scholarly journals Determinants of Mortality among HIV Positives after Initiating Antiretroviral Therapy in Western Ethiopia: A Hospital-Based Retrospective Cohort Study

ISRN AIDS ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Mitiku Teshome Hambisa ◽  
Ahmed Ali ◽  
Yadeta Dessie
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Incidence Density ◽  
Rank Test ◽  
Time To Death ◽  
Art Initiation ◽  
Mortality Incidence ◽  
Cox Proportional Hazard Regression ◽  
Western Ethiopia

Studies revealed that there are various determinants of mortality among HIV positives after ART initiation. These determinants are so variable with context and dynamic across time with the advancement of cares and treatments. In this study we tried to identify determinants of mortality among HIV positives after initiating ART. A retrospective cohort study was conducted among 416 ART attendees enrolled between July 2005 to January 2012 in Nekemte Referral Hospital, Western Ethiopia. Actuarial table was used to estimate survival of patients after ART initiation and log rank test was used to compare the survival curves. Cox proportional-hazard regression was applied to determine the independent determinants of time to death. The estimated mortality was 4%, 5%, 6%, 7%, and 7% at 6, 12, 24, 36 and 48 months respectively with mortality incidence density of 1.89 deaths per 100 person years (95% CI 1.74, 3.62). Forty years and above AHR = 3.055 (95% CI 1.292, 7.223), low baseline hemoglobin level (AHR = 0.523 (95% CI .335, 0.816)), and poor ART adherence (AHR 27.848 (95% CI 8.928, 86.8)) were found to be an independent determinants of mortality. These determinants of mortality have to be taken into account to enhance better clinical outcomes of ART attendees.

scholarly journals Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bora Nam ◽  
Bon San Koo ◽  
Tae-Han Lee ◽  
Ji-Hui Shin ◽  
Jin-Ju Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Tumor Necrosis Factor ◽  
Disease Activity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tumor Necrosis ◽  
Activity Index ◽  
Rank Test ◽  
Necrosis Factor

Abstract Background The purpose of this study was to determine the prevalence of high disease activity as measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS) in ankylosing spondylitis (AS) patients who nonetheless have low Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores after anti-tumor necrosis factor (TNF) treatment. Its clinical impact on anti-TNF survival was also investigated. Methods We conducted a single-centre retrospective cohort study of AS patients having low BASDAI scores (< 4) and available ASDAS-C-reactive protein (CRP) data after 3 months of first-line anti-TNF treatment. Patients were grouped into high-ASDAS (≥ 2.1) and low-ASDAS (< 2.1) groups according to the ASDAS-CRP after 3 months of anti-TNF treatment. Their characteristics were compared. And survival analyses were carried out using Kaplan–Meier curves and log-rank test with the event being discontinuation of anti-TNF treatment due to lack/loss of efficacy. Results Among 116 AS patients with low BASDAI scores after 3 months of anti-TNF treatment, 38.8% were grouped into the high-ASDAS group. The high-ASDAS group tended to have greater disease activity after 9 months of treatment (BASDAI 2.9 ± 1.1 vs. 2.3 ± 1.4, p=0.007; ASDAS-CRP 1.8 ± 0.6 vs. 1.5 ± 0.7, p=0.079; proportion of high ASDAS-CRP 27.8% vs. 13.8%, p=0.094) and greater risk of discontinuing anti-TNF treatment due to lack/loss of efficacy than the low-ASDAS group (p=0.011). Conclusions A relatively high proportion of AS patients with low BASDAI scores had high ASDAS-CRP. These low-BASDAI/high-ASDAS-CRP patients also had a greater risk for discontinuation of anti-TNF treatment due to low/lack of efficacy than the low-ASDAS group. The use of the ASDAS-CRP alone or in addition to the BASDAI may improve the assessment of AS patients treated with anti-TNF agents.

