To investigate the association between hormonal contraceptive use and the risk of retinal vascular occlusions in women of reproductive age. Register-based, nationwide cohort study. A total of 2,208,172 women aged 15-49 years were followed from January 1, 1996, to June 30, 2021, excluding those with prior venous or arterial thrombosis, thrombophilia, cancer (except non-melanoma skin cancer), liver disease, chronic kidney disease, hysterectomy, bilateral oophorectomy, hormone therapy, infertility treatment, endometriosis, or polycystic ovary syndrome. Women were followed until study end, age 50, emigration, death, or occurrence of exclusion criteria. Individual-level, time-updated hormonal contraception use was identified through prescription records; retinal vascular occlusion events were detected through hospital diagnoses. Poisson regression models estimated incidence rate ratios of retinal vascular occlusion by duration, dosage, and type of hormonal contraceptives, adjusting for age, educational level, hypertension, diabetes, hypercholesterolemia, atrial fibrillation/flutter during observation. Adjusted incidence rate ratios (AIRR) and standardized incidence rate differences (SIRD) of retinal vein occlusion and retinal artery occlusion with hormonal contraceptive use compared to non-use. The cohort contributed 23,882,016 person-years with a median follow-up time of 10 years (1st to 3rd quartile: 4 to 17). Compared to non-use, current hormonal contraception use was associated with a 40% increased rate of retinal vein occlusion (AIRR 1.4, 95% Confidence Interval (95% CI): 1.1-1.8), corresponding to SIRD of 4.6 (95% CI: 0.9-8.4) additional cases per 1,000,000 person-years. AIRR of retinal artery occlusion was 1.2 (95% CI: 0.8-1.7) with current hormonal contraception use compared to non-use. The increased rate of retinal vein occlusion persisted with use of combined oral contraceptives containing 30-40 µg of estrogen (AIRR 1.6, 95% CI: 1.2-2.3), while no increased rate was observed with the low-dose 20 µg combined contraceptives (AIRR 0.7, 95% CI: 0.3-1.5). No increase observed with use of hormonal intrauterine devices. Combined oral contraceptives containing 30-40 µg estrogen were associated with an increased rate of retinal vein occlusion compared to non-use, although the absolute increase was low. No increased rate was observed for retinal artery occlusions.

Background: Predicting mortality in emergency departments (EDs) using machine learning models presents challenges, particularly in balancing simplicity with performance. This study aims to develop models that are both simple and effective for predicting short- and long-term mortality in ED patients. Our approach uses a minimal set of variables derived from one single blood sample obtained at admission. Methods: Data from three cohorts at two large Danish university hospitals were analyzed, including one retrospective and two prospective cohorts where prognostic models were applied to predict individual mortality risk, spanning the years 2013–2022. Routine biochemistry analyzed in blood samples collected at admission was the primary data source for the prediction models. The outcomes were mortality at 10, 30, 90, and 365 days after admission to the ED. The models were developed using Light Gradient Boosting Machines. The evaluation of mortality predictions involved metrics such as Area Under the Receiver Operating Characteristic Curve (AUC), sensitivity, specificity, negative predictive values, positive predictive values, and Matthews correlation coefficient (MCC). Results: A total of 43,648 unique patients with 65,484 admissions were analyzed. The models showed high accuracy, with very good to excellent AUC values between 0.87 and 0.93 across different time intervals. Conclusions: This study demonstrates that a single assessment of routine clinical biochemistry upon admission can serve as a powerful predictor for both short-term and long-term mortality in ED admissions.

Purpose: To investigate the association between glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) use and nonarteritic anterior ischaemic optic neuropathy (NAION) in type 2 diabetes, examining treatment recency and cumulative duration. Methods: This nationwide registry‐based nested case–control study utilizedz Danish health registries (1996–2023). Among 201 776 metformin‐treated adults initiating second‐line antihyperglycaemic therapy, 123 incident NAION cases were matched to 4920 controls by birth year and sex (incidence‐density sampling). Conditional logistic regression estimated adjusted hazard rate ratios (HRs) for GLP‐1RA exposure by recency (current 0–90 days; recent 91–365 days) and cumulative duration, adjusting for socio‐economic factors, hypertension, hypercholesterolaemia, sleep apnoea, and diabetes duration. Results: GLP‐1RA use occurred in 63/123 cases (51.2%) and 1688/4920 controls (34.3%). Ever use was associated with a higher NAION rate than other second‐line therapies (HR 2.13, 95% CI: 1.43–3.18). Current use was associated with elevated rates (HR 2.28, 95% CI: 1.49–3.48), whereas the estimate for recent use was imprecise (HR 1.69, 95% CI: 0.88–3.25). By cumulative duration, no clear evidence of an increase was seen within 0–½ years (HR 0.80, 95% CI: 0.32–2.05), and rates were highest at ½–1 year (HR 3.63, 95% CI: 2.06–6.40) and 1–1½ years (HR 3.52, 95% CI: 1.73–7.17). Findings were consistent after HbA1c adjustment and in a new‐user analysis. Conclusion: GLP‐1RA use is associated with a higher NAION rate in type 2 diabetes. This association appears time‐dependent, being most pronounced during current treatment and peaking after 6–18 months of cumulative exposure.

Purpose: To investigate the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and nonarteritic anterior ischaemic optic neuropathy (NAION) in type 2 diabetes, examining treatment recency and cumulative duration. Methods: This nationwide registry-based nested case-control study utilised Danish health registries (1996–2023). Among 201,776 metformin-treated adults initiating second-line antihyperglycaemic therapy, 123 incident NAION cases were matched to 4,920 controls by birth year and sex (incidence-density sampling). Conditional logistic regression estimated adjusted hazard rate ratios (HRs) for GLP-1RA exposure by recency (current 0–90 days; recent 91–365 days) and cumulative duration, adjusting for socioeconomic factors, hypertension, hypercholesterolaemia, sleep apnoea, and diabetes duration. Results: GLP-1RA use occurred in 63/123 cases (51.2%) and 1,688/4,920 controls (34.3%). Ever use was associated with a higher NAION rate than other second-line therapies (HR 2.13, 95% CI 1.43–3.18). Current use was associated with elevated rates (HR 2.28, 95% CI 1.49–3.48), whereas the estimate for recent use was imprecise (HR 1.69, 95% CI 0.88–3.25). By cumulative duration, no clear evidence of an increase was seen within 0–½ years (HR 0.80, 95% CI 0.32–2.05), and rates were highest at ½–1 year (HR 3.63, 95% CI 2.06–6.40) and 1–1½ years (HR 3.52, 95% CI 1.73–7.17). Findings were consistent after HbA1c adjustment and in a new-user analysis. Conclusion: GLP-1RA use is associated with a higher NAION rate in type 2 diabetes. This association appears time-dependent, being most pronounced during current treatment and peaking after 6–18 months of cumulative exposure.