scholarly journals A Propensity Score Analysis Shows that Empirical Treatment with Linezolid Does Not Increase the Thirty-Day Mortality Rate in Patients with Gram-Negative Bacteremia

2014 ◽  
Vol 58 (12) ◽  
pp. 7025-7031 ◽  
Author(s):  
Hugo-Guillermo Ternavasio-de la Vega ◽  
Ana-María Mateos-Díaz ◽  
Jose-Antonio Martinez ◽  
Manel Almela ◽  
Nazaret Cobos-Trigueros ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Mortality Rate ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Propensity Score Analysis ◽  
Mortality Rates ◽  
Empirical Treatment ◽  
Gram Negative ◽  
Score Analysis ◽  
Gram Negative Bacteremia

ABSTRACTThe role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on the 30-day mortality rates in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare the mortality rates between patients who received linezolid or glycopeptides, the propensity scores on baseline variables were used to balance the treatment groups, and both propensity score matching and propensity-adjusted logistic regression were used to compare the 30-day mortality rates between the groups. The overall 30-day mortality rate was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid, and 1,058 received glycopeptides. The propensity score matching included 64 patients in each treatment group. After matching, the mortality rates were 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid, and a nonsignificant association between empirical linezolid treatment and mortality rate (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.69 to 3.82;P= 0.275, McNemar's test) was found. This association remained nonsignificant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, the stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and the mortality rate after adjustment by propensity score quintiles or other variables potentially associated with mortality. In conclusion, the propensity score analysis showed that empirical treatment with linezolid compared with that with glycopeptides was not associated with 30-day mortality rates in patients with Gram-negative bacteremia.

Abstract 13351: Association of Atrial Fibrillation With In-hospital Mortality Among Patients With Takotsubo Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Qiying Dai ◽  
Abhishek Bose ◽  
Pengyang Li ◽  
PENG CAI ◽  
Douglas Laidlaw
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Mortality Rate ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Mortality Rates ◽  
Primary Diagnosis ◽  
Propensity Score Matching Analysis ◽  
Significant Difference

Introduction: Takotsubo cardiomyopathy (TC), characterized by transient left ventricular dysfunction, is known to be precipitated by sudden physical or emotional stress. Atrial fibrillation (AF) is a common arrhythmia and its presence increases mortality in patients with chronic underlying diseases. Furthermore, multiple studies have suggested that in TC patients, underlying AF correlates with a higher in-hospital mortality. However, these studies were constrained by either a disproportionate percentage of AF patients or lack of risk factor matching. To systematically explore the association between TC and AF, we decided to perform a propensity score matching analysis. Methods: We performed a retrospective cohort analysis using the ICD-10 codes for a primary diagnosis of TC from the 2016 National Inpatient Sample. To adjust for underlying risk factors a multivariable logistic regression model was employed followed by a propensity score matching analysis for the AF group and the non-AF group. A similar analysis method was followed for the subset of patients with paroxysmal AF. In-hospital mortality rates were compared between the two groups. Results: Out of the total 3139 patients with a primary diagnosis of TC, 433 (13.7%) had AF and 243 (7.7%) had paroxysmal AF. In the unmatched group, patients with AF appeared to be older (74.7 vs. 65.3 years, P<0.001) and more likely to have comorbidities like diabetes mellitus (24.0% vs 19.2%, P=0.024), chronic kidney disease (15.7% vs 7.6%, P<0.001) and obstructive sleep apnea (8.8% vs 4.9%, P=0.002). On multivariable logistic regression, in-hospital mortality was higher in the AF group (3.9% vs 1.3%, P< 0.001). However, after propensity score matching, there was no significant difference in the mortality rate between the two groups (3.7% vs 1.9%, P=0.082). Similarly, on logistic regression followed by propensity matching for patients with paroxysmal AF, no significant difference was noted for in-hospital mortality rates (3.3% vs 1.3%, P=0.112). Conclusions: In patients with TC, the presence of underlying AF had no effect on the in-hospital mortality rate.

scholarly journals Morbidity and mortality of lobectomy or pneumonectomy after neoadjuvant treatment: an analysis from the ESTS database

2019 ◽  
Author(s):  
Alessandro Brunelli ◽  
Gaetano Rocco ◽  
Zalan Szanto ◽  
Pascal Thomas ◽  
Pierre Emmanuel Falcoz
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Bronchopleural Fistula ◽  
Neoadjuvant Treatment ◽  
Mortality Rates ◽  
Induction Treatment ◽  
Score Analysis ◽  
Cardiopulmonary Complications ◽  
Lung Resections

