with type 2 diabetes.

In this cohort study emulating a target trial, we included all adult metformin users initiating SGLT2is or GLP-1RAs in Denmark in 2016-2021 and used inverse-probability of treatment (IPT) weighting to balance potential confounders. We estimated IPT-weighted risk and risk ratios of community- or hospital-treated UTI and GTI, performing both intention-to-treat and on-treatment analyses.

This study included 52,414 SGLT2i initiators and 27,023 GLP-1RA initiators with a median follow-up of 2.9 to 3.9 years. The estimated risks of UTI within the first year were nearly identical: 10.0% for SGLT2is and 10.2% for GLP-1RAs in intention-to-treat analyses corresponding to a risk ratio of 0.98 (95% CI 0.94, 1.03). For GTI, the 1-year risks were elevated under SGLT2i therapy at 2.0% vs. 0.7% (risk ratio 2.95 [95% CI 2.52, 3.44]). During the 5-year follow-up, the relative UTI risk remained almost constant (0.96 [95% CI 0.94, 0.99]) whereas the GTI risk ratio with SGLT2is decreased to 1.64 (95% CI 1.49, 1.80).

In routine clinical care, SGLT2i initiation is not associated with increased risk of UTI compared with GLP-1RA initiation. However, early GTI risk is up to threefold larger in SGLT2i users.

Cardiac Amyloidosis (CA) is characterised by amyloid fibril deposits causing heart failure (HF). Lumbar spinal stenosis (LSS) is recognised as a potential red flag for CA, but the association remains underexplored in large-scale studies.

This nationwide registry-based cohort study in Denmark included subjects ≥60 years with a history of LSS surgery. LSS patients were matched 1:1 with controls by age, sex, ischaemic heart disease, chronic obstructive lung disease, chronic kidney disease, diabetes, and atrial fibrillation.

A total of 44,548 LSS surgery patients and matched controls were included (median age 71.5 years, 56.2% women). The cumulative incidence of amyloidosis after 10 years was higher in the LSS group (0.16% vs. 0.08%, HR 2.29 [95% CI 1.46-3.60]) after adjustment for malignancy, hypertension, and liver disease. The cumulative incidence of HF after 10 years was 10.1% in LSS patients compared with 7.5% in controls (HR 1.28 [95% CI 1.22-1.35], p < 0.0001).

In this nationwide cohort study, LSS surgery was associated with a significantly higher risk of amyloidosis and HF. Prospective studies are warranted to explore the association further.

Estimate the incidence of asthma among children aged 0 to 15 years in Denmark, Finland, Norway and Sweden during 2000-2017.

Cases of preschool asthma (up to 6 years) and school-age asthma (from 6 years) were identified through national registers using an algorithm including hospital diagnoses and prescription medicines. The respective cumulative incidence (CI) was estimated in 1-year age intervals for each country and birth year.

The CI of algorithm-based preschool asthma peaked for the birth cohorts 2008 or 2009 at 14.8% in Denmark, 11.0% in Finland, 15.1% in Norway and 13.7% in Sweden. For later birth cohorts, a slight decrease was observed. The CI of school-age asthma was 7.1% in Denmark, 10.5% in Finland, 9.7% in Norway and 10.2% in Sweden (children born in 2002). A slight decline over time was seen in Denmark and Norway, and a slight increase in Sweden and Finland.

Finland had a markedly lower CI of preschool asthma and Denmark lower CI of school-age asthma as estimated by prescriptions and hospital diagnoses. Preschool asthma may have plateaued in the Nordic countries. For school-age asthma trends over time varied by country. Differences in diagnostic and prescription practices may have influenced the results.

This study investigated the 1-year risk of injuries and poisonings among anabolic androgenic steroid users compared with controls from the general population.

In a cohort study conducted in Denmark, 1,189 anabolic androgenic steroid users were identified through a national antidoping program and matched with 59,450 controls. Participants were followed for 1 year. Data on hospital contacts, educational length, and occupational status were retrieved from nationwide registries. The primary outcomes were the incidence of injuries and poisonings. The secondary outcomes differentiated between fracture and nonfracture injuries, and medicinal versus nonmedicinal causes of poisonings, and described specific causes of injury-related hospital contacts.

Anabolic androgenic steroid users had significantly higher incidences of injuries and poisonings compared with controls. The risk difference for any injury was 7.8% (95% confidence interval [CI] 5.5 to 10.2) and the adjusted hazard ratio (aHR) was 1.46 (95% CI 1.29 to 1.66). Specifically, the risk of fractures was more than doubled among anabolic androgenic steroid users (aHR of 2.23, 95% CI 1.72 to 2.89), with head injuries being particularly prevalent. The risk difference for any poisoning was 1.2% (95% CI 0.5 to 1.9) and the aHR was 2.98 (95% CI 1.82 to 4.90). Medicinal poisoning was the most common poisoning among anabolic androgenic steroid users, with an aHR of 3.53 (95% CI 1.94 to 6.41).

