scholarly journals Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Michael J. Baine ◽  
Chi Lin
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Pancreatic Adenocarcinoma ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Medical Center ◽  
Cox Proportional Hazards Model ◽  
Seer Database ◽  
Nebraska Medical ◽  
Seer Data

Objectives. We examined the role of radiation therapy (RT) in pancreatic adenocarcinoma (PA) treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC) as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS) were age, gender, race, stage, year of diagnosis, and treatment with surgery, chemotherapy (CT), or RT. Time to death was plotted by Kaplan-Meier method. A Cox proportional hazards model was used to evaluate prognostic factors for OS. Results. The median OS was 7.3 and 5 months for patients from UNMC and the SEER database, respectively. A Cox model of patients from UNMC showed that RT was associated with improved OS (HR 0.77, P=0.018) after adjusting for factors including age, race, gender, stage, year of diagnosis, having surgery, or having CT. Cox analysis of patients from the SEER showed similar results (HR 0.65, P<0.0001). Conclusions. RT confers an independent survival advantage in patients being treated for PA which is apparent both at UNMC and through SEER data.

Factors Predicting Survival for Cancer of the Ethmoid Sinus

2002 ◽  
Vol 16 (5) ◽  
pp. 281-286 ◽  
Author(s):  
Neil Bhattacharyya
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Survival Data ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Ethmoid Sinus ◽  
Cox Proportional Hazards Model ◽  
T Stage ◽  
Hazards Model

Objective The aim of this study was to determine survival and prognostic factors for ethmoid sinus cancer. Methods From the Surveillance, Epidemiology, and End Results database for the time period 1988–1998, all cases of ethmoid sinus malignancy were extracted. Demographic, staging, treatment, and survival data were computed. Survival analysis was conducted with the Kaplan-Meier method. Clinical factors influencing survival were determined with the Cox proportional hazards model. Results After excluding patients with metastatic disease on presentation (8.9%) and patients with missing data for T stage, a total of 180 cases were identified. Average age was 60.2 years. Squamous cell carcinoma was the most common tumor (27.8%), followed by adenocarcinoma (12.8%). Overall mean survival was 57 months (median, 38 months) with a 5-year survival of 40.3%. The percentage of patients presenting with T4 lesions was 45.6%, which had a notably lower mean survival of 38 months (median, 18 months). Only 2.3% of patients had positive nodal disease. Increasing age, T stage, and absence of radiation therapy predicted poorer survival in the multivariate model. Adenocarcinoma, adenoid cystic carcinoma, esthesioneuroblastoma, and melanoma showed more favorable survival than other tumor types. Conclusions T stage and tumor histology are the most important prognostic factors in ethmoid sinus carcinoma. Survival for T4 lesions is markedly worse than survival for T1-T3 lesions. Radiation therapy offers a survival benefit in ethmoid sinus malignancy.

Prognostic factors for survival after embolization of hepatic metastases in uveal melanoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8562-8562 ◽  
Author(s):  
A. Yamamoto ◽  
I. Chervoneva ◽  
K. Sullivan ◽  
D. Eschelman ◽  
C. Gonsalves ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Uveal Melanoma ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Hepatic Metastases ◽  
Cox Proportional Hazards Model ◽  
Gelatin Sponge ◽  
Rank Test ◽  
First Choice ◽  
Melanoma Patients

8562 Background: Liver is the most common site of metastasis (>80%) in patients with uveal melanoma. Embolization of the hepatic artery has been used to control hepatic metastases. Methods: Uveal melanoma patients with hepatic metastases embolized with iodized poppy seed oil and gelatin sponge, and either BCNU (chemoembolization, CE) or GM-CSF (immunoembolization, IE) during periods when each of these drugs was the agent of first choice, were evaluated. Prognostic factors that predict OS and progression free survival (PFS) in the liver (PFS-L) and in the extra-hepatic systemic organs (PFS-S) were analyzed univariately using the log-rank test and multivariately using Cox proportional hazards model. The following parameters were evaluated: age, gender, pre-existing extrahepatic metastases (EHM), LDH, AST, ALP, and treatment modality (CE or IE). Results: A total of 53 uveal melanoma patients with < 50% liver involvement with melanoma were analyzed. In comparison to the 19 patients (14 males/5 females) who underwent CE, the 34 patients who underwent IE (12 males/22 females) have significantly better OS (14.1 vs. 9.7 months, p=0.012) and PFS-S (10.2 vs. 4.8 months, P=0.013) in univariate analyses. Female patients outlived male patients (14.2 vs. 9.7 months, p=0.005). In Cox model, the shorter OS was associated with male gender (hazard ratio (HR)=2.1; 95% CI, 1.1–4.0; p=0.020), and marginally related to EHM (HR=1.8; 95% CI, 1.0–3.4; p=0.052). Independent predictors of shorter PFS-S included older age (HR=1.04 per year; 95% CI: 1.01–1.06; p=0.007), EHM (HR=2.1; 95% CI, 1.1–3.8; p=0.017), and CE (HR=2.1; 95% CI, 1.2–3.8; p=0.012). The gender-by-treatment interaction was also considered in all Cox models, but it was not significant. None of the covariates was a predictor of PFS-L in univariate or multivariate analyses. Conclusions: IE and female gender were found to be positive prognostic factors for survival after embolization of hepatic metastases. No significant financial relationships to disclose.

