Risteys · HERING

Endpoint definition steps	FinnGen
Phenotype data	520210
1. Apply sex-specific rule None	520210
2. Check conditions None	520210
3. Check pre-conditions, main-only, mode, registry filters Registry filters: Hospital discharge: ICD-10 — K41.3, K41.4, K41.9 Cause of death: ICD-10 — K41.3, K41.4, K41.9 2 out of 7 registries used, show all original rules.	983
4. Check minimum number of events None	983
5. Include endpoints None	983
6. Filter based on genotype QC (FinnGen only)	983

Summary Statistics

↥

-FinRegistry-

Key figures

	All	Female	Male
Number of individuals
Whole population	8437	5168	3231
Only index persons	7546	4656	2890
Unadjusted period prevalence (%)
Whole population	0.13	0.15	0.09
Only index persons	0.15	0.17	0.11
Median age at first event (years)
Whole population	64.81	66.55	61.92
Only index persons	62.89	64.41	60.44

-FinnGen-

Key figures

	All	Female	Male
Number of individuals	983	565	418
Unadjusted period prevalence (%)	0.19	0.19	0.18
Median age at first event (years)	60.63	58.76	63.16

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

CodeWAS (R11)

↥

CodeWAS is a tool for exploring the associations between an endpoint and all of the medical codes and drug codes.

This is a new tool, please reach out using the contact form for feedback and improvement ideas.

First, a cohort is built by matching controls to the endpoint cases using year of birth and sex. Then, a Fisher test is done for all the medical codes and drug codes between the cases and controls of this cohort. Codes are reported in the table below if they have −log₁₀(p-value) ≥ 6.

Matched cohort

Matched cases
863: Matched controls
8630

Code

Vocabulary

Description

Odds Ratio

-log₁₀(p)

