scholarly journals Quantitative assessment of erector spinae muscles and prognosis in elderly patients with pneumonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroki Yoshikawa ◽  
Kosaku Komiya ◽  
Takashi Yamamoto ◽  
Naoko Fujita ◽  
Hiroaki Oka ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Regression Models ◽  
Proportional Hazards ◽  
Community Acquired Pneumonia ◽  
Cox Proportional Hazards ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Proportional Hazards Regression ◽  
Survivor Group

AbstractErector spinae muscle (ESM) size has been reported as a predictor of prognosis in patients with some respiratory diseases. This study aimed to assess the association of ESM size on all-cause in-hospital mortality among elderly patients with pneumonia. We retrospectively included patients (age: ≥ 65 years) admitted to hospital from January 2015 to December 2017 for community-acquired pneumonia who underwent chest computed tomography (CT) on admission. The cross-sectional area of the ESM (ESMcsa) was measured on a single-slice CT image at the end of the 12th thoracic vertebra and adjusted by body surface area (BSA). Cox proportional hazards regression models were used to assess the influence of ESMcsa/BSA on in-hospital mortality. Among 736 patients who were admitted for pneumonia, 702 patients (95%) underwent chest CT. Of those, 689 patients (98%) for whom height and weight were measured to calculate BSA were included in this study. Patients in the non-survivor group were significantly older, had a greater frequency of respiratory failure, loss of consciousness, lower body mass index, hemoglobin, albumin, and ESMcsa/BSA. Multivariate analysis showed that a lower ESMcsa/BSA independently predicted in-hospital mortality after adjusting for these variables. In elderly patients with pneumonia, quantification of ESMcsa/BSA may be associated with in-hospital mortality.

Effect of HPV Status on Survival of Oropharynx Cancer with Distant Metastasis

2020 ◽  
Vol 163 (2) ◽  
pp. 372-374 ◽  
Author(s):  
Adam W. Kaplon ◽  
Thomas J. Galloway ◽  
Mihir K. Bhayani ◽  
Jeffrey C. Liu
Keyword(s):  
Distant Metastasis ◽  
Survival Data ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
National Cancer Database ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Hpv Status ◽  
Oropharynx Squamous Cell Carcinoma

Human papillomavirus (HPV)–positive oropharynx squamous cell carcinoma (OPSCC) is known to have improved survival over HPV-negative disease. However, it is largely unknown whether HPV status similarly affects survival in patients presenting with distant metastatic disease. We queried the National Cancer Database for OPSCC with distant metastasis. Kaplan-Meier curves and Cox proportional hazards regression models controlling for relevant demographics were used to evaluate overall survival. In total, 768 OPSCC cases were available for analysis with HPV and survival data: 50% of cases were HPV negative and 50% were HPV positive. The 1- and 2-year survival for HPV-negative disease was 49% and 27%, respectively, as compared with 67% and 42% in the HPV-positive cohort. HPV positivity was associated with improved median survival in treated and untreated patients. Age, comorbidities, and HPV status were predictive of improved survival on multivariate analysis. HPV-positive OPSCC has improved survival in the setting of distant metastatic presentation as compared with HPV-negative disease and shows greater responsiveness to treatment.

Doxorubicin, cardiac risk factors and cardiac toxicity in elderly patients with diffuse b-cell non-Hodgkin's lymphoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9050-9050
Author(s):  
D. L. Hershman ◽  
A. Eisenberger ◽  
J. Wang ◽  
J. Jacobson ◽  
V. Grann ◽  
...  
Keyword(s):  
Elderly Patients ◽  
B Cell ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cardiac Toxicity ◽  
B Cell Lymphoma ◽  
Female Gender ◽  
Cox Proportional Hazards ◽  
Black Race ◽  
Increased Risk

