scholarly journals P1517SURVIVAL ON DIALYSIS: SWITZERLAND IN COMPARISON WITH OTHER COUNTRIES - A FOLLOW UP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rebecca Winzeler ◽  
Patrice Max Ambühl

Abstract Background and Aims Survival in dialysis patients is substantially reduced compared to the general population. The aim of the present analysis was to compare the survival of Swiss dialysis patients with other countries with an additional year of follow up and a higher number of patients. Method Incident dialysis patients (hemo- or peritoneal dialysis; N=4525) from the Swiss dialysis registry were followed up from 2014 on until December 31, 2018 (mean follow up days=684). Deaths occurring during this time (N=976) were recorded and survival was examined using the Kaplan Meier method, censored for transplantation. Results Characteristics of the dialysis population stratified according to survival status are provided in Table 1. Dialysis patients in Switzerland have an approximately 8% higher survival in the first and second year after start of dialysis compared to other European countries (Annual ERA-EDTA Report 2016). In the oldest age group, it amounts to up to 13 and 14%, in the first and in the second year, respectively. The proportion in survival rates between genders is similar in Switzerland, as well as in Europe. Dialysis patients aged younger than 45 years have a worse survival in Switzerland compared to other European countries. Conclusion The markedly better survival in dialysis patients in Switzerland compared to other European countries could be confirmed with an additional year of follow up and more patients. Also, causes of death vary widely among European countries. With an additional year of follow up, data to analyze 5-year survival probability will be available for comparison with the ERA-EDTA report. In addition, we will be able to verify whether dialysis patients under 45 years in Switzerland have an increased mortality or whether this is due to the small number of patients in these two age groups.

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rebecca Winzeler ◽  
Patrice Max Ambühl

Abstract Background and Aims Survival in dialysis patients is substantially reduced compared to the general population. The aim of the present analysis was to compare the survival of dialysis patients in Switzerland with other countries with an additional year of follow up and a higher number of patients. Method Incident dialysis patients (hemo- or peritoneal dialysis; N=5'406) from the Swiss dialysis registry were followed up from 2014 to December 31, 2019 (median follow up days=658). Deaths occurring during this time (N=1'353) were recorded and survival was examined using the Kaplan Meier method, censored for transplantation. Results Characteristics of the dialysis population stratified according to survival status are provided in Table 1. Dialysis patients in Switzerland have an approximately 8% higher survival in the first and second year and about 10% higher 5 years after start of dialysis, compared to other European countries (Annual ERA-EDTA Report 2017). In the first two years, the proportion in survival rates between genders is similar in Switzerland, as well as in Europe. After 5 years, however, a difference in survival rates between genders becomes apparent, with women having a 5-year survival probability of 56.6%, compared to a lower 5-year survival probability of 49.7% in men. Conclusion The markedly better survival in dialysis patients in Switzerland compared to other European countries could be confirmed with an additional year of follow up and more patients. Also, causes of death vary widely among European countries. 5-year survival was calculated for the first time, with Switzerland showing almost 10% better survival rates than other European countries.


Author(s):  
Florin Eggmann ◽  
Thomas J. W. Gasser ◽  
Hanjo Hecker ◽  
Mauro Amato ◽  
Roland Weiger ◽  
...  

Abstract Objectives This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.


Neurosurgery ◽  
2002 ◽  
Vol 51 (4) ◽  
pp. 905-911 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford

Abstract OBJECTIVE Hemangiopericytomas are highly aggressive meningeal tumors with tendencies for recurrence and metastasis. The purpose of this retrospective, single-institution review was to evaluate the efficacy and role of stereotactic radiosurgery in the management of recurrent hemangiopericytomas. METHODS We reviewed data for patients who underwent stereotactic radiosurgery at the University of Pittsburgh between 1987 and 2001. Fourteen patients underwent radiosurgery for 15 discrete tumors. Prior treatments included transsphenoidal resection (n = 1), craniotomy and resection (n = 27), embolization (n = 1), and conventional radiotherapy (n = 7). Clinical and radiological responses were evaluated. Follow-up periods varied from 5 to 76 months (mean, 31.3 mo; median, 21 mo). The mean radiation dose to the tumor margin was 15 Gy. RESULTS Seventy-nine percent of patients (11 of 14 patients) with recurrent hemangiopericytomas demonstrated local tumor control after radiosurgery. Twelve of 15 tumors (i.e., 80%) dramatically decreased in size on follow-up imaging scans. Regional intracranial recurrences were retreated with radiosurgery for two patients (i.e., 15%); neither of those two patients experienced long-term tumor control. Local recurrences occurred 12 to 75 months (median, 21 mo) after radiosurgery. Local tumor control and survival rates at 5 years after radiosurgery were 76 and 100%, respectively (Kaplan-Meier method). We could not correlate prior irradiation or tumor size with tumor control. Twenty-nine percent of the patients (4 of 14 patients) developed remote metastases. Radiosurgery did not seem to offer protection against the development of intra- or extracranial metastases. CONCLUSION Gamma knife radiosurgery provided local tumor control for 80% of recurrent hemangiopericytomas. When residual tumor is identified after resection or radiotherapy, early radiosurgery should be considered as a feasible treatment modality. Despite local tumor control, patients are still at risk for distant metastasis. Diligent clinical and radiological follow-up monitoring is necessary.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1423
Author(s):  
E. Bustos-Vázquez ◽  
E. Padilla-González ◽  
D. Reyes-Gómez ◽  
M. C. Carmona-Ramos ◽  
J. A. Monroy-Vargas ◽  
...  

Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to analyse the characteristics of survivors and their relationship with comorbidities. We had access to a database containing information on 16,747 hospitalized patients from Mexico, all infected with SARS-CoV-2, as part of a regular follow-up. The descriptive analysis looked for clusters of either success or failure. We categorized the samples into no comorbidities, or one and up to five coexisting with the infection. We performed a logistic regression test to ascertain what factors were more influential in survival. The main variable of interest was survival associated with multimorbidity factors. The database hosted information on hospitalized patients from Mexico between March 2020 through to April 2021. Categories 2 and 3 had the largest number of patients. Survival rates were higher in categories 0 (64.8%), 1 (57.5%) and 2 (51.6%). In total, 1741 (10.5%) patients were allocated to an ICU unit. Mechanical ventilators were used on 1415 patients, corresponding to 8.76%. Survival was recorded in 9575 patients, accounting for 57.2% of the sample population. Patients without comorbidities, younger people and women were more likely to survive.


2020 ◽  
pp. 112070001989697 ◽  
Author(s):  
Nam Hoon Moon ◽  
Won Chul Shin ◽  
Min Uk Do ◽  
Suk-Woong Kang ◽  
Sang-Min Lee ◽  
...  

Background: Although highly positive results for wear reduction of highly cross-linked polyethylene (HXLPE) have been reported around the 10-year follow-up, the long-term result related to reoperation and wear-related survival is still an issue. Therefore, this study aimed to compare the follow-up results of a single manufacture’s polyethylene liner for >15 years in terms of survival and wear rate. Methods: This retrospective cohort study included 134 primary total hip arthroplasties (THAs) who were followed up for at least 15 years. The mean age at the time of surgery was 50.7 years (conventional polyethylene [CPE] group = 22; HXLPE group = 112). Linear and volumetric wear rates of polyethylene were measured, and the reoperation rate and radiographic osteolysis were evaluated and Kaplan-Meier survival analysis was performed in both groups. Implant-related complications were also examined. Results: HXLPE group showed a significantly lower wear rate in both linear and volumetric wear. None of the hip radiographs showed evidence of loosening or osteolysis in the HXLPE group. The survival rates at 15- to 18-year follow-up were 90.9% and 95.5% in the CPE and HXLPE groups when all-cause reoperation was the endpoint, and 90.9% and 100.0% when the wear-related reoperation was the endpoint, respectively. Implant-related complications were not different between the 2 groups. Conclusions: Wear reduction and osteolysis showed a great advantage in HXLPE after a 15-year follow-up. Although the CPE and HXLPE showed excellent survival, wear and osteolysis were more frequent in the CPE; therefore, the high risk of reoperation in the future should be considered.


