Postmortem serum erythropoietin levels in establishing the cause of death and survival time at medicolegal autopsy

Abstract Abstract 4587 Chronic Lymphocytic Leukemia (CLL) is the most common lymphoprolipherative disorder of the elderly population in Western countries. It shows a highly variable clinical course. In fact, some patients may die within few months from the diagnosis because of CLL itself or disease-related complications. Other patients do not require any treatment for many years and have a long-standing disease. Many of them could die because of disease different from CLL. The identification of subgroups of patients with peculiar features predictive of the clinical behaviour of the disease is important. This retrospective analysis has the purpose to study patients affected by CLL, diagnosed and followed at our single centre of Haematology, focusing our attention on their causes of death. We selected 340 patients affected by CLL from our data-base, diagnosed from January 1999 to December 2010 and followed until March 2012. We distinguished the causes of death in two groups: one related to CLL (as progression of the disease, evolution to Richter's Syndrome, infections due to chemotherapy) and the other not related to CLL (i.e. cardiovascular diseases, solid tumours, old age). Statistical analysis, conducted using SPSS version 16.0 for Windows and “GraphPad Prism” GraphPad Software Inc., compared these two groups and tried to select other subgroups. We recorded 69 deaths: 47 related to CLL (68.1%) and 22 unrelated to CLL (31.9%). The median age of death of our cohort of patients was 76 years (range 40–92); those patients with a CLL-related death (related pts) died at a median age of 76 years (range 40–89) and the patients with a CLL-unrelated death (unrelated pts) died at a median age of 76 years (range 61–92). No differences in terms of median age of death were found analysing the data by gender. Also, considering the overall survival time from diagnosis to death, it was 58 months (range 9–155) in the related group and 43 months (range 14–121) in the unrelated group (p=0.185). When divided our population by the disease behaviour, we obtained 3 subgroups of patients: patients who progressed and died for CLL related causes (group A), patients who progressed and died for CLL unrelated causes (group B) and patients who did not progress and died for CLL unrelated causes (group C) (Table 1). The only statistical significant difference was found among the median overall survival times in un-progressive patients who died for non CLL related causes (p=0.043). The median age of death was not affected by the cause of death in our CLL population. Moreover, patients with un-progressive CLL showed an overall survival time shorter than the progressive CLL subgroups. Patients with un-progressive CLL probably had a shorter survival because unrelated CLL diseases could are more difficult aggressive than CLL itself. Table 1. group A group B group C p N° patients 47 13 9 Median age at diagnosis (years) (range) 70 (39–85) 71 (56–83) 77 (67–86) n.s. Median age at death (years) (range) 76 (40–89) 75 (61–84) 79 (68–92) n.s. Overall survival time (months) (range) 58 (9–155) 48 (18–121) 22 (14–78) 0.043 Disclosures: No relevant conflicts of interest to declare.

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Survival time, mortality, and cause of death in elderly patients with Parkinson's disease. A 9-year follow-up

Movement Disorders ◽

10.1002/mds.10537 ◽

2003 ◽

Vol 18 (11) ◽

pp. 1312-1316 ◽

Cited By ~ 113

Author(s):

Per-Arne Fall ◽

Avin Saleh ◽

Mats Fredrickson ◽

Jan-Edvin Olsson ◽

Ann-Kathrine Granérus

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Elderly Patients ◽

Survival Time ◽

Cause Of Death

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Weight change, survival time and cause of death in Dutch elderly

Archives of Gerontology and Geriatrics ◽

10.1016/0167-4943(90)90048-b ◽

1990 ◽

Vol 10 (1) ◽

pp. 97-111 ◽

Cited By ~ 26

Author(s):

Dorly J.H. Deeg ◽

Toni P. Miles ◽

Robert J. Van Zonneveld ◽

J.David Curb

Keyword(s):

Survival Time ◽

Cause Of Death ◽

Weight Change

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Evaluation of postmortem calcium and magnesium levels in the pericardial fluid with regard to the cause of death in medicolegal autopsy

Legal Medicine ◽

10.1016/j.legalmed.2009.01.028 ◽

2009 ◽

Vol 11 ◽

pp. S276-S278 ◽

Cited By ~ 16

Author(s):

Dong-Ri Li ◽

Li Quan ◽

Bao-Li Zhu ◽

Takaki Ishikawa ◽

Tomomi Michiue ◽

...

Keyword(s):

Cause Of Death ◽

Pericardial Fluid ◽

Medicolegal Autopsy ◽

Calcium And Magnesium

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Medicolegal Autopsy: Histopathological Examination of Medicolegal Autopsy Cases and Its Correlation with Causes of Death

10.53350/pjmhs211551495 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1495-1497

Author(s):

S. S. A. Naqvi ◽

Gulshad . ◽

K. Sheikh ◽

I. Wagan ◽

A. Maher ◽

...