9050 Background: Anthracyclines are known to cause acute and chronic cardiotoxicity. In a population-based sample of elderly patients with diffuse large B-cell lymphoma (DLBCL), we studied the cardiac effects of doxorubicin (DOX)-containing regimens and of pre-existing diabetes (DM), hypertension (HTN), and heart disease (HD). Methods: Patients aged =65 years diagnosed with DLBCL 1/1/1992–12/31/2000 in the SEER/Medicare database were grouped by treatment: no chemotherapy, doxorubicin-based chemotherapy, or other chemotherapy. We developed multivariable logistic regression models of the associations of DOX-based chemotherapy with demographic and clinical variables and pre-diagnosis DM, HTN, and HD. We then developed Cox proportional hazards regression models of the association between treatment and subsequent congestive heart failure (CHF) taking the predictors of treatment into account. Results: Of 6,413 patients with DLBCL, 2,536 (39%) received doxorubicin-based chemotherapy. DOX use was associated with later year of diagnosis, female gender, younger age, and being married. Black race (HR 0.50, 95% CI 0.33–0.75), comorbidities, preexisting CHF, HD, and DM (HR 0.73, 95% CI 0.62–0.86) were associated with decreased DOX use. The post-treatment HR for CHF following DOX treatment vs. no chemotherapy was 1.39 (95% CI 1.15–1.67); CHF risk increased with duration of DOX use. It was also associated with increasing age, comorbidities, black race, DM, HTN, and HD. There was a significant interaction between race and DOX (P=0.01); For black patients treated with DOX the HR for CHF was 3.4, as compared to a HR of 1.3 for white patients. Conclusions: Among patients with DLBCL, black race, CRFs and pre-existing HD are all associated with both a reduced likelihood of receiving anthracyclines, and an increased risk of CHF. We have previously found a powerful effect of DOX on survival in this patient population; thus, for most patients, the benefits of treatment would appear to outweigh the risks of cardiac toxicity. However, as the number of long-term survivors grows, the need for research on the side effects of treatment, on host factors that may increase the risk of adverse effects, and on ways to minimize such risks will also grow. No significant financial relationships to disclose.

Association of anxiety and depression concerns with overall levels of patient reported distress during radiotherapy.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 182-182
Author(s):  
Robin Landy ◽  
Dale Alan Whitaker ◽  
Niveditha Jagadesh ◽  
Gerald Strong ◽  
Nicolette Chimato ◽  
...  
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Anxiety And Depression ◽  
Patient Anxiety ◽  
Proportional Hazards Regression ◽  
Patient Reported ◽  
Level Of Concern ◽  
Anxiety Depression ◽  
Palliative Patients

182 Background: The purpose of this study was to examine the associations of three different measures of anxiety and depression with patient reported distress (PRD) level and survival after radiotherapy (RT). Methods: 518 patients who underwent RT between 2012 and 2016 were included in this retrospective study. PRD was assessed at the time of RT using the NCCN thermometer and a 30 question survey of distress related items. PRD and clinical and demographic data was retrospectively collected and analyzed. The three measures this study focused on that assessed patient anxiety and depression involved asking patients about their level of concern regarding feeling down, regarding loss of interest, and regarding feeling nervous. Associations between baseline patient characteristics and survival after start of RT were evaluated using single variable Cox proportional hazards regression models. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. Associations of level of concern regarding patient anxiety/depression with survival after RT were evaluated using single variable and multivariable Cox proportional hazards regression models. Results: Overall, PRD level and concern regarding anxiety/depression were positively correlated (p < 0.001). Additionally, there was a significant association between level of concern regarding feeling down and palliative patients (p = 0.03). There was also a significant association between level of concern regarding loss of interest and palliative patients (p = 0.03), with level of concern highest for thorax, breast, and head and neck. There was also a significant different between level of concern regarding feeling nervous and gender (p = 0.05). There was not a significant difference between any of the three measures and survival after RT (all p ≥ 0.21). Conclusions: Anxiety and depression in patients receiving palliative and curative RT was associated with overall distress. Baseline screening of PRD may identify patients who would benefit from intervention to address the causes of their underlying anxiety and depression.

scholarly journals The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan

2020 ◽  
Vol 17 (12) ◽  
pp. 4236 ◽  
Author(s):  
Tao Huang ◽  
Ta-Chien Chan ◽  
Ying-Jhen Huang ◽  
Wen-Chi Pan
Keyword(s):  
Metabolic Syndrome ◽  
Regression Models ◽  
Noise Exposure ◽  
Proportional Hazards ◽  
Traffic Noise ◽  
Noise Pollution ◽  
Cox Proportional Hazards ◽  
High Noise ◽  
Proportional Hazards Regression ◽  
Using Data

