title: Initial Presentation Sites as Predictors of Herpes Zoster Complications: A Nationwide Cohort Study.
abstract: Herpes zoster (HZ) is associated with complications such as postherpetic neuralgia (PHN) and HZ ophthalmicus (HZO). However, few studies have focused on identifying patients having a high risk of PHN and HZO according to the initial presentation sites. The current study investigated these factors in a nationwide population-based cohort derived from Taiwan's Longitudinal Health Insurance Database. The results indicate that the initial presentation sites can predict the complication site of HZ. In this study, elderly patients were found to be more susceptible to HZ and were the first to present with neurological signs (HZN). Furthermore, compared with patients with HZO and other signs (HZT), those with HZN had a higher comorbidity risk. Patients with HZN showed a significantly higher visceral complication risk than did those with HZO (adjusted hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.27-1.71). In addition, patients with HZT showed lower risks of ocular and neurological complications than did those with HZN after stratification by age and sex (adjusted HR = 0.46, 95% CI = 0.31-0.68 and HR = 0.73, 95% CI = 0.59-0.91, respectively).
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Sing-Huh
authors.initials: SH
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical School of Medicine, Taipei Medical University, Taipei County, Taiwan.|Institute of Clinical Medicine, School of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Meng-Yin
authors.initials: MY
authors.lastname: Lin
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Che-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.|Institute of Clinical Medicine, School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: I-Jong
authors.identifier: http://orcid.org/0000-0002-3045-0614
authors.initials: IJ
authors.lastname: Wang
mesh_terms: D015331:Cohort Studies; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan