P2852Risk factors for death and survival after TLE in the groups of eighty- and ninety-year-olds

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
W Jachec ◽  
A Polewczyk ◽  
L Segreti ◽  
M G Bongiorni ◽  
A Kutarski
Keyword(s):  
Risk Factors ◽  
Old Age ◽  
Cox Regression ◽  
Nyha Class ◽  
Lead Extraction ◽  
Cox Regression Analysis ◽  
Group A ◽  
Group B

Abstract Background Despite the fact that the transvenous lead extraction (TLE) is the method of choice of treatment for pacing complications, these procedures are not often performed in the elderly. The prognosis after TLE in these groups of patients is uncertain. Aim Evaluation of risk factors for death of patients who underwent TLE over the age 80 and 90 years. Methods 3368 patients with complete follow-up data (mean age at the time of procedure; 65.38±15.64 years old, 1198 female) who underwent TLE procedures in two high volume experienced European centers. Risk factors for death in patients divided in to three groups depending on the age: below the age of 80 (group A, n=2854) and in groups of eighty-years-old (group B, n=484) and ninety-years old (group C, n=30) were determined using the Cox multivariable model. The survival of eighty-year-olds and ninety-year-olds was worse compared to younger patients and they did not differ between themselves (Figure 1). Results 815 deaths occurred during 3.87±2.76 years of follow-up; 611 (21.4%) in group A, 192 (39.7%) in group B (p<0,001) and 12 (40%) in group C (p<0.001) (B, C vs A, χ2 test). Results of multivariable Cox regression analysis are present in Table 1. Table 1 Group A Group B Group C Age <80 years old Age between 80–90 years old Age ≥90 years old HR (95% CI) HR (95% CI) HR (95% CI) Female (y/n) 1.026; (0.851–1.238) 1.202 (0.874–1.654) 1.332; (0.428–4.146) Age in TLE (year) 1.021; (1.013–1.029) 1.053 (0.996–1.114) 0.997; (0.701–1.418) NYHA class (by one) 1.391; (1.240–1.561) 1.409 (1.134–1.750) 1.312; (0.698–2.466) LVEF (1%) 0.974; (0.967–0.980) 0.993 (0.982–1.005) 1.003; (0.947–1.063) Hypertension (y/n) 1.062; (0.889–1.268) 0.595 (0.428–0.828) 0.679; (0.203–2.271) Diabetes (y/n) 1.384; (1.152–1.662) 1.333 (0.951–1.868) 1.522; (0.398–5.821) Creatinin level (umol/l) 1.045; (1.020–1.070) 1.608 (1.385–1.866) 2.247; (0.704–7.171) Atrial fibrillation (y/n) 1.402; (1.169–1.682) 1.066 (0.783–1.451) 1.278; (0.380–4.296) ICD (y/n) 0.994; (0.825–1.198) 0.942 (0.618–1.437) 1.922; (0.419–8.830) Infectious indications (y/n) 1.137; (0.913–1.415) 1.014 (0.671–1.533) 1.104; (0.298–4.091) Lead related endocarditis 1.511; (1.174–1.945) 1.576 (1.004–2.474) 1.942; (0.385–9.804) Conclusion The survival of eighty-year-olds and ninety-year-olds did not differ between themselves in long term follow-up after TLE. There were no specific risk factors affecting the risk of mortality in long-term observation after TLE in nanogenarius

Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients

Vascular ◽  
2020 ◽  
pp. 170853812092595
Author(s):  
Kai-Ni Lee ◽  
Li-Ping Chou ◽  
Chi-Chu Liu ◽  
Tsang-Shan Chen ◽  
Eric Kim-Tai Lui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Cox Regression ◽  
Ankle Brachial Index ◽  
Hemodialysis Patients ◽  
Serum Phosphate ◽  
Cox Regression Analysis