Metabolic syndrome is becoming more common worldwide. Studies suggest environmental pollution, including traffic noise, might be linked with metabolic syndrome. This study sought to evaluate how noise exposure is linked to the development of metabolic syndrome and its components in Taiwan. Using data from a cohort of 42,509 participants and Cox proportional hazards regression models, the effects of noise exposure on metabolic syndrome and its components were quantified. After adjustment for covariates (age, gender, body mass index, and physical activity), the hazard ratio for metabolic syndrome was 1.13 (95% CI: 1.04–1.22) for medium noise exposure and 1.24 (95% CI: 1.13–1.36) for high noise exposure. Noise exposure was also positively associated with all of metabolic syndrome’s components. This finding suggests noise exposure might contribute to metabolic syndrome and its components. Policies aiming to reduce noise pollution might reduce the risks of metabolic syndrome and its components.

Abstract P370: Opioid and Gabapentinoid Medication Use and the Risks of Atrial Fibrillation and Supraventricular Ectopy in the Multi-ethnic Study of Atherosclerosis

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Barbara N Harding ◽  
Kerri Wiggins ◽  
Paul Jensen ◽  
Bruce M Psaty ◽  
Susan R Heckbert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cardiovascular Effects ◽  
Cox Proportional Hazards ◽  
Ecg Monitoring ◽  
Opioid Use ◽  
Cross Sectional ◽  
Ethnic Study ◽  
Logistic Regression Models

Purpose: Opioids and gabapentinoids may have adverse cardiovascular effects. We evaluated whether these medications were associated with incident clinically-detected atrial fibrillation (AF) or monitor-detected supraventricular ectopy (SVE), including premature atrial contractions (PACs) and supraventricular tachycardia (SVT). Methods: We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort study that enrolled 6,814 Americans without clinically-detected cardiovascular disease (CVD) in 2000-2002. At the 2016-2018 examination, a subset of participants received extended ambulatory electrocardiographic (ECG) monitoring with a device that records up to 14 days of continuous data. Longitudinal analyses investigated time-varying medication exposures at 5 exams (through 2012) and the risk of incident clinically-detected AF through 2015 using Cox proportional hazards regression models. Cross-sectional analyses investigated medication exposures at the 2016-2018 examination and the risk of monitor-detected SVE using linear and logistic regression models. Methods: The longitudinal cohort included 6,652 participants. Opioid and gabapentenoid use increased over time (Figure). During 12.4 years of mean follow-up, 961 participants (14.4%) experienced incident AF. Opioid use and gabapentinoid use were not associated with the risk of incident AF compared with no use. The cross-sectional analysis included 1,435 participants with ECG monitoring. Compared with non-use, gabapentinoid use was associated with an 84% greater count of PACs/hour (95% CI, 25%-171%) and with a 44% greater average number of runs of SVT/day (95% CI, 3%-100%) but not with a higher odds of SVT. No associations were found with use of opioids in cross-sectional analyses. Conclusions: In this study, gabapentinoid use was associated with more SVE. Given the rapid increase in gabapentinoid use, additional studies are needed to clarify whether these medications increase the risk of CVD complications.

Association between pneumoconiosis and pulmonary emboli

2015 ◽  
Vol 113 (05) ◽  
pp. 952-957
Author(s):  
Chih-Hao Shen ◽  
Hsuan-Ju Chen ◽  
Te-Yu Lin ◽  
Wen-Yen Huang ◽  
Tsai-Chung Li ◽  
...  
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Pulmonary Thromboembolism ◽  
Cox Proportional Hazards ◽  
Vein Thrombosis ◽  
Proportional Hazards Regression ◽  
Taiwan National Health Insurance ◽  
Deep Vein ◽  
Insurance Database

SummaryStudies on the association between pneumoconiosis and deep-vein thrombosis (DVT) and pulmonary thromboembolism (PE) are few. This study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2006, with a follow-up period extending to the end of 2011. We identified 3719 pneumoconiosis patients and 14876 non-pneumoconiosis patients who were selected by frequency matched based on sex, age, and the index year. We analysed the risks of DVT and PE by using Cox proportional hazards regression models by including sex, age, and CCI score. The risk of developing PE was 1.90-fold in the patients with pneumoconiosis compared with the comparison cohort after adjustments for age, sex, and CCI score. By contrast, we did not observe significant effect of pneumoconiosis on DVT. However, the cumulative incidence curves for DVT were similar in the pneumoconiosis patients and non-pneumoconiosis patients. The multiplicative increased risks of PE were significant in patients with pneumoconiosis and CCI score of one and more. In conclusion, physicians should include pneumoconiosis in evaluating pulmonary embolism risk.