Anabolic androgenic steroid use is associated with an increased risk of both injuries and poisonings, thereby quantifying a substantial risk of external harm among users.

Preclinical data suggest that gestational exposure to selective serotonin reuptake inhibitors (SSRI) alter gut innervation, and delays colonic motility. In this study we investigated associations between gestational SSRI exposure and offspring disorders of gut-brain interaction (DGBI). Using population-based registries, we included all single-birth Danish children born 1997-2015 with follow-up until outcome occurrence, age 15 years, death, emigration, or December 2018. Children to mothers who continued SSRIs during pregnancy and children to mothers who discontinued SSRI use before pregnancy were compared using Cox regression. Main outcomes were the first diagnosis of a childhood DGBI (functional nausea and vomiting, functional abdominal pain disorders, functional diarrhea, and functional constipation), or a physician-prescribed laxative. Among 1,158,560 children, 21,969 children (1.9%) were exposed to SSRIs prenatally and 30,174 children (2.6%) were born to mothers who discontinued SSRIs before pregnancy. Overall, the estimated 15-year cumulative incidence of any DGBI was 15.5% (95% CI, 14.9-16.2) in the SSRI-exposed group and 14.7% (14.0-15.3) in the unexposed group. SSRI-exposed children had an overall increased risk of DGBIs (HR 1.08, [1.02-1.14]), which was driven by functional constipation (HR 1.19, [1.10-1.28]) rather than functional nausea and vomiting (HR 0.97, [0.83-1.13]) or functional abdominal pain disorders (HR 0.90, [0.81-1.00]). These data suggest that prenatal SSRI exposure is associated with an increased risk of developing functional constipation. These findings are also consistent with extensive preclinical data supporting key roles for serotonin in gut development and function. Together findings support the need for further investigation of the long-term impact of maternal depression and SSRI exposure on development of common gastrointestinal disorders.

Only approximately 30% of conceptions result in live births. Historically, research has predominantly focused on maternal factors impacting pregnancy success, despite the cause remaining unidentified in most cases. The influence of paternal factors on a couple's likelihood of achieving a successful pregnancy is still not well understood and warrants further investigation.

This study aims to examine the chance of biochemical pregnancy, clinical pregnancy, and a live-born child in couples where the male partner has ischemic heart disease.

This nationwide cohort study based on Danish health registries included couples undergoing in vitro fertilization with or without intracytoplasmic sperm injection from 2006 to 2019. The cohort was divided into two groups: exposed and unexposed. The exposed cohort included embryo transfers in couples where the male partner had ischemic heart disease, while the unexposed group included those where the male partner did not have this condition.

A total of 101,875 couples with a known male partner were included. Among these, 653 couples were included in the exposed cohort and 101,222 were included in the unexposed cohort. The adjusted odd ratios (ORs) for a biochemical pregnancy, clinical pregnancy, and live-born child were 0.99 (95% confidence interval [CI]: 0.79; 1.23), 0.79 (95% CI: 0.51, 1.23), and 0.94 (95% CI: 0.62, 1.44), respectively.

These findings indicate that paternal ischemic heart disease prior to oocyte retrieval is not associated with a statistically significant decrease in the chances of biochemical pregnancy, clinical pregnancy, or live birth.

Sepsis survivors often experience cognitive, physiological, and functional impairments that may limit return to work (RTW). We aimed to describe changes in workforce attachment among working-age patients with sepsis, both overall and stratified by treatment in general wards versus the intensive care unit (ICU). Additionally, we aimed to evaluate the impact of educational level and to identify factors associated with RTW.

A register-based cohort study including all patients aged 20-63 years with incident community-acquired sepsis admitted to a hospital in the Region of Southern Denmark between 1 January 2016 and 20 March 2018. Labour market attachment was illustrated using area charts, overall and stratified by treatment in general wards versus the ICU. Further, the overall area chart was stratified by educational level. Patients were classified as part of the workforce or non-workforce. A subgroup of the workforce comprised those working. RTW was estimated for the workforce and those working after 12, 52, 104, and 156 weeks. Factors associated with RTW were identified using cause-specific hazards.

Of the 1610 patients with sepsis included, 651 were part of the workforce, with 488 working. After 12 weeks, 69.0% of workforce patients (excluding those censored) had returned to work. This proportion increased to 81.6%, 87.5%, and 90.4% after 52, 104, and 156 weeks, respectively. Among patients working before sepsis, RTW proportions were higher. Several baseline variables and in-hospital measures were associated with RTW among the workforce including younger age (20-39 years), HR = 1.33 (95% CI, 1.05-1.68), no ICU admission, HR = 2.64 (95% CI, 1.81-3.86), lactate < 4 mmol/L, HR = 2.19 (1.13-4.24), and single organ failure, HR = 2.33 (95% CI, 1.16-4.69). While ICU admission had impact on RTW in both the workforce and those working, educational level was unrelated to RTW among those working.

Most working-age patients with sepsis were outside the workforce. Working before sepsis was the strongest predictor of RTW. While educational level influenced whether patients were part of the workforce, it was not associated with RTW among those working. No ICU admission was associated with RTW.

