scholarly journals Risk factors of recurrence in patients with cancer-associated venous thromboembolism: from the COMMAND VTE Registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y Nishimoto ◽  
Y Yamashita ◽  
T Morimoto ◽  
S Saga ◽  
Y Sato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anticoagulation Therapy ◽  
Hazard Model ◽  
Cancer Site ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Patients With Cancer ◽  
Cox Proportional Hazard ◽  
Recurrent Vte

Abstract Background/Introduction Cancer is a strong risk factor for the development of venous thromboembolism (VTE) including pulmonary embolism (PE) and deep vein thrombosis (DVT). Patients with VTE have a long-term risk of recurrence, which can be prevented by anticoagulation therapy. Prolonged anticoagulation therapy is recommended for patients with cancer-associated VTE, although the risk of recurrence might depend on the individual patient. Purpose We aimed to identify the risk factors of recurrence in patients with cancer-associated VTE. Methods The COMMAND VTE Registry is a multicenter retrospective registry enrolling 3027 consecutive patients with acute symptomatic VTE among 29 Japanese centers between January 2010 and August 2014. The present study population consisted of 695 cancer-associated VTE patients. The primary outcome measure in the present study was recurrent VTE, which was defined as PE and/or DVT with symptoms accompanied by confirmation of a new thrombus or exacerbation of the thrombus by objective imaging examinations or autopsy. Discontinuation of anticoagulation was defined as a withdrawal of anticoagulation therapy lasting >14 days for any reason. We selected clinically relevant variables and variables with P values <0.1 in a univariate analysis as potential risk factors, and constructed a multivariable Cox proportional hazard model for recurrent VTE incorporating the anticoagulation therapy status as a time-updated covariate. Results Among the 695 study patients, recurrent VTE occurred in 78 patients, of whom 54 (69%) occurred within 6 months. The cumulative incidence of recurrent VTE was 7.7% at 3-months, 8.9% at 6-months, 11.8% at 1-year, and 17.7% at 5-years. The cumulative incidence of discontinuation of anticoagulation therapy was 18.0% at 3-months, 29.5% at 6-months, 43.4% at 1-year, and 66.5% at 5-years. The cumulative 5-year incidence of recurrent VTE was most frequent in patients with uterus/ovary cancer (26.0%), followed by those with lung cancer (24.7%). The multivariable Cox proportional hazard model revealed that chronic kidney disease (HR, 2.27; 95% CI, 1.36–3.77, P=0.002), a high D-dimer level at the time of VTE diagnosis (HR, 2.85; 95% CI, 1.71–4.74, P<0.001), advanced cancer (HR, 1.69; 95% CI, 1.05–2.72, P=0.03) and discontinuation of anticoagulation therapy (HR, 2.66; 95% CI, 1.53–4.63, P<0.001) were independently associated with an increased risk of recurrent VTE. No cancer site was independently associated with an increased risk for recurrent VTE when adjusting for the above mentioned risk factors in the multivariable Cox proportional hazard model, although the risk of recurrent VTE numerically differed according to the cancer site. Conclusions Among patients with cancer-associated VTE, chronic kidney disease, a high D-dimer level at the time of VTE diagnosis, advanced cancer, and discontinuation of anticoagulation therapy were independent risk factors of recurrence. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation Figure 1 Figure 2

scholarly journals Delay of Detection Of COVID-19 Patients In Bangladesh; An Application To Cox Proportional Hazard Model

2020 ◽  
Author(s):  
Sujan Rudra ◽  
Shuva Das ◽  
Md. Ehsanul Hoque ◽  
Abul Kalam ◽  
Mohammad Arifur Rahman
Keyword(s):  
Risk Factors ◽  
Hazard Model ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Cox Proportional Hazard

Abstract Objective: To delineate the survival rate of the patients with coronavirus disease 2019 (COVID-19) who did the diagnostic tests lately after the development of symptoms. The aim is to determine the socio-demographic risk factors associated with the delay of the detection of COVID-19 patients. Methods: For this cross-sectional study, 300 patients were selected who were diagnosed as COVID-19 patients in the Molecular Biology Laboratory of Chittagong Medical College, Chattogram, Bangladesh. Data were collected from May to July 2020. Clinical characteristics were obtained from over phone interviews and laboratory diagnosis by Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR). Cox proportional hazard model is applied to estimate risk factors affecting the delay of detection of COVID-19 patients.Result: Female mortality rate was 44.9% higher compared to males, graduates died 32% more than undergraduates, unmarried peoples’ death rate were 56% more than married and those who were in traveling irregularly and in contact with symptomatic patients, were 86% more died than non-travelers.Conclusion: Early diagnosis of COVID-19 can save a huge amount of lives and special attention should be emphasized on the significant explanatory variable.

scholarly journals Clinical Characteristics, Prognosis, and Nomogram for Esophageal Cancer Based on Adenosquamous Carcinoma: A SEER Database Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Haisheng Qian ◽  
Xiaofeng Ji ◽  
Chang Liu ◽  
Yini Dang ◽  
Xuan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Clinical Characteristics ◽  
Adenosquamous Carcinoma ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Seer Database ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard

Objective: Esophageal adenosquamous carcinoma (ASC) is a rare pathological type of cancer. Its clinical features and prognosis is poorly understood. The purpose of this study was to identify the characteristics of ASC patients and analyze the risk factors of esophageal carcinoma.Methods: Patients with esophageal cancer in the SEER database diagnosed from 1975–2016 were obtained. The epidemiology, clinical characteristics, and outcomes between these three groups were compared. The nomogram and online dynamic nomogram were constructed according to the Cox proportional hazard model.Results: The age-adjusted incidences of AC (1975–1999), AC (1999–2016), and ASC (1975–1989) increased over time (p < 0.05). Age-adjusted incidences of SqCC (1986–2012) and ASC (1989–2016) decreased (p < 0.05). Survival of patients with ASC was significantly worse when compared to AC and SqCC (ASC vs. AC, p < 0.001, ASC vs. SqCC, p = 0.01). ASC, older age, black race, male, overlapping site, higher tumor grade, lymph node metastasis, and a higher summary stage or AJCC stage were considered to be risk factors for a poor survival in the multivariate Cox analysis. The ROC curves and AUC indicated that the model has a good discrimination ability (AUC were 0.774 for a 3-year OS and 0.782 for a 5-year OS). An online dynamic nomogram was built based on the Cox proportional hazard model for convenient clinical use.Conclusions: ASC is somewhat closer to AC rather than SqCC in terms of the demographics and tumor site, but has a worse OS than both AC and SqCC.

scholarly journals Delay of Detection Of COVID-19 Patients In Bangladesh; An Application To Cox Proportional Hazard Model

2020 ◽  
Author(s):  
Sujan Rudra ◽  
Shuva Das ◽  
Md. Ehsanul Hoque ◽  
Abul Kalam ◽  
Mohammad Arifur Rahman
Keyword(s):  
Risk Factors ◽  
Hazard Model ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Cox Proportional Hazard

Abstract Objective: To delineate the survival rate of the patients with coronavirus disease 2019 (COVID-19) who did the diagnostic tests lately after the development of symptoms. The aim is to determine the socio-demographic risk factors associated with the delay of the detection of COVID-19 patients. Methods: For this cross-sectional study, 300 patients were selected who were diagnosed as COVID-19 patients in the Molecular Biology Laboratory of Chittagong Medical College, Chattogram, Bangladesh. Data were collected from May to July 2020. Clinical characteristics were obtained from over phone interviews and laboratory diagnosis by Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR). Cox proportional hazard model is applied to estimate risk factors affecting the delay of detection of COVID-19 patients.Result: Female mortality rate was 44.9% higher compared to males, graduates died 32% more than undergraduates, unmarried peoples’ death rate were 56% more than married and those who were in traveling irregularly and in contact with symptomatic patients, were 86% more died than non-travelers.Conclusion: Early diagnosis of COVID-19 can save a huge amount of lives and special attention should be emphasized on the significant explanatory variable.

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

scholarly journals SMOKING STATUS AFFECTING SURVIVAL OF ADENOCARCINOMA LUNG CANCER PATIENTS IN KUALA LUMPUR, MALAYSIA

2017 ◽  
Vol 10 (9) ◽  
pp. 312
Author(s):  
Nida Sajid Ali Bangash ◽  
Natasha Hashim ◽  
Nahlah Elkudssiah Ismail
Keyword(s):  
Lung Cancer ◽  
Prognostic Significance ◽  
Hazard Model ◽  
Rank Test ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Kuala Lumpur ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Survival Difference

  Objective: Adenocarcinoma (AC) of the lung is now the most common histologic type of non-small cell lung cancer (NSCLC) worldwide since the past 20 years. This study was conducted to investigate survival difference among smoker and non-smoker lung AC patients.Methods: A retrospective observational study was conducted for 81 advanced NSCLC adult Malaysian patients in Radiotherapy and Oncology Clinic at Hospital Kuala Lumpur, Malaysia. A total of adult 30 Malaysian smokers and 51 non-smokers with lung AC were included. Ex-smokers were not included in the study. Demographic and clinical data were collected and described. For survival analysis, Kaplan–Meier test and log-rank test were used to calculate overall survival (OS) and analyse the difference in the survival curve. Cox proportional hazard model was used to identify prognostic significance of smoking status.Results: Non-smokers showed a significant association with female gender and Stage IV NSCLC. The median OS was higher for non-smokers (493 days) as compared to smokers (230 days). The Cox proportional hazard model showed higher hazard ratio for smokers.Conclusion: Non-smoking is an independent positive prognostic factor in lung AC.

scholarly journals Introduction of Two-Dose Mumps-Containing Vaccine into Routine Immunization Schedule in Quzhou, China, Using Cox-Proportional Hazard Model

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhiying Yin ◽  
Canjie Zheng ◽  
Quanjun Fang ◽  
Xiaoying Gong ◽  
Guoping Cao ◽  
...  
Keyword(s):  
Hazard Model ◽  
Routine Immunization ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Immunization Schedule ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Routine Immunization Schedule ◽  
Different Doses

Mumps is a vaccine-preventable disease caused by the mumps virus, but the incidence of mumps has increased among the children who were vaccinated with one-dose measles-mumps-rubella (MMR) in recent years. In this study, we analyzed the influence of different doses of mumps-containing vaccine (MuCV) against mumps using Cox-proportional hazard model. We collected 909 mumps cases of children who were born from 2006 to 2010 and vaccinated with different doses of MuCV in Quzhou during 2006-2018, which were all clinically diagnosed. Kaplan-Meier survival methods and Cox-proportional hazard model were used to estimate the hazard probabilities. Kaplan–Meier curves showed that the cumulative hazard of male and female has no difference; lower hazards were detected among those who were vaccinated with two-dose MuCV, born in 2006, and infected after supplementary immunization activities (SIA). Cox-proportional hazard regression suggested that onset after SIA, born in 2006, and vaccinated with two-dose MuCV were protective factors against infection even after adjusting for potential confounding effects. Our study showed that it was necessary to revise the diagnostic criteria of mumps and identify RT-PCR as the standard for mumps diagnosis in China. We suggested that routine immunization schedule should introduce two doses of MMR and prevaccination screening should be performed before booster immunization in vaccinated populations.

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