Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

2015 ◽  
Vol 40 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Camiel L.M. de Roij van Zuijdewijn ◽  
Menso J. Nubé ◽  
Piet M. ter Wee ◽  
Peter J. Blankestijn ◽  
Renée Lévesque ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Mortality Risk ◽  
Survival Benefit ◽  
Regression Models ◽  
Cox Regression ◽  
Treatment Time ◽  
High Volume ◽  
P Values ◽  
Hazard Ratios

Background/Aims: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time. Methods: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable. Results: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap. Conclusion: The survival benefit of high-volume HDF over HD is independent of treatment time.

Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

2018 ◽  
Vol 48 (6) ◽  
pp. 425-433 ◽  
Author(s):  
Solène Guilloteau ◽  
Thierry Lobbedez ◽  
Sonia Guillouët ◽  
Christian Verger ◽  
Maxence Ficheux ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lower Risk ◽  
Regression Models ◽  
Cox Regression ◽  
French Language ◽  
Dialysis Modality ◽  
Technique Survival ◽  
Hazard Ratios ◽  
Effect Of Pd ◽  
Assisted Peritoneal Dialysis

Background: Patients on peritoneal dialysis (PD) can be assisted by a nurse or a family member and treated either by automated PD (APD) or continuous ambulatory PD (CAPD). The aim of this study was to evaluate the effect of PD modality and type of assistance on the risk of transfer to haemodialysis (HD) and on the peritonitis risk in assisted PD patients. Method: This was a retrospective study based on data from the French Language PD Registry. All adults starting assisted PD in France between 2006 and 2015 were included. Events of interest were transfer to HD, peritonitis and death. Cox regression models were used for statistical analysis. Results: Among the 12,144 incident patients who started PD in France during the study period, 6,167 were assisted. There were 5,060 nurse-assisted and 1,095 family-assisted PD patients. Overall, 5,171 were treated by CAPD and 996 by APD. In multivariate analysis, CAPD, compared to APD, was not associated with the risk of transfer to HD (cause specific hazard ratios [cs-HR] 0.96 [95% CI 0.84–1.09]). Patients on nurse-assisted PD had a lower risk of transfer to HD than family assisted PD patients (cs-HR 0.85 [95% CI 0.75–0.97]). Neither PD modality nor type of assistance were associated with peritonitis risk. Conclusions: In assisted PD, technique survival was not associated with PD modality. Nurse-assisted patients had a lower risk of transfer to HD than family assisted patients. Peritonitis risk was not influenced either by PD modality, or by type of assistance. Both APD and CAPD should be offered to assisted-PD patients.

Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Community Dwelling ◽  
Representative Study ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

scholarly journals Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study

2017 ◽  
Vol 17 (2) ◽  
pp. 411-422 ◽  
Author(s):  
Yi-Ting Kuo ◽  
Hou-Hsun Liao ◽  
Jen-Huai Chiang ◽  
Mei-Yao Wu ◽  
Bor-Chyuan Chen ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Mortality Risk ◽  
Cox Regression ◽  
Population Based ◽  
Hazard Ratio ◽  
Chinese Herbal ◽  
Hazard Ratios ◽  
Lower Hazard

Background: Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan. Methods: We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. Results: According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively. Conclusions: Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.

Indo-Oceanic Mycobacterium tuberculosis strains from Thailand associated with higher mortality

2019 ◽  
Vol 23 (9) ◽  
pp. 972-979 ◽  
Author(s):  
N. Smittipat ◽  
R. Miyahara ◽  
T. Juthayothin ◽  
P. Billamas ◽  
K. Dokladda ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Mortality Risk ◽  
Regression Models ◽  
Cox Regression ◽  
East Asian ◽  
Registration System ◽  
Asian Lineage ◽  
Associated Risk Factors ◽  
Highly Virulent