 Awareness of socioeconomic disparities in outcomes following surgical procedures is increasing. This highlights a critical challenge for clinical practice and public health. We examined whether low socioeconomic position (SEP) was associated with the incidence of revisions due to periprosthetic joint infection (PJI) following total knee arthroplasty (TKA).

 This cohort study included 75,141 patients undergoing TKA (2010-2021), identified from the Danish Knee Arthroplasty Registry (DKR). Individual-level SEP information, including wealth, living arrangements, and education, was obtained from Danish social and administrative registries. Revisions due to PJI were identified using a method combining the DKR and microbiology data. We calculated the cumulative incidence of revision due to PJI at 90 days and 2 years, and 2-year hazard ratios (aHRs) of revision due to PJI for lower vs. higher SEP groups, adjusted for age, sex, weight, and Charlson Comorbidity Index scores, with 95% confidence intervals (CI).

 The incidence of revision due to PJI after 2 years of follow-up was 1.5% (CI 1.3-1.6) for low-wealth patients vs. 1.2% (CI 1.1-1.3) for high-wealth patients (aHR 1.3, CI 1.1-1.5); 1.5% (CI 1.3-1.7) for patients living alone vs. 1.2% (CI 1.1-1.3) for those cohabiting (aHR 1.4, CI 1.2-1.6); and 1.3% (CI 1.1-1.4) for patients with low education vs. 1.2% (CI 1.0-1.4) for those with high education (aHR 1.0, CI 0.8-1.2).

 Revision due to PJI among low-wealth patients and those living alone versus the corresponding high-SEP group were associated with increased risk of revision due to PJI.

Hyperkalemia and hypokalemia are common in admitted patients and recognized as a reversible cause of cardiac arrest. How the risk of in-hospital cardiac arrest changes relative to the severity of hyperkalemia and hypokalemia remains uncertain. The objective of this study was to estimate the association between pre-cardiac arrest hyperkalemia and hypokalemia and in-hospital cardiac arrest and outcomes after in-hospital cardiac arrest.

Registry-based matched case-control study.

Hospitalized patients in Denmark from 2017 to 2021.

Cases were adults with in-hospital cardiac arrest identified through the Danish in-hospital cardiac arrest Registry. These were matched with controls on age, sex, and length and time of admission. The index time was defined for cases as their time of cardiac arrest. A corresponding index time was assigned to matched controls.

None.

The exposure was potassium levels within 24 hours of the index time. Outcomes were in-hospital cardiac arrest and return of spontaneous circulation, 30-day survival, and 1-year survival in those with cardiac arrest. A total of 6,658 cases and 49,906 controls were included. Severe hyperkalemia (K+ > 6.5) and hypokalemia (K+ < 2.5) were associated with 2.03 (95% CI, 1.28-3.23) and 2.65 (95% CI, 1.61-4.38) times the odds of in-hospital cardiac arrest compared with normokalemia, respectively. Increasing severity of hyperkalemia was associated with decreased odds of return of spontaneous circulation, 30-day survival, and 1-year survival after in-hospital cardiac arrest. There was no clear association between hypokalemia and these outcomes.

Hyperkalemia was associated with an increased risk of in-hospital cardiac arrest and with worse outcomes after cardiac arrest. Hypokalemia was associated with an increased risk of in-hospital cardiac arrest but was not associated with outcomes after cardiac arrest.

This study investigates the potential correlation between the surgical stress response and long-term survival in patients undergoing treatment for colon cancer using either RAS (robot-assisted surgery) or LAS (laparoscopic surgery) and whether this correlation is influenced by the surgical approach. The primary objective was to assess the association between postoperative C-reactive protein (CRP) response and recurrence-free survival in RAS compared with LAS. Secondary endpoints included all-cause mortality and time-to-recurrence.

This Danish nationwide cohort study included patients diagnosed with Union for International Cancer Control (UICC) stage I-III colon cancer who underwent either RAS or LAS between 2010 and 2018. We employed the Cox proportional regression model to analyze the time-to-event outcomes for both primary and secondary endpoints in patients exhibiting either a low postoperative CRP response (< 80 mg/L) or a high CRP response (CRP ≥ 80 mg/L).

A total of 3484 patients were included in the study, with 490 (14.1%) undergoing RAS and 2994 (85.9%) undergoing LAS. The median follow-up time was 32.5 months (interquartile range [IQR] = 21.0-48.7) for the RAS group and 35.4 months (IQR = 22.8-50.9) for the LAS group. In the RAS group, a lower CRP response (CRP < 80 mg/L) was not associated with improved recurrence-free survival (HR = 0.78, 95% confidence interval [CI] [0.53-1.13], p = 0.184), all-cause mortality (hazard ratio [HR] = 0.76, 95% CI [0.46-1.26], p = 0.282), or time-to-recurrence (HR = 0.64, 95% CI [0.49-1.06], p = 0.079).