N matched cases

N matched controls

K41.9

ICD-10 Finland

Unilateral or unspecified femoral hernia, without obstruction or gangrene

+∞

323.0

640

K40.9

ICD-10 Finland

Unilateral or unspecified inguinal hernia, without obstruction or gangrene

553.4

323.0

451

JAB30

NOMESCO Finland

Repair of inguinal hernia using prosthetic material

764.0

286.5

267

K41.3

ICD-10 Finland

Unilateral or unspecified femoral hernia, with obstruction, without gangrene

+∞

244.8

223

JAC10

NOMESCO Finland

Repair of femoral hernia

+∞

149.4

139

JAC30

NOMESCO Finland

Repair of femoral hernia using prosthetic material

1596.3

142.9

135

JAB11

NOMESCO Finland

Laparoscopic repair of inguinal hernia

1349.9

123.1

117

K40.3

ICD-10 Finland

Unilateral or unspecified inguinal hernia, with obstruction, without gangrene

+∞

108.7

102

JAC11

NOMESCO Finland

Laparoscopic repair of femoral hernia

+∞

62.2

K44.9

ICD-10 Finland

Diaphragmatic hernia without obstruction or gangrene

32.4

58.3

K43.9

ICD-10 Finland

Other and unspecified ventral hernia without obstruction or gangrene

62.7

55.3

JAB10

NOMESCO Finland

Repair of inguinal hernia

+∞

54.8

K42.9

ICD-10 Finland

Umbilical hernia without obstruction or gangrene

55.5

52.6

K41.4

ICD-10 Finland

Unilateral or unspecified femoral hernia, with gangrene

+∞

47.3

K40.2

ICD-10 Finland

Bilateral inguinal hernia, without obstruction or gangrene

165.4

45.3

D89

ICPC

Inguinal hernia

82.8

42.3

JAB12

NOMESCO Finland

Laparoscopic repair of inguinal hernia, TEP

+∞

41.0

6123

FHL

Radical surgery

214.9

40.2

55099

ICD-8 Finland

Inguinal hernia without mention of obstruction

+∞

37.8

K40

ICD-10 Finland

Inguinal hernia

50.1

36.0

R10.3

ICD-10 Finland

Pain localized to other parts of lower abdomen

3.0

31.9

221

896

JAF10

NOMESCO Finland

Repair of umbilical hernia

42.9

30.1

JA1AE

NOMESCO Finland

Ultrasound examination of groin and abdominal wall

13.1

28.9

JAC12

NOMESCO Finland

Laparoscopic repair of femoral hernia, TEP

+∞

27.2

JFB00

NOMESCO Finland

Partial resection of small intestine

13.4

23.6

R10.4

ICD-10 Finland

Other and unspecified abdominal pain

2.2

23.0

321

1843

5509B

ICD-9 Finland

Inguinal hernia, without mention of obstruction or gangrene[HERNIA INGUINALIS SINE GANGR/OBSTR,LATERALIS (SCROT]

+∞

20.9

JAF30

NOMESCO Finland

Repair of umbilical hernia using prosthetic material

214.9

20.7

N02BE01

ATC

paracetamol; systemic, rectal

2.4

20.2

746

6260

ZXA00

NOMESCO Finland

Right side

2.1

19.9

277

1565

5509A

ICD-9 Finland

Inguinal hernia, without mention of obstruction or gangrene[HERNIA INGUINALIS SINE GANGR/OBSTR,MEDIALIS]

+∞

19.9

JAD30

NOMESCO Finland

Repair of incisional hernia using prosthetic material

107.5

19.6

ZXA05

NOMESCO Finland

Left side

2.1

17.9

255

1442

JAD11

NOMESCO Finland

Laparoscopic repair of incisional hernia

+∞

17.8

WX320

NOMESCO Finland

Spinalanesthesy

2.1

16.4

219

1199

WX408

NOMESCO Finland

General anesthesy, balanced

2.0

15.1

242

1422

JN3BD

NOMESCO Finland

Extensive abdominal CT

2.6

14.7

113

470

K43.0

ICD-10 Finland

Incisional hernia with obstruction, without gangrene

+∞

14.6

K40.4

ICD-10 Finland

Unilateral or unspecified inguinal hernia, with gangrene

+∞

14.6

K41

ICD-10 Finland

Femoral hernia

+∞

13.6

JAC96

NOMESCO Finland

Other repair of femoral hernia

+∞

12.5

N02AX02

ATC

tramadol; systemic, rectal

1.7

12.4

353

2476

SPAT1153

SPAT

Removal of sutures

1.8

12.0

279

1839

J01CA04

ATC

amoxicillin; systemic

1.7

11.7

644

5419

UJD10

NOMESCO Finland

Esophagoscopy, gastroscopy and duodenoscopy

1.8

11.6

236

1486

K59.09

ICD-10 Finland

Constipation, unspecified

3.1

11.5

222

6124

FHL

Radical cutting and plastic with foreign material

+∞

11.5

K42.0

ICD-10 Finland

Umbilical hernia with obstruction, without gangrene

+∞

11.5

G04CA02

ATC

tamsulosin; oral

1.9

11.5

197

1172

JAH01

NOMESCO Finland

Laparoscopy

3.8

11.4

132

WX404

NOMESCO Finland

Intravenous generell anesthesy

1.9

11.4

178

1019

K21.0

ICD-10 Finland

Gastro-oesophageal reflux disease with oesophagitis

2.6

10.7

328

M54.5

ICD-10 Finland

Low back pain

1.7

10.6

265

1771

B01AB05

ATC

enoxaparin; parenteral

1.7

10.6

266

1779

WX402

NOMESCO Finland

General anaesthesia

2.0

10.5

134

710

I87.2

ICD-10 Finland

Venous insufficiency (chronic)(peripheral)