Abstract OBJECTIVES To evaluate the postoperative complications and 30-day mortality rates associated with neoadjuvant chemotherapy before major anatomic lung resections registered in the European Society of Thoracic Surgeons (ESTS) database. METHODS Retrospective analysis on 52 982 anatomic lung resections registered in the ESTS database (July 2007–31 December 2017) (6587 pneumonectomies and 46 395 lobectomies); 5143 patients received neoadjuvant treatment (9.7%) (3993 chemotherapy alone and 1150 chemoradiotherapy). To adjust for possible confounders, a propensity case-matched analysis was performed. The postoperative outcomes (morbidity and 30-day mortality) of matched patients with and without induction treatment were compared. RESULTS 8.2% of all patients undergoing lobectomies and 20% of all patients undergoing pneumonectomies received induction treatment. Lobectomy analysis: propensity score analysis yielded 3824 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the neoadjuvant group (626 patients, 16% vs 446 patients, 12%, P < 0.001), but 30-day mortality rates were similar (71 patients, 1.9% vs 75 patients, 2.0%, P = 0.73). The incidence of bronchopleural fistula and prolonged air leak >5 days were similar between the 2 groups (neoadjuvant: 0.5% vs 0.4%, P = 0.87; 9.2% vs 9.9%, P = 0.27). Pneumonectomy analysis: propensity score analysis yielded 1312 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the treated patients compared to those without neoadjuvant treatment (neoadjuvant 275 cases, 21% vs 18%, P = 0.030). However, the 30-day mortality was similar between the matched groups (neoadjuvant 68 cases, 5.2% vs 5.3%, P = 0.86). Finally, the incidence of bronchopleural fistula was also similar between the 2 groups (neoadjuvant 1.8% vs 1.4%, P = 0.44). CONCLUSIONS Neoadjuvant chemotherapy is not associated with an increased perioperative risk after either lobectomy or pneumonectomy, warranting a more liberal use of this approach for patients with locally advanced operable lung cancer.

scholarly journals A Case Study About Why It Can Be Difficult To Test Whether Propensity Score Analysis Works in Field Experiments

2013 ◽  
Vol 3 (2) ◽  
pp. 1 ◽  
Author(s):  
William R. Shadish ◽  
Peter M. Steiner ◽  
Thomas D. Cook
Keyword(s):  
Experimental Data ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Field Experiments ◽  
Propensity Score Analysis ◽  
Randomized Experiment ◽  
Score Analysis ◽  
Quasi Experimental ◽  
Do So

Peikes, Moreno and Orzol (2008) sensibly caution researchers that propensity score analysis may not lead to valid causal inference in field applications. But at the same time, they made the far stronger claim to have performed an ideal test of whether propensity score matching in quasi-experimental data is capable of approximating the results of a randomized experiment in their dataset, and that this ideal test showed that such matching could not do so. In this article we show that their study does not support that conclusion because it failed to meet a number of basic criteria for an ideal test. By implication, many other purported tests of the effectiveness of propensity score analysis probably also fail to meet these criteria, and are therefore questionable contributions to the literature on the effects of propensity score analysis. DOI:10.2458/azu_jmmss_v3i2_shadish

scholarly journals Silicone oil versus gas tamponade for primary rhegmatogenous retinal detachment treated successfully with a propensity score analysis: Japan Retinal Detachment Registry

2021 ◽  
pp. bjophthalmol-2021-319876
Author(s):  
Ryoh Funatsu ◽  
Hiroto Terasaki ◽  
Chihaya Koriyama ◽  
Toshifumi Yamashita ◽  
Hideki Shiihara ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Propensity Score Analysis ◽  
Gas Tamponade ◽  
Score Analysis ◽  
Primary Success ◽  
Silicone Oil Tamponade

Background/aimsTo compare the effects of silicone oil tamponade (SOT) to that of gas tamponade (GT) on the best-corrected visual acuity (BCVA) after successful vitrectomy for retinal detachment (RD).MethodsA retrospective, multicentre, nationwide study with RD who were registered in the Japan-RD Registry. All cases with RD treated with successful vitrectomy between February 2016 and March 2017 were studied. A propensity score matching was performed using the preoperative findings as covariates to adjust the relevant confounders. The primary outcome was the estimated mean difference of the postoperative BCVA in 6 months between eyes treated with SOT to those treated with GT.ResultsOf the 3446 cases registered, 2097 cases met the entry criteria. There were 2042 eyes that had GT and 55 eyes that had SOT. Primary success was defined as a reattached retina with no tamponade at 6 months. After propensity score matching, each group contained 40 cases. The preoperative BCVA was 0.966±0.738 logMAR units in the GT group and 1.270±0.945 logMAR units in the SOT group (p=0.177). Six months postoperatively, the BCVA in the GT group was significantly better at 0.309 logMAR units in the GT group than the 0.671 logMAR units in the SOT group (p=0.002).ConclusionsEven after successful surgery for RD, eyes that experienced SOT had poorer BCVA than eyes treated with GOT. SOT should be considered cautiously.PrecisPropensity score analysis of eyes with rhegmatogenous RD showed that postoperative vision was worse in eyes treated once with silicone oil than with gas even after completely successful surgery.

scholarly journals Propensity score matching for multilevel spatial data: accounting for geographic confounding in health disparity studies

