Kuan-Yang Chen

Taipei City Hospital, T’ai-pei, Taipei, Taiwan

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Publications (4)11.44 Total impact

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    ABSTRACT: This study aimed to assess the risk of pancreatic cancer after acute pancreatitis using a nationwide population-based data set in Taiwan. We conducted a retrospective cohort study of 747 patients hospitalized between 2000 and 2003 with a principal diagnosis of acute pancreatitis (the study cohort) and 5976 comparison patients. Stratified Cox proportional hazard regression adjusted for monthly income, urbanization, and geographic location of residence was used to calculate the 5-year hazard ratio (HR) of pancreatic cancer for the study versus comparison cohort. Of the total sample, 21 patients (0.31%) developed pancreatic cancer in the 5 years after index hospitalization: 11 (1.47%) of the study group patients and 10 (0.17%) of the comparison group patients. After adjusting for confounders, acute pancreatitis patients were 9 times as likely as the comparison group to develop pancreatic cancer in the following 5 years (HR = 9.10; 95% confidence interval, 3.81-21.76). Among patients with acute pancreatitis, the adjusted HR of pancreatic cancer was 40.03 and 3.72 times greater, respectively, for those with chronic pancreatitis and for those without than comparison patients. Patients with acute pancreatitis have more than 9 times the risk of comparison patients to develop pancreatic cancer in the subsequent 5 years among the Hun Chinese ethnic population in Taiwan.
    Pancreas 09/2011; 41(1):142-6. · 2.95 Impact Factor
  • Yi-Hua Chen, Kuan-Yang Chen, Herng-Ching Lin
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    ABSTRACT: As habitual heavy alcohol consumption is one of the major causes of cirrhosis in the western world, the majority of studies on the relationship between cirrhosis and stroke have focused on patients with alcohol-related liver diseases. Using a nationwide population-based dataset, this study therefore aimed to examine the risk of stroke among non-alcoholic cirrhosis patients over a 5-year period following their diagnosis with non-alcoholic cirrhosis, as compared with the general population during the same period. We used the 'Longitudinal Health Insurance Database', derived from the Taiwan National Health Insurance program. The study cohort comprised 2336 patients with cirrhosis and the comparison cohort consisted of 11,680 randomly selected subjects. Stratified Cox's proportional hazard regressions were performed to compare the 5-year stroke survival rate for the two cohorts. In the total sample of 14,016 patients, 1187 patients (8.5%) experienced stroke during the 5-year follow-up period: 176 from the study cohort (7.5% of the patients with cirrhosis) and 1011 from the comparison cohort (8.7% of patients without cirrhosis) (P=0.076). After adjusting for the patients' geographical location, hypertension, diabetes, coronary heart disease, heart failure, atrial fibrillation and hyperlipidaemia, the regression analysis shows that patients with cirrhosis were less likely to experience stroke compared with those without cirrhosis during the 5-year period (hazard ratio=0.59, 95% confidence interval=0.52-0.67, P<0.001). We conclude that patients with non-alcoholic cirrhosis were at a reduced risk for stroke compared with the general population.
    Liver international: official journal of the International Association for the Study of the Liver 03/2011; 31(3):354-60. · 3.87 Impact Factor
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    ABSTRACT: To examine the seasonal variation in the incidence of gastroesophageal reflux disease (GERD) for different gender and age groups and its association with climatic parameters (ambient temperature, relative humidity, atmospheric pressure, rainfall, and hours of sunshine). A total of 76,636 ambulatory care visits for the treatment of GERD between 2001 and 2006 were included. Monthly GERD incidence rates per 10,000 people were calculated over 72 months and categorized by gender and age groupings (19-44, 45-64, and >or=65 years). Seasonality is a general component of time-series patterns. The auto-regressive integrated moving average (ARIMA) regression method was used to evaluate the effects of climatic and monthly factors on GERD incidence rates after adjusting for the time-trend effect. Seasonal trends showed an incidence peak in October to December, followed by a sharp decrease in January, and a trough in February; a fairly similar seasonal pattern of GERD incidence was apparent for gender, age, and combined groups. The ARIMA test for seasonality found a significant association for the total group (P < 0.01), for female (P < 0.05) patients, and for the 45 to 64 years (P < 0.01) and >64 years (P < 0.01) age groups. The ARIMA models also showed that relative humidity was negatively related to monthly GERD incidence rates for men (P < 0.01) and the >64 years (P < 0.01) age group. Data showed seasonal variations in GERD incidence. Relative humidity was associated with monthly GERD incidence rates for men and the >64 years age group.
    The American Journal of the Medical Sciences 10/2009; 338(6):453-8. · 1.33 Impact Factor
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    Horng-Yuan Lou, Herng-Ching Lin, Kuan-Yang Chen
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    ABSTRACT: No study has explored the volume-outcome relationship for peptic ulcer treatment. To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset. A retrospective cross-sectional study, set in Taiwan. There were 48,250 peptic ulcer patients included. Each patient was assigned to one of three hospital volume groups: low-volume (< or = 189 case), medium volume (190-410 cases), and high volume (> or = 411 cases). Logistic regression analysis employing generalized estimating equations was used to examine the adjusted relationship of hospital volume with in-hospital mortality and 14-day readmission. After adjusting for other factors, results showed that the likelihood of in-hospital mortality for peptic ulcer patients treated by low-volume hospitals (mortality rate = 0.68%) was 1.6 times (p < 0.05) that of those treated in high-volume hospitals (mortality rate = 0.72%) and 1.4 times (p < 0.05) that of those treated in medium-volume hospitals (mortality rate = 0.73%). The adjusted odds ratio of 14-day readmission likewise declined with increasing hospital volume, with the odds of 14-day readmission for those patients treated by low-volume hospitals being 1.5 times (p < 0.001) greater than for high-volume hospitals and 1.3 times (p < 0.01) greater than for medium-volume hospitals. We found that, after adjusting for other factors, peptic ulcer patients treated in the low-volume hospitals had inferior clinical outcomes compared to those treated in medium-volume or high-volume ones.
    Journal of General Internal Medicine 10/2008; 23(10):1693-7. · 3.28 Impact Factor