Homocysteine Predicts Incident Isolated Systolic Hypertension in Older Adults

0019 Untreated isolated systolic hypertension (ISH) indicates arterial stiffening and carries a risk for both stroke and cardiovascular disease. Elevated plasma homocysteine, a metabolite of the essential amino acid methionine, has been linked to vascular stiffness. 187 normotensive (defined as systolic blood pressure (SBP) < 160 mmHg and diastolic blood pressure < 90 mmHg) men and women (mean age 71.29 + 6.3 yrs) were followed for an average of 7 years for incident ISH. ISH was defined as a SBP ≥160 mmHg (while maintaining a DBP of < 90 mmHg) at least one time at 3 year follow-up visits, or the initiation of antihypertensive therapy. The mean baseline systolic and diastolic blood pressures (DBP) were 127 and 69 mmHg, respectively. Over the 7 year period, 59(31.5%) participants developed ISH, 76% qualified by antihypertensive use, and 24% by blood pressure values. The Kaplan Meier Estimate of 7 year survival free from ISH was 67% (95% CI: 61%, 74%). The relationship between incident ISH and the traditional cardiovascular risk factors, creatinine, homocysteine, and carotid artery intima-media wall thickness (IMT) was assessed by Cox proportional hazards regression. The strongest predictor of incident ISH was baseline SBP. For participants with baseline SBPs of < 130, 130-139, and 140+ mmHg, the corresponding 7 year survival free from ISH was 80% (95% CI: 73%, 88% ), 53% (95%CI: 38%, 67%), and 44% (95% CI: 26%, 62%). Factors independently associated with time to ISH were higher triglycerides (upper tertile,RR=2.0, p=0.012), homocysteine levels (> 12.0 μmol/l, RR=2.2, p=0.005), and baseline SBP (per 10 mmHg,RR=1.4, p=0.003). The results were similar when the analysis was restricted to the 157 participants with a baseline SBP of < 140 mmHg. Baseline IMT was found to be univariately related to time to ISH (RR per each 1.0 mm increment=3.0; p=0.016). In multivariate analysis, this association remained independent of triglycerides and homocysteine, but not baseline SBP (RR per each 1.0 mm increment=2.5; p=0.049). In conclusion, among normotensive older adults, 32% can be expected to develop ISH over a 7 year period, and higher triglyceride and homocysteine levels are risk factors.

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Risk Factors and Blood Pressure Control Targets Associated With the Clinical Outcome of Elderly COVID-19 Patients With Hypertension: a Retrospective Cohort Study

10.21203/rs.3.rs-711780/v1 ◽

2021 ◽

Author(s):

