Abstract 15412: Long-term Outcomes of the Truncal Valve in Truncus Arteriosus

Objectives: Long-term survival in patients with truncus arteriosus (TA) is favorable, but there remains significant morbidity associated with need for ongoing re-interventions. The purpose of this study was to understand the long-term outcomes of the truncal valve (TV) and identify risk factors associated with the need for TV intervention. Methods: We retrospectively reviewed 170 patients who underwent initial TA repair at our institution from 1985-2015. Analysis of long-term outcomes was performed on the 148 patients who survived greater than 30 days post-operatively and to hospital discharge using multivariable competing risks Cox regression modeling. Results: Median follow up time was 12.6 years (IQR 5.0, 22.1 years) after full repair. Freedom from death or transplant at 1, 5, 10, and 20 years was 93.1 ± 2.1%, 88.0 ± 2.7%, 86.2 ± 3.0% and 78.3 ± 4.1%. Thirty patients (20%) underwent at least one intervention on the TV (22 repairs, 21 replacements). Freedom from any TV intervention at 1, 5, 10 and 20 years was 99 ± 1%, 94 ± 8%, 82 ± 9%, and 70 ± 5%. Of those with TV repair, 59% subsequently underwent TV replacement. Independent risk factors for need for TV intervention included ≥moderate TV regurgitation (TVR) (HR 4.77, p<0.001) or stenosis (HR 4.12, p<0.001) prior to full repair, and ≥moderate TVR at initial hospital discharge after full repair (HR 8.6, p<0.001). A single coronary ostium was also independently associated with need for TV intervention (HR 6.94, p=0.01). Quadricuspid valve morphology and TV repair at initial TA repair, risk factors in univariate analysis, were not independent predictors on multivariable analysis. Overall, 28% of patients progressed to ≥moderate TVR and to Z-scores of greater than 5 for valve dimensions. Conclusion: Long-term need for TV intervention remains significant. Moderate or worse initial TVR or stenosis, residual TVR after initial TA repair, and single coronary ostium are risk factors associated with need for subsequent TV intervention.

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Long‐Term Fate of the Truncal Valve

Journal of the American Heart Association ◽

10.1161/jaha.120.019104 ◽

2020 ◽

Vol 9 (22) ◽

Author(s):

Laura Gellis ◽

Geoffrey Binney ◽

Laith Alshawabkeh ◽

Minmin Lu ◽

Michael J. Landzberg ◽

...

Keyword(s):

Risk Factors ◽

Cox Regression ◽

Truncus Arteriosus ◽

Valve Regurgitation ◽

Term Survival ◽

Factors Associated ◽

Patients At Risk ◽

Independent Risk Factors

Background Long‐term survival in patients with truncus arteriosus is favorable, but there remains significant morbidity associated with ongoing reinterventions. We aimed to study the long‐term outcomes of the truncal valve and identify risk factors associated with truncal valve intervention. Methods and Results We retrospectively reviewed patients who underwent initial truncus arteriosus repair at our institution from 1985 to 2016. Analysis was performed on the 148 patients who were discharged from the hospital and survived ≥30 days postoperatively using multivariable competing risks Cox regression modeling. Median follow‐up time was 12.6 years (interquartile range, 5.0–22.1 years) after discharge from full repair. Thirty patients (20%) underwent at least one intervention on the truncal valve during follow‐up. Survival at 1, 10, and 20 years was 93.1%, 87.0%, and 80.9%, respectively. The cumulative incidence of any truncal valve intervention by 20 years was 25.6%. Independent risk factors for truncal valve intervention included moderate or greater truncal valve regurgitation (hazard ratio [HR], 4.77; P <0.001) or stenosis (HR, 4.12; P <0.001) before full truncus arteriosus repair and moderate or greater truncal valve regurgitation at discharge after full repair (HR, 8.60; P <0.001). During follow‐up, 33 of 134 patients (25%) progressed to moderate or greater truncal valve regurgitation. A larger truncal valve root z ‐score before truncus arteriosus full repair and during follow‐up was associated with worsening truncal valve regurgitation. Conclusions Long‐term rates of truncal valve intervention are significant. At least moderate initial truncal valve stenosis and initial or residual regurgitation are independent risk factors associated with truncal valve intervention. Larger truncal valve root z ‐score is associated with significant truncal valve regurgitation and may identify a subset of patients at risk for truncal valve dysfunction over time.

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Risk factors associated with long-term outcomes after active and supporting periodontal treatments: impact of various compliance definitions on tooth loss

Clinical Oral Investigations ◽

10.1007/s00784-019-02851-x ◽

2019 ◽

Vol 23 (11) ◽

pp. 4123-4131 ◽

Cited By ~ 2

Author(s):

Catherine Petit ◽

Sylvie Schmeltz ◽

Alexandre Burgy ◽

Henri Tenenbaum ◽

Olivier Huck ◽

...