Keyword(s):

Cause Of Death ◽

Traffic Accidents ◽

Causes Of Death ◽

Histopathological Examination ◽

Histopathological Analysis ◽

Common Cause ◽

Medical College ◽

Medicolegal Autopsy ◽

The Brain ◽

Keywords Histopathology

Objective: The aim of this study is to determine the histopathological examination of medicolegal autopsy cases and its correlation with causes of death. Study Design: Retrospective/observational Place and Duration: This study was conducted at department of Pathology, Khairpur Medical College Khairpur Mir's for duration of eight months from 15thMay, 2020 to 15thJanuary, 2021. Methods: Hundred cases of both genders were presented in this study. Cases were aged between 15-75 years. Cases detailed demographics age, sex and body mass index were calculated after taking informed written consent from authorities. Autopsy laboratory was used to take medicolegal autopsies of enrolled cases. 10% formalin solution was used for histopathological examination of all the specimens. In the course of the post-mortem investigation we examined the histopathology results for five major organs, such as the brain, heart, lung, liver and kidneys and compared them with gross anatomical results. Complete data was analyzed by SPSS 24.0 version. Results: 62 (62%) cases were males and 38 (38%) patients were females. Mean age of the participants were 30.52±13.17 years with mean BMI 24.52±16.21kg/m2. Most of the participants 40 (40%) were aged between 25-35 years of age followed by 27 (27%) were aged between 36-45 years. Most of the participants 70 (70%) were from urban area and the rest were 30 (30%) from rural area. Instant death was the most common cause found in 35 (35%) cases, followed by traffic accidents 24 (24%) cases. Most frequent effected organs were lung 29%, heart 26%, liver 21% and brain 18%. In lungs pneumonia was the most common effected pathology among 20 (68.97%) and in heart atherosclerosis was the most common effected pathology among 21 (80.77%). Conclusion: In medicolegal autopsy cases, histopathological analysis may be regarded as a useful method. The most common organ in these cases were the heart, liver and lungs. In certain cases, the histopathological exam of these bodies has been useful in identifying the cause of death. Often pathological results included pneumonia, atherosclerosis and congestion. Keywords: Histopathology, Medicolegal, Cause of death, Autopsy

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Extraskeletal osteosarcomas in dogs: a retrospective study of 169 cases (1986-1996)

Journal of the American Animal Hospital Association ◽

10.5326/15473317-34-2-113 ◽

1998 ◽

Vol 34 (2) ◽

pp. 113-120 ◽

Cited By ~ 61

Author(s):

A Langenbach ◽

MA Anderson ◽

DM Dambach ◽

KU Sorenmo ◽

FD Shofer

Keyword(s):

Retrospective Study ◽

Soft Tissue ◽

Survival Time ◽

Cause Of Death ◽

Median Survival ◽

Median Survival Time ◽

Subcutaneous Tissue ◽

Mammary Glands ◽

German Shepherd ◽

Mixed Breed

Extraskeletal osteosarcomas (EOSs) are rare tumors that arise in various soft-tissue sites (e.g., gastrointestinal tract, subcutaneous tissue, spleen, liver, skin, kidney, urinary bladder, muscle, thyroid gland, eye, and mammary glands). Soft-tissue osteosarcomas (STOs) occur in older dogs with no sex predilection; beagles and rottweilers are at higher risk. Mammary gland osteosarcomas (MGOs) occur in older females; mixed-breed dogs, German shepherd dogs, and miniature poodles are at higher risk. The median survival time for cases with STO was 26 days, and the major cause of death was local recurrence (92%). The median survival time for cases with MGO was 90 days, and the major cause of death was pulmonary metastasis (62.5%).

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Postmortem serotonin levels in cerebrospinal and pericardial fluids with regard to the cause of death in medicolegal autopsy

Legal Medicine ◽

10.1016/j.legalmed.2010.11.003 ◽

2011 ◽

Vol 13 (2) ◽

pp. 75-78 ◽

Cited By ~ 18

Author(s):

Li Quan ◽

Takaki Ishikawa ◽

Junpei Hara ◽

Tomomi Michiue ◽

Jian-Hua Chen ◽

...

Keyword(s):

Cause Of Death ◽

Medicolegal Autopsy

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Estimating restricted mean survival time and expected life-years lost in the presence of competing risks within flexible parametric survival models

BMC Medical Research Methodology ◽

10.1186/s12874-021-01213-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sarwar I. Mozumder ◽

Mark J. Rutherford ◽

Paul C. Lambert

Keyword(s):

Survival Time ◽

Cause Of Death ◽

Competing Risks ◽

Survival Models ◽

Mean Survival Time ◽

Competing Risks Analysis ◽

Life Years ◽

Restricted Mean Survival Time ◽

Life Years Lost ◽

Parametric Survival

Abstract Background Royston-Parmar flexible parametric survival models (FPMs) can be fitted on either the cause-specific hazards or cumulative incidence scale in the presence of competing risks. An advantage of modelling within this framework for competing risks data is the ease at which alternative predictions to the (cause-specific or subdistribution) hazard ratio can be obtained. Restricted mean survival time (RMST), or restricted mean failure time (RMFT) on the mortality scale, is one such measure. This has an attractive interpretation, especially when the proportionality assumption is violated. Compared to similar measures, fewer assumptions are required and it does not require extrapolation. Furthermore, one can easily obtain the expected number of life-years lost, or gained, due to a particular cause of death, which is a further useful prognostic measure as introduced by Andersen. Methods In the presence of competing risks, prediction of RMFT and the expected life-years lost due to a cause of death are presented using Royston-Parmar FPMs. These can be predicted for a specific covariate pattern to facilitate interpretation in observational studies at the individual level, or at the population-level using standardisation to obtain marginal measures. Predictions are illustrated using English colorectal data and are obtained using the Stata post-estimation command, standsurv. Results Reporting such measures facilitate interpretation of a competing risks analysis, particularly when the proportional hazards assumption is not appropriate. Standardisation provides a useful way to obtain marginal estimates to make absolute comparisons between two covariate groups. Predictions can be made at various time-points and presented visually for each cause of death to better understand the overall impact of different covariate groups. Conclusions We describe estimation of RMFT, and expected life-years lost partitioned by each competing cause of death after fitting a single FPM on either the log-cumulative subdistribution, or cause-specific hazards scale. These can be used to facilitate interpretation of a competing risks analysis when the proportionality assumption is in doubt.

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