Ting Li ◽

Maomao Wang ◽

Yifei Wang ◽

Pei Zhang ◽

Yang Wang ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cohort Study ◽

Clinical Outcome ◽

Retrospective Cohort ◽

Proportional Hazards ◽

Pressure Control ◽

Cox Proportional Hazards ◽

Adverse Outcomes ◽

Blood Pressures

Abstract Background: COVID-19 is a global pandemic, especially among the elderly. Our study aimed to explore the risk factors and identify the blood pressure control targets associated with the clinical outcome of elderly COVID-19 patients with hypertension. Methods: In this retrospective cohort study, elderly COVID-19 patients who were admitted to Wuhan Huoshenshan Hospital from February 8 to 17, 2020 was included. Demographic, medical history, clinical data, and laboratory test data were collected from medical records. The adverse clinical outcomes were intensive care unit (ICU) admission and death. Difference between hypertension and non-hypertension groups were compared. Hypertension group were further divided into 3 subgroups according to their maximum blood pressures. Kaplan–Meier (K–M) method was used to find the differences both between hyperntesion and non-hypertension groups, and among the 3 hypertension subgroups. Univariable and multivariable Cox proportional hazards regression model were used to find risk factors.Results: All 133 elderly COVID-19 patients (79 patients with hypertension) were included. (1) Univariate analysis between hypertension and non-hypertension patients showed most laboratory tests were significantly (P < 0.05, or P < 0.01), particularly in adverse clinical outcomes (32.91% vs 7.41% at 30 days, P < 0.05). (2) Multivariate Cox proportional hazards models confirmed hypertension (HR 3.202, 95% CI:1.164 - 8.807) were the most important independent risk factors of outcomes in elderly patients, as well as low lymphocyte count, while the statistical difference of other values diminished. (3) Hypertension group were further divided into 3 subgroups according to their maximum blood pressures. K-M analysis showed maximum systolic blood pressure (SBP) ≥160mmHg subgroup (P < 0.01) and maximum blood pressure (DBP) ≥90mmHg subgroup (P < 0.05) experienced more adverse outcomes than others. (4) Multivariate Cox-proportional hazard model confirmed that maximum SBP≥160mmHg and maximum DBP ≥90mmHg were risk factors (HR 8.279, 95% CI: 1.346, 50.914; HR 5.080, 95% CI: 1.606,16.071; respectively). Conclusions: Hypertension is the most important independent risk factor of adverse outcomes in elderly COVID-19 patients, controlling the maximum blood pressure levels under 160/90 mmHg will decrease large part risks of adverse outcomes, the first week are key treatment period for patient prognosis.

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Prevalence, Risk Factors, and Complications of Cholelithiasis in Adults With Short Bowel Syndrome: A Longitudinal Cohort Study

Frontiers in Nutrition ◽

10.3389/fnut.2021.762240 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xuejin Gao ◽

Li Zhang ◽

Siwen Wang ◽

Yaqin Xiao ◽

Deshuai Song ◽

...

Keyword(s):

Risk Factors ◽

Short Bowel Syndrome ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Clinical Trial Registration ◽

Short Bowel ◽

Kaplan Meier ◽

Clinical Consequences

Background: Patients with short bowel syndrome (SBS) are at a high risk of cholestasis or cholelithiasis. This study aimed to determine the incidence, risk factors, and clinical consequences of cholelithiasis in adults with SBS over an extended period.Methods: All eligible adults diagnosed with SBS and admitted to a tertiary hospital center between January 2010 and December 2019 were retrospectively identified from the hospital records database. Kaplan–Meier analysis was used to estimate the cumulative incidence of SBS during the 10-year period. For assessment the risk factors for cholelithiasis, we used multivariate Cox proportional hazards model with estimation of hazard ratio (HR) with 95% confidence intervals (95 %CI).Results: This study enrolled 345 eligible patients with SBS. Kaplan–Meier analysis revealed that 72 patients (20.9%) developed cholelithiasis during the 10-year observation period. In multivariate analyses using the Cox proportional hazard model revealed that the remnant jejunum (HR = 2.163; 95% confidence interval [CI]: 1.156–4.047, p = 0.016) and parenteral nutrition dependence (HR = 1.783; 95% CI: 1.077–2.952, p = 0.025) were independent risk factors for cholelithiasis in adults with SBS. Twenty-eight patients developed symptoms and/or complications in the cholelithiasis group. Proportions of acute cholecystitis or cholangitis and acute pancreatitis were significantly increased in the cholelithiasis group compared with the non-cholelithiasis group (31.9 vs. 7.7%, p < 0.01; and 6.9 vs. 1.1%, p = 0.003, respectively).Conclusion: Because of the adverse clinical consequences of cholelithiasis, adult patients with SBS should be closely monitored, and preventive interventions should be considered.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04867538.

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Prevalence, Classification, and Risk Factors for Postoperative Lower Extremity Lymphedema in Women With Gynecologic Malignancies: A Retrospective Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000405 ◽

2015 ◽

Vol 25 (4) ◽

pp. 751-757 ◽

Cited By ~ 59

Author(s):

Hitoshi Hareyama ◽

Kenichi Hada ◽

Kumiko Goto ◽

Sawako Watanabe ◽

Minako Hakoyama ◽

...