Keyword(s):

Risk Factors ◽

Tooth Loss ◽

Long Term Outcomes ◽

Factors Associated

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Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

10.21203/rs.3.rs-34163/v2 ◽

2020 ◽

Author(s):

Marius Kryzauskas ◽

Augustinas Bausys ◽

Austeja Elzbieta Degutyte ◽

Vilius Abeciunas ◽

Eligijus Poskus ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Rectal Resection ◽

Multivariable Analysis ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Male Sex ◽

The Impact

Abstract Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR=10.54, p=0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR=2.40, p=0.004), CCI score >5 (OR=1.72, p=0.025) and T3/T4 stage tumors (OR=2.25, p=0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p=0.009 and p=0.001) and rectal (p=0.003 and p=0.014) surgery.Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

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T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: a cohort study

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02400-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Kentaro Matsuo ◽

Sang-Woong Lee ◽

Ryo Tanaka ◽

Yoshiro Imai ◽

Kotaro Honda ◽

...

Keyword(s):

Gastric Cancer ◽

Survival Rate ◽

Venous Invasion ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Factors Associated ◽

T Stage ◽

History Of

Abstract Background The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we investigated the clinicopathological factors associated with the long-term outcomes of RGC. Methods We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical and Pharmaceutical University Hospital, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival. Results No significant differences were noted in the survival rate based on clinical factors (age, body mass index, diabetes mellitus, hypertension, cardiovascular disease, pulmonary complications, liver disease, diet, history of alcohol drinking, and history of smoking) or the type of remnant gastrectomy. Significant differences were noted in the survival rate based on pathological factors and surgical characteristics (intraoperative blood loss, operation time, and the number of positive lymph nodes). Multivariate analysis revealed that the T stage (hazard ratio, 5.593; 95% confidence interval [CI], 1.183–26.452; p = 0.030) and venous invasion (hazard ratio, 3.351; 95% CI, 1.030–10.903; p = 0.045) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC. Conclusions T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be keys to managing and identifying therapeutic strategies for improving prognosis in RGC.

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Long-term survival (over 10 years) of inoperable/metastatic GISTs: A retrospective series of 141 patients (pts) of the french sarcoma group (FSG).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.11041 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 11041-11041

Author(s):

Florence Duffaud ◽

Edouard Auclin ◽

Antoine Italiano ◽

Julien Mancini ◽

Francois Bertucci ◽

...

Keyword(s):

Medical Records ◽

Univariate Analysis ◽

Median Number ◽

Term Survival ◽

Primary Tumors ◽

Long Term Survival ◽

Factors Associated ◽

Metastatic Gist ◽

Median Size

11041 Background: A subset of metastatic GIST exhibit very long-term survival after imatinib (IM) introduction. The aim of this study was to analyse the clinico-biological characteristics of GIST pts alive > 10 years (yrs) after diagnosis (dx) of metastases (mets) and identify possible factors associated with long-term survival. Methods: Pts were identified from 2 sarcoma databases; NetSarc and ConticaGIST. Clinical data prospectively registered in the databases were supplemented with retrospective review of medical records. Results: We identified 141 pts (75 men, 66 women) with median age 54 (17-84) yrs and median ECOG 0 (0-2). Primary tumors (T) were all CD117+, and mainly gastric or intestinal (64 & 45 pts), with median size 10 (2-40) cm, CD34+ (82 pts), mitoses/50 HPF ≤ 5 (n = 36), or > 5 (n = 81). Genotype was documented in 82 (58%) pts with 73 (89%) KIT mutations (in exons 11,9 and 12 of 69, 3, and 1 pts respectively) and 9 WT KIT. 129 (91%) T were resected, 124 upfront, 5 post IM, with R0/R1/R2 resections in 61, 11, and 10 pts. Mets were mainly hepatic or peritoneal (78 & 51 respectively). 1st line TKI was given to 139 pts: 130 received IM; 88 (63%) within a clinical trial (CT), 41 (29%) had mets resection. Second, 3d and 4th line TKI were given to 81, 51 and 37 pts respectively, comprising 27, 7 and 10 from CT. Median number of TKIs was 2 (0-7), but 60 (44%) pts received only 1st line with no GIST progression within or after 10 yrs. 2 pts never received TKI but had mets resection. After median FU of 14.3 yrs (10-34.5), 104 remain alive, 37 died. Mean and Median OS from initial dx are 24 yrs (CI95% 21.6-27) and 20,8 yrs. Median PFS on TKIs are 127, 29, 21 and 22 mos on 1st, 2d, 3d and 4th line of TKI. In univariate analysis no factor is significantly associated with OS, but T size (≤ 10 vs > 10 cm) and oligometastatic disease (≤5 vs > 5 mets) are borderline significant (p = 0.056 and 0.07), and good PS (ECOG ≤ 1) at 2dline TKI initiation is associated with better PFS (p = 0.03). Conclusions: This large series of long-term ( > 10 yrs) survivors of metastatic GIST shows a high proportion of mets resection and a longer duration of PFS for TKI at any line. In this selected population, no prognostic factor is associated with long OS.

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Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy

Journal Of Clinical Periodontology ◽

10.1111/jcpe.12266 ◽

2014 ◽

Vol 41 (7) ◽

pp. 701-707 ◽

Cited By ~ 59

Author(s):

Giovanni E. Salvi ◽

Daniel C. Mischler ◽

Kurt Schmidlin ◽

Giedre Matuliene ◽

Bjarni E. Pjetursson ◽

...