The postoperative CRP response was not significantly associated with improved long-term survival outcomes in patients undergoing RAS or LAS for UICC stage I-III colon cancer.

The ideal treatment for chronic and recurrent colonic diverticular disease (crDD) remains unresolved, partly due to lacking evidence regarding surgical safety. This study evaluated 90-day reoperation and mortality rates following elective surgery for crDD and explored predictors for reoperation and mortality.

This national cohort study included all patients with crDD undergoing elective colonic resection or stoma formation in Denmark from 1996-2021. Outcomes were the 90-day cumulative incidence proportion (CIP) of reoperation and mortality, and predictors were explored in Cox proportional hazard models.

Among 35,174 patients with crDD, 3,584 (10%) underwent elective surgery. The 90-day reoperation rate was 18.0%; mortality was 1.6%. During the 25-year period, the reoperation rate declined 30%, from 19.5% to 13.8%, and mortality declined 74%, from 2.7% to 0.7%. Among 2,942 patients with colonic resection and no stoma formation, the reoperation rate due to anastomotic leak was 3.0% overall and 0.9% in the most recent years. Mortality was 18 times higher in patients aged ≥ 80 years versus those aged < 60 years (CIP 8.0% versus 0.4%). The reoperation rate was increased in patients with ≥ 4 hospital contacts or ≥ 3 admissions compared to patients with fewer contacts, while mortality was not associated with the number of hospital contacts before surgery.

Elective surgery in crDD was safe with careful patient selection. The risk of reoperation due to anastomotic leak was very low. Patients with most hospital contacts had an increased reoperation rate, supporting consideration for elective surgery early in patients with disabling diverticular disease.

Women with preeclampsia often deliver preterm (under37 weeks gestation). Preterm birth is associated with an increased risk of offspring kidney disease, but whether preeclampsia is independently associated with kidney disease risk is unknown. Here, we conducted a register-based cohort study to explore associations between maternal preeclampsia and offspring kidney disease after accounting for preterm birth.

Using Cox regression, we estimated hazard ratios (HRs) comparing kidney disease rates, overall and by subtype, in offspring with and without exposure to maternal preeclampsia.

The study included 2,288,589 persons born in Denmark 1978-2017 of whom 63,191 were exposed to preeclampsia; 37,782 individuals developed kidney disease during 43,137,193 person-years of follow-up. Offspring exposed to preeclampsia and born at term (37 or more weeks' gestation) were 26% more likely than offspring born at term but not exposed to preeclampsia to develop kidney disease in infancy (HR 1.26, 95% confidence interval [1.09-1.46]), and had increased rates of all kidney disease subtypes except acute kidney disease after one year of age (HR range 1.11 to 1.88). Associations between term preeclampsia and offspring chronic, and unspecified and diabetic kidney disease were strongest after 25 years of age (HRs 1.36, 1.70 and 2.85, respectively). Conversely, there was little evidence that exposure to preeclampsia with preterm delivery was associated with increased rates of offspring kidney disease beyond the first year of life (under 1 year: 1.41, [1.05-1.90]; one year or more: 0.94, [ 0.79- 1.11]).

Associations of maternal term preeclampsia with offspring kidney disease hint at underlying mechanisms different from those potentially explaining established associations with preterm birth.

Aim: This study aimed to examine the demographic characteristics associated with participation in the COVIDPregDK cohort, aiming to identify potential sources of selection bias. Methods: In this nationwide register-based cohort study, data were used from the COVIDPregDK study, which encompasses a cohort of pregnant women from 2020 and linked them to data from the Danish registries. A comparison between women responding and those who did not respond to the questionnaire was conducted to assess their demographic and socioeconomic characteristics. The associations between respondents and various characteristics were analysed using logistic regression models. Results: The questionnaire garnered a response rate of 60%, with participation from 17,047 pregnant women and non-participation from 11,577. Respondent women were most often 30-34 years of age, of Danish origin, highly educated, and had the highest family income than non-respondents. Additionally, women above 35 years represented the most decisive risk factor of responding (35-39: odds ratio (OR) 1.17 (95% confidence interval (CI) 1.08-1.27); 40+: OR 1.27 95% CI 1.10-1.48)). Characteristics of non-respondents: families with three or more children (OR 0.55 (95% CI 0.47-0.64)); immigrants (OR 0.38 (95% CI 0.35-0.40)) and descendants (OR 0.39 (95% CI 0.34-0.45)); low educated (OR 0.40 (95% CI 0.36-0.44)) and low income (OR 0.67 (95% CI 0.61-0.72)). Conclusions: This study found significant demographic and socioeconomic disparities between respondent and non-respondent pregnant women in the COVIDPregDK study, indicating higher participation from women with higher socioeconomic status. Despite the societal lockdown during COVID-19, the lockdown did not mitigate the pre-existing factors hindering women with low socioeconomic status from engaging in research.

The CHA2DS2-VASc score predicts ischemic stroke risk in patients with atrial fibrillation or flutter (AF/AFL). However, it is unknown whether AF/AFL and the CHA2DS2-VASc score interact to increase the risk of ischemic stroke beyond their individual effects.

