Intraepithelial growth pattern for eyelid sebaceous carcinoma: a cohort of 214 patients from a single institution

2021 ◽  
pp. bjophthalmol-2021-319789
Author(s):  
Chuandi Zhou ◽  
Peiwei Chai ◽  
Wenwen Xia ◽  
Jiang Li ◽  
Renbing Jia ◽  
...  
Keyword(s):  
Growth Pattern ◽  
Cox Regression ◽  
Diagnostic Delay ◽  
Intraepithelial Neoplasia ◽  
Sebaceous Carcinoma ◽  
Growth Patterns ◽  
Tumour Invasion ◽  
Intraepithelial Spread ◽  
Related Mortality

AimsTo determine the distribution of three different intraepithelial growth patterns (pagetoid, bowenoid and papillary) in eyelid sebaceous carcinoma (SC) and correlate them with the clinical characteristics and prognosis.MethodsA retrospective cohort study. The medical charts and pathological sections were retrospectively reviewed. All eligible patients were followed up for recurrence, metastasis and tumour-related mortality. The clinical significance of each intraepithelial growth pattern was determined by Cox regression.ResultsOf the 214 patients, 67 (31%) presented with intraepithelial invasion, among them, 34 (16%) were pagetoid, 27 (13%) were bowenoid and 6 (2.8%) were papillary. Patients of pagetoid intraepithelial spread showed significantly longer diagnostic delay (p=0.001) and more initial misdiagnoses of blepharitis (p=0.035). After a median follow-up period of 34.0 months, 67 (46%) patients in the non-intraepithelial group, 17 (50%) in the pagetoid group, 8 (30%) in the bowenoid group and 2 (33%) in the papillary group recurred. And 30 (20%) patients in the non-intraepithelial group, 9 (27%) in the pagetoid group and 4 (15%) in the bowenoid group developed metastasis. Moreover, 15 (10%) patients in the non-intraepithelial group, 6 (18%) in the pagetoid group and 1 (3.7%) in the bowenoid group died of SC. Cox regression indicated that pagetoid intraepithelial growth pattern was remarkably associated with increased chances of tumour-related mortality (HR=2.95, 95% CI 1.14 to 7.64, p=0.026).ConclusionsIntraepithelial tumour invasion was presented in nearly one third of patients with eyelid SC. Pagetoid intraepithelial neoplasia, the predominant growth pattern, significantly increased the risk of tumour-related mortality. Meticulous histopathological intraepithelial examination is recommended for every patient of eyelid SC. Special attention should be paid to those with pagetoid invasion, who may require more intensive managements.

Equivalent Outcome Between Reduced Intensity Versus Conventional Myeloablative Conditioning Hematopoietic Stem Cell Transplantation for Patients Older Than 35 Years with Acute Myeloid Leukemia.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3103-3103
Author(s):  
Marie Sebert ◽  
Raphaël Porcher ◽  
Marie Robin ◽  
Lionel Ades ◽  
Emmanuel Raffoux ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Research Funding ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Conditioning Regimen ◽  
Hematopoietic Stem ◽  
Treatment Related Mortality ◽  
Related Mortality

