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The Evidence Speaks

The Evidence Speaks (June 2020)

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The Evidence Speaks Series is a recurring feature highlighting the latest in CHÉOS research. This series features summaries of select publications as well as in-depth features on the latest work from our investigators. The Series is designed to keep media and the research community up-to-date with CHÉOS’ current research results in the health outcomes field.

Raymakers A, Sin D, Sadatsafavi M, FitzGerald J, Marra C, Lynd L. Statin use and lung cancer risk in chronic obstructive pulmonary disease patients: a population-based cohort study. Respir Res. 2020 May 19;21(118).

Chronic obstructive pulmonary disease (COPD) is often associated with comorbidities including cardiovascular disease (CVD), which is typically treated using statins. Data indicate that individuals living with COPD are also at an increased risk of developing lung cancer. In some cases, this risk is due to increased inflammation — an issue exacerbated by concomitant CVD and COPD. To further explore these interactions, CHÉOS Scientist Dr. Larry Lynd joined a team from UBC and University of Otago to evaluate the association between statin use and the risk of lung cancer among a cohort of COPD patients. Using information from several databases in B.C., the team identified 39,879 COPD patients. Of these, there were 994 cases of lung cancer and 12,469 patients who received statins during the study period. The analyses conducted suggest that statin use in COPD patients may reduce the risk of lung cancer. While the effect was not statistically significant across all exposure definitions, the results lend support to the hypothesis that COPD patients, likely characterized by elevated levels of inflammation, could significantly benefit from statin use.

Larouche M, Albert AYK, Lipsky N, Walmsley S, Loutfy M, Smaill F, Trottier S, Bitnun A, Yudin MH, Cundiff GW, Money DM. Urinary symptoms and quality of life in women living with HIV: a cross-sectional study. Int Urogynecol J. 2020 May 22 epub ahead of print.

Lower urinary tract symptoms (LUTS) occur in around 20–50 per cent of women and the prevalence increases with age. It is not known whether HIV status contributes to LUTS incidence or severity in women; however, with HIV treatments improving life expectancy and quality of life, there is an increasing focus on healthy aging with HIV. CHÉOS Scientist Dr. Geoffrey Cundiff collaborated with investigators from the CTN 236 HPV in HIV study group to determine the prevalence of LUTS in women living with HIV, and its impact on their quality of life. To gather the data needed, a cross-sectional urinary questionnaire was conducted, which included the Urinary Distress Inventory (UDI-6) and Urinary Impact Questionnaire (UIQ-7), addressing symptom burden and impact on quality of life, respectively. Demographic information was also collected, and current CD4 count, HIV viral load, and antiretroviral regimen were recorded. Many of the 177 women who completed the questionnaire had experienced LUTS; however, quality of life was not significantly affected in most cases. While this result is reassuring, further studies are needed to determine whether HIV is a risk factor for troublesome LUTS, particularly in the aging population.

Heidet M, Fraticelli L, Grunau B, Cheskes S, Baert V, Vilhelm C, Hubert H, Tazarourte K, Vaillancourt C, Tallon J, Christenson J, Khoury CE, on behalf of the Gr-ReAC CanROC investigators. ReACanROC: Towards the Creation of a France-Canada Research Network for Out-of-Hospital Cardiac Arrest. Resuscitation. 2020 July;152:133-40.

Outcomes following out-of-hospital cardiac arrest (OHCA) vary between communities and countries. This, in part, may be due to differences between emergency medical systems (EMS). In this study, CHÉOS Scientists Drs. Brian Grunau and Jim Christenson joined researchers from across Canada and France to compare prehospital organizations, response modes, patient characteristics, and outcomes following OHCA to determine the requirements for the first international Europe–North America OHCA research network — ReACanROC (RéAC, France; CanROC, Canada). Using data from the RéAC and CanROC registries, the researchers determined that France and Canada have comparable populations of patients suffering OHCA; however, the countries have different geographies, EMS systems, practices, and outcomes. For example, in Canada, professionally attempted resuscitation occurred in 60 per cent of cases versus 82 per cent in France, while in France, initially attempted resuscitation was discontinued before transportation to hospital in 79 per cent cases versus only 45 per cent in Canada. The researchers conclude that the creation of ReACanROC will assist in the planning of additional analyses to better understand predictors of the variabilities between French and Canadian OHCA prehospital systems and, ultimately, patient outcomes.