SETTING: This study was conducted among tuberculosis (TB) patients in a highly endemic Thai province.OBJECTIVE: To evaluate the association between different Mycobacterium tuberculosis lineages and clinical characteristics, especially mortality.DESIGN: We enrolled 1,304 TB patients registered from 2002–2011 with culture isolates whose lineages were identified by specific regions of deletion. Data on mortality within 1 year of follow-up were extracted from the registration system and hospital records. Mortality-associated risk factors, including bacterial lineages, as independent variables were analysed using Cox regression models.RESULTS: Of 1,304 isolates, 521 (40.0%) and 582 (44.6%) belonged to Indo-Oceanic and East-Asian lineages, respectively. Indo-Oceanic strains significantly increased the mortality risk compared with East-Asian strains (adjusted hazard ratio [aHR] 1.42, 95%CI 1.02–1.99) or modern lineages (aHR 1.49, 95%CI 1.08–2.06) in the 172 patients who died within 1 year after TB diagnosis. The former also caused significantly higher mortality than modern lineages among patients who died within 6 months after TB diagnosis (aHR 1.62, 95%CI 1.12–2.35). No significant association was found between drug resistance and death.CONCLUSION: In Thailand, the Indo-Oceanic lineage of M. tuberculosis increased mortality risk compared with modern lineages or the East-Asian lineage, the latter being considered highly virulent in previous studies.

scholarly journals Alcohol consumption and mortality in individuals with diabetes mellitus

2011 ◽  
Vol 108 (7) ◽  
pp. 1307-1315 ◽  
Author(s):  
Diewertje Sluik ◽  
Heiner Boeing ◽  
Manuela M. Bergmann ◽  
Madlen Schütze ◽  
Birgit Teucher ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Alcohol Consumption ◽  
Mortality Risk ◽  
Cox Regression ◽  
Total Mortality ◽  
Premature Mortality ◽  
Men And Women ◽  
Hazard Ratios ◽  
History Of ◽  
Current Alcohol

Studies have suggested that moderate alcohol consumption is associated with a reduced risk of CVD and premature mortality in individuals with diabetes mellitus. However, history of alcohol consumption has hardly been taken into account. We investigated the association between current alcohol consumption and mortality in men and women with diabetes mellitus accounting for past alcohol consumption. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was defined of 4797 participants with a confirmed diagnosis of diabetes mellitus. Men and women were assigned to categories of baseline and past alcohol consumption. Hazard ratios (HR) and 95 % CI for total mortality were estimated with multivariable Cox regression models, using light alcohol consumption (>0–6 g/d) as the reference category. Compared with light alcohol consumption, no relationship was observed between consumption of 6 g/d or more and total mortality. HR for >6–12 g/d was 0·89 (95 % CI 0·61, 1·30) in men and 0·86 (95 % CI 0·46, 1·60) in women. Adjustment for past alcohol consumption did not change the estimates substantially. In individuals who at baseline reported abstaining from alcohol, mortality rates were increased relative to light consumers: HR was 1·52 (95 % CI 0·99, 2·35) in men and 1·81 (95 % CI 1·04, 3·17) in women. The present study in diabetic individuals showed no association between current alcohol consumption >6 g/d and mortality risk compared with light consumption. The increased mortality risk among non-consumers appeared to be affected by their past alcohol consumption rather than their current abstinence.

scholarly journals Combined Hepatocellular Cholangiocarcinomas; Analysis of a Large Database

2008 ◽  
Vol 1 ◽  
pp. CPath.S500 ◽  
Author(s):  
Mitchell S. Wachtel ◽  
Yan Zhang ◽  
Tom Xu ◽  
Maurizio Chiriva-Internati ◽  
Eldo E Frezza
Keyword(s):  
Confidence Intervals ◽  
Cox Regression ◽  
Large Database ◽  
Combined Tumor ◽  
Point Estimates ◽  
Hazard Ratios ◽  
Asian Pacific ◽  
Survival Patterns ◽  
Distant Spread ◽  
Combined Tumors

Aim Combined hepatocellular cholangiocarcinoma (combined tumor) has been described as either a variant of hepatoma or a variant of cholangiocarcinoma. Prior studies evaluated fewer than 50 patients with combined tumors, precluding multivariate analyses. Posited was the notion that analysis of a large database would yield more definite answers. Methods This study used SEER (Surveillance, Epidemiology, and End Results Program of the National Cancer Institute) to analyze 282 combined tumors, 2,035 intrahepatic cholangiocarcinomas, and 19,336 hepatomas between the years 1973-2003. Multinomial logit regression calculated point estimates and 95% confidence intervals (c.i.) for relative risk (rr). Cox regression calculated point estimates and 95% confidence intervals (c.i.) for hazard ratios (ĥ). Results Men less often had cholangiocarcinomas than they had combined tumors (rr = 0.63, c.i. = 0.49-0.81). Hepatomas less often than combined tumors presented with distant spread (rr = 0.56, c.i. = 0.43-0.72). Men (rr = 1.50, c.i. = 1.17-1.93) and patients with a known Asian or Pacific birthplace (rr = 2.36, c.i. = 1.56-3.56) more often had hepatomas than they had combined tumors. Among patients not known to have an Asian/Pacific birthplace, a diagnosis of cholangiocarcinoma (ĥ = 0.72, c.i. = 0.63-0.82) or hepatoma (ĥ = 0.75, c.i. = 0.66-0.86) provided a better prognosis than did a diagnosis of combined tumor. Conclusion Combined tumors differ from hepatomas and cholangiocarcinomas in terms of distribution and survival patterns in the population; they should be considered neither cholangiocarcinomas nor hepatomas.

scholarly journals Visualization Strategies for Regression Estimates with Randomization Inference

2019 ◽  
Author(s):  
Marshall A. Taylor
Keyword(s):  
Confidence Interval ◽  
Confidence Intervals ◽  
Regression Models ◽  
Statistical Significance ◽  
Permutation Tests ◽  
P Value ◽  
P Values ◽  
Alpha Level ◽  
Significance Levels ◽  
Nonprobability Sample

Coefficient plots are a popular tool for visualizing regression estimates. The appeal of these plots is that they visualize confidence intervals around the estimates and generally center the plot around zero, meaning that any estimate that crosses zero is statistically non-significant at at least the alpha-level around which the confidence intervals are constructed. For models with statistical significance levels determined via randomization models of inference and for which there is no standard error or confidence intervals for the estimate itself, these plots appear less useful. In this paper, I illustrate a variant of the coefficient plot for regression models with p-values constructed using permutation tests. These visualizations plot each estimate's p-value and its associated confidence interval in relation to a specified alpha-level. These plots can help the analyst interpret and report both the statistical and substantive significance of their models. Illustrations are provided using a nonprobability sample of activists and participants at a 1962 anti-Communism school.

scholarly journals Origin and schizophrenia in young refugees and inter-country adoptees from Latin America and East Africa in Sweden: a comparative study

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Hélio Manhica ◽  
Anna-Clara Hollander ◽  
Ylva B. Almquist ◽  
Mikael Rostila ◽  
Anders Hjern
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
East Africa ◽  
Regression Models ◽  
Psychiatric Care ◽  
Cox Regression ◽  
Income Levels ◽  
Latin Americans ◽  
Factors Associated ◽  
Hazard Ratios

BackgroundMigrants' socioeconomic adversity has been linked to schizophrenia.AimsTo investigate whether the more favourable socioeconomic situation of adoptees prevents them from the high risk of schizophrenia found in other migrants.MethodRegister study in a cohort of refugees and inter-country adoptees aged 16–40 years, born in East Africa (n=8389), Latin America (n=11 572) and 1.2 million native Swedes. Cox-regression models estimated hazard ratios (HRs) of schizophrenia in data from psychiatric care.ResultsDespite diverse income levels, HRs for schizophrenia were similar for refugees and adoptees, with East Africans having the highest HRs: 5.83 (3.30–10.27) and 5.80 (5.03–6.70), followed by Latin Americans: HRs 3.09 (2.49–3.83) and 2.31 (1.79–2.97), compared with native Swedes. Adjustment for income decreased these risks slightly for refugees, but not for adoptees.ConclusionsThis study suggests that risk factors associated with origin are more important determinants of schizophrenia than socioeconomic adversity in the country of settlement.