We conducted a cohort study of all adult Danish patients with a hospital diagnosis of AF/AFL from 1996 to 2021 (n = 287,990), and a comparison cohort matched on age, sex, and CHA2DS2-VASc score components (n = 1,404,705). During 1-, 1-5-, and 5-10-year follow-up, we calculated ischemic stroke rates across CHA2DS2-VASc score categories (0, 1, 2, and ≥ 3). We also estimated the interaction effect between AF/AFL and the CHA2DS2-VASc score components individually. Interaction was assessed via interaction contrasts.

During the 1-year follow-up, the ischemic stroke rate per 1000 person-years in individuals with a CHA2DS2-VASc score of 0 was 5.47 in the AF/AFL cohort and 2.11 in the comparison cohort. For persons with a CHA2DS2-VASc score of 1, the rate was 10.19 in the AF/AFL cohort and 5.76 in the comparison cohort. The corresponding interaction contrast of 1.07 ([10.19-5.47]-[5.76-2.11]) suggested that 11 % of the ischemic stroke rate was due to interaction. Another interaction was observed between AF/AFL and a CHA2DS2-VASc score ≥ 3 during 5-10-year follow-up (6 %). No other interactions were observed, except for female sex, which showed a large interaction effect in all follow-up periods.

AF/AFL and the CHA2DS2-VASc score interacted to increase ischemic stroke rate beyond their individual effects. Among individual CHA2DS2-VASc score components, female sex was associated with the largest interaction effect.

The emergence of new systemic treatments for alopecia areata underscores the importance of estimating rates of potential treatment safety events among individuals with alopecia areata. In this population-based cohort study, data linked across Danish population-based registries were used to examine the rates of the following safety events of interest before approval of Janus kinase inhibitor treatments by the European Medicines Agency: serious infections, herpes zoster infections, malignancies, arterial and venous cardiovascular events, and all-cause death in an alopecia areata cohort, defined as individuals ≥ 12 years old with hospital-treated alopecia areata, including its sub-types alopecia totalis and alopecia universalis. Incidence rates of the safety events of interest were computed and their associations with alopecia areata were estimated as standardized incidence ratios computed with regard to the age- and sex-matched general Danish population. The alopecia areata cohort included 2,778 individuals (472 with alopecia totalis/alopecia universalis) with a first-recorded diagnosis of alopecia areata in 1995-2016, followed through to the end of 2016, during a hospital admission or treatment at an outpatient clinic. Hospital-treated alopecia areata was associated with serious infections (standardized incidence ratio [95% confidence interval], 1.89 [1.72-2.06]), herpes zoster infections (1.83 [1.63-2.05]), lymphoma (3.44 [1.88-5.77]), arterial and venous cardiovascular outcomes (1.41 [1.12-1.75]), and death (1.16 [1.00-1.34]).

Patients with congestive heart failure (HF) are often burdened with comorbidities that increase mortality. Comorbidity indices provide a standardised method to measure comorbidity burden and predict prognosis. We aimed to investigate whether the Danish Comorbidity Index for Acute Myocardial Infarction (DANCAMI) can discriminate mortality in patients with HF.

We conducted a population-based cohort study of all adult Danish patients with first-time HF during 1995-2020 (N = 311,628). We used logistic regression to calculate the area under the receiver operating characteristic curve (AUC) for cardiovascular and all-cause mortality within 30 days, 1 year, and 10 years of diagnosis. The AUCs were computed for a model including age and sex (baseline) and models also including the DANCAMI, the Charlson Comorbidity Index (CCI), or the Elixhauser Comorbidity Index (ECI).

For all-cause mortality, the AUCs were higher for the DANCAMI than for the baseline model (30-day: 0.688 vs. 0.662; 1-year: 0.715 vs. 0.680; 10-year: 0.840 vs. 0.810). For cardiovascular mortality, the AUCs were comparable between the DANCAMI and the baseline model (30-day: 0.683 vs. 0.676; 1-year: 0.690 vs. 0.684; 10-year: 0.659 vs. 0.658). For both 30-day, 1-year, and 10-year all-cause and cardiovascular mortality, the AUCs for the CCI and the ECI were comparable to those for the DANCAMI.

Adding the DANCAMI to a model including patient age and sex improved discrimination of short and long-term all-cause mortality but not of cardiovascular mortality.

To investigate the separate and combined impact of family major depression (MD) history and ten childhood adversities (CA) on the risk of adult MD.

All Danish citizens born 1977-2000 with known parental identity were followed from their 18th birthday until diagnosis of MD, migration, death, or December 31, 2022, in nationwide registers. Exposures were family MD history and ten selected CAs. Family MD history was operationalized using the ICD 8th Revision codes 296.09, 296.29, 298.09, and 300.49 or 10th Revision codes F32.0-F33.9. CAs were; relative family poverty, long-term parental unemployment, foster care, parental alcohol abuse, parental drug abuse, parental and sibling somatic illness, parental long-term unemployment, parental separation, and parental and sibling death. Multivariable Poisson regression was applied to estimate the incidence rate ratio (IRR) with 95 % CI of first-time MD.