Keyword(s):

Risk Factors ◽

Lower Extremity ◽

Lymph Nodes ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cancer Type ◽

Kaplan Meier ◽

Gynecology And Obstetrics ◽

Independent Risk Factors ◽

Stage 1

ObjectiveLower extremity lymphedema (LEL) is a major long-term complication of radical surgery. We aimed to estimate the incidence and grading of LEL in women who underwent lymphadenectomy and to evaluate risk factors associated with LEL.Materials and MethodsWe retrospectively reviewed 358 patients with cervical, endometrial, and ovarian cancer who underwent transabdominal complete systematic pelvic and para-aortic lymphadenectomy between 1997 and 2011. Lower extremity lymphedema was graded according to criteria of the International Society of Lymphology. Incidence of LEL and its correlation with various clinical characteristics were investigated using Kaplan-Meier survival and Cox proportional hazards methods.ResultsOverall incidence of LEL was 21.8% (stage 1, 60%; stage 2, 32%; and stage 3, 8%). Cumulative incidence increased with observation period: 12.9% at 1 year, 20.3% at 5 years, and 25.4% at 10 years. Age, cancer type, stage (International Federation of Gynecology and Obstetrics), body mass index, hysterectomy type, lymphocyst formation, lymph node metastasis, and chemotherapy were not associated with LEL. Multivariate analysis confirmed that removal of circumflex iliac lymph nodes (hazard ratio [HR], 4.28; 95% confidence interval [CI], 2.09–8.77; P < 0.0001), cellulitis (HR, 3.48; 95% CI, 2.03–5.98; P < 0.0001), and number of removed lymph nodes (HR, 0.99; 95% CI, 0.98–0.99; P = 0.038) were independent risk factors for LEL.ConclusionsPostoperative LEL incidence increased over time. The results of the present study showed a significant correlation with removal of circumflex iliac lymph nodes and cellulitis with the incidence of LEL. Multicenter or prospective studies are required to clarify treatment efficacies.

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Risk Factors for Mortality in Chinese Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00164 ◽

2015 ◽

Vol 35 (2) ◽

pp. 199-205 ◽

Cited By ~ 8

Author(s):

Fan Zhang ◽

Hong Liu ◽

Xiaoli Gong ◽

Fuyou Liu ◽

Youming Peng ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Patient Survival ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Hazards Model ◽

Kaplan Meier

ObjectiveThe intent of this study was to evaluate the clinical outcome and risk factors affecting mortality of the continuous ambulatory peritoneal dialysis (CAPD) patients in a single peritoneal dialysis (PD) center over a period of 10 years.Patients and methodsWe retrospectively analyzed patients on PD from June 2001 to June 2011. The clinical and biochemical data were collected from the medical records. Clinical variables included gender, age at the start of PD, smoking status, body mass index (BMI), cause of end-stage renal disease (ESRD), presence of diabetes mellitus and blood pressure. Biochemical variables included hemoglobin, urine volume, residual renal function (RRF), serum albumin, blood urea nitrogen (BUN), creatinine, total cholesterol, triglyceride, comorbidities, and outcomes. Survival curves were made by the Kaplan-Meier method. Univariate and multivariate analyses to identify mortality risk factors were performed using the Cox proportional hazard regression model.ResultsA total of 421 patients were enrolled, 269 of whom were male (63.9%). The mean age at the start of PD was 57.9 ± 14.8 years. Chronic glomerulonephritis was the most common cause of ESRD (39.4%). Estimation of patient survival by Kaplan-Meier was 92.5%, 80.2%, 74.4%, and 55.7% at 1, 3, 5, and 10 years, respectively. Patient survival was associated with age (hazard ratio [HR]: 1.641 [1.027 – 2.622], p = 0.038), cardiovascular disease (HR: 1.731 [1.08 – 2.774], p = 0.023), hypertriglyceridemia (HR: 1.782 [1.11 – 2.858], p = 0.017) in the Cox proportional hazards model analysis. Estimation of technique survival by Kaplan-Meier was 86.7%, 68.8%, 55.7%, and 37.4% at 1, 3, 5, and 10 years, respectively. In the Cox proportional hazards model analysis, age (HR: 1.672 [1.176 – 2.377], p = 0.004) and hypertriglyceridemia (HR: 1.511 [1.050 – 2.174], p = 0.026) predicted technique failure.ConclusionThe PD patients in our center exhibited comparable or even superior patient survival and technical survival rates, compared with reports from other centers in China and other countries.