Abstract Abstract 3103 Introduction: Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) provides the best chance of long-term survival for patients with intermediate or high-risk acute myeloid leukemia (AML). The major limitation of this procedure is the risk of treatment related mortality (TRM). Use of reduced intensity conditioning (RIC) regimen has become standard practice among older candidates with comorbidities. Although RIC regimen have been used for over a decade in older patients, the benefit of this approach in younger patients with AML compared with the risk of toxicity of standard regimen (MAC) is still discussed. We compared the outcomes for patients with AML over 35 years using RIC or MAC HSCT. Patients, methods, and transplantation characteristics: From January 2000 to December 2010, 132 consecutive patients older than 35 years with AML (18 secondary AML) received HSCT in our center, either from siblings (n=87) or HLA 10/10 allele-matched donors (n=45). MAC (n=72) and RIC (n=60) regimens were defined as previously described (Bacigalupo, 2009). Seventy-three patients were in first complete remission (CR1); 30% of patients had poor risk cytogenetics (MRC classification). Karnofsky performance status was scored at time of HSCT. Engraftment, acute and chronic graft-versus-host disease (GvHD), transplantation-related mortality (TRM), relapse rate as well as overall survival (OS) at 4 years were compared according to the intensity of the conditioning regimen. First a classical multivariable Cox analysis was conducted. In a second step, baseline confounding factors were adjusted for using inverse probability-of-treatment weighting (IPTW). Results of the comparison: Patient characteristics according to the intensity of the conditioning regimen were similar for AML type (de novo versus secondary), gender, karnofsky performance status, CR#, donor type and number of CD34+ infused. Particularly, cytogenetic risks were comparable in both groups. Patients were younger in the MAC group (median age 44 years [range 35 to 56 years] vs 54[37 to 66] for RIC, p<0,0001), received mainly bone marrow as source of stem cells (54% versus 2% for RIC, p<0,0001) and GvHD prophylaxis using cyclosporine plus methotrexate (89% versus 5% for RIC, p<0,0001). Moreover, ATG in the conditioning regimen (more ATG in RIC: 51 vs. 14%, p<0.0001), donor age (older for RIC: 49 vs. 39 years, p=0.002) and number of nucleated cells infused (higher in RIC: 11 vs. 4 × 108/kg, p<0.0001) were also different. The median follow-up was 47 months (10 to 134), and 25% of patients had a follow-up of at least 74 months. During evolution, all patients engrafted. The cumulative incidence (CIf) of acute GVHD grade II-IV was 49% (35% after RIC vs 61% after MAC, p=0.001). The 5-year CIf of chronic GVHD was 37% (40% after RIC vs 30% after MAC, p=0.32). During FU, 71 patients died. The 5-year CIf of TRM was 21% (13% after RIC vs 28% after MAC, p=0.009). Adjusting for cytogenetic risk, gender donor/recipient mismatch and infused nucleated cells, no difference was observed between RIC and MAC (HR 0.9, p=0.16). The 5-year CIf of relapse was 42% (51% after RIC vs 35% after MAC (p=0.22)). Adjusting for gender donor/recipient mismatch, donor/recipient CMV serostatus and infused CD34+ cells, no marked difference was observed between RIC and MAC (HR 0.8, 95%CI 0.4–1.5, p=0.50). The 5-year OS was 39% (50% after RIC vs 34% after MAC, p=0.38). Using both Cox regression and IPTW to account for imbalance in patients characteristics, similar OS was found after RIC and MAC (Figure 1), with adjusted HRs for MAC vs RIC of 0.9 (95%CI 0.4–1.8, p=0.68) with Cox regression and 0.9 (95%CI 0.4–1.8, p=0.76) with IPTW. Conclusion: In patients with AML over 35 years, MAC regimen lead to a non significant higher rate of treatment related mortality with no benefit in terms of relapse when compared with RIC regimen. Until prospective trials are completed, this study supports the use of a RIC regimen for patients with AML older than 35 years who are transplanted either from siblings or matched unrelated donors. Disclosures: Fenaux: Amgen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Roche: Honoraria, Research Funding; GSK: Honoraria, Research Funding; Novartis: Honoraria, Research Funding.

scholarly journals Ultrafiltration rate and diabetes as useful indicators of cardiovascular-related death in hemodialysis patients below 60 years of age

2017 ◽  
Vol 71 (0) ◽  
pp. 0-0
Author(s):  
Marcin Krzanowski ◽  
Katarzyna Krzanowska ◽  
Artur Dziewierz ◽  
Małgorzata Banaszkiewicz ◽  
Artur Jurczyszyn ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Mortality Data ◽  
Cox Regression Analysis ◽  
Time To Death ◽  
All Cause Mortality ◽  
Dm Type 2 ◽  
Related Mortality