scholarly journals Self-reported visual impairment, physical activity and all-cause mortality: The HUNT Study

2016 ◽  
Vol 45 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Audun Brunes ◽  
W. Dana Flanders ◽  
Liv Berit Augestad
Keyword(s):  
Physical Activity ◽  
Visual Impairment ◽  
Mortality Risk ◽  
Cox Regression ◽  
Age Groups ◽  
Health Study ◽  
Cox Models ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Hunt Study

Aims: To examine the associations of self-reported visual impairment and physical activity (PA) with all-cause mortality. Methods: This prospective cohort study included 65,236 Norwegians aged ⩾20 years who had participated in the Nord-Trøndelag Health Study (HUNT2, 1995−1997). Of these participants, 11,074 (17.0%) had self-reported visual impairment (SRVI). The participants’ data were linked to Norway’s Cause of Death Registry and followed throughout 2012. Hazard ratios and 95% confidence intervals (CI) were assessed using Cox regression analyses with age as the time-scale. The Cox models were fitted for restricted age groups (<60, 60−84, ⩾85 years). Results: After a mean follow-up of 14.5 years, 13,549 deaths were identified. Compared with adults with self-reported no visual impairment, the multivariable hazard ratios among adults with SRVI were 2.47 (95% CI 1.94–3.13) in those aged <60 years, 1.22 (95% CI 1.13–1.33) in those aged 60–84 years and 1.05 (95% CI 0.96–1.15) in those aged ⩾85 years. The strength of the associations remained similar or stronger after additionally controlling for PA. When examining the joint associations, the all-cause mortality risk of SRVI was higher for those who reported no PA than for those who reported weekly hours of PA. We found a large, positive departure from additivity in adults aged <60 years, whereas the departure from additivity was small for the other age groups. Conclusions: Adults with SRVI reporting no PA were associated with an increased all-cause mortality risk. The associations attenuated with age.

scholarly journals Influenza Hospitalizations during Childhood in Children born Preterm

2021 ◽  
Author(s):  
Siri Hauge ◽  
Birgitte De Blasio ◽  
Siri E Håberg ◽  
Laura Oakley
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
National Registry ◽  
Elevated Risk ◽  
Early Term ◽  
Very Preterm ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Influenza Vaccinations ◽  
National Registry Data

Objective: To determine if children born preterm were at increased risk of influenza hospitalization up to age five. Methods: National registry data on all children born in Norway between 2008 and 2011 was used in Cox regression models to estimate adjusted hazard ratios (aHR) for influenza hospitalizations up to age five in children born preterm (<37 pregnancy weeks). HRs were also estimated separately for very preterm (<32 weeks), early term (37-38 weeks), and post-term (≥42 weeks) children. Results: Among 238 628 children born in Norway from January 2008 to December 2011, 15 086 (6.3%) were born preterm. There were 754 (0.3%) children hospitalized with influenza before age five. The rate of hospitalizations in children born preterm was 1.4 per 10 000 person-years (95% confidence interval [CI]: 1.1-1.7), and 0.6 per 10 000 person-years (95% CI: 0.5-0.6) in children born at term (≥37 weeks). Children born preterm had a higher risk of influenza hospitalization before age 5: aHR 2.33 (95% CI: 1.85-2.93). The risk increased with decreasing gestational age and was highest among those born very preterm; aHR 4.07 (95% CI: 2.63-6.31). Compared to children born at 40-41 weeks, children born early term also had an elevated risk of influenza hospitalization; aHR (37 weeks) 1.89 (95% CI: 1.43-2.40), aHR (38 weeks) 1.43 (95% CI: 1.15-1.78). Conclusion: Children born preterm had a higher risk of influenza hospitalizations before age five. An elevated risk was also present among children born at an early term. Children born preterm would benefit from influenza vaccinations.

Sign in / Sign up

Export Citation Format

Share Document