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The Prevalence and Risk Factors of Isolated Systolic Hypertension Among Elderly Chinese Population

10.21203/rs.3.rs-44193/v1 ◽

2020 ◽

Author(s):

QingKun Zheng ◽

Pengshun Rong ◽

Xiaobo Huang ◽

Yang Zhang ◽

Jianxiong Liu ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Physical Exercise ◽

Chinese Population ◽

Systolic Hypertension ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Cluster Sampling ◽

Isolated Systolic Hypertension ◽

Elderly Chinese

Abstract Objective To investigate the prevalence status of the isolated systolic hypertension (ISH) among the elderly Chinese population and analyze risk factors of ISH. Methods The survey was conducted from September 2015 to September 2016 enrolling 1269 people aging above 80 in the urban community in Chengdu, China. The participants were recruited by using a stratified cluster sampling method. The average blood pressure of an individual was obtained by using a standardized mercury sphygmomanometer to measure the blood pressure twice after a 10-minute seated rest. Results The prevalence of ISH was 53.0% among the elderly population; the ISH was accounted for 82.2% of all hypertension cases. The prevalence of ISH of males and females was 54.7% and 51.5%, respectively, without significant differences (P = 0.25). The prevalence of ISH in the 80–84 group, 85–89 group, and > 90 group were 52.5%, 53.0%, and 60.0%, respectively without significant differences (P for trend = 0.36). Multivariate logistic regression analysis showed that drinking alcoholic, obesity, and heart rate (HR) > 75 beats/min were all positively correlated to the incident of ISH; however, physical exercise was negatively correlated to the occurrence of ISH. Conclusion 53.0% of the elderly Chinese population aged above 80 has ISH. The gender and physical exercise are not the independent risk factor of ISH. But drinking alcoholic, obesity and HR > 75 are significantly related to the occurrence of ISH.

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Faktor risiko loss to follow up terapi ARV pada pasien HIV

Berita Kedokteran Masyarakat ◽

10.22146/bkm.12732 ◽

2017 ◽

Vol 33 (4) ◽

pp. 173

Author(s):

Listy Handayani ◽

Riris Andono Ahmad ◽

Yanri Wijayanti Subronto

Keyword(s):

Risk Factors ◽

Health Insurance ◽

Antiretroviral Therapy ◽

Protective Factor ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Loss To Follow Up ◽

Kaplan Meier ◽

Adherence Counseling

Risk factors for loss to follow up of antiretroviral therapy in HIV patientsPurposeThis study aimed to determine risk factors for loss to follow-up of antiretroviral therapy among HIV-infected patients in Dr. Sardjito Yogyakarta, 2011-2014.MethodsA retrospective cohort study was conducted involving 499 HIV patients. Observations were conducted for four years using medical records. Data analysis was performed using Kaplan-Meier and Cox proportional hazards regression tests.ResultsThere were 190 loss to follow-up patients. Risk factors for loss to follow-up of ARV therapy were: a student (AHR = 2.42; 95% CI = 1.20-4.89), the distance ≥ 10 km (AHR = 1.58; 95% CI = 1:09 to 2:31), using health insurance (AHR = 1.67; 95% CI = 1:11 to 2:51) and homosexual as a protective factor of loss to follow-up of antiretroviral therapy (HR = 0:49; 95% CI = 0.30-0.80).ConclusionBeing a college student, the distance between home and ARV service ≥10 km and using health insurance were the risk factors for loss to follow-up of ARV treatment. Adherence counseling for students, cooperation with the drug taking supervisor and decentralization ARV service, as well as effective and efficient services for patients who use health insurance need to be strengthened.