Background: The survival rate of elderly hemodialyzed (HD) patients is commonly thought to be poor. In a prospective, single center, non-interventional, observational study, the cause of all-cause and cardiovascular (CV) and heart failure (HF) mortality in this patient group were examined and compared with a younger cohort (below 60 years). Material/Methods: The study included 223 patients (90 women and 133 men) with age ranging from 34.5 to 75.0 years treated with HD. Median duration of HD was 70.0 months (24.0-120.0). Mortality data was collected over a period of six years. We divided patients into groups: <60 (n=123), ≥60 years (n=100), and with (n=33) and without DM type 2 (n=190). Results: During a six-year follow-up, 100 patients (44.8%) died, including 83 (37.2%) patients who died due to CV reasons. Median follow-up was 2015.0 days (946.0-2463.0) with the median time to death of 1166.0 days (654.5-1631.0). The factors negatively affecting patients’ survival in univariate Cox regression analysis included for all-cause mortality were: inter-dialytic weight gain (IDWG) (hazard ratio [HR]=1.60; p=0.01), ultrafiltration (UF) rate (HR=3.63; p=0.012) for group <60 years; for CV death: UF rate (HR=4.20; p=0.03), DM (HR=5.11; p=0.002) for group <60 years; for HF death: mellitus type 2 (DM) (HR=2.93; p=0.027) for group ≥60 years). In a multivariate Cox regression analysis for patients <60 years, the UF rate was the only independent predictor of all-cause mortality (HR 3.63 (1.34-9.67); p=0.011). Both DM (HR 4.91 (1.71-14.10); p=0.003) and UF rate (HR 3.62 (1.04-12.61); p=0.044) were independent predictors of CV-related mortality in patients <60 years. Conclusions: The UF rate can be a simple, useful indicator of higher long-term all-cause and CV mortality in HD patients <60 years of age. Also, DM may be a predictor of CV–related mortality in younger HD patients.

scholarly journals 0048 The Association Between REM Sleep and Risk of Mortality in Three Independent Cohorts

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A19-A20
Author(s):  
E B Leary ◽  
K T Watson ◽  
S Ancoli-Israel ◽  
S Redline ◽  
K Yaffe ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Mortality Risk ◽  
Rem Sleep ◽  
Cox Regression ◽  
Older Men ◽  
Sensitivity Analyses ◽  
Sample Mean ◽  
Risk Of Mortality ◽  
Related Mortality

Abstract Introduction Sleep disorders and sleep characteristics have been linked to higher risk of mortality. Despite the emerging evidence of a sleep-mortality association, the relationship between sleep architecture and mortality aren’t well understood. We hypothesize that reduced REM is associated with increased mortality risk. Methods The Osteoporotic Fractures in Men (MrOS) study is a population-based study of 2,675 older men. Cox regression was used to evaluate the association between %REM and mortality rate. Potential covariates were evaluated using 6-fold cross validation. Sensitivity analyses were performed to rule out alternative explanations. Wisconsin Sleep Cohort (WSC) and Sleep Heart Health Study (SHHS) data were used to replicate the findings. Results The MrOS sample mean age was 76.3 years (SD=5.51) and the median follow-up time was 12.1 years. There was a 13% higher rate of mortality for every absolute 5% reduction in REM sleep (HR=1.13, 95%CI, 1.08–1.19) after adjusting for multiple demographic, sleep, and health covariates. The association persisted for cardiovascular disease-related mortality (CVD) (HR=1.18, 95%CI, 1.09–1.28), cancer-related mortality (HR=1.14, 95%CI, 1.03–1.26), and other mortality (HR=1.19, 95%CI, 1.10–1.28). The WSC included 45.7% women. The mean age of the 1,388 individuals analyzed was 51.5 (SD=8.5); the median follow-up time was 20.8 years. The effect size for 5% reduction in REM on rate of all-cause mortality was similar in this cohort despite the younger age, inclusion of women, and longer follow-up period (HR=1.17, 95%CI, 1.03–1.34). SHHS data is still being analyzed; however the unadjusted model is consistent with the other cohorts. Conclusion We found an association between reduced REM and mortality in two, possibly three independent cohorts, which persisted across different causes of death and multiple sensitivity analyses. Mechanistic studies are needed and strategies to preserve REM may influence clinical therapies and reduce mortality risk. Support NHLBI provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839. Wisconsin Sleep Cohort was supported by R01HL62252, RR03186, and R01AG14124 from the NIH. Dr. Redline was partially supported by NHLBI R35 HL135818.

scholarly journals Serum β-2 microglobulin predicts mortality in people with diabetes

2013 ◽  
Vol 169 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Ching-Lung Cheung ◽  
Karen S L Lam ◽  
Bernard M Y Cheung
Keyword(s):  
Cox Regression ◽  
Threshold Model ◽  
Linear Increase ◽  
Diabetic Patients ◽  
Cox Regression Analysis ◽  
Health And Nutrition ◽  
Risk Of Mortality ◽  
The Relationship ◽  
Related Mortality