Does radiation therapy increase late cardiac death in patients with esophageal cancer?

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 90-90
Author(s):  
Chi Lin ◽  
Kyle A. Denniston
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Cardiac Death ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Multivariate Logistic Regression Model

90 Background: The objective of this study was to evaluate the effect of radiation therapy (RT) on late cardiac death in patients with esophageal cancer. Methods: A total of 35,618 patients diagnosed with esophageal squamous cell carcinoma (SCC) or adenocarcinoma (ADE) between 1973 and 2008 were identified from the SEER database. After excluding records with missing data, 24983 patients remained. Patients who survived ≥ 5 years (2075) were identified for this analysis. Examined risk factors for cardiac death include age (≤55/56-65/66-75/>75), gender, race (white/non-white), stage (local/regional/distant), histology (SCC/ADE), esophageal subsite (<18cm/18-24cm/25-32cm/33-40cm), diagnosis year (1973-1983/1984-1993/1994-2003), and treatment with surgery or RT. Time to cardiac death was evaluated using the Kaplan-Meier method. A multivariate logistic regression model with backward elimination and the Cox Proportional Hazards model were used to evaluate risk factors for cardiac death. Results: Patients who received RT tended to be younger, white, diagnosed more recently, have more advanced disease, SCC histology and not undergo surgery. RT group had a higher risk of cardiac death than no-RT group (Log-Rank p < 0.0001). Median time to cardiac death in RT group was 251 months (95% CI 223-367) and was not reached in no-RT group. The probability of cardiac death increased with age and decreased with diagnosis year. This trend was more pronounced in RT group. Multivariate analysis found RT to be associated with higher probability of cardiac death (OR 1.45, 95% CI 1.10-1.93), after adjusting for age and diagnosis year. Gender, race, histology, stage, esophageal subsite and surgery status were not associated with cardiac death. After adjusting for age, Cox model showed that patients who received RT were more likely to die of cardiac causes than those who did not receive RT (HR 1.91, 95% CI 1.47-2.47). Diagnosis year was not a risk factor in the Cox model. Conclusions: Patients with esophageal cancer who received RT and survived ≥ 5 years had a higher risk of cardiac death than those who did not receive RT. Further study of cardiac outcome in long term survivors of esophageal cancer treated with RT, and accounting for comorbidity, is warranted.

scholarly journals Differences between primary peritoneal serous carcinoma and advanced serous ovarian carcinoma: a study based on the SEER database

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiaoduo Li ◽  
Qiao Yang ◽  
Mingjing Chen ◽  
Changqing Yang ◽  
Jianfen Gu ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Prognostic Factors ◽  
Ovarian Carcinoma ◽  
Clinical Features ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Serous Carcinoma ◽  
Rank Test ◽  
Seer Database ◽  
Serous Ovarian Carcinoma

Abstract Objective This study aimed to compare clinical features and overall survival (OS) between patients with primary peritoneal serous carcinoma (PPSC) and those with advanced serous ovarian carcinoma (ASOC) and to identify prognostic factors. Methods Patients diagnosed with PPSC and ASOC from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled. Pearson’s chi-square test was used to compare clinical features. The primary endpoint was OS. The Kaplan–Meier method and log–rank test were used to perform the survival analysis. Propensity score matching was also conducted. Univariate, multivariate and subgroup analyses were performed using the Cox proportional hazards model. Results A total of 708 PPSC patients and 7610 ASOC patients were enrolled. The clinical features of PPSC patients were noticeably different from those of ASOC patients. The survival analysis showed that PPSC patients had poorer outcomes than ASOC patients. Even after the clinical features were balanced, PPSC patients still had poorer survival. Univariate and multivariate analyses indicated that older age, higher tumor grade and advanced American Joint Committee on Cancer stage were adverse prognostic factors in both groups, while surgery and chemotherapy were protective factors. A subgroup analysis demonstrated that most factors favored ASOC patients. The total distant metastasis rates of PPSC and ASOC were similar. Liver or lung metastasis was common, but bone and brain metastases were rare. A higher proportion of liver metastasis was observed in the ASOC group. Conclusion The clinical features and survival outcomes between PPSC patients and ASOC patients are clearly different, and PPSC is more aggressive than ASOC.

