scholarly journals Increased Monocyte/Lymphocyte Ratio as Risk Marker for Cardiovascular Events and Infectious Disease Hospitalization in Dialysis Patients

2021 ◽  
pp. 1-9
Author(s):  
Reiko Muto ◽  
Sawako Kato ◽  
Bengt Lindholm ◽  
Abdul Rashid Qureshi ◽  
Takuji Ishimoto ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Rank Test ◽  
Differential Count ◽  
Dialysis Patients ◽  
Cox Models ◽  
Lymphocyte Ratio ◽  
Relative Risks ◽  
Log Rank Test ◽  
Increased Risk ◽  
Laboratory Biomarkers

<b><i>Introduction:</i></b> In dialysis patients, cardiovascular disease (CVD) and infectious disease contribute to poor clinical outcomes. We investigated if a higher monocyte/lymphocyte ratio (MLR) is associated with an increased risk of CVD events and infectious disease hospitalizations in incident dialysis patients. <b><i>Methods:</i></b> In an ongoing observational prospective cohort study, 132 Japanese dialysis patients (age 58.7 ± 11.7 years; 70% men) starting dialysis therapy were enrolled and followed up for a median of 48.7 months. Laboratory biomarkers, including white blood cell count and its differential count, were determined at baseline. Event-free time and relative risks (RRs) were calculated using the Kaplan-Meier curves and Cox models, respectively. <b><i>Results:</i></b> When divided into 2 groups according to median MLR (0.35 [range, 0.27–0.46]), the periods without CVD events were significantly shorter in the high MLR group than in the low MLR group (log-rank test = 5.60, <i>p</i> = 0.018). The RR of CVD events, after adjusting for age, sex, and diabetes, was 2.43 (1.22–4.84) in the high MLR group compared to the low MLR group. The periods without infections requiring hospitalization were also shorter (log-rank test = 4.16, <i>p</i> = 0.041). The RR of infections requiring hospitalization was 1.98 (1.02–3.83) after the same adjustments. The number of CVD events was higher in the high MLR group (18.6 events per 100 person-years at risk [pyr]) than the low MLR group (11.1 events per 100 pyr). The duration of infectious disease hospitalization was longer in the high MLR group (6.3 days per pyr) than in the low MLR group (2.8 days per pyr). <b><i>Conclusion:</i></b> A higher MLR is associated with increased risks of both CVD events and infectious disease hospitalization in dialysis patients.

Baseline neutrophil-to-lymphocyte ratio and absolute lymphocyte count in patients with HER2-negative breast cancer treated with eribulin may predict overall survival.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13005-e13005
Author(s):  
Shigeto Maeda ◽  
Keisei Anan ◽  
Kenichiro Koga ◽  
Sayaka Kuba ◽  
Hiroshi Yano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Overall Survival ◽  
Lymphocyte Count ◽  
Group Performance ◽  
Absolute Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Rank Test ◽  
Lymphocyte Ratio ◽  
Log Rank Test