Objectives The ankle–brachial index is a noninvasive modality to evaluate atherosclerosis and is a predictive role for future cardiovascular events and mortality. However, few studies have evaluated its relation to long-term future ischemic stroke in hemodialysis patients. Therefore, we examined the relationship between ankle–brachial index and ischemic stroke events among hemodialysis patients in a seven-year follow-up. Methods A total of 84 patients were enrolled. Ankle–brachial index was assessed in January 2009. Primary outcomes included ischemic stroke. An ankle–brachial index < 0.9 was considered abnormal and 1.4 ≥ ankle–brachial index ≥ 0.9 to be normal ankle–brachial index. Results Mean values for ankle–brachial index were 0.98 ± 0.21at study entrance. In addition, 28 patients encountered ischemic stroke in the seven-year follow-up. In univariate Cox regression analysis, old age (hazard ratio (HR): 1.065, 95% confidence interval (CI): 1.030–1.102, p < 0.001), low seven-year averaged serum phosphate levels (HR: 0.473, 95% CI: 0.306–0.730, p = 0.001), and abnormal ankle–brachial index (HR: 0.035, 95% CI: 0.009–0.145, p < 0.001) were risk factors for ischemic stroke. In multivariate Cox regression analysis for significant variables in univariate analysis, abnormal ankle–brachial index (HR: 0.058, 95% CI: 0.012–0.279, p < 0.001) and low seven-year averaged serum phosphate levels (HR: 0.625, 95% CI: 0.404–0.968, p = 0.035) remained the risk factors for ischemic stroke. The risk of ischemic stroke was 3.783-fold in patients with abnormal ankle–brachial index compared with patients with normal ankle–brachial index (HR: 3.783, 95% CI: 1.731–8.269, p = 0.001). Conclusions These findings suggest that ankle–brachial index is an impressive predictor of future ischemic stroke among hemodialysis patients.

scholarly journals Risk of Hepatocellular Carcinoma Remains High in Patients with HBV-Related Decompensated Cirrhosis and Long-Term Antiviral Therapy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Dong-Mei Zhu ◽  
Jing Xie ◽  
Chun-Yan Ye ◽  
Mei-Yun Qian ◽  
Yuan Xue
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Antiviral Therapy ◽  
Cox Regression ◽  
Decompensated Cirrhosis ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Difference

Background. This study aimed to evaluate the risk factors of HCC development in patients with hepatitis B virus (HBV)-related DC and who underwent long-term antiviral therapy. Methods. Data from 308 patients with HBV-related DC and long-term antiviral therapy were collected and retrospectively reviewed. Cox regression analysis was used to analyze independent risk factors of HCC development. Results. Data from 129 patients with definite records were analyzed. The median follow-up time was 5 years (range, 1 to 8 years). At the end of the follow-up, 41 (31.8%) patients developed HCC, and the time from DC diagnosis to HCC incidence who received antiviral therapy was 4.4 years (range, 1–7 years). The incidence of HCC was higher in males (30/78, 38.5%) than in females (11/51, 21.6%) ( P  = 0.04). Patients who developed HCC were significantly older than those who did not develop HCC ( P  < 0.01). The incidence of HCC in patients receiving nucleoside analogues, nucleotide analogues, and combination therapy was 34.7%, 38.1%, and 33.3%, respectively, and the difference showed no significant differences ( P  = 0.95). Multivariate Cox regression analysis demonstrated that male gender and age ≥50 years are independent risk factors of HCC development (OR = 2.987 and 2.408; 95% CI (1.301–6.858) and (1.126–5.149); P  = 0.01 and 0.02, respectively). Conclusion. The risk of HCC remains to be high in patients with HBV-related DC, especially in males aged ≥50 years.

Full Dose of Lenalidomide for 12 Months Followed by a Lower Maintenance Dose Improves Progression-Free Survival in Patients with Relapsed/Refractory Multiple Myeloma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2874-2874 ◽  
Author(s):  
Meletios A Dimopoulos ◽  
Mohamad Hussein ◽  
Arlene S. Swern ◽  
Donna Weber
Keyword(s):  
Dose Reduction ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Duration Of Treatment ◽  
Cox Regression Analysis ◽  
Full Dose ◽  
Group A ◽  
Group B ◽  
Dose Reductions