scholarly journals A novel prognostic model for angioimmunoblastic T-cell lymphoma: A retrospective study of 55 cases

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110132
Author(s):  
Jie Sun ◽  
Sha He ◽  
Hong Cen ◽  
Da Zhou ◽  
Zhe Li ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
T Cell ◽  
Prognostic Model ◽  
Proportional Hazards Model ◽  
Cell Lymphoma ◽  
Initial Diagnosis ◽  
Cox Proportional Hazards Model ◽  
T Cell Lymphoma ◽  
Chinese Patients ◽  
Angioimmunoblastic T Cell Lymphoma

Objective To explore prognostic factors and develop an accurate prognostic prediction model for angioimmunoblastic T-cell lymphoma (AITL). Methods Clinical data from Chinese patients with newly diagnosed AITL were retrospectively analysed. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier method survival curves; prognostic factors were determined using a Cox proportional hazards model. The sensitivity and specificity of the predicted survival rates were compared using area under the curve (AUC) of receiver operating characteristic (ROC) curves. Results The estimated 5-year OS and PFS of 55 eligible patients with AITL were 22% and 3%, respectively. Multivariate analysis showed that the presence of pneumonia, and serous cavity effusions at initial diagnosis were significant prognostic factors for OS. Based on AUC ROC values, our novel prognostic model was superior to IPI and PIT based models and suggested better diagnostic accuracy. Conclusions Our prognostic model based on pneumonia, and serous cavity effusions at initial diagnosis enabled a balanced classification of AITL patients into different risk groups.

scholarly journals Ureteral Involvement and Diabetes Increase the Risk of Subsequent Bladder Recurrence after Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Che-Yuan Hu ◽  
Yu-Chieh Tsai ◽  
Shuo-Meng Wang ◽  
Chao-Yuan Huang ◽  
Huai-Ching Tai ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cox Model ◽  
Medical Center ◽  
Upper Urinary Tract ◽  
Increased Risk ◽  
The Impact ◽  
Bladder Recurrence ◽  
Urinary Tract Urothelial Carcinoma

Objectives.To investigate the prognostic factors for bladder recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UUT-UC).Methods.From 1994 to 2012, 695 patients with UUT-UC treated with RNU were enrolled in National Taiwan University Medical Center. Among them, 532 patients with no prior bladder UC history were recruited for analysis. We assessed the impact of potentially prognostic factors on bladder recurrence after RNU.Results.The median follow-up period was 47.8 months. In the Cox model, ureteral involvement and diabetes mellitus (DM) were significantly associated with a higher bladder recurrence rate in the multivariate analysis (hazard ratio [HR]: 1.838;P=0.003and HR: 1.821;P=0.010, resp.). In the Kaplan-Meier analysis, DM patients with concomitant ureteral UC experienced about a threefold increased risk of bladder recurrence as compared to those without both factors (HR: 3.222;P<0.001). Patients with either of the two risk factors experienced about a twofold increased risk as compared to those without both factors (with DM, HR: 2.184,P=0.024; with ureteral involvement, HR: 2.006,P=0.003).Conclusions.Ureteral involvement and DM are significantly related to bladder recurrence after RNU in patients with UUT-UC.

scholarly journals 1388. Dose Discrimination for ASN100: Bridging from Rabbit Survival Data to Predicted Activity in Humans Using a Minimal Physiologically Based Pharmacokinetic (mPBPK) Model

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S426-S426
Author(s):  
Christopher M Rubino ◽  
Lukas Stulik ◽  
Harald Rouha ◽  
Zehra Visram ◽  
Adriana Badarau ◽  
...  
Keyword(s):  
Survival Data ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Virulent Strain ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Simulated Patients ◽  
Research Support ◽  
Mpbpk Model