e13005 Background: In Japan, eribulin has been approved for inoperative or recurrent breast cancer, following treatment with an anthracyclines and a taxanes. We reported the efficacy and safety of eribulin as a first-line to third-line treatment in patients with advanced/metastatic breast cancer (MBC) previously treated with anthracylinsanthracyclines and taxanes (Breast 2017). Briefly, the main inclusion criteria were as follows: no history of eribulin administration; an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 2,; human epidermal growth factor receptor 2 (HER2)-negative,; 20–75 years; ≥4 weeks from the last dose of chemotherapy, or ≥2 weeks from the last dosing of endocrine or radiation therapy; measurable lesion based on Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1; sufficient organ function; life expectancy of ≥3 months; and no significant abnormalities on electrocardiogram. Patients in this clinical trial were enrolled between December 1, 2011, and November 30, 2013. Eribulin was administered intravenously at a dose of 1.4 mg/m2 during a 2-5 min infusion on days 1 and 8 every 3 weeks. In contrast, baseline neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) were reported to predict progression-free survival (PFS) or overall survival (OS). However, these reports were mainly retrospective analysis. Therefore, retrospective evaluation of NLR/ALC in a prospective clinical trial is important to understand the association between NLR/ALC and OS/PFS. Methods: Of 47 prospectively enrolled patients in a previous trial, 45 patients were retrospectively evaluated for baseline NLR/ACL and at the time of 3 cycles of eribulin. The association between NLR/ALC and OS/PFS was also were analyzed for association with OS/PFS. The Kaplan-Meier method was used to estimate the OS/PFS distribution. The cut-off values for baseline NLR and ALC were set at 3 and 1500 /ul, respectively. Results: The median OS of patients with a baseline NLR < 3 was significantly longer than that of patients with a baseline NLR ≥ ≧3 (769 days vs. 409 days; log-rank test p = 0.0333). The median OS of patients with a baseline ALC ≥ ≧1500 was also significantly longer than that of patients with a baseline ALC < 1500 (964 days vs.vs 427 days; log-rank test p = 0.0425). Association between baseline NLR/ALC and PFS were not seen, and also association between at the time of 3 cycles of NLR/ALC and OS/PFS were not seen neither. Conclusions: Baseline NLR and ALC in the patients with HER2- negative breast cancer who plan to treat eribulin may predict overall survival. Clinical trial information: UMIN000007121.

Increased BAX Expression Is Associated With an Increased Risk of Relapse in Childhood Acute Lymphocytic Leukemia

Blood ◽  
1999 ◽  
Vol 93 (8) ◽  
pp. 2671-2678 ◽  
Author(s):  
Linda A. Hogarth ◽  
Andrew G. Hall
Keyword(s):  
Internal Control ◽  
Important Determinant ◽  
Lymphoblastic Leukemia ◽  
Lymphocytic Leukemia ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Increased Risk ◽  
B Lineage ◽  
Induced Apoptosis

Studies in cell lines have indicated that expression of the BCL-2 family of proteins is an important determinant of chemotherapy-induced apoptosis; however, the level of expression of these proteins in childhood acute lymphoblastic leukemia (ALL) has not been extensively reported. Using quantitative Western blotting we have determined the level of expression of BCL-2, BAX, MCL-1, and BCL-X in lymphoblasts from 47 children with ALL (33 at presentation only, 4 at relapse only, and 10 at both presentation and on relapse). Results were determined as a ratio to actin as an internal control. BCL-2, BAX, and MCL-1 were detected in all samples. BCL-XL was only detected in 6 cases (4 at presentation and 2 at relapse) and BCL-XS in none. No correlation was found between expression and white blood cell count, age at diagnosis, gender, or blast karyotype. BCL-2 levels and the BCL/BAX and MCL-1/BAX ratios were found to be significantly higher in B-lineage as compared with T-lineage disease (P < .003, .02, and .02, respectively). No consistent pattern of change in expression was noted in the 10 cases studied at both presentation and relapse. Kaplan-Meier analysis showed a significant correlation between high BAX expression and an increased probability of relapse (P< .05 by the log rank test), suggesting that chemosensitivity in leukemic blasts may be regulated by factors that override the BCL-2 pathway.

High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study

2016 ◽  
Vol 42 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Sawako Kato ◽  
Bengt Lindholm ◽  
Yukio Yuzawa ◽  
Yoshinari Tsuruta ◽  
Kana Nakauchi ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Hospital Admissions ◽  
Ferritin Level ◽  
Nutrition Status ◽  
Rank Test ◽  
Risk Of Infection ◽  
Dialysis Patients ◽  
Clinical Biomarkers ◽  
Kaplan Meier ◽  
Increased Risk

Aims: The aim of the study was to clarify the relationship between serum ferritin and infectious risks. Methods: We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. Results: Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. Conclusion: Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.