The study included 1,461,034 individuals (Male: 51.5 %). During a mean follow-up of 14.5 years (SD ± 7.2), 50,231 (3.5 %) of cohort members were diagnosed with first-time MD in adulthood. Family MD history was associated with an IRR of 1.94 (95 % CI [1.88-2.00]) for MD. In all models, both CAs and family MD, separately and combined, were associated with an increased IRR for MD. The IRRs for individuals with a family MD history with or without CA, respectively, were generally relatively comparable.

Individuals exposed to family MD history and CAs are at increased risk of MD. However, the associations between family MD and onset of MD in adulthood remain largely unchanged regardless of the presence of any of the ten CAs.

Renal cell carcinoma (RCC) management has advanced due to increased imaging-based diagnoses and improved therapies for metastatic disease. This nationwide registry-based cohort study examines changes in the number of primary RCC cases, stage at diagnosis, prognosis during the past 30 years in Denmark, and how these are associated with sex and age. All Danish patients aged 18 and older diagnosed with primary RCC from 1992 to 2021 with no prior cancer history (except non-melanoma skin cancer) were included and followed from diagnosis until death or end of follow-up (31-12-2023). Statistical analyses included Pearson's χ2, Cramer's V, Wilcoxon rank-sum test, Kruskal-Wallis, competing risk regression, Cox proportional hazard regression, and Kaplan-Meier. 17,423 RCC patients were identified. Primary RCC cases increased from 2,244 in 1992-1996 to 3,947 in 2017-2021. In this period, the proportion of male patients increased from 59 to 72% (P < 0.001). Male patients were younger at diagnosis than female patients (median age 65 vs. 69 years, P < 0.001). Localized cancer cases increased from 44% (N = 983) in 1992-1996 to 70% (N = 2,766) in 2017-2021, while metastatic cases declined from 29% (N = 640) to 17% (N = 652). Median survival for metastatic RCC improved from 4.1 months in 1992-1996 to 13.3 months in 2017-2021. Over three decades, RCC incidence in Denmark has grown, particularly among men, largely due to localized disease, adding pressure on urological departments. The number of metastatic cases remained stable, but survival improved, reflecting advances in early detection and treatment.

This study aimed to translate and validate the Danish version of the DV-QOL questionnaire, originally developed in 2015, to assess the impact of diverticular disease on quality of life (QOL) in Danish-speaking patients with diverticulosis.

Following international standards, the DV-QOL was translated. A cross-sectional survey was conducted in 2023 with Danish-speaking subjects. The survey included the Danish DV-QOL, an anchor QOL question, and the EuroQol visual analogue scale. Psychometric properties were evaluated for validity, internal consistency, and the ability to identify significant impacts on QOL.

The validation cohort included 16,766 subjects. The DV-QOL score showed a strong correlation with overall QOL (p < 0.001) and high discriminative validity (p < 0.001). Reliability was confirmed with an inter-item correlation of 0.41 and a Cronbach's α of 0.92. The score accurately identified patients with a significant impact of bowel function on QOL, achieving 82% sensitivity and 79% specificity.

The Danish DV-QOL is a valid and reliable tool for measuring diverticular disease-specific QOL, beneficial for both clinical and research applications in understanding the impact of the disease and patient outcomes.

The coronavirus disease 2019 (COVID-19) pandemic and lockdowns prompted a major concern for mental health effects. Comprehensive nationwide studies are lacking on the indirect effect of the COVID-19 pandemic on the mental health of the population. We aimed to determine whether the COVID-19 pandemic and lockdowns affected mental health service usage, suicide attempts and suicides. This comprehensive nationwide register-linked study followed all individuals in Denmark from 1990. The main outcomes were rates of psychiatric admissions, use of psychotropic medication, suicide attempts, suicides, patients in community-based private psychiatry or psychology practices and referrals to psychiatric hospitals. The impact of the pandemic (11 March 2020-30 June 2023) and lockdowns was assessed with log-normal models adjusted for pre-pandemic trends (1 January 2017-10 March 2020). We reported rate ratios (RR) of the observed and counterfactual rates. We identified the 5 807 714 (50.3% female) individuals living in Denmark on 1 March 2020. The rates of psychiatric admissions [RR: 0.95, 95% confidence interval (CI): 0.91 to 0.99, P-value: 0.017] and suicide attempts (RR: 0.85, 95% CI: 0.76 to 0.95, P-value: 0.007) were lower during the pandemic compared with the pre-pandemic trend. The rates of suicides (RR: 0.89, 95% CI: 0.75-1.05, P-value: 0.173), patients in private practices (RR: 1.00, 95% CI: 0.96-1.04, P-value: 0.986) and referrals (RR: 1.06, 95% CI: 0.95-1.18, P-value: 0.307) were not significantly different during the pandemic compared with the pre-pandemic trend. During the first lockdown, rates were lower for psychiatric admissions (RR: 0.85, 95% CI: 0.80 to 0.90, P-value <0.001), suicide attempts (RR: 0.80, 95% CI: 0.69 to 0.94, P-value: 0.007), suicides (RR: 0.67, 95% CI: 0.52 to 0.86, P-value: 0.002), patients in private practices (RR: 0.88, 95% CI: 0.82 to 0.93, P-value <0.001) and referrals (RR: 0.69, 95% CI: 0.60 to 0.81, P-value <0.001) compared with the pre-pandemic trend. However, during the pandemic, the rate of psychotropic medication users increased by 6% compared with the pre-pandemic trend (RR: 1.06, 95% CI: 1.05 to 1.06, P-value < 0.001). The COVID-19 pandemic and lockdowns did not severely influence pre-pandemic trends of the mental health burden in the population of Denmark on a nationwide level.