Abstract Abstract 2874 Poster Board II-850 Background: Lenalidomide (len) is an oral immunomodulatory agent which is active in patients (pts) with multiple myeloma (MM). Two pivotal phase III studies in pts with relapsed/refractory MM (MM-009 and MM-010) demonstrated significant improvements in time to progression (TTP) and overall survival (OS) in those receiving len + dexamethasone (dex) compared to pts receiving placebo + dexamethasone. The aim of this analysis is to evaluate the effect of lenalidomide dose adjustments on patient outcomes from the MM-009/010 studies in order to determine an optimal long-term treatment strategy. Methods: Data up to the cut-off date of July 2008 were included in this analysis. All pts began lenalidomide at 25 mg daily for 21 days of each 28-day cycle. As previously described a protocol sanctioned dose reduction was only for an adverse event (AE). All pts received the same dose of dex. The impact of lenalidomide dose reduction, either before or after 12 months of therapy vs no dose reduction, on response and progression-free survival (PFS) was evaluated by performing a landmark analysis including only pts who had not progressed and were still on lenalidomide at 12 months . Pts were categorized based on their lenalidomide dose as follows: Group A (dose reduced from 25 mg daily therapy prior to 12 months. Group B (dose reduced from 25 mg daily therapy after 12 months), and Group C (no dose reduction during the study period). To control for possible biases in the comparison of these groups, only pts who were progression free and still receiving lenalidomide treatment at 12 months were included in the analysis. To determine if underlying factors, in addition to the reduction in dose, influenced PFS in these patient cohorts, baseline patient characteristics and laboratory values at baseline and 12 months were assessed with Cox regression analysis using PFS. Each covariate was evaluated by itself and all covariates with a p-value <0.25 were included in a multivariate model and all possible regression models were analyzed to select the best subset of covariates Results: Of the 116 pts who were still receiving lenalidomide and that had not progressed after 12 months, 39 (34%) had a dose reduction prior to 12 months (Group A), 25 (22%) had a dose reduction after 12 months (Group B), and 52 (45%) had no dose reduction at any time (Group C). Pts who were treated with lenalidomide 25 mg daily for at least 12 months and subsequently had dose reductions (Group B) demonstrated significantly longer PFS (median PFS not yet reached at median follow-up of 48 months) compared to pts who experienced a dose reduction prior to completing 12 months of therapy at 25 mg daily (Group A, median PFS 28.0 months, p= 0.007) or pts who never had a dose reduction (Group C, median PFS 36.8 months, p=0.039). Similarly, pts in Group B had longer median duration of treatment (44.4 months) compared to Group A (23.5 months) or Group C (29.7 months). Among pts who experienced a dose reduction, there was a similar rate of dose reductions due to AEs in each group (Group A – 92.3%, Group B – 88.0%). However, among all pts a higher rate of neutropenia (Group A – 71.8%, Group B – 76.0% Group C – 44.2%) and thrombocytopenia (Group A – 38.5%, Group B – 24.0%, Group C – 13.5%) was observed in pts with a dose reduction before or after 12 months. In the Cox regression analysis using PFS as an endpoint, pts reducing their dose after 12 months (Group B), had a 53% lower risk of progression or death compared to Groups A and C. A significantly higher proportion of pts in Group B exhibited a poorer ECOG performance status (PS) (79.2%, PS ≥ 1) vs 48.8%, PS ≥ 1) for Group A and C p < 0.01) Despite this difference, the significant improvement in PFS in Group B pts compared to other patient groups was maintained. Conclusions: This analysis suggests that pts responding and maintained on a full dose of lenalidomide (25 mg daily for 21 days of a 28-day cycle) for the first 12 months of therapy benefit from subsequent dose reductions. This was demonstrated by a statistically significant improvement in PFS in pts receiving dose reduction only after completing 12 months of full dose therapy. These data support the hypothesis that a lower maintenance dose of lenalidomide after 12 months of full dose therapy improves long-term patient tolerability and extends the duration of treatment, thereby improving long-term outcomes. Further studies to define the role of immunologic modulation and maintenance therapy are in progress. Disclosures: Dimopoulos: Celgene Corporation: Honoraria. Hussein:Celgene Corporation: Employment. Swern:Celgene: Employment. Weber:Celgene Corporation: Honoraria, Research Funding.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

Long-Term Clinical Outcome in Elderly Patients Undergoing Mitral Valve Repair

2020 ◽  
Author(s):  
Julia Götte ◽  
Armin Zittermann ◽  
Kavous Hakim-Meibodi ◽  
Masatoshi Hata ◽  
Rene Schramm ◽  
...  
Keyword(s):  
Mitral Valve ◽  
General Population ◽  
Elderly Patients ◽  
Cox Regression ◽  
Functional Class ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Cox Regression Analysis

