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Supplementary DataTable S1. ICD-10 codes for hematological malignancy.Hematological malignancyC81-C96, D45, D46, D471, D473LeukemiaC91-C95 (except for C911, C913, C914, C916)LymphomaC81-C85, C88, C911, C913, C914, C916, C96MyelomaC90Myelodysplastic syndromeD46Myeloproliferative neoplasmD45, D471, D473Table S2. ICD-10 codes for cardiovascular diseases and psychiatric disorders.ICD-10Cardiovascular diseasesI00-I99HypertensionI10, I11, I12, I13, I14, I15Myocardial infarctionI21, I22Embolism or thrombosisI26, I74, I81, I82Heart failureI50StrokeI60, I61, I62, I63, I64Psychiatric disordersF10-F99Stress reaction or adjustment disorderF43DepressionF32, F33AnxietyF40, F41Table S3. The three most frequent discharge diagnoses during the three months before and three months after biopsy for biopsied individuals.Bone marrow aspiration or biopsyLymph node biopsy1Anemia(n=749, 36.5%)Infection (n=5356, 31.8%)2Medical observation and evaluation for suspected diseases and conditions(n=481, 23.5%)Medical observation and evaluation for suspected diseases and conditions(n=4325, 25.7%)3Coagulation defects, purpura or other hemorrhagic conditions (n=312, 15.2%)Autoimmune diseases(n=2319, 13.8%)Table S4. Incidence rates (IRs, per 1000 person-months) and incidence rate ratios (IRRs) of individual cardiovascular diseases and psychiatric disorders during diagnostic workup of patients with hematological malignancy and biopsied individuals, a population-based cohort study in Sk?ne, Sweden 2005-2014aReference periodbPatients with hematological malignancyBiopsied individualsNo. of diagnosesCrude IR IRR (95% CI)cNo. of diagnosesCrude IRIRR (95% CI)cNo. of diagnosesCrude IR IRR (95% CI)cCardiovascular diseasesHypertension49,4010.41.016 2.82.5 (1.6-4.1)702.94.1 (3.2-5.2)Myocardial infarction33,1940.21.0193.33.6 (2.2-5.8)261.12.2 (1.5-3.4)Embolism or thrombosis18,6230.11.0193.38.1 (5.2-12.8)210.94.4 (4.2-5.2)Stroke42,1620.31.0335.85.1 (3.6-7.4)55023.237.5 (34.1-41.2)Heart failure53,7100.41.0417.24.2 (3.1-5.8)431.82.0 (1.5-2.7)Psychiatric disorderDepression173,0651.31.030.50.4 (0.1-1.7)1847.83.5 (3.0-4.0)Anxiety144,5081.11.0101.82.1 (1.0-4.4)843.62.2 (1.7-2.8)Stress reaction or adjustment disorder85,8220.61.0132.34.4 (2.6-7.6)602.52.7 (2.1-3.5)a Diagnostic workup was defined as the time interval starting from 1 week before date of diagnosis until 1 week after diagnosis for patients with leukemia, myelodysplastic syndrome, and myeloproliferative neoplasm, from 3 weeks until 1 week after diagnosis for patients with myeloma, and from 5 weeks before until 1 week after diagnosis for patients with lymphoma. Diagnostic workup was defined as the time interval starting from 1 week before date of biopsy until 1 week after biopsy for biopsied individuals with a bone marrow aspiration or biopsy, and from 5 weeks before until 1 week after biopsy for biopsied individuals with a lymph node biopsy.b Reference included person-time accumulated during the follow-up of individuals that were not identified as patients with hematological malignancy or biopsied individuals as well as person-time accumulated before the defined diagnostic workup from patients with hematological malignancy and biopsied individuals.c Adjusted for attained age and calendar year, sex, civil status, preexisting cardiovascular disease or psychiatric disorder, and registered parish. CI, confidence interval.Table S5. Incidence rates (IRs, per 1000 person-months) and incidence rate ratios (IRRs) of cardiovascular diseases and psychiatric disorders during the diagnostic workup of patients with hematological malignancy and biopsied individuals, according to sex, age, calendar period, civil status, and preexisting cardiovascular disease or psychiatric disorder, a population-based cohort study in Sk?ne, Sweden 2005-2014aReferencebPatients with hematological malignancyBiopsied