2.3

10.5

459

GD1AA

NOMESCO Finland

Thorax X-ray examination

1.6

10.5

360

2630

JAF11

NOMESCO Finland

Laparoscopic repair of umbilical hernia

+∞

10.4

A02BC02

ATC

pantoprazole; systemic

1.6

10.3

534

4332

SPAT1263

SPAT

Sampling

1.6

10.0

347

2528

S18

ICPC

Laceration/cut

1.6

9.8

339

2466

JAD10

NOMESCO Finland

Repair of incisional hernia

55.6

9.7

JN2AE

NOMESCO Finland

Ultrasound examination of lower part of abdomen without contrast

9.2

9.6

WX110

NOMESCO Finland

Local anesthesy

1.6

9.5

527

4302

M79.6

ICD-10 Finland

Pain in limb

1.6

9.4

283

1977

N02AA59

ATC

codeine, combinations excl. psycholeptics; systemic

1.6

9.4

361

2689

JAB97

NOMESCO Finland

Other laparoscopic repair of inguinal hernia

+∞

9.4

JAB91

NOMESCO Finland

Repair of recurrent inguinal hernia, endoscopy

+∞

9.4

JAB96

NOMESCO Finland

Other repair of inguinal hernia

+∞

9.4

UJF32

NOMESCO Finland

Coloscopy

1.7

9.2

217

1417

PHD99

NOMESCO Finland

Resection of other vein

2.6

9.2

259

N02AJ06

ATC

codeine and paracetamol; systemic

1.6

9.1

286

2024

Z01.8

ICD-10 Finland

Other specified special examinations

1.8

9.0

175

1079

SPAT1301

SPAT

No procedures

1.6

9.0

264

1831

NBG15

NOMESCO Finland

Acromioplastia, arthroscopic

2.6

8.8

270

SPAT1230

SPAT

Aid fitting and borrowing and monitoring of use

1.8

8.2

146

871

103

Kela drug reimbursment

Diabetes, insulin-treated

0.5

8.2

1632

N03AX12

ATC

gabapentin; oral

1.9

8.1

128

734

R03AC02

ATC

salbutamol; inhalant

1.5

8.1

405

3180

Y83

ICD-10 Finland

Surgical operation and other surgical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure

2.4

8.0

312

D91

ICPC

Abdominal hernia other

22.3

8.0

A02BC05

ATC

esomeprazole; systemic

1.5

7.9

316

2350

TPH04

NOMESCO Finland

Cathetrisation of vein

1.7

7.9

173

1098

R07.4

ICD-10 Finland

Chest pain, unspecified

1.6

7.9

219

1490

PHD76

NOMESCO Finland

Resection of long saphenous vein

2.7

7.7

197

M54.4

ICD-10 Finland

Lumbago with sciatica

1.9

7.7

125

721

J01DB01

ATC

cefalexin; oral

1.6

7.6

648

5682

WX704

NOMESCO Finland

Intubation

2.3

7.5

296

203

Kela drug reimbursment

Chronic asthma and similar chronic obstructive pulmonary diseases

1.7

7.4

159

1003

LEF03

NOMESCO Finland

Posterior colporrpahy with sutures for primary rectocele

3.1

7.3

126

5509X

ICD-9 Finland

Inguinal hernia, without mention of obstruction or gangrene[HERNIA INGUINALIS SINE GANGR/OBSTR,ALIA SEU NUD]