We aimed to assess real-world implementation of guideline-directed medical therapy (GDMT) for heart failure (HF) with reduced ejection fraction (HFrEF) and its association with mortality and hospitalization.

We analysed 46 816 incident HFrEF patients from the Danish Heart Failure Registry (2008-2022). We examined the utilization of GDMT-renin-angiotensin system inhibitors (RASi), beta-blockers, mineralocorticoid receptor antagonists (MRAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i)-at 4, 8 and 12 weeks of follow-up according to the European Society of Cardiology guidelines within the intervals 2008-2011, 2012-2015, 2016-2020 and 2021-2022. Using Cox regression, we assessed the associations between GDMTs [none (reference), 1-2 GDMTs, and 3-4 GDMTs] initiated at 4, 8 and 12 weeks and 1 and 3 year mortality (all-cause and cardiovascular) and hospitalization (all-cause and HF).

Between 2008-2011 and 2021-2022, RASi utilization at 4 weeks of follow-up was 93.2% and 93.7%, respectively, and at 12 weeks of follow-up, 97.2% and 97.8%, respectively. Beta-blocker use was 81.1% and 78.2% at 4 weeks and 89.6% and 90.4% at 12 weeks of follow-up while MRA utilization was 27.2% and 34.6% at 4 weeks and 32.6% and 52.2% at 12 weeks of follow-up. The SGLT2i use at 4 weeks increased from 0.0% to 21.3%, and at 12 weeks of follow-up from 3.2% to 35.8% between 2016-2020 and 2021-2022. The initiation of GDMTs at 4 weeks of follow-up was associated with lower adjusted hazard ratios (HRs) [95% confidence intervals (CI)] for 1 year all-cause mortality [1-2 GDMTs: 0.73 (95% CI: 0.61-0.86), 3-4 GDMTs: 0.65 (95% CI: 0.55-0.78)], 3 year all-cause mortality [1-2 GDMTs: 0.75 (95% CI: 0.66-0.86); 3-4 GDMTs: 0.67 (95% CI: 0.59-0.76)] and 3 year cardiovascular mortality [1-2 GDMTs: 0.74 (95% CI: 0.62-0.89); 3-4 GDMTs: 0.72 (95% CI: 0.59-0.87)]. Lower adjusted HRs were also observed for 1 year all-cause hospitalization [1-2 GDMTs: 0.80 (95% CI: 0.75-0.86); 3-4 GDMTs: 0.78 (95% CI: 0.73-0.84)] and 3 year all-cause hospitalization [1-2 GDMTs: 0.77 (95% CI: 0.72-0.83); 3-4 GDMTs: 0.77 (95% CI: 0.71-0.82)].

We demonstrated high use of RASi and beta-blockers and rising use of MRA and SGLT2i, reflecting rapid adaption to guidelines changes in incident HFrEF patients. Early GDMT initiation was associated with lower 1 and 3 year mortality and all-cause hospitalization. Upfront treatment with GDMT, according to the latest guidelines, is crucial.

Short-term exposure to ultrafine particles (UFP; <100 nm) may trigger respiratory hospitalizations, potentially even more so among children than adults, but available evidence is limited. We examined the association between short-term UFP exposure and respiratory infection hospital admissions in children in Copenhagen, Denmark.

Daily concentrations of UFP were monitored at an urban background station during 2002-2018. Hospital admissions for lower and upper respiratory infections (LRTIs/URTIs), pneumonia, bronchitis, and influenza in children (0-18 years) were obtained from the Danish National Patient Register. Associations between UFP concentrations up to one week prior to admission and hospital admissions were examined using case-crossover design. Relative risks (RR) with 95 % confidence intervals (CI) were estimated per interquartile range (IQR) increase in UFP for the total population, and by sex, age (0-4/5-14/15-18 years) and socio-economic status (income, mother's education).

We observed 109,585 hospital admissions for respiratory infections. We found positive associations of UFP with total respiratory infections, URTIs, and pneumonia with RRs of 1.04 (95 % CI: 1.01, 1.06), 1.04 (1.01, 1.08), and 1.06 (1.01, 1.12), respectively, per IQR increase in three-day mean UFP (lag 0-2), that were robust to PM2.5 and NO2 adjustment. Associations were stronger in boys and children younger than 15 years, with no differences between socio-economic groups.