individualsNo. of diagnosesCrude IRIRR (95% CI)cNo. of diagnosesCrude IR IRR (95% CI)cNo. of diagnosesCrude IR IRR (95% CI)cCardiovascular diseasesSex Male370,2805.41.020063.83.4 (2.9-3.9)62057.54.4 (4.1-4.9) Female276,3924.01.010540.73.3 (2.7-4.0)53741.45.6 (5.1-6.2)Age, years 0-2011,242 0.31.017.99.0 (1.1-76.5)237.312.3 (8.0-18.8) 21-4034,5070.91.01544.530.6 (17.1-54.1)11825.715.8 (12.7-19.5) 41-60144,1554.11.04541.36.3 (4.6-8.7)34059.69.5 (8.4-10.7) 61-80330,18214.11.015251.02.9 (2.4-3.4)51362.83.5 (3.2-3.8) ≥81126,58622.41.09277.93.2 (2.5-4.0)16376.43.2 (2.7-3.7)Calendar period 2005-2009306,2754.51.013449.13.4 (2.8-4.0)51853.55.9 (5.4-6.6) 2010-2014340,3974.91.017157.43.3 (2.8-3.9)63945.54.3 (4.0-4.7)Civil status Cohabitating332,6857.11.017356.53.4 (2.9-4.0)55252.34.2 (3.8-4.6) Non-cohabitating313,9873.51.013249.83.3 (2.7-4.0)60545.65.9 (5.4-6.4)Preexisting cardiovascular diseases Yes504,06137.21.0181100.32.4 (2.0-2.8)585109.72.9 (2.6-3.2) No142,6111.11.031631.79.0 (7.5-10.7)57231.114.8 (13.8-15.8)Psychiatric disordersSex Male473,3836.91.03511.22.5 (1.5-3.9)33731.53.5 (3.1-4.0) Female510,8857.41.0249.31.7 (1.1-2.5)41132.02.9 (2.6-3.2)Age, years 0-20 267,5187.51.017.91.2 (0.2-8.6)10935.03.4. (2.8-4.1) 21-40318,0638.51.0617.82.4 (1.1-5.0)13429.62.2 (1.8-2.7) 41-60291,1238.31.01917.62.0 (1.3-3.1)22540.03.0 (2.5-3.4) 61-8096,9664.21.03010.12.7 (1.6-4.6)22928.14.1 (3.5-4.7) ≥8110,5981.91.032.51.5 (0.4-6.3)5123.96.6 (4.7-9.1)Calendar period 2005-2009467,5846.91.0259.21.9 (1.3-2.8)30431.63.1 (2.7-3.5) 2010-2014516,6847.41.03411.42.2 (1.4-3.6)44431.93.2 (2.9-3.6)Civil status Cohabitating184,4953.91.0175.62.0 (1.2-3.4)23622.53.6 (3.1-4.1) Non-cohabitating799,7738.81.04215.92.1 (1.4-3.2)51239.23.0 (2.7-3.3)Preexisting psychiatric disorders Yes849,49063.11.03993.21.5 (1.0-2.4)539143.72.4 (2.2-2.6) No134,4781.11.0203.85.9 (3.8-5.2)20910.612.3 (10.7-14.1)a Diagnostic workup was defined as the time interval starting from 1 week before date of diagnosis until 1 week after diagnosis for patients with leukemia, myelodysplastic syndrome, and myeloproliferative neoplasm, from 3 weeks until 1 week after diagnosis for patients with myeloma, and from 5 weeks before until 1 week after diagnosis for patients with lymphoma. Diagnostic workup was defined as the time interval starting from 1 week before date of biopsy until 1 week after biopsy for biopsied individuals with a bone marrow aspiration or biopsy, and from 5 weeks before until 1 week after biopsy for biopsied individuals with a lymph node biopsy.b Reference included person-time accumulated during the follow-up of individuals that were not identified as patients with hematological malignancy or biopsied individuals as well as person-time accumulated before the defined diagnostic workup from patients with hematological malignancy and biopsied individuals. c Adjusted for attained age and calendar year, sex, civil status, preexisting cardiovascular disease or psychiatric disorder, and registered parish. CI, confidence interval.Table S6. Incidence rates (IRs, per 1000 person-months) and incidence rate ratios (IRRs) of cardiovascular diseases and psychiatric disorders during the diagnostic workup among patients with hematological malignancy and biopsied individuals, with further adjustment for frequency of healthcare visits, a population-based cohort study in Sk?ne, Sweden 2005-2014a Diagnostic workupNo. of diagnosesCrude IRIRR (95% CI)cCardiovascular diseasesReferenceb 646,6724.71.0Patients with hematological malignancy30553.42.7 (2.3-3.0)Biopsied individuals1,15748.73.8 (3.6-4.1)Psychiatric disorderReferenceb 984,2687.21.0Patients with hematological malignancy5910.41.8 (1.3-2.5)Biopsied individuals74831.82.7 (2.5-2.9)a Diagnostic workup was defined as the time interval starting from 1 week before date of diagnosis until 1 week after diagnosis for patients with leukemia, myelodysplastic