Clinicopathologic features and clinical outcomes associated with Gleason upgrading from biopsy to radical prostatectomy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5056-5056
Author(s):  
Sun Mi Yoo ◽  
Lillian Werner ◽  
Mari Nakabayashi ◽  
Christopher Sweeney ◽  
Michelle S. Hirsch ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Rank Test ◽  
Clinical Implications ◽  
Low Grade ◽  
Log Rank Test ◽  
Positive Biopsy ◽  
Dana Farber Cancer Institute ◽  
Increased Risk ◽  
Prostate Cancers ◽  
Tissue Specimens

5056 Background: Gleason score stratifies patients into prognostic categories and is critical in guiding treatment. Previous series indicate that ~25% of patients with low-grade (Gleason ≤6) disease on biopsy are upgraded to higher grade disease upon radical prostatectomy (RP). We sought to characterize the clinical and pathologic variables associated with upgrading and investigate its clinical implications. Methods: 1,469 prostate cancer patients underwent prostate biopsy and RP, were seen at Dana-Farber Cancer Institute/Brigham and Women’s Hospital (DFCI/BWH), and had tissue specimens reviewed by DFCI/BWH genitourinary pathologists between 1999-2011. Associations between Gleason upgrading and clinical and pathologic variables were assessed using Wilcoxon’s non-parametric test and Fisher’s exact tests. Log rank test was used to assess association between upgrading and time to biochemical recurrence (BCR). Results: Of 1,469 patients, 958 (65%) had biopsy Gleason 6 and 511 (35%) had biopsy Gleason 7. Among individuals with biopsy Gleason 6, 336 (35%) were upgraded to Gleason ≥7 upon RP (275 3+4 and 49 4+3) while 622 (65%) remained Gleason 6 at RP. Variables associated with increased risk of upgrading: greater PSA at diagnosis (p=1x10-4); age >58 (OR=1.62, p < 1x10-4); >1/3 positive biopsy cores (OR=2.1 for 33-50% compared to ≤33%, p < 1x10-4). In this study the number of cores biopsied was not associated with upgrading. Gleason upgrading was also associated with extraprostatic tissue involvement (OR=1.69, p=0.005). Patients upgraded from biopsy Gleason ≤6 to Gleason 7 on RP had a longer time to BCR than those with Gleason 7 on both biopsy and RP, but a shorter time to BCR than those who remained Gleason 6 on RP (adjusted hazard ratio 0.69, 95% CI 0.49-0.98, p=0.03). Conclusions: Gleason upgrading from low-grade to higher grade disease is associated with a higher PSA at diagnosis, older age at diagnosis, and a greater number of positive biopsy cores. Clinically, prostate cancers upgraded from Gleason ≤6 to Gleason 7 appear to behave differently than those who are not upgraded. These results could have implications in determining ideal candidates for active surveillance.

scholarly journals Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weelic Chong ◽  
Zhenchao Zhang ◽  
Rui Luo ◽  
Jian Gu ◽  
Jianqing Lin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
Cellsearch System ◽  
Cox Models ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Risk Of Death ◽  
Castration Resistant ◽  
Increased Risk

Abstract Background The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and circulating tumor cells (CTCs) have been associated with survival in castration-resistant prostate cancer (CRPC). However, no study has examined the prognostic value of NLR and PLR in the context of CTCs. Methods Baseline CTCs from mCRPC patients were enumerated using the CellSearch System. Baseline NLR and PLR values were calculated using the data from routine complete blood counts. The associations of CTC, NLR, and PLR values, individually and jointly, with progression-free survival (PFS) and overall survival (OS), were evaluated using Kaplan-Meier analysis, as well as univariate and multivariate Cox models. Results CTCs were detected in 37 (58.7%) of 63 mCRPC patients, and among them, 16 (25.4%) had ≥5 CTCs. The presence of CTCs was significantly associated with a 4.02-fold increased risk for progression and a 3.72-fold increased risk of death during a median follow-up of 17.6 months. OS was shorter among patients with high levels of NLR or PLR than those with low levels (log-rank P = 0.023 and 0.077). Neither NLR nor PLR was individually associated with PFS. Among the 37 patients with detectable CTCs, those with a high NLR had significantly shorter OS (log-rank P = 0.024); however, among the 26 patients without CTCs, the OS difference between high- and low-NLR groups was not statistically significant. Compared to the patients with CTCs and low NLR, those with CTCs and high levels of NLR had a 3.79-fold risk of death (P = 0.036). This association remained significant after adjusting for covariates (P = 0.031). Combination analyses of CTC and PLR did not yield significant results. Conclusion Among patients with detectable CTCs, the use of NLR could further classify patients into different risk groups, suggesting a complementary role for NLR in CTC-based prognostic stratification in mCRPC.