1995 ◽  
Vol 73 (7) ◽  
pp. 1312-1322 ◽  
Author(s):  
S. C. Amstrup ◽  
G. M. Durner

Polar bears (Ursus maritimus) are hunted throughout most of their range. In addition to hunting, polar bears of the Beaufort Sea region are exposed to mineral and hydrocarbon extraction and related human activities such as shipping, road building, and seismic testing. As human populations increase and demands for polar bears and other arctic resources escalate, reliable estimates of survivorship of polar bears are needed to predict and manage the impacts of those activities. We used the Kaplan–Meier model to estimate annual survival (with 95% confidence intervals) for radio-collared female polar bears and their dependent young that were followed during a 12-year study in the Alaskan Beaufort Sea. Survival of adult female polar bears was higher than had been previously thought: Ŝ = 0.969 (range 0.952–0.983). If human-caused mortalities were deleted, the computed survival rate was 0.996 (0.990–1.002). Survival of young from den exit to weaning was 0.676 (0.634–0.701). Survival during the second year of life, 0.860 (0.751–0.903), was substantially higher than during the first year, 0.651 (0.610–0.675). Shooting by local hunters accounted for 85% of the documented deaths of adult female polar bears. Conversely, 90% of documented losses of young accompanying radio-collared females were not directly caused by humans. Deaths of dependent young were independent of litter size (P = 0.36), indicating that parental investment in single cubs was not different from investment in litters of two or more. Precise estimates of the survival of independent juveniles and adult males still need to be developed.


1999 ◽  
Vol 29 (2) ◽  
pp. 485-489 ◽  
Author(s):  
J. J. CLAUS ◽  
G. J. M. WALSTRA ◽  
P. M. BOSSUYT ◽  
S. TEUNISSE ◽  
W. A. VAN GOOL

Background. We studied whether heterogeneous profiles of cognitive function are relevant to survival in patients with early Alzheimer's disease.Methods. CAMCOG subscales of cognitive function were used as predictors of survival, together with gender in 157 consecutively referred patients with early Alzheimer's disease. Statistical analysis was performed with Cox proportional hazards analysis and Kaplan–Meier survival curves. Survival rates were compared with those in the general population.Results. Eighty patients (51%) died during the follow-up that extended to 5·7 years, with a median survival of 4·4 years after entry. Only the praxis subscore was statistically significant related to survival (P<0·0001). Its predictive power was based on only two items, including copying ability for a spiral and a three-dimensional house, independent of age, sex, education, overall CAMCOG score, dementia severity and symptom duration. Kaplan–Meier curves for the combined score of these items (0, 1, or 2) showed three groups with significantly different survival rates for both men and women. Comparison of gender specific survival rates with data from the general population showed that excess mortality was statistically significant (P<0·01) higher in men (51%) than in women (21%) after follow-up extending to 5 years.Conclusions. A simple test of copying ability defines subgroups of AD patients with large differences in survival rates. This suggests that parietal lobe impairment is an important predictor of mortality in AD. Also, the course of AD may be more benign in women than in men.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Fatmah N. AlMotawah ◽  
Sharat Chandra Pani ◽  
Tala AlKharashi ◽  
Saleh AlKhalaf ◽  
Mohammed AlKhathlan ◽  
...  