syndrome, and myeloproliferative neoplasm, from 3 weeks before until 1 week after diagnosis for patients with myeloma, and from 5 weeks before until 1 week after diagnosis for patients with lymphoma. Diagnostic workup was defined as the time interval starting from 1 week before date of biopsy until 1 week after biopsy for biopsied individuals with a bone marrow aspiration or biopsy, and from 5 weeks before until 1 week after biopsy for biopsied individuals with a lymph node biopsy. b Reference included person-time accumulated during the follow-up of individuals that were not identified as patients with hematological malignancy or biopsied individuals as well as person-time accumulated before the defined diagnostic workup from patients with hematological malignancy and biopsied individuals. c Adjusted for attained age and calendar year, sex, civil status, preexisting cardiovascular disease or psychiatric disorder, registered parish, and frequency of healthcare visits. CI, confidence interval.Table S7. Incidence rates (IRs, per 1000 person-months) and incidence rate ratios (IRRs) of cardiovascular diseases and psychiatric disorders during the diagnostic workup among biopsied individuals, compared with patients with hematological malignancy, a population-based cohort study in Sk?ne, Sweden 2005-2014a Diagnostic workupNo. of diagnosesCrude IRIRR (95% CI)bCardiovascular diseasesPatients with hematological malignancy30553.41.0Biopsied individuals1,15748.71.1 (1.0-1.2)Psychiatric disorderPatients with hematological malignancy5910.41.0Biopsied individuals74831.81.4 (1.2-1.7)a Diagnostic workup was defined as the time interval starting from 1 week before date of diagnosis until 1 week after diagnosis for patients with leukemia, myelodysplastic syndrome, and myeloproliferative neoplasm, from 3 weeks before until 1 week after diagnosis for patients with myeloma, and from 5 weeks before until 1 week after diagnosis for patients with lymphoma. Diagnostic workup was defined as the time interval starting from 1 week before date of biopsy until 1 week after biopsy for biopsied individuals with a bone marrow aspiration or biopsy, and from 5 weeks before until 1 week after biopsy for biopsied individuals with a lymph node biopsy.b Adjusted for attained age and calendar year, sex, civil status, preexisting cardiovascular disease or psychiatric disorder, and registered parish. CI, confidence interval.Figure S1. Flow chart.128270228601,527,449 individuals residing during 2005-2014 in Sk?ne, Sweden 001,527,449 individuals residing during 2005-2014 in Sk?ne, Sweden 447675337185410527514795554,245 with prevalent cancer before entry to cohort0054,245 with prevalent cancer before entry to cohort108077010287015474942508251473202597151,473,204 included in the final cohort001,473,204 included in the final cohort2376805146685008124825161290563880018097532238951549402295525215905,495 individuals with a newly diagnosed hematological malignancy during follow-up 005,495 individuals with a newly diagnosed hematological malignancy during follow-up 46767751206418,906 individuals with a bone marrow aspiration or biopsy or lymph node biopsy during follow-up 0018,906 individuals with a bone marrow aspiration or biopsy or lymph node biopsy during follow-up 7934325120651.448,803 individuals not identified as patients with hematological malignancy or biopsied individuals 001.448,803 individuals not identified as patients with hematological malignancy or biopsied individuals Figure S2. Weekly frequency of healthcare visits before and after the date of diagnosis for patients with hematological malignancy, a population-based cohort study in Sk?ne, Sweden 2005-2014.Note: Red arrow represents the week from which the weekly number of healthcare visits increased statistically significantly compared to the week before. ................
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