ObjectiveSerum β-2 microglobulin (B2M) level predicts mortality in chronic kidney disease. Glycation of B2M is cytotoxic and may contribute to the risk of mortality in diabetic patients. Our objective was to evaluate the relationship between B2M and mortality in diabetic patients.MethodsIn this prospective study, 896 participants of the Third National Health and Nutrition Examination Survey with diabetes were included in the analysis. Serum B2M level was used in multivariate Cox regression analysis to predict all-cause and diabetes-related mortality.ResultsDuring a median follow-up of 11.8 years (range 0.1–18.2 years) and 9220.5 person/years, 541 (42.4%) and 207 (16.8%) participants died from all causes and diabetes-related causes respectively. One natural-log unit of B2M was significantly associated with all-cause (hazard ratio (HR)=6.53, 95% CI 2.07–20.6) and diabetes mortality (HR=7.35, 95% CI 1.01–53.38) after multivariable adjustment. Similar results were obtained when B2M was analyzed as tertiles or in the threshold model (T1+T2 vs T3). Examination of regression splines suggests a linear increase in hazard for mortality with increasing B2M levels.ConclusionsSerum B2M level is a novel predictor of all-cause and diabetes-related mortality in people with diabetes regardless of renal function.

Serial volumetric assessment of the natural history and growth pattern of incidentally discovered meningiomas

2009 ◽  
Vol 110 (4) ◽  
pp. 675-684 ◽  
Author(s):  
Tetsuo Hashiba ◽  
Naoya Hashimoto ◽  
Shuichi Izumoto ◽  
Tsuyoshi Suzuki ◽  
Naoki Kagawa ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Natural History ◽  
Tumor Growth ◽  
Exponential Growth ◽  
Growth Pattern ◽  
Linear Growth ◽  
Growth Patterns ◽  
Surgical Removal ◽  
Volumetric Assessment

Object Due to advances in neuroimaging and the increasing use of imaging to screen for brain disease (“brain checkups”), meningiomas are now often detected as an incidental finding. The natural history of these asymptomatic meningiomas remains unclear, however. In this study, the authors investigated the natural history and growth pattern of incidentally detected meningiomas using serial volumetric assessment and regression analysis. Methods In 70 patients with incidentally discovered meningiomas who underwent follow-up for longer than 1 year, tumor volumes were calculated volumetrically at each follow-up visit, and tumor growth was determined. In patients with tumor growth, regression analysis was performed to determine the pattern of growth. Results Forty-four tumors exhibited growth and 26 did not. In a regression analysis, 16 of the tumors that grew followed an exponential growth pattern and 15 exhibited linear growth patterns. The presence of calcification was the only imaging characteristic that significantly distinguished the group with tumor growth from that without, although no radiological characteristics significantly distinguished the exponential growth group from the linear growth group. Two patients with obvious tumor growth underwent surgical removal and the pathological specimens extracted showed a high proliferative potential. Conclusions The authors found that incidentally discovered meningiomas did not always follow an exponential growth pattern but often exhibited more complex patterns of growth. Serial monitoring of tumor volumes and regression analysis may reveal the growth pattern of incidental meningiomas and provide information useful for determining treatment strategy.

scholarly journals Alcohol-related mortality following the loss of a child: a register-based follow-up study from Norway

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e038826
Author(s):  
Solveig Glestad Christiansen ◽  
Anne Reneflot ◽  
Kim Stene-Larsen ◽  
Lars Johan Hauge
Keyword(s):  
Fixed Effects ◽  
Cox Regression ◽  
Adult Population ◽  
Alcohol Problems ◽  
Fixed Effect ◽  
Stressful Events ◽  
Follow Up Study ◽  
Bereaved Parents ◽  
Related Mortality