Effectiveness of the Bactiseal Universal Shunt for reducing shunt infection in a sub-Saharan African context: a retrospective cohort study in 160 Ugandan children

2014 ◽  
Vol 13 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Jordan D. Lane ◽  
John Mugamba ◽  
Peter Ssenyonga ◽  
Benjamin C. Warf
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Shunt Infection ◽  
Low Income Countries ◽  
Rank Test ◽  
Log Rank Test ◽  
Significant Difference ◽  
Chi Square Analysis

Object Antibiotic-impregnated shunts have yet to find widespread use in the developing world, largely due to cost. Given potential differences in the microbial spectrum, their effectiveness in preventing shunt infection for populations in low-income countries may differ and has not been demonstrated. This study is the first to compare the efficacy of a Bactiseal shunt system with a non–antibiotic-impregnated system in a developing country. Methods The Bactiseal Universal Shunt (BUS) was placed in 80 consecutive Ugandan children who required a shunt. In this retrospective cohort study, the outcome for that group was compared with the outcome for the immediately preceding 80 consecutive children in whom a Chhabra shunt had been placed. The primary end points were shunt failure, shunt infection, and death. Shunt survival was analyzed using the Kaplan-Meier method. Significance of differences between groups was tested using the log-rank test, chi-square analysis, Fisher's exact test, and t-test. Results There was no difference between groups in regard to age, sex, or etiology of hydrocephalus. Mean follow-up for cases of nonfailure was 7.6 months (median 7.8 months, interquartile range 6.5–9.5 months). There was no significant difference between groups for any end point. The BUS group had fewer infections (4 vs 11), but the difference was not significant (p = 0.086, log-rank test). Gram-positive cocci were the most common culturable pathogens in the Chhabra group, while the only positive culture in the BUS group was a gram-negative rod. Conclusions These results provide equipoise for a randomized controlled trial in the same population and this has been initiated. It is possible that the observed trends may become significant in a larger study. The more complex task will involve determining not only the efficacy, but also the cost-effectiveness of using antibiotic-impregnated shunt components in limited-resource settings.

scholarly journals FOLLOW-UP OF PATIENTS AND PROGNOSTIC IMPACT OF TUMOUR MARKER CA 15-3 ON PATIENTS OF BREAST CANCER: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 8 (11) ◽  
pp. 656-660
Author(s):  
Anjali Vinocha ◽  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Cancer Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Relative Survival ◽  
Rank Test ◽  
Prognostic Impact ◽  
Breast Cancer Patients

Introduction:Breast cancer is the most common cancer in women, with 5- and 10-year relative survival rates are 91% and 84%, respectively for women with invasive breast cancer. This study aimed to detect the role of serum breast cancer marker CA 15-3 for early detection of metastasis, relapse or recurrence for management of breast cancer patients. Methods: It was a retrospective cohort study with a total of 132 breast cancer patients from the year 2010 to march 2020 were taken and followed up. For these patients demographic, biochemical parameters, radiological and clico-pathological data were collected and analysed. Result: The mean age at the time of presentation and mean duration of follow-up was 47 years and 31 months respectively. There was elevation in the serum level of CA 15-3 at the time of diagnosis of metastasis, recurrence or residual disease in 41 patients. This shows that sensitivity of elevated CA 15-3 (> 30 IU/ml) level in Ca Breast patients was 84%, 75 % and 75 % with respect to metastasis, recurrence and relapse. Log Rank test Chi- square value was 7.39 which was statistically significant (p=0.007). Cox proportional hazard model was created for effect of age at presentation, CA 15-3 at the time of diagnosis and MRM on distant metastasis and was statistically significant (p=0.037). Conclusion: We recommend that for the management of breast cancer patients, Cancer antigen (CA 15-3) levels can be used as prognostic marker for early diagnosis of metastasis, recurrence or relapse.

scholarly journals Associated Factories and Time to Occurrence of Tuberculosis Among Children on HIV/AIDS Care in Assosa and Pawe General Hospitals North West Ethiopia: A Retrospective Cohort Study 2020

2020 ◽  
Author(s):  
Fassikaw kebede Bizuneh ◽  
Tadese Tollosa Daba ◽  
Belayneh Mengist Mitike ◽  
Tamrat sheawno Fikretsion ◽  
Belete Negese Negese
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Cox Model ◽  
Incidence Density ◽  
Human Immune Deficiency Virus ◽  
Cox Regression Analysis ◽  
Hiv Aids

