TY - JOUR
T1 - Appendectomy and risks of autoimmune diseases-A nationwide population-based cohort study
AU - 胡, 莉芳(Li-Fang Hu)
AU - 林, 子閔(Tzu-Min Lin)
AU - 張, 又升(Yu-Sheng Chang)
AU - 許, 惠晴(Hui-Ching Hsu)
AU - 林, 聖閎(Sheng-Hung Lin)
AU - 陳, 瑋昇(Wei-Sheng Chen)
AU - 郭, 姵邑(Pei-I Kuo)
AU - 林, 怡諄(Yi-Chun Lin)
AU - 陳, 錦華(Jin-Hua Chen)
AU - 張, 棋楨(Chi-Ching Chang)
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objectives: The appendix is involved in immune function, and appendectomy may alter the immune system. Studies have evaluated the relationship between appendectomy and the risks of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), but information on the risks of other autoimmune diseases (ADs) remains lacking. In this study, we investigated the relationship between appendectomy and the subsequent risks of ADs using a population-based dataset in Taiwan. Methods: Patients who underwent appendectomy from January 1, 2006, through December 31, 2015, were identified from the National Health Insurance Research Database (NHIRD) and assigned to the appendectomy cohort. Patients without appendectomy were randomly selected from the NHIRD and assigned to the control cohort. All patients were followed up until ADs diagnosis. We used Cox regression models to estimate the adjusted hazard ratio (aHR) for comparing the risks of ADs between the two cohorts. Results: The study identified 196,036 patients who underwent appendectomy (54.38% men, mean age = 36.89 years, P ＜ 0.001) and 23,513,690 controls (50.21% men, mean age = 36.16 years). The overall risk of ADs was 1.31 fold higher for the appendectomy cohort than for the control cohort after adjustment for age, sex, and comorbidities (aHR = 1.31, 95% CI = 1.24, 1.38). In the appendectomy cohort, the patients had increased risks of ADs in Addison's disease, type 1 diabetes mellitus (type 1 DM), Graves' disease, Hashimoto's thyroiditis, Henoch-Schönlein purpura (HSP), inflammatory bowel disease (IBD), ankylosing spondylitis (AS), psoriasis, and systemic lupus erythematosus (SLE) subgroups. Conclusions: This nationwide retrospective cohort study demonstrated that patients who have undergone appendectomy have significantly higher risks of Ads compared with the general population.
AB - Objectives: The appendix is involved in immune function, and appendectomy may alter the immune system. Studies have evaluated the relationship between appendectomy and the risks of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), but information on the risks of other autoimmune diseases (ADs) remains lacking. In this study, we investigated the relationship between appendectomy and the subsequent risks of ADs using a population-based dataset in Taiwan. Methods: Patients who underwent appendectomy from January 1, 2006, through December 31, 2015, were identified from the National Health Insurance Research Database (NHIRD) and assigned to the appendectomy cohort. Patients without appendectomy were randomly selected from the NHIRD and assigned to the control cohort. All patients were followed up until ADs diagnosis. We used Cox regression models to estimate the adjusted hazard ratio (aHR) for comparing the risks of ADs between the two cohorts. Results: The study identified 196,036 patients who underwent appendectomy (54.38% men, mean age = 36.89 years, P ＜ 0.001) and 23,513,690 controls (50.21% men, mean age = 36.16 years). The overall risk of ADs was 1.31 fold higher for the appendectomy cohort than for the control cohort after adjustment for age, sex, and comorbidities (aHR = 1.31, 95% CI = 1.24, 1.38). In the appendectomy cohort, the patients had increased risks of ADs in Addison's disease, type 1 diabetes mellitus (type 1 DM), Graves' disease, Hashimoto's thyroiditis, Henoch-Schönlein purpura (HSP), inflammatory bowel disease (IBD), ankylosing spondylitis (AS), psoriasis, and systemic lupus erythematosus (SLE) subgroups. Conclusions: This nationwide retrospective cohort study demonstrated that patients who have undergone appendectomy have significantly higher risks of Ads compared with the general population.
KW - Appendectomy
KW - autoimmune diseases
KW - risk
KW - cohort study
KW - 盲腸切除
KW - 自體免疫疾病
KW - 類過敏性紫斑
KW - 僵直性脊椎炎
KW - 乾癬
KW - 全身性紅斑狼瘡
U2 - 10.6313/FJR.202009_34(1).0003
DO - 10.6313/FJR.202009_34(1).0003
M3 - Article
SN - 2075-0374
VL - 34
SP - 17
EP - 29
JO - Formosan Journal of Rheumatology
JF - Formosan Journal of Rheumatology
IS - 1
ER -