ObjectivesThe death of one’s child is one of the most stressful events a person can experience. Research has shown that bereaved parents have a higher mortality than non-bereaved parents. This increased mortality might partly be caused directly by long-term stress. However, changes in health behaviour such as an increase in alcohol consumption might also play a role. This study examines the association between losing a child and alcohol-related mortality. In addition to Cox regression models using data covering the entire Norwegian adult population, we employ sibling fixed-effect models in order to partly control for genes and childhood experiences that might be associated with both losing a child and alcohol-related mortality.DesignA follow-up study between 1986 and 2014 based on Norwegian register data.SettingNorway.ParticipantsThe entire Norwegian adult population.Primary outcome measureAlcohol-related mortality.ResultsAn increased alcohol-related mortality was found among parents who had experienced the death of a child. The HR of alcohol-related mortality among those bereaved of a child was 1.59 (95% CI 1.48 to 1.71) compared with non-bereaved parents, for women 2.03 (95% CI 1.78 to 2.32) and for men 1.46 (95% CI 1.34 to 1.59). After including sibling fixed effects, the HR of alcohol-related mortality among parents who had lost a child was 1.30 (95% CI 1.03 to 1.64).ConclusionsThis study provides evidence of an elevated alcohol-related mortality among parents who have lost a child compared with non-bereaved parents. Although strongly attenuated, there is still an association when adjusting for genetic predisposition for alcohol problems as well as childhood environment using sibling fixed-effect models.

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

2015 ◽  
Vol 24 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Petra A. Golovics ◽  
Laszlo Lakatos ◽  
Michael D. Mandel ◽  
Barbara D. Lovasz ◽  
Zsuzsanna Vegh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cox Regression ◽  
Diagnostic Procedures ◽  
Population Based ◽  
Disease Course ◽  
Inception Cohort ◽  
Disease Extent ◽  
Cox Regression Analysis ◽  
Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

The impact of statin therapy after surgical or endovascular treatment of cerebral aneurysms

2020 ◽  
Vol 133 (1) ◽  
pp. 182-189
Author(s):  
Tae-Jin Song ◽  
Seung-Hun Oh ◽  
Jinkwon Kim
Keyword(s):  
Statin Therapy ◽  
Coil Embolization ◽  
Primary Outcome ◽  
Cox Regression ◽  
Cerebral Aneurysms ◽  
Time Dependent ◽  
Lipid Lowering ◽  
Surgical Clipping ◽  
The Impact

OBJECTIVECerebral aneurysms represent the most common cause of spontaneous subarachnoid hemorrhage. Statins are lipid-lowering agents that may expert multiple pleiotropic vascular protective effects. The authors hypothesized that statin therapy after coil embolization or surgical clipping of cerebral aneurysms might improve clinical outcomes.METHODSThis was a retrospective cohort study using the National Health Insurance Service–National Sample Cohort Database in Korea. Patients who underwent coil embolization or surgical clipping for cerebral aneurysm between 2002 and 2013 were included. Based on prescription claims, the authors calculated the proportion of days covered (PDC) by statins during follow-up as a marker of statin therapy. The primary outcome was a composite of the development of stroke, myocardial infarction, and all-cause death. Multivariate time-dependent Cox regression analyses were performed.RESULTSA total of 1381 patients who underwent coil embolization (n = 542) or surgical clipping (n = 839) of cerebral aneurysms were included in this study. During the mean (± SD) follow-up period of 3.83 ± 3.35 years, 335 (24.3%) patients experienced the primary outcome. Adjustments were performed for sex, age (as a continuous variable), treatment modality, aneurysm rupture status (ruptured or unruptured aneurysm), hypertension, diabetes mellitus, household income level, and prior history of ischemic stroke or intracerebral hemorrhage as time-independent variables and statin therapy during follow-up as a time-dependent variable. Consistent statin therapy (PDC > 80%) was significantly associated with a lower risk of the primary outcome (adjusted hazard ratio 0.34, 95% CI 0.14–0.85).CONCLUSIONSConsistent statin therapy was significantly associated with better prognosis after coil embolization or surgical clipping of cerebral aneurysms.

Red Blood Cell Indices in Relation to Post-stroke Psychiatric Disorders: A Longitudinal Study in a Follow-up Stroke Clinic

2020 ◽  
Vol 17 (3) ◽  
pp. 218-223
Author(s):  
Haichao Wang ◽  
Li Gong ◽  
Xiaomei Xia ◽  
Qiong Dong ◽  
Aiping Jin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Cox Regression ◽  
Depression And Anxiety ◽  
Cox Regression Analysis ◽  
Post Stroke ◽  
Rbc Indices ◽  
Post Stroke Depression

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.

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