scholarly journals Prognostic impact of a lymphocyte activation-associated gene signature in GBM based on transcriptome analysis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12070
Author(s):  
Yujia Lan ◽  
Erjie Zhao ◽  
Xinxin Zhang ◽  
Xiaojing Zhu ◽  
Linyun Wan ◽  
...  
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Lymphocyte Activation ◽  
Risk Groups ◽  
Gene Signature ◽  
Cox Proportional Hazards ◽  
Low Risk ◽  
Training Dataset ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

Background Glioblastoma multiforme (GBM) is a highly, malignant tumor of the primary central nervous system. Patients diagnosed with this type of tumor have a poor prognosis. Lymphocyte activation plays important roles in the development of cancers and its therapeutic treatments. Objective We sought to identify an efficient lymphocyte activation-associated gene signature that could predict the progression and prognosis of GBM. Methods We used univariate Cox proportional hazards regression and stepwise regression algorithm to develop a lymphocyte activation-associated gene signature in the training dataset (TCGA, n = 525). Then, the signature was validated in two datasets, including GSE16011 (n = 150) and GSE13041 (n = 191) using the Kaplan Meier method. Univariate and multivariate Cox proportional hazards regression models were used to adjust for clinicopathological factors. Results We identified a lymphocyte activation-associated gene signature (TCF3, IGFBP2, TYRO3 and NOD2) in the training dataset and classified the patients into high-risk and low-risk groups with significant differences in overall survival (median survival 15.33 months vs 12.57 months, HR = 1.55, 95% CI [1.28–1.87], log-rank test P < 0.001). This signature showed similar prognostic values in the other two datasets. Further, univariate and multivariate Cox proportional hazards regression models analysis indicated that the signature was an independent prognostic factor for GBM patients. Moreover, we determined that there were differences in lymphocyte activity between the high- and low-risk groups of GBM patients among all datasets. Furthermore, the lymphocyte activation-associated gene signature could significantly predict the survival of patients with certain features, including IDH-wildtype patients and patients undergoing radiotherapy. In addition, the signature may also improve the prognostic power of age. Conclusions In summary, our results suggested that the lymphocyte activation-associated gene signature is a promising factor for the survival of patients, which is helpful for the prognosis of GBM patients.

scholarly journals Acute Myocardial Infarction During Hospitalization for Community-Acquired Pneumonia in Geriatric Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Yu Kang ◽  
Xiang-Yang Fang ◽  
Dong Wang ◽  
Xiao-Juan Wang
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Respiratory Failure ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Cross Sectional

Abstract Background: Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in elderly. Little is known regarding characteristics of AMI in elderly hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients.Methods: 11009 adult inpatients consisted of 5111 elderly patients≥ 65 years and 5898 patients＜65 years in respiratory ward and 1095 inpatients ≥65 years in geriatrics ward diagnosed with CAP were retrospectively analyzed by electronic medical records. Results: 159 (3.1%) elderly patients in respiratory ward and 77 (7.0%) patients in geriatrics ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in elderly patients (3.1% vs. 1.0 %), Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P=0.046), blood urea nitrogen (BUN)≥7mmol/L (P < 0.001), serum sodium <130 mmol/L(P = 0.005) and had higher in-hospital mortality compared to patients＜65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24-1.82]; P<0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P<0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02), BUN (OR, 1.23 [1.01–1.49]; P = 0.04), and impaired consciousness (OR, 1.19 [1.07–1.32]; P = 0.03) were correlated with the occurrence of AMI in the elderly.Conclusions: The incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Characteristics of the elderly differ from the general population. Particular attention should be paid to elderly patients with risk factors for AMI. Our study may represent useful information for clinical strategies aimed at preventing AMI and decreasing mortality in geriatric patients hospitalization for CAP.

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