Abstract Background: Tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied in Ethiopia, but among children on HIV/AIDS care is overlooked. Knowledge of the time when TB develops during successive follow up could be helpful for time relevant intervention strategies.Methods: health institution based retrospective cohort study conducted among 421 children on HIV/AIDS from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05.Result: Totally 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 8 years (IQR=2-15). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1).Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children.

scholarly journals A Nomogram Prediction of Length of Hospital Stay in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kang Li ◽  
Chi Zhang ◽  
Ling Qin ◽  
Chaoran Zang ◽  
Ang Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Characteristic Curve ◽  
Length Of Hospital Stay ◽  
Cox Proportional Hazards ◽  
Brier Score ◽  
Rank Test

Assessing the length of hospital stay (LOS) in patients with coronavirus disease 2019 (COVID-19) pneumonia is helpful in optimizing the use efficiency of hospital beds and medical resources and relieving medical resource shortages. This retrospective cohort study of 97 patients was conducted at Beijing You’An Hospital between January 21, 2020, and March 21, 2020. A multivariate Cox proportional hazards regression based on the smallest Akaike information criterion value was used to select demographic and clinical variables to construct a nomogram. Discrimination, area under the receiver operating characteristic curve (AUC), calibration, and Kaplan–Meier curves with the log-rank test were used to assess the nomogram model. The median LOS was 13 days (interquartile range [IQR]: 10–18). Age, alanine aminotransferase, pneumonia, platelet count, and PF ratio (PaO2/FiO2) were included in the final model. The C-index of the nomogram was 0.76 ( 95 % confidence   interval   CI = 0.69 – 0.83 ), and the AUC was 0.88 ( 95 % CI = 0.82 – 0.95 ). The adjusted C-index was 0.75 ( 95 % CI = 0.67 – 0.82 ) and adjusted AUC 0.86 ( 95 % CI = 0.73 – 0.95 ), both after 1000 bootstrap cross internal validations. A Brier score of 0.11 ( 95 % CI = 0.07 – 0.15 ) and adjusted Brier score of 0.130 ( 95 % CI = 0.07 – 0.20 ) for the calibration curve showed good agreement. The AUC values for the nomogram at LOS of 10, 20, and 30 days were 0.79 ( 95 % CI = 0.69 – 0.89 ), 0.89 ( 95 % CI = 0.83 – 0.96 ), and 0.96 ( 95 % CI = 0.92 – 1.00 ), respectively, and the high fit score of the nomogram model indicated a high probability of hospital stay. These results confirmed that the nomogram model accurately predicted the LOS of patients with COVID-19. We developed and validated a nomogram that incorporated five independent predictors of LOS. If validated in a future large cohort study, the model may help to optimize discharge strategies and, thus, shorten LOS in patients with COVID-19.

scholarly journals Survival Analysis on Time-To-Recovery of Diabetic Patients at Minlik Referral Hospital, Ethiopia: Retrospective Cohort Study

2021 ◽  
Author(s):  
Assaye Belay ◽  
Bizuwork Derebew ◽  
Solomon Abebaw
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Intensive Therapy ◽  
Rank Test ◽  
Diabetic Patients ◽  
Fast Blood Glucose Level ◽  
Global Test ◽  
Oral Agents

Abstract AimThe study aimed to determine the time to recovery of diabetic patients who have been treated in the hospital under follow-up. Subject and MethodsA retrospective cohort study design was carried out. The fast blood glucose level of diabetic patients who are under follow-up in the hospital was measured from 2016 to 2020. One thousand seven hundred diabetic patients were included in the study. Kaplan-Meier, Log-rank test, global test, Schoenfeld residuals, and Cox-PH model were used for statistical analysis.ResultsOut of the total of 1278 patients, 27.4% were censored (withdrawal from follow-up) and 72.6% recovered from the diabetic disease. For sex, the expected hazard is 1.322 times higher in males than female diabetic patients or there is a 32.2% increase in the expected hazard in males relative to female diabetic patients. For Spdrt, The expected hazard is 1.164 times higher in the patients who had taken leute than diabetic patients who took doanied. For regimen, the expected hazard is 1.495 times higher in the patients who had been treated by insulin agent only than diabetic patients who were treated by oral agents only ConclusionThe intensive-therapy regimen, Spdrt, and gender differences were statistically significant and critically contribute to the survival time to recovery of diabetic patients.