Aim. This study aimed to retrospectively compare the survival outcomes over two years between teeth with proximal dental caries that were restored with stainless-steel crowns to those that were pulpotomized and then restored with a stainless-steel crown in patients who were rehabilitated under general anesthesia. Participants and Methods. The records of 131 patients aged between two to six years who had stainless-steel crowns placed under general anesthesia and had two-year follow-up were screened. 340 teeth with moderate proximal caries on the radiograph (D2) were included in the study. Of these, 164 teeth were treated with a pulpotomy and stainless-steel crown, while 176 teeth were crowned without a pulpotomy. The type of each tooth was compared using the Chi-squared test and Kaplan–Meier survival analysis, and curves were plotted based on the two-year outcomes. Results. Treatment: the sample comprised 59 males (mean age 4.73 years, SD ± 1.4 years) and 72 females (mean age 5.2 years, SD ± 2.0 years). The Kaplan–Meier regression model showed no significant difference in survival outcomes between teeth that had been pulpotomized and those that had not ( p  = 0.283). Conclusion. Within the limitations of the current study, we can conclude that performing a pulpotomy does not influence the survival outcome of mild/moderate proximal caries restored with stainless-steel crowns under general anesthesia.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S252-S253
Author(s):  
U N Shivaji ◽  
A Bazarova ◽  
T Critchlow ◽  
S C Smith ◽  
O M Nardone ◽  
...  

Abstract Background In clinical practice, patients with IBD have their biologic therapies withdrawn due to variety of reasons. The aim of the study was to report on predictors of prognosis in IBD patients after biologics have been discontinued, with a minimum follow-up of 24 months. Methods All IBD patients who discontinued their first-use biologic were identified between January 2013 and Dec 2016 from EMR at a tertiary referral centre, to ensure at least 24 months follow-up. Reasons for discontinuation and pre-defined adverse outcomes (steroid and other rescue therapies, hospitalisations, surgery including perianal) were recorded. The data were analysed using multivariable and univariable logistic regressions within a machine learning technique in order to predict adverse outcomes, within the stated timeframe. We tested the significance of the identified predictors and performed Kaplan–Meier survival analysis to compare patients with elective vs. non-elective discontinuation of biologics. Results 147 patients who discontinued biologics (M = 74, median age 39y; CD = 110) were identified. Follow-up ranged from 24 to 60 months (median 40 months). The reasons for non-elective discontinuation included side effects (n = 21, 14%), primary or secondary non-response (n = 33, 22%) and patient choice (n = 10, 7%), among others. 59 (40%) patients had elective discontinuation. In this cohort, elective discontinuation resulted in fewer IBD-related adverse outcomes (AO) compared with non-elective. Figure 1 shows a Kaplan–Meier curve comparing the two (p = 0.003). Using data from all 147 patients, multivariable logistic regression analysis was done to identify significant predictors of prognosis. These are represented in Table 1. Overall, a significant number of patients (n = 80, 54%) had AO within 6 months of discontinuation, and 96 (65%) patients needed biologics to be restarted by the end of the study follow-up period. Conclusion Among IBD patients who discontinued biologics, there were fewer AO when they were electively discontinued. However, majority of patients required restart of biologics to manage their disease during the follow-up period. Clinicians need to be cautious when considering biologic discontinuation given the high proportion of AO and re-escalation to biologics therapy.


2019 ◽  
Vol 45 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Farhad Farzaliyev ◽  
Hans-Ulrich Steinau ◽  
Halil-Ibrahim Karadag ◽  
Alexander Touma ◽  
Lars Erik Podleska

In this retrospective study, we analysed the long-term oncological and functional results after extended ray resection for sarcoma of the hand. Recurrence-free and overall survivals were calculated using the Kaplan–Meier method. The function of the operated hand was assessed with the Michigan Hand Questionnaire and compared with the contralateral side. Extended ray resection was performed in 25 out of 168 consecutive patients with soft-tissue and bony sarcomas of the hand. The overall 5- and 10-year, disease-specific survival rates were 86% and 81%, respectively. Local recurrences were observed in two patients. The Michigan Hand Questionnaire score for the affected hand at follow-up in nine patients was 82 points versus 95 for the healthy contralateral hands. We conclude that extended ray resection of osseous sarcomas breaking through the bone into the soft tissue or for soft tissue sarcomas invading bone is a preferable alternative to hand ablation when excision can be achieved with tumour-free margins. Level of evidence: III


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