Abstract Background Long-term data on patients over 75 years undergoing mitral valve (MV) repair are scarce. At our high-volume institution, we, therefore, aimed to evaluate mortality, stroke risk, and reoperation rates in these patients. Methods We investigated clinical outcomes in 372 patients undergoing MV repair with (n = 115) or without (n = 257) tricuspid valve repair. The primary endpoint was the probability of survival up to a maximum follow-up of 9 years. Secondary clinical endpoints were stroke and reoperation of the MV during follow-up. Univariate and multivariable Cox regression analysis was performed to assess independent predictors of mortality. Mortality was also compared with the age- and sex-adjusted general population. Results During a median follow-up period of 37 months (range: 0.1–108 months), 90 patients died. The following parameters were independently associated with mortality: double valve repair (hazard ratio, confidence interval [HR, 95% CI]: 2.15, 1.37–3.36), advanced age (HR: 1.07, CI: 1.01–1.14 per year), diabetes (HR: 1.97, CI: 1.13–3.43), preoperative New York Heart Association (NYHA) functional class (HR: 1.41, CI: 1.01–1.97 per class), and operative creatininemax levels (HR: 1.32, CI: 1.13–1.55 per mg/dL). The risk of stroke in the isolated MV and double valve repair groups at postoperative year 5 was 5.0 and 4.1%, respectively (p = 0.65). The corresponding values for the risk of reoperation were 4.0 and 7.0%, respectively (p = 0.36). Nine-year survival was comparable with the general population (53.2 vs. 53.1%). Conclusion Various independent risk factors for mortality in elderly MV repair patients could be identified, but overall survival rates were similar to those of the general population. Consequently, our data indicates that repairing the MV in elderly patients represents a suitable and safe surgical approach.

scholarly journals The Role of Hydraulic Silicate Cements on Long-Term Properties and Biocompatibility of Partial Pulpotomy in Permanent Teeth

Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 305
Author(s):  
Chung-Min Kang ◽  
Saemi Seong ◽  
Je Seon Song ◽  
Yooseok Shin
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Antimicrobial Properties ◽  
Permanent Teeth ◽  
Success Rates ◽  
Pulp Tissue ◽  
Cox Regression Analysis ◽  
Clinical Variables

The use of hydraulic silicate cements (HSCs) for vital pulp therapy has been found to release calcium and hydroxyl ions promoting pulp tissue healing and mineralized tissue formation. The present study investigated whether HSCs such as mineral trioxide aggregate (MTA) affect their biological and antimicrobial properties when used as long-term pulp protection materials. The effect of variables on treatment outcomes of three HSCs (ProRoot MTA, OrthoMTA, and RetroMTA) was evaluated clinically and radiographically over a 48–78 month follow-up period. Survival analysis was performed using Kaplan–Meier survival curves. Fisher’s exact test and Cox regression analysis were used to determine hazard ratios of clinical variables. The overall success rate of MTA partial pulpotomy was 89.3%; Cumulative success rates of the three HSCs were not statistically different when analyzed by Cox proportional hazard regression analysis. None of the investigated clinical variables affected success rates significantly. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long-term follow-up, with no statistical differences between clinical factors.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

scholarly journals The Role of Quantic Molecular Resonance (QMR) in the Treatment of Inferior Turbinate Hypertrophy (ITH): Our Experience With Long-Term Follow-Up in Allergic and Nonallergic Rhinitis Refractory to Medical Therapy. Preliminary Results

2021 ◽  
pp. 014556132110015
Author(s):  
Filippo Ricciardiello ◽  
Davide Pisani ◽  
Pasquale Viola ◽  
Raul Pellini ◽  
Giuseppe Russo ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Nonallergic Rhinitis ◽  
Turbinate Hypertrophy ◽  
Group A ◽  
Group B ◽  
Inferior Turbinate Hypertrophy ◽  
Molecular Resonance

Objective: The aim of this study was to assess the long-term effectiveness of quantic molecular resonance (QMR) in the treatment of inferior turbinate hypertrophy (ITH) in allergic and nonallergic rhinitis refractory to medical therapy. Methods: This study enrolled 281 patients, 160 males (56.9%) and 121 females (43.1%), mean age 37.8 ± 4.1 years, range 18 to 71. Fifty-four patients have been lost to follow up and have been therefore excluded from the final analysis. Based on skin prick test results, 69 patients were considered allergic (group A) and 158 nonallergic (group B). All subjects underwent before surgery (T0) and 3 (T1), 12 (T2), 24 (T3), and 36 months (T4) after QMR treatment to: 4-phase rhinomanometric examination, nasal endoscopy evaluation, and visual analogue scale to quantify the subjective feelings about nasal obstruction. Results: Subjective and objective parameters showed statistically significant improvement in both groups. Group B parameters not changed during follow-up, while group A showed significant worsening between T1 and subsequent assessments. T4 outcome indicates a better result in nonallergic patients. Conclusions: In accordance with the literature, our preliminary data validate QMR treatment as a successful therapeutic option for nasal obstruction due to ITH. Nonallergic patients had a very good T4 outcome. Allergic patients showed a worsening trend after 1 year probably due to other causes.