scholarly journals Survival and predictive factors in dialysis patients with COVID-19 in Japan: a nationwide cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kan Kikuchi ◽  
Masaomi Nangaku ◽  
Munekazu Ryuzaki ◽  
Tomoyuki Yamakawa ◽  
Oota Yoshihiro ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Predictive Factors ◽  
Mortality Risk ◽  
Japanese Society ◽  
Task Force ◽  
Rank Test ◽  
Dialysis Patients ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Background The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients. Methods This registry of the COVID-19 Task Force Committee was used to collect data of dialysis patients; a total of 1010 dialysis patients with COVID-19 were included in the analysis. Overall survival of patients was investigated with stratification by age group, complication status, and treatment. In addition, predictive factors for mortality were also investigated. The overall survival was estimated by Kaplan–Meier methods and compared by using log-rank test. Multivariate analysis was performed to identify the risk factor of mortality. For all statistical analyses, p < 0.05 was considered to be statistically significant. Results The mortality risk was increased with age (p < 0.001). The mortality risk was significantly higher in patients with peripheral arterial disease (HR: 1.49, 95% CI 1.05–2.10) and significantly lower in patients who were treated with remdesivir (HR: 0.60, 95% CI 0.37–0.98). Multivariate analysis showed increased risk of mortality with increment in BMI, and increment in CRP, and decreased risk with increment in albumin. Conclusion Dialysis patients have a high severity of illness and a high risk of mortality in cases of COVID-19. Treatment with remdesivir might be effective in shortening the duration of hospitalization and reducing the risk of mortality.

The prognostic significance of lymphatic invasion in primary melanoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9050-9050
Author(s):  
X. Xu ◽  
L. Chen ◽  
W. Hwang ◽  
P. Dawson ◽  
D. Guerry ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Prognostic Significance ◽  
Primary Melanoma ◽  
Risk Groups ◽  
Lymphatic Invasion ◽  
Independent Prognostic Factor ◽  
Rank Test ◽  
Survival Curves ◽  
Cox Models ◽  
Log Rank Test

9050 Background: Lymphatic invasion (LI) is an under-observed phenomenon in primary malignancies that can be better detected by immunostaining and that may associate with prognosis. In this study we sought to test the hypothesis that LI was associated with melanoma-specific survival (MSS) and was an independent prognostic factor. Methods: This study included 277 patients with stage I/II melanomas in vertical growth phase (VGP) who had at least 10 years of follow up. The log-rank test was used to test the study hypothesis - 72 melanoma-specific deaths were needed for 80% power to detect an odds ratio of 2.1. Paraffin sections were stained with antibodies to podoplanin (lymphatic vessels) and S-100 (melanoma cells) to identify LI. Univariate and multivariate Cox models were used to evaluate the prognostic significance of LI. An independent cohort of 106 similar patients was used for validation of the 10-year MSS rates. Results: LI was observed in 44.5% (95% CI: 38.6% - 50.4%) of the melanomas and its presence was significantly associated with thickness, mitotic rate, gender, age, and ulceration (U). The Kaplan-Meier survival curves for those with and without LI were significantly different (log-rank test p=0.022). The final multivariate model for time to MSD identified 4 independent prognostic factors: thickness (HR=1.5, p<0.001), U (HR=2.2 p=0.013), site (HR=3.9, p<0.001) and LI (HR=1.9, p=0.015). These factors were used to define a prognostic tree with 5 risk groups defined by melanomas that were thin (≤1.0mm) with no LI or U; thin with LI but no U; 1–3mm with no U; 1–3mm with U; and >3mm. Respectively, MSS rates were 100%, 88.6%, 77%, 48% and 42%. In the validation set, observed 10-year MSS rates in each risk group were not significantly different from those predicted from the survival curves for the tree-based risk groups. Conclusions: LI is an independent prognostic factor for MSS. Among patients with thin melanomas without U the 10-year MSS was lower for those patients with LI (89%, 95% CI=78% - 99%; n=41) compared to those without (100%, n=78). LI is an important prognostic factor that needs further validation in a population of patients from the sentinel node biopsy era. No significant financial relationships to disclose.