+∞

7.3

K41.2

ICD-10 Finland

Bilateral femoral hernia, without obstruction or gangrene

+∞

7.3

D06

ICPC

Abdominal pain localized other

2.3

7.2

296

B01AF02

ATC

apixaban; oral

2.0

7.1

439

R52.2

ICD-10 Finland

Other chronic pain

3.2

7.0

114

L12

ICPC

Hand/finger symptom/complaint

1.9

6.9

110

631

J45.1

ICD-10 Finland

Nonallergic asthma

2.3

6.9

267

K57.3

ICD-10 Finland

Diverticular disease of large intestine without perforation or abscess

1.7

6.9

141

877

J06.9

ICD-10 Finland

Acute upper respiratory infection, unspecified

1.5

6.9

278

2057

R13

ICD-10 Finland

Dysphagia

2.4

6.9

237

I83.9

ICD-10 Finland

Varicose veins of lower extremities without ulcer or inflammation

2.0

6.8

452

K45.8

ICD-10 Finland

Other specified abdominal hernia without obstruction or gangrene

40.4

6.8

R22.9

ICD-10 Finland

Localized swelling, mass and lump, unspecified

2.4

6.7

235

R51.80

ICD-10 Finland

Headache

1.9

6.6

105

601

SPAT1256

SPAT

Intramuscular and subcutaneous injection

1.5

6.6

328

2536

N03AX16

ATC

pregabalin; oral

1.6

6.5

186

1267

M51.3

ICD-10 Finland

Other specified intervertebral disc degeneration

2.2

6.5

310

SPAT1033

SPAT

Irrigation or wax removal of outer auditory canal

1.6

6.5

170

1131

WX725

NOMESCO Finland

Noninvasive ventilation

2.6

6.3

164

A06AC01

ATC

ispaghula (psylla seeds); oral

1.6

6.3

192

1330

JAB93

NOMESCO Finland

Repair of recurrent inguinal hernia, implantation

+∞

6.3

K43.2

ICD-10 Finland

Incisional hernia without obstruction or gangrene

+∞

6.3

JN3AD

NOMESCO Finland

Abdominal CT examination

2.1

6.2

318

N06AA09

ATC

amitriptyline; systemic

2.0

6.1

435

M01AE02

ATC

naproxen; oral, rectal

1.4

6.1

414

3386

Mortality – FinRegistry

↥

Association

Association between endpoint HERING_UNILATERAL and mortality.

Females

Parameter	HR [95% CI]	p-value
HERING_UNILATERAL	1.295 [1.16, 1.44]	< 0.001
Birth year	0.992 [0.98, 1.0]	0.062

During the follow-up period (1.1.1998 — 31.12.2019), 1286 out of 4333 females with HERING_UNILATERAL died.

Males

Parameter	HR [95% CI]	p-value
HERING_UNILATERAL	1.073 [0.95, 1.21]	0.246
Birth year	0.986 [0.98, 1.0]	0.003

During the follow-up period (1.1.1998 — 31.12.2019), 809 out of 2808 males with HERING_UNILATERAL died.

Mortality risk

Mortality risk for people of age

years, who have HERING_UNILATERAL.

N-year risk	Females	Males
1	0.119%	0.186%
5	0.747%	1.151%
10	1.797%	3.065%
15	3.311%	5.71%
20	5.777%	9.605%

Relationships between endpoints

↥

Index endpoint: HERING_UNILATERAL – Inguinal hernia, unilateral

GWS hits: -

Endpoint

Case Overlap

Survival Analysis

Genetic Correlations

Genetic Signals

N (Jaccard index)

HR [CI]

Extremity

rg [CI]

Extremity

Hits

Coloc Hits

FinRegistry

FinnGen

FinRegistry

FinnGen

Loading data

NAME	HERING_UNILATERAL
CONTROL_EXCLUDE	K11_HERNIA
CONTROL_PRECONDITIONS
CONTROL_CONDITIONS
SEX
INCLUDE
PRE_CONDITIONS
CONDITIONS
OUTPAT_ICD
OUTPAT_OPER
HD_MAINONLY
HD_ICD_10_ATC
HD_ICD_10	K41[3-9]
HD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_10_EXCL
HD_ICD_9_EXCL
HD_ICD_8_EXCL
COD_MAINONLY
COD_ICD_10	K41[3-9]
COD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_10_EXCL
COD_ICD_9_EXCL
COD_ICD_8_EXCL
OPER_NOM
OPER_HL
OPER_HP1
OPER_HP2
KELA_REIMB
KELA_REIMB_ICD
KELA_ATC_NEEDOTHER
KELA_ATC
KELA_VNRO_NEEDOTHER
KELA_VNRO
CANC_TOPO
CANC_TOPO_EXCL
CANC_MORPH
CANC_MORPH_EXCL
CANC_BEHAV

Inguinal hernia, unilateral

Endpoint definition

Endpoint definition steps

FinnGen

Phenotype data

1. Apply sex-specific rule

2. Check conditions

3. Check pre-conditions, main-only, mode, registry filters

4. Check minimum number of events

5. Include endpoints

6. Filter based on genotype QC (FinnGen only)

Similar endpoints

Case counts by codes

Summary Statistics

-FinRegistry-

Key figures

-FinnGen-

Key figures

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

CodeWAS (R11)

Matched cohort

Mortality – FinRegistry

Association

Females

Males

Mortality risk

Relationships between endpoints