scholarly journals Long-term follow-up results of medial opening wedge high tibia osteotomy with a pre-countered non-locking steel plate

2021 ◽  
Author(s):  
Simo S. A. Miettinen ◽  
Hannu J. A. Miettinen ◽  
Jussi Jalkanen ◽  
Antti Joukainen ◽  
Heikki Kröger
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Mechanical Axis ◽  
Steel Plate ◽  
Cox Regression ◽  
Opening Wedge ◽  
Cumulative Survival ◽  
Long Term Follow Up

Abstract Introduction This retrospective study investigated the long-term follow-up results of medial opening wedge high tibial osteotomy (MOWHTO) with a pre-countered non-locking steel plate implant (Puddu plate = PP) used for medial knee osteoarthrosis (OA) treatment. Materials and methods Consecutive 70 MOWHTOs (66 patients) were performed between 01.01.2004 and 31.12.2008 with the mean follow-up time of 11.4 (SD 4.5; range 1.2–16.1) years. The Kaplan–Meier survival analysis was used to evaluate the cumulative survival of the implant in terms of age (< 50 years old and ≥ 50 years old) and gender. Adverse events were studied and Cox regression analysis was used to evaluate risk factors [age, gender, body mass index (BMI), preoperative mechanical axis, severity of OA, use of bone grafting or substitution and undercorrection of mechanical axis from varus to valgus] for revisions. Results The estimates for the cumulative survival with no need for TKA after MOWHTO were 86% at 5 years, 67% at 10 years and 58% at 16.1 years (SE 0.6, CI 95% 11.1–13.5). A total of 33/70 (47%) adverse events occurred and 38/70 (54%) knees required some revision surgery during the follow-up. Cox regression did not show any statistically significant risk factors for revision. Conclusions The PP has feasible MOWHTO results with a cumulative survival of 67% at 10 years with no need for conversion to TKA. Many adverse events occurred and revision rate due to any reason was high. Age or gender did not have statistically significant differences in terms of survival.

scholarly journals A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Tan ◽  
Yi Tang ◽  
Gaiqin Pei ◽  
Zhengxia Zhong ◽  
Jiaxing Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iga Nephropathy ◽  
Cox Regression ◽  
Renal Outcome ◽  
Matched Cohort ◽  
Negative Group ◽  
Renal Survival ◽  
Cox Regression Analysis ◽  
Renal Outcomes

AbstractIt was reported that histopathologic lesions are risk factors for the progression of IgA Nephropathy (IgAN). The aim of this study was to investigate the relationships between mesangial deposition of C1q and renal outcomes in IgAN. 1071 patients with primary IgAN diagnosed by renal biopsy were enrolled in multiple study centers form January 2013 to January 2017. Patients were divided into two groups: C1q-positive and C1q-negative. Using a 1: 4 propensity score matching (PSM) method identifying age, gender, and treatment modality to minimize confounding factors, 580 matched (out of 926) C1q-negative patients were compared with 145 C1q-positive patients to evaluate severity of baseline clinicopathological features and renal outcome. Kaplan–Meier and Cox proportional hazards analyses were performed to determine whether mesangial C1q deposition is associated with renal outcomes in IgAN. During the follow-up period (41.89 ± 22.85 months), 54 (9.31%) patients in the C1q negative group and 23 (15.86%) patients in C1q positive group reached the endpoint (50% decline of eGFR and/or ESRD or death) respectively (p = 0.01) in the matched cohort. Significantly more patients in C1q negative group achieved complete or partial remission during the follow up period (P = 0.003) both before and after PSM. Three, 5 and 7-year renal survival rates in C1q-positive patients were significantly lower than C1q-negative patients in either unmatched cohort or matched cohort (all p < 0.05). Furthermore, multivariate Cox regression analysis showed that independent risk factors influencing renal survival included Scr, urinary protein, T1-T2 lesion and C1q deposition. Mesangial C1q deposition is a predictor of poor renal survival in IgA nephropathy.Trial registration TCTR, TCTR20140515001. Registered May 15, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074.

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