Association of smoking status with p16 and cyclin D1 (CCND1) expression with clinical characteristics and overall survival (OS) in oropharyngeal squamous cell carcinoma (OSC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5551-5551
Author(s):  
Mei-Kim Ang ◽  
Siok Hoon Ang ◽  
Sai Sakktee Krishna ◽  
Wallace Jian Jun Chen ◽  
Minn Minn Myint Thu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Smoking Status ◽  
Multivariable Analysis ◽  
Rank Test ◽  
Cox Models ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Point Increase ◽  
A Cell ◽  
P16 Expression

5551 Background: Smoking-related head and neck cancer (HNC) is genetically different, with higher mutation rates compared with non-smokers (NS). Human papillomavirus (HPV)-positive (+) OSC has a superior prognosis independent of treatment. Among HPV+ patients (pt), current or prior smokers (CS) have poor OS compared with NS. Expression of p16, a known HPV surrogate, and CYD1, a cell cycle marker often dysregulated in HNC, was evaluated with respect to smoking status and OS. Methods: Expression of p16 and CYD1 was assessed by immunohistochemistry in 108 OSC pt treated between 1999-2009, using cutoffs of ≥70% (p16+) and ≥10% (CYD1+) stained tumor cells. Associations between expression, clinical characteristics and OS were evaluated by Kaplan-Meier method and compared by log rank test. Hazard ratio (HR) for death was estimated using Cox models. Results: 31 pt (28.7%) were p16+ and 80 pt (75.5%) were CYD1 negative(-). p16+ pt were younger (median age 57 v 66 yrs, p=0.002), more likely female (35.5% v 15.2%, p=0.035), NS (51.6% v 13.9%, p<0.001) with lower combined age-comorbidity score (ageCS) (p=0.003). CYD1+ pt were older (median 66 v 57 yrs, p=0.015), more likely CS (81.5% v 48.1%, p=0.002) with higher ageCS (p=0.018). At a median f/u of 65.7 months, median OS was 57.3 months. p16+ pt had better OS than p16- pt (median OS not reached (NR) v 22.3 mths, p<0.001). CYD1+ pt had poorer OS than CYD1- pt (median OS NR v 17.7 mths, p<0.001). On multivariable analysis p16 and CYD1 status were independently associated with OS (HR 0.412, p=0.045 and HR 4.06, p=0.011 respectively), independent of smoking status (HR 5.01, p=0.008), ageCS (HR 1.32 per 1 point increase, p<0.001) and stage. Strikingly, among NS, 5-year OS in p16+ compared with p16- pt was 100% vs 67% (p<0.001). In contrast, among CS, p16 status had no association with OS (HR 0.97, p=0.943), while CYD1 status and ageCS were independent predictors of death (HR 4.70, p=0.025 and HR 1.28, p<0.001 respectively). Conclusions: In OSC, NS with high p16 expression have excellent prognosis. Among CS, pt with fewer comorbidities and low CYD1 expression have better OS. p16 status was not prognostic in the latter group of patients.

scholarly journals The Effect of Fluid Overload on Clinical Outcome in Southern Chinese Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 35 (7) ◽  
pp. 691-702 ◽  
Author(s):  
Qunying Guo ◽  
Jianxiong Lin ◽  
Jianying Li ◽  
Chunyan Yi ◽  
Haiping Mao ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Fluid Overload ◽  
Event Rate ◽  
Rank Test ◽  
Dialysis Patients ◽  
Log Rank Test ◽  
Southern Chinese ◽  
All Cause Mortality ◽  
Technique Failure