Abstract Background ASN100 is a combination of two co-administered fully human monoclonal antibodies (mAbs), ASN-1 and ASN-2, that together neutralize the six cytotoxins critical to S. aureus pneumonia pathogenesis. ASN100 is in development for prevention of S. aureus pneumonia in mechanically ventilated patients. A pharmacometric approach to dose discrimination in humans was taken in order to bridge from dose-ranging, survival studies in rabbits to anticipated human exposures using a mPBPK model derived from data from rabbits (infected and noninfected) and noninfected humans [IDWeek 2017, Poster 1849]. Survival in rabbits was assumed to be indicative of a protective effect through ASN100 neutralization of S. aureus toxins. Methods Data from studies in rabbits (placebo through 20 mg/kg single doses of ASN100, four strains representing MRSA and MSSA isolates with different toxin profiles) were pooled with data from a PK and efficacy study in infected rabbits (placebo and 40 mg/kg ASN100) [IDWeek 2017, Poster 1844]. A Cox proportional hazards model was used to relate survival to both strain and mAb exposure. Monte Carlo simulation was then applied to generate ASN100 exposures for simulated patients given a range of ASN100 doses and infection with each strain (n = 500 per scenario) using a mPBPK model. Using the Cox model, the probability of full protection from toxins (i.e., predicted survival) was estimated for each simulated patient. Results Cox models showed that survival in rabbits is dependent on both strain and ASN100 exposure in lung epithelial lining fluid (ELF). At human doses simulated (360–10,000 mg of ASN100), full or substantial protection is expected for all four strains tested. For the most virulent strain tested in the rabbit pneumonia study (a PVL-negative MSSA, Figure 1), the clinical dose of 3,600 mg of ASN100 provides substantially higher predicted effect relative to lower doses, while doses above 3,600 mg are not predicted to provide significant additional protection. Conclusion A pharmacometric approach allowed for the translation of rabbit survival data to infected patients as well as discrimination of potential clinical doses. These results support the ASN100 dose of 3,600 mg currently being evaluated in a Phase 2 S. aureus pneumonia prevention trial. Disclosures C. M. Rubino, Arsanis, Inc.: Research Contractor, Research support. L. Stulik, Arsanis Biosciences GmbH: Employee, Salary. H. Rouha, 3Arsanis Biosciences GmbH: Employee, Salary. Z. Visram, Arsanis Biosciences GmbH: Employee, Salary. A. Badarau, Arsanis Biosciences GmbH: Employee, Salary. S. A. Van Wart, Arsanis, Inc.: Research Contractor, Research support. P. G. Ambrose, Arsanis, Inc.: Research Contractor, Research support. M. M. Goodwin, Arsanis, Inc.: Employee, Salary. E. Nagy, Arsanis Biosciences GmbH: Employee, Salary.

scholarly journals Disparities in Stage at Diagnosis, Treatment, and Survival in Nonelderly Adult Patients With Cancer According to Insurance Status

2014 ◽  
Vol 32 (28) ◽  
pp. 3118-3125 ◽  
Author(s):  
Gary V. Walker ◽  
Stephen R. Grant ◽  
B. Ashleigh Guadagnolo ◽  
Karen E. Hoffman ◽  
Benjamin D. Smith ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Cox Regression ◽  
Insurance Coverage ◽  
Cox Proportional Hazards Model ◽  
Disease Stage ◽  
Insurance Status ◽  
Seer Database ◽  
Poverty Level ◽  
Medicaid Coverage ◽  
To Receive

Purpose The purpose of this study was to determine the association of insurance status with disease stage at presentation, treatment, and survival among the top 10 most deadly cancers using the SEER database. Patients and Methods A total of 473,722 patients age 18 to 64 years who were diagnosed with one of the 10 most deadly cancers in the SEER database from 2007 to 2010 were analyzed. A Cox proportional hazards model was used for multivariable analyses to assess the effect of patient and tumor characteristics on cause-specific death. Results Overall, patients with non-Medicaid insurance were less likely to present with distant disease (16.9%) than those with Medicaid coverage (29.1%) or without insurance coverage (34.7%; P < .001). Patients with non-Medicaid insurance were more likely to receive cancer-directed surgery and/or radiation therapy (79.6%) compared with those with Medicaid coverage (67.9%) or without insurance coverage (62.1%; P < .001). In a Cox regression that adjusted for age, race, sex, marital status, residence, percent of county below federal poverty level, site, stage, and receipt of cancer-directed surgery and/or radiation therapy, patients were more likely to die as a result of their disease if they had Medicaid coverage (hazard ratio [HR], 1.44; 95% CI, 1.41 to 1.47; P < .001) or no insurance (HR, 1.47; 95% CI, 1.42 to 1.51; P < .001) compared with non-Medicaid insurance. Conclusion Among patients with the 10 most deadly cancers, those with Medicaid coverage or without insurance were more likely to present with advanced disease, were less likely to receive cancer-directed surgery and/or radiation therapy, and experienced worse survival.