scholarly journals Effect of Earlier Door-to-CT and Door-to-Bleeding Control in Severe Blunt Trauma: A Retrospective Cohort Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1522
Author(s):  
Shuhei Murao ◽  
Kazuma Yamakawa ◽  
Daijiro Kabata ◽  
Takahiro Kinoshita ◽  
Yutaka Umemura ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Blunt Trauma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Ct Scanning ◽  
Control Procedure ◽  
Bleeding Control ◽  
Cox Proportional Hazard Regression

Blunt trauma is a potentially life-threatening injury that requires prompt diagnostic examination and therapeutic intervention. Nevertheless, how impactful a rapid response time is on mortality or functional outcomes has not been well-investigated. This study aimed to evaluate effects of earlier door-to-computed tomography time (D2CT) and door-to-bleeding control time (D2BC) on clinical outcomes in severe blunt trauma. This was a single-center, retrospective cohort study of patients with severe blunt trauma (Injury Severity Score > 16). To assess the effect of earlier D2CT and D2BC on clinical outcomes, we conducted multivariable regression analyses with a consideration for nonlinear associations. Among 671 patients with severe blunt trauma who underwent CT scanning, 163 patients received an emergency bleeding control procedure. The median D2CT and D2BC were 19 min and 57 min, respectively. In a Cox proportional hazard regression model, earlier D2CT was not associated with improved 28-day mortality (p = 0.30), but it was significantly associated with decreased mortality from exsanguination (p = 0.003). Earlier D2BC was significantly associated with improved 28-day mortality (p = 0.026). In conclusion, earlier time to a hemostatic procedure was independently associated with decreased mortality. Meanwhile, time benefits of earlier CT examination were not observed for overall survival but were observed for decreased mortality from exsanguination.

scholarly journals Association between Cervical Spondylosis and Migraine: A Nationwide Retrospective Cohort Study

2018 ◽  
Author(s):  
Wang-Sheng Lin ◽  
Tung-Fu Huang ◽  
Tien-Yow Chuang ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cervical Spondylosis ◽  
Population Based ◽  
Hazard Ratio ◽  
Cox Proportional Hazard ◽  
Longitudinal Association ◽  
Cox Proportional Hazard Regression

Background: Few studies have investigated the longitudinal association between cervical spondylosis (CS) and migraine by using a nationwide population-based database. Methods: We conducted a retrospective cohort study from 2000 to 2011 identifying 27,930 cases of cervical spondylosis and 111,720 control subjects (those without cervical spondylosis) from a single database. The subjects were frequency-matched on the basis of sex, age, and diagnosis date. The non- cervical spondylosis cohort was four times the size of the cervical spondylosis cohort. To quantify the effects of cervical spondylosis on the risk of migraine, univariate and multivariate Cox proportional hazard regression analyses were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: After a 10-year follow-up controlling for potential confounding factors, overall migraine incidence was higher in the cervical spondylosis cohort than in the non- cervical spondylosis cohort (5.16 and 2.09 per 1,000 people per year, respectively; crude hazard ratio = 2.48, 95% confidence interval = 2.28&ndash;2.69) with an adjusted hazard ratio of 2.03 (95% confidence interval = 1.86&ndash;2.22) after accounting for sex, age, comorbidities, and medication. Individuals with myelopathy in the cervical spondylosis cohort had a 2.19 times (95% confidence interval = 1.80&ndash;2.66) higher incidence of migraine compared than did those in the non- cervical spondylosis cohort. Conclusion: Individuals with cervical spondylosis exhibited a higher risk of migraine than those without cervical spondylosis. The migraine incidence rate was even higher among individuals with cervical spondylotic myelopathy.

Sign in / Sign up

Export Citation Format

Share Document