BackgroundFluid overload is frequently present in dialysis patients and one of the important predictors of patient outcome. This study aimed to investigate the influence of fluid overload on all-cause mortality and technique failure in Southern Chinese continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsThis was a post hoc study from a cross-sectional survey originally designed to investigate the prevalence and associated risk factors of fluid overload defined by bioimpedance analysis (BIA) in CAPD patients from January 1, 2008, to December 31, 2009. All 307 CAPD patients completing the original study were followed up until December 31, 2012.ResultsWith a median follow-up period of 38.4 (19.2 - 47.9) months, 52 patients died. Patients with fluid overload (defined by extracellular water/total body water [ECW/TBW] ≥ 0.40) had a significantly higher peritonitis rate (0.016 vs 0.011 events/month exposure, p = 0.018) and cerebrovascular event rate (3.9 vs 1.1 events/100 patient years, p = 0.024) than the normal hydrated patients. Moreover, the results showed a significant rising of all-cause mortality (log-rank test = 5.59, p = 0.018), and a trend of increasing cardiovascular disease (CVD) mortality (log-rank test = 2.90, p = 0.089) and technique failure (log-rank test = 3.78, p = 0.052) in the patients with fluid overload. Fluid overload independently predicted all-cause mortality (hazard ratio [HR] = 12.98, 95%, confidence interval [CI] = 1.06 - 168.23, p = 0.042) and technique failure (HR = 13.56, 95% CI = 2.53 - 78.69, p = 0.007) in CAPD patients after adjustment for confounders.ConclusionsFluid overload defined by BIA was an independent predictor for all-cause mortality and technique failure in CAPD patients. Continuous ambulatory peritoneal dialysis patients with fluid overload had a higher peritonitis rate, cardiovascular event rate, and poorer clinical outcome than those patients with normal hydration.

scholarly journals Comparing EWGSOP2 and FNIH Sarcopenia Definitions: Agreement and Three-Year Survival Prognostic Value in Older Hospitalized Adults. The GLISTEN Study

2019 ◽  
Author(s):  
Lara Bianchi ◽  
Elisa Maietti ◽  
Pasquale Abete ◽  
Giuseppe Bellelli ◽  
Mario Bo ◽  
...  
Keyword(s):  
Predictive Value ◽  
Kappa Statistic ◽  
National Institutes Of Health ◽  
Rank Test ◽  
Cox Models ◽  
Increased Risk ◽  
European Working ◽  
Study Participants ◽  
Classification Agreement ◽  
Group Variable

Abstract Background Sarcopenia is common among older hospitalized adults but estimates vary according to definitions used. Aims of this study were to investigate the agreement between the European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria and to compare the predictive value of both definitions for 3-year mortality. Methods Analysis was performed on 610 older hospitalized patients enrolled in the GLISTEN study. Participants were categorized as sarcopenic or not sarcopenic according to EWGSOP2 and FNIH definitions separately and in a four-group variable (neither criterion positive, only EWGSOP2, only FNIH, both criteria). Results Sarcopenia prevalence was 22.8% and 23.9% using EWGSOP2 and FNIH criteria respectively, with a low classification agreement (Cohen’s kappa statistic: 0.29). Sarcopenic participants by each definitions had higher mortality rate when compared to those not sarcopenic (both log-rank test: p<0.001). Participants that met both positive criteria had the shorter survival as compared with the other three groups. Cox models showed that, after adjustment for potential confounders, only EWGSOP2 definition predicted 3-years mortality (HR 1.84; 95%C.I. 1.33-2.57). When the four-group variable was used, compared with the NO EWGSOP2/NO FNIH group, significant mortality risk was found for the EWGSOP2 (HR 2.08; 95%C.I. 1.38-3.16) and the combined EWGSOP2/FNIH group (HR 1.75; 95%C.I. 1.11-2.79). Conclusions Agreement between EWGSOP2 and FNIH definitions is poor. Sarcopenia on hospital admission is associated with increased risk of 3-year mortality and EWGSOP2 criteria seem to have the highest predictive value.

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