Short-term exposure to UFP triggered hospital admissions for respiratory infections, especially URTIs and pneumonia, in children in Copenhagen independently from PM2.5 and NO2. Our findings emphasize the need for policies and regulations aimed at improving urban air quality to protect children's health.

Temporary stays for patients requiring short-term care outside the home, often following hospital discharge, has gained increasing importance. This study aimed to describe the characteristics and care trajectories of older patients in Danish temporary stays to improve care delivery and patient safety.

We conducted a descriptive study on a cohort of patients in temporary stays across 14 Danish municipalities from 2016 to 2023, using data from national health registries.

We identified 11,424 patients with a median age of 81 years (interquartile range [IQR] 73-87 years); 54% were women. Patients exhibited a high level of comorbidity, with a median Charlson Comorbidity Index of 1 (IQR 0-2), and a median of 3 hospital admissions (IQR 2-6) in the year preceding their move into temporary care. The majority (70%) transitioned to temporary stays following hospital discharge, while 30% were admitted directly from their homes. The median duration of temporary stays was 24 days (IQR 11-49 days), with 9.1% staying ≥ 90 days. Additionally, 7.0% of patients were hospitalised directly from the temporary stay facility, with a median time to hospital admission of 13 days (IQR 5-28 days). Median survival after admission to a temporary stay was 23 months (IQR 3.6-57 months). Predictors of mortality included male sex, older age, higher comorbidity burden, and increased number of hospital admissions prior to temporary stay.

Patients in temporary stays are generally older individuals with multimorbidity and limited life expectancy. Most patients are admitted following hospital discharge, and their stays are often prolonged.

Placental dysfunction is important to recognize, and more evidence is needed on the dynamics of the placental biomarkers, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), in early pregnancy. This study aimed to establish reference intervals for placental biomarkers in early pregnancy.

This was a retrospective cohort study of pregnant women (n = 702) in the North Denmark Region, 2013, who had blood samples drawn in early pregnancy including measurements of sFlt-1 and PlGF (Kryptor Compact, Thermofisher Scientific). Reference intervals were established, and the association between sFlt-1 and PlGF and maternal characteristics (age, body mass index [BMI], country of birth, and smoking in pregnancy) was evaluated using linear regression analyses and reported as adjusted beta coefficient (aβ) with 95% confidence intervals (CIs).

The placental biomarkers showed a dynamic trend with higher levels for increasing week of pregnancy; however, sFlt-1 reached a plateau around week 10 of pregnancy. Higher maternal age associated with higher sFlt-1 and PlGF (sFlt-1: aβ 1.02 [95% CI, 1.01-1.03], PlGF: aβ 1.02 [95% CI, 1.01-1.03]), and higher maternal BMI associated with lower sFlt-1 (aβ 0.97 [95% CI, 0.96-0.98]). Furthermore, the level of PlGF was higher among women born outside of Denmark (aβ 1.17 [95% CI, 1.03-1.34]) compared to women born in Denmark and among smokers (aβ 1.56 [95% CI, 1.38-1.78]) compared to nonsmokers.

In a large cohort of pregnant women in Denmark, levels of sFlt-1 and PlGF increased during early pregnancy and were influenced by a series of maternal characteristics.

This study aims to study the association between socioeconomic factors and risk of prevalent eye diseases, including glaucoma, cataract and retinal vein occlusion (RVO) in an elderly Danish population.

This study was a nationwide cohort study.

The included subjects were extracted from Danish nationwide health registers, and the association between socioeconomic factors and prevalent eye diseases was assessed by estimating the incidence rate and the cumulative incidence. The differences between the investigated groups were quantified using the Cox proportional hazard model.

Based on a 10-year follow-up period, the highest levels of education and household income were associated with higher rates and risks of glaucoma compared with the lowest and middle levels. This results in absolute risks ranging from 3.2% (3.1%-3.3%) in both the lowest educational and income group to 4.0% (3.9-4.1%) and 3.8% (3.8-3.9%) in the highest educational and income group, respectively. For cataract, the middle and lowest educational and income levels were associated with increased rates and risks, which were statistically significant compared with the highest levels. The risk of cataract ranged from 6.5% (6.4%-6.7%) to 8.1% (8.0%-8.2%) and 6.0% (5.9%-6.1%) to 8.7% (8.5%-8.8%) in the highest to the lowest educational and income group, respectively. For RVO, the event rate was low, showing no statistically significant differences. The risk of RVO remained constant in all investigated socioeconomic groups, with a risk of 0.3% (0.3%-0.3%).

Our findings indicate that socioeconomic factors, such as education and household income, are associated with the diagnosis glaucoma and cataract. Incorporating socioeconomic considerations into public health initiatives may enhance the management of eye diseases and improve information and awareness about these conditions.