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The different risk factors for isolated diastolic hypertension and isolated systolic hypertension: a national survey

10.21203/rs.3.rs-221215/v1 ◽

2021 ◽

Author(s):

Kun Xie ◽

Xiufang Gao ◽

Liwen Bao ◽

Ying Shan ◽

Haiming Shi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Systolic Hypertension ◽

Young Patients ◽

Significant Risk ◽

Significant Risk Factor ◽

Isolated Systolic Hypertension ◽

Logistic Analysis ◽

Diastolic Hypertension ◽

Convenience Sampling

Abstract Background Hypertension is highly prevalent and is one of the modifiable risk factors for cardiovascular outcomes. Isolated diastolic hypertension (IDH), however, tend to be ignored due to insufficient recognition. We sought to depict the clinical manifestation of IDH and isolated systolic hypertension (ISH) in order to find a more efficient way to improve the management. Methods Patients with primary hypertension aged over 18 years were investigated from all over the country using convenience sampling during 2017–2019. IDH was defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) ≥ 90 mmHg. ISH was defined as SBP ≥ 140 mmHg and DBP < 90 mmHg. Results Totally 8548 patients were screened and 8475 participants were included. The average age was 63.67 ± 12.78 years and male accounted for 54.4%. Among them, 361 (4.3%) had IDH and 2096 had ISH (24.7%). Patients with IDH (54.84 ± 13.21 years) was much younger. Aging turned out to be negatively associated with IDH but positively associated with ISH. Logistic analysis showed BMI was a significant risk factor for IDH (OR 1.30, 95%CI 1.05–1.61, p = 0.018), but not for ISH (OR 1.05, 95%CI 0.95–1.16, p = 0.358). Moreover, smoking was significantly associated with IDH (OR 1.36, 95%CI 1.04–1.78, p = 0.026) but not with ISH (OR 1.04, 95%CI 0.90–1.21, p = 0.653). Conclusions Patients with IDH were much younger and the prevalence decreased with aging. BMI and smoking were remarkably associated with IDH rather than ISH. Keeping fit and giving up smoking might be particularly efficient in the management of young patients with IDH. Trial registration: NCT03862183, retrospectively registered on March 5, 2019

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The different risk factors for isolated diastolic hypertension and isolated systolic hypertension: a national survey

BMC Public Health ◽

10.1186/s12889-021-11686-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kun Xie ◽

Xiufang Gao ◽

Liwen Bao ◽

Ying Shan ◽

Haiming Shi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Systolic Hypertension ◽

Young Patients ◽

Significant Risk ◽

Multivariate Logistic Regression Analysis ◽

Significant Risk Factor ◽

Isolated Systolic Hypertension ◽

Diastolic Hypertension ◽

Convenience Sampling

Abstract Background Hypertension is highly prevalent and is one of the modifiable risk factors for cardiovascular outcomes. Isolated diastolic hypertension (IDH), however, tends to be ignored due to insufficient recognition. We sought to depict the clinical manifestation of IDH and isolated systolic hypertension (ISH) to find a more efficient way to improve the management. Methods Patients with primary hypertension aged over 18 years were investigated from all over the country using convenience sampling during 2017–2019. IDH was defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg. ISH was defined as SBP ≥ 140 mmHg and DBP < 90 mmHg. Results A total of 8548 patients were screened, and 8475 participants were included. The average age was 63.67 ± 12.78 years, and males accounted for 54.4%. Among them, 361 (4.3%) had IDH, and 2096 had ISH (24.7%). Patients with IDH (54.84 ± 13.21 years) were much younger. Aging turned out to be negatively associated with IDH but positively associated with ISH. Multivariate logistic regression analysis showed BMI was a significant risk factor for IDH (OR 1.30, 95%CI 1.05–1.61, p = 0.018), but not for ISH (OR 1.05, 95%CI 0.95–1.16, p = 0.358). Moreover, smoking was significantly associated with IDH (OR 1.36, 95%CI 1.04–1.78, p = 0.026) but not with ISH (OR 1.04, 95%CI 0.90–1.21, p = 0.653). Conclusions Patients with IDH were much younger, and the prevalence decreased with aging. BMI and smoking were remarkably associated with IDH rather than ISH. Keeping fit and giving up smoking might be particularly efficient in the management of young patients with IDH. Trial registration NCT03862183, retrospectively registered on March 5, 2019.

