national cause-, gender-, race-, year-, age-specific mortality rates. Mortality data in the cohort study were analyzed in terms of cause-specific standardized mortality ratios (SMRs) and 95% confidence intervals (95% CIs), with expected deaths based on U.S. The observation period covered 1979–2001. Materials and Methods: The retrospective cohort study consisted of 2179 employees at 11 plants in the United States where wood (primarily railroad ties and utility poles) is treated with creosote-based preservatives. For background, a literature review is also presented. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.The objective of this study was to assess both malignant and nonmalignant mortality risks of workers exposed to creosote. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. This association was not modified by race or ethnicity data. The risk of poor functional outcome 3 months after intracranial hemorrhage was increased amongst individuals with CKD (58.8%) compared with those who did not have CKD (47.9%), p= 0.003. Genetically driven CKD was associated with increased odds of ICH even when using a conservative analytic approach (weighted-mean) yielding an odds ratio of 1.72 (95% confidence interval 1.06-2.82). The analysis of patients in the general population demonstrated that CKD was associated with increased odds of ICH as well: in unadjusted analyses (OR, 3.60 95% CI, 2.89-4.48) and adjusted analyses (OR 1.28 95% CI, 1.01-1.62). End stage kidney disease was associated with higher odds of ICH: in unadjusted analyses (OR, 5.44 95% CI, 2.85-10.37) and adjusted analyses (OR, 2.93 95% CI, 1.51-5.67). The analysis of the ERICH cohort confirmed that CKD was associated with an increased risk of ICH: in unadjusted analyses (odds ratio, 3.35 95% CI, 2.33-4.82) and adjusted analyses (OR, 1.95 95% CI, 1.35-2.89).

Genetic analysis was performed using standard methods. Cases in the ERICH study had an image-confirmed diagnosis of ICH. Eligible patients in all phases of this study were adults living within 75 miles of a study recruitment center. Finally, a Mendelian randomization genetic analysis was performed amongst this larger cohort to determine which patients with CKD had inherited disease, and whether this affected its relationship with ICH risk. This same analysis was then repeated in an ethnically diverse cohort derived from the general population. Observational data from ERICH case-control study of patients with CKD was collected retrospectively to assess for any association between CKD and ICH. In Depth : A multi-step study was conducted. Relevant reading: Chronic kidney disease and the risk of stroke: a systematic review and meta-analysis Considering this, further research is needed to better understand the mechanism underlying the association described in this study. However, a primary limitation of this work is the potential for confounding: for example, patients with CKD are known to be relatively comorbid and this may additionally influence the risk of ICH. A strength of this study is the large sample size as well as the plausibility of the results reported based on previous study in this field. These results are significant because they provide early rationale for screening for hypertension and related intracranial pathologies in patients with CKD. This observational study by Vanent et al demonstrated that individuals with CKD are at increased risk of dangerous cerebral hemorrhagic events and also at greater risk of poor function following ICH. Analysis of functional outcomes 3 months after intracranial hemorrhage demonstrated that patients with CKD had worse outcomes. Finally, 1078 genetically driven CKD cases were identified, which were also associated with an increased risk of ICH. The prevalence of CKD amongst patients with ICH was 6.4% and 1.9% amongst the non-ICH controls.

Amongst the general population cohort of 502,536 individuals, 1341 patients with ICH were identified. The prevalence of CKD amongst cases was 4.3% and 1.3% amongst controls this difference was statistically significant. The present study by Vanent et al combined observational and genetic data from a large cohort of individuals to assess the association between CKD and spontaneous, nontraumatic intracranial hemorrhage (ICH).Ī total of 6,868 patients from the ERICH case-control study were included. Previous studies have suggested an increased risk of ischemic stroke in individuals with chronic kidney disease (CKD) but the relationship between CKD and hemorrhagic stroke is less clear.

Study Rundown: Spontaneous, nontraumatic intracranial hemorrhage can be a devastating event which is often secondary to hypertension, vascular aneurysms or other malformations in the cerebral vessels.

Retrospective cohort vs case control