scholarly journals Incidence and Predictors of Hospitalization in Patients with Atrial Fibrillation: Results from the Chinese Atrial Fibrillation Registry Study

2020 ◽  
Author(s):  
Zhaojie Dong ◽  
Xin Du ◽  
Shangxin Lu ◽  
Chao Jiang ◽  
Shijun Xia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Diseases ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Chronic Obstructive ◽  
Unique Identifier ◽  
Clinical Trial Registration

Abstract Background: Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which, however, has not been paid much attention in clinic. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients.Methods: From August 2011 to December 2017, 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were enrolled in this study. We described the incidence, causes of hospitalization according to age and gender categories. The Cox proportional hazards model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results: After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total frequency of hospitalizations); while patients aged 65-74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). Multivariate Cox model analysis verified the higher risk of hospitalization in patients complicated with heart failure (HF)[hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.08-1.24], established coronary artery disease (CAD) (HR 1.26, 95%CI 1.19-1.34), ischemic stroke/transient ischemic attack (TIA) (HR 1.26, 95%CI 1.18-1.33), diabetes (HR 1.16, 95%CI 1.10-1.22), chronic obstructive pulmonary disease (COPD) (HR 1.41, 95%CI 1.13-1.76), gastrointestinal disorder (HR 1.39, 95%CI 1.23-1.58), and renal dysfunction (HR 1.31, 95%CI 1.16-1.48). Conclusions: More than one-third of AF patients included in this study were hospitalized at least once during almost 3 years of follow-up. The main cause for hospitalization among elderly patients (≥65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated as strategies to reduce hospitalization in AF patients.Clinical Trial Registration: URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729.

Hospital readmissions and the day of the week

2018 ◽  
Vol 23 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Aman Verma ◽  
Christian Rochefort ◽  
Guido Powell ◽  
David Buckeridge
Keyword(s):  
Markov Model ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Hospital Readmissions ◽  
Cox Proportional Hazards Model ◽  
Effect Estimate ◽  
Time Varying ◽  
Confounding Effect ◽  
Day Of The Week ◽  
Emergency Readmission

Objectives Patients discharged from hospitals on a Friday (Friday discharges) are readmitted sooner (a shorter time-to-emergency-readmission) than those discharged on any other day of the week. To evaluate the cost-effectiveness of increasing weekend capacity, the effect estimate of Friday discharge on time-to-emergency-readmission needs to be precise. However, precise effect estimation is complicated by the confounding effect of differing healthcare-seeking behaviour and admission practices, and therefore different admission probability, by day of the week. The objective of this research was to examine how differing admission probability by day of the week influences the effect of discharge day on time-to-emergency-readmission. Methods We used a Markov model to determine how day of the week admission probability would theoretically affect the time-to-emergency-readmission for Friday and Wednesday discharges. We tested this in a cohort of patients who have had a history of respiratory illness, using a Cox proportional hazards model to fit the time-to-emergency-readmission to any Quebec hospital as a function of the day of the week of discharge and admission. We fitted another Cox model with an additional time-varying covariate for the current day of the week, to model differing admission probabilities by day of the week. Results Our Markov model showed that if admission probability is lower on the weekends, Friday discharges will be readmitted later (longer time-to-emergency-readmission) than Wednesday discharges. Using hospital admission data, we found that Friday discharges were readmitted slightly earlier than Wednesday discharges (HR: 1.03, 95% CI: (1.02, 1.05)). After adding a time-varying covariate for the current day of the week, the length of time-to-emergency-readmission for a Friday discharge increased, but it was still earlier than a Wednesday discharge (HR: 1.04, 95% CI: (1.01, 1.07)). Conclusions The lower admission probabilities on the weekend confound the effect of Friday discharge on time-to-emergency-readmission by increasing the time-to-emergency-readmission. This confounding effect causes an underestimate of the effect of Friday discharge on time-to-emergency-readmission.

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