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Melanie L. Davis ◽  
Brian Neelon ◽  
Paul J. Nietert ◽  
Lane F. Burgette ◽  
Kelly J. Hunt ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spatial Heterogeneity ◽  
Racial Disparities ◽  
Propensity Score Matching ◽  
Random Effects ◽  
Propensity Score Analysis ◽  
Specialty Care ◽  
Spatial Random Effects ◽  
Patient Level ◽  
Score Analysis

Abstract Background Diabetes is a public health burden that disproportionately affects military veterans and racial minorities. Studies of racial disparities are inherently observational, and thus may require the use of methods such as Propensity Score Analysis (PSA). While traditional PSA accounts for patient-level factors, this may not be sufficient when patients are clustered at the geographic level and thus important confounders, whether observed or unobserved, vary by geographic location. Methods We employ a spatial propensity score matching method to account for “geographic confounding”, which occurs when the confounding factors, whether observed or unobserved, vary by geographic region. We augment the propensity score and outcome models with spatial random effects, which are assigned scaled Besag-York-Mollié priors to address spatial clustering and improve inferences by borrowing information across neighboring geographic regions. We apply this approach to a study exploring racial disparities in diabetes specialty care between non-Hispanic black and non-Hispanic white veterans. We construct multiple global estimates of the risk difference in diabetes care: a crude unadjusted estimate, an estimate based solely on patient-level matching, and an estimate that incorporates both patient and spatial information. Results In simulation we show that in the presence of an unmeasured geographic confounder, ignoring spatial heterogeneity results in increased relative bias and mean squared error, whereas incorporating spatial random effects improves inferences. In our study of racial disparities in diabetes specialty care, the crude unadjusted estimate suggests that specialty care is more prevalent among non-Hispanic blacks, while patient-level matching indicates that it is less prevalent. Hierarchical spatial matching supports the latter conclusion, with a further increase in the magnitude of the disparity. Conclusions These results highlight the importance of accounting for spatial heterogeneity in propensity score analysis, and suggest the need for clinical care and management strategies that are culturally sensitive and racially inclusive.

scholarly journals Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250611
Author(s):  
Mehdi Assal ◽  
Jérôme Lambert ◽  
Laurent Chow-Chine ◽  
Magali Bisbal ◽  
Luca Servan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Propensity Score ◽  
Tracheal Intubation ◽  
Corticosteroid Therapy ◽  
Propensity Score Analysis ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Prognostic Impact ◽  
Score Analysis ◽  
Haematology Patients

Purpose While early adjunctive corticosteroid therapy (EACST) has been proven effective in HIV patients with Pneumocystis Jirovecii Pneumonia (PJP), data remains controversial concerning non-HIV oncology or haematology patients. Methods This retrospective study included cancer patients without HIV and with diagnosis of PJP admitted in a cancer referral centre, from January-1-2010 to March-31-2017. We compared 30-day and 1-year mortality rate, change in the respiratory item of the Sequential Organ Failure Assessment score(SOFA-resp worsening), use of tracheal intubation between day-1 and day-5 of anti-pneumocystis therapy and occurrence of coinfections between patients with EACST and those with no or late corticosteroid therapy, using an inverse probability weighting propensity score-based (IPW) analysis. Results 133 non-HIV oncology or haematology PJP patients were included (EACST n = 58, others n = 75). The main underlying conditions were haematological malignancies (n = 107, 80,5%), solid tumour (n = 27, 20,3%) and allogeneic stem cell transplantation (n = 17, 12,8%). Overall 30-day and 1-year mortality rate was 24,1% and 56,4%, respectively. IPW analysis found no difference on 30-day (HR = 1.45, 95% CI [0.7–3.04], p = 0.321) and 1-year (HR = 1.25, CI 95% [0.75–2.09], p = 0.39) mortality rate between groups. Conclusion No difference in SOFA-resp worsening, tracheal intubation and coinfections was found between groups. Combination of EACST with anti-pneumocystis therapy in non-HIV onco-haematology PJP-patients was not associated with clinical improvement.

scholarly journals A Case Study About Why It Can Be Difficult To Test Whether Propensity Score Analysis Works in Field Experiments

2013 ◽  
Vol 3 (2) ◽  
pp. 1 ◽  
Author(s):  
William R. Shadish ◽  
Peter M. Steiner ◽  
Thomas D. Cook
Keyword(s):  
Experimental Data ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Field Experiments ◽  
Propensity Score Analysis ◽  
Randomized Experiment ◽  
Score Analysis ◽  
Quasi Experimental ◽  
Do So

Peikes, Moreno and Orzol (2008) sensibly caution researchers that propensity score analysis may not lead to valid causal inference in field applications. But at the same time, they made the far stronger claim to have performed an ideal test of whether propensity score matching in quasi-experimental data is capable of approximating the results of a randomized experiment in their dataset, and that this ideal test showed that such matching could not do so. In this article we show that their study does not support that conclusion because it failed to meet a number of basic criteria for an ideal test. By implication, many other purported tests of the effectiveness of propensity score analysis probably also fail to meet these criteria, and are therefore questionable contributions to the literature on the effects of propensity score analysis. DOI:10.2458/azu_jmmss_v3i2_shadish

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