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Blood pressure from mid‐ to late life and risk of incident dementia

Neurology ◽

10.1212/wnl.0000000000004741 ◽

2017 ◽

Vol 89 (24) ◽

pp. 2447-2454 ◽

Cited By ~ 46

Author(s):

Emer R. McGrath ◽

Alexa S. Beiser ◽

Charles DeCarli ◽

Kendra L. Plourde ◽

Ramachandran S. Vasan ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Hypertension ◽

Proportional Hazards ◽

Late Life ◽

Cox Proportional Hazards ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Dementia Risk ◽

Incident Dementia ◽

Steep Decline

Objective:To determine the association between blood pressure during midlife (40–64 years) to late life (≥65 years) and risk of incident dementia.Methods:This study included 1,440 (758 women, mean age 69 ± 6 years) Framingham Offspring participants who were free of dementia and attended 5 consecutive examinations at 4-year intervals starting at midlife (1983–1987, mean age 55 years) until late life (1998–2001, mean 69 years) and subsequently were followed up for incident dementia (mean 8 years). We determined the effect of midlife hypertension (≥140/90 mm Hg), late life hypertension, lower late life blood pressure (<100/70 mm Hg), persistence of hypertension during mid- to late life, and steep decline in blood pressure from mid- to late life over an 18-year exposure period.Results:During the follow-up period, 107 participants (71 women) developed dementia. Using multivariable Cox proportional hazards models, we found that midlife systolic hypertension (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.05–2.35) and persistence of systolic hypertension into late life (HR 1.96, 95% CI 1.25–3.09) were associated with an elevated risk of incident dementia. However, in individuals with low to normal blood pressure (≤140/90 mm Hg) at midlife, a steep decline in systolic blood pressure during mid- to late life was also associated with a >2-fold increase in dementia risk (HR 2.40, 95% CI 1.39–4.15).Conclusions:Elevated blood pressure during midlife, persistence of elevated blood pressure into late life, and, among nonhypertensives, a steep decline in blood pressure during mid- to late life were associated with an increased dementia risk in a community-based cohort. Our data highlight the potential sustained cognitive benefits of lower blood pressures in midlife but also suggest that declining blood pressure in older adults with prehypertension or normotension, but not in those with hypertension, may be a risk marker for dementia.

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Efficacy Analysis of Multidisciplinary Treatment for Wilm’s Tumor in Single Center

10.21203/rs.3.rs-1185550/v1 ◽

2022 ◽

Author(s):

Bing Yan ◽

Fengming Ji ◽

Chengchuang Wu ◽

Ye Li ◽

Haoyu Tang ◽

...

Keyword(s):

Risk Factors ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Multidisciplinary Treatment ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Histological Type ◽

Factors Affecting ◽

Hazards Model ◽

Kaplan Meier

Abstract Objective: To analyze the efficacy of multidisciplinary treatment (MDT) for Wilm’s tumor (WT) in Kunming Children’s Hospital, and investigate the risk factors affecting the prognosis of WT.Method: The clinic-pathological data were collected and analyzed in patients with unilateral WT treated in Kunming Children's Hospital from January 2017 to July 2021. Research objects were selected according to inclusion criteria and exclusion criteria. The risk factors and independent risk factors that affect the prognosis of patients with WT were determined by Kaplan-Meier survival analysis and Cox proportional hazards model, respectively. Outcome: A total of 68 children were included in this study, and the 5-year overall survival (OS) rate was 92.65%. Kaplan-Meier survival analysis results showed that ethnicity (P=0.020), the tumor volume of resection (P=0.001), histological type (P<0.001), and postoperative recurrence (P<0.001) were the factors affecting the prognosis of children with WT. The results of the Cox proportional hazards model showed that only the histological type (P=0.028) was the independent risk factor for the prognosis of WT.Conclusion: The efficacy of MDT for WT was satisfying. The histological type has important predictive value for the prognosis of WT, and the patient with unfavorable histology has a poor prognosis.

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