Keyword(s):

Risk Factors ◽

Periodontal Therapy ◽

Long Term Outcomes ◽

Factors Associated ◽

Supportive Periodontal Therapy

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Long-Term Outcomes and Risk Factors Associated With Acute Encephalitis in Children

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piv075 ◽

2015 ◽

Vol 6 (1) ◽

pp. 20-27 ◽

Cited By ~ 8

Author(s):

Suchitra Rao ◽

Benjamin Elkon ◽

Kelly B. Flett ◽

Angela F. D. Moss ◽

Timothy J. Bernard ◽

...

Keyword(s):

Risk Factors ◽

Long Term Outcomes ◽

Factors Associated ◽

Acute Encephalitis

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Risk factors associated with mechanical ventilation, autonomic nervous dysfunction and physical outcome in Vietnamese adults with tetanus

Tropical Medicine and Health ◽

10.1186/s41182-021-00336-w ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Rachel Davies-Foote ◽

Truong Ngoc Trung ◽

Nguyen Van Thanh Duoc ◽

Du Hong Duc ◽

Phung Tran Huy Nhat ◽

...

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Mechanical Ventilation ◽

Physical Function ◽

Hospital Discharge ◽

Post Discharge ◽

Long Term Outcome ◽

Autonomic Nervous ◽

Factors Associated

Abstract Background Tetanus remains common in many low- and middle-income countries, but as critical care services improve, mortality from tetanus is improving. Nevertheless, patients develop severe syndromes associated with autonomic nervous system disturbance (ANSD) and the requirement for mechanical ventilation (MV). Understanding factors associated with worse outcome in such settings is important to direct interventions. In this study, we investigate risk factors for disease severity and long-term physical outcome in adults with tetanus admitted to a Vietnamese intensive care unit. Methods Clinical and demographic variables were collected prospectively from 180 adults with tetanus. Physical function component scores (PCS), calculated from Short Form Health Survey (SF-36), were assessed in 79 patients at hospital discharge, 3 and 6 months post discharge. Results Age, temperature, heart rate, lower peripheral oxygen saturation (SpO2) and shorter time from first symptom to admission were associated with MV (OR 1.03 [ 95% confidence interval (CI) 1.00, 1.05], p = 0.04; OR 2.10 [95% CI 1.03, 4.60], p = 0.04; OR 1.04 [ 95% CI 1.01, 1.07], p = 0.02); OR 0.80 [95% CI 0.66, 0.94], p = 0.02 and OR 0.65 [95% CI 0.52, 0.79, p < 0.001, respectively). Heart rate, SpO2 and time from first symptom to admission were associated with ANSD (OR 1.03 [95% CI 1.01, 1.06], p < 0.01; OR 0.95 [95% CI 0.9, 1.00], p = 0.04 and OR 0.64 [95% CI 0.48, 0.80], p < 0.01, respectively). Median [interquartile range] PCS at hospital discharge, 3 and 6 months were 32.37 [24.95–41.57, 53.0 [41.6–56.3] and 54.8 [51.6–57.3], respectively. Age, female sex, admission systolic blood pressure, admission SpO2, MV, ANSD, midazolam requirement, hospital-acquired infection, pressure ulcer and duration of ICU and hospital stay were associated with reduced 0.25 quantile PCS at 6 months after hospital discharge. Conclusions MV and ANSD may be suitable endpoints for future research. Risk factors for reduced physical function at 3 months and 6 months post discharge suggest that modifiable features during hospital management are important determinants of long-term outcome.

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Long-term outcomes of patients admitted to an intensive care unit with intentional self-harm

Anaesthesia and Intensive Care ◽

10.1177/0310057x20978987 ◽

2021 ◽

pp. 0310057X2097898

Author(s):

Matthew J Maiden ◽

Roth Trisno ◽

Mark E Finnis ◽

Catherine M Norrish ◽

Anne Mulvey ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hospital Discharge ◽

Cause Of Death ◽

Relative Survival ◽

Term Survival ◽

Factors Associated ◽

Icu Admission ◽

Self Harm

Self-harm is one of the most common reasons for admission to an intensive care unit (ICU). While most patients with self-harm survive the ICU admission, little is known about their outcomes after hospital discharge. We conducted a retrospective cohort study of patients in the Barwon region in Victoria admitted to the ICU with self-harm (between 1998 and 2018) who survived to hospital discharge. The primary objective was to determine mortality after hospital discharge, and secondarily estimate relative survival, years of potential life lost, cause of death and factors associated with death. Over the 20-year study period, there were 710 patients in the cohort. The median patient age was 37 years (interquartile range (IQR) 26–48 years). A total of 406 (57%) were female, and 527 (74%) had a prior psychiatric diagnosis. The incidence of ICU admission increased over time (incidence rate ratio 1.05; 95% confidence interval (CI) 1.03–1.06 per annum). There were 105 (15%) patients who died after hospital discharge. Relative survival decreased each year after discharge, with the greatest decrement during the first 12 months. At ten years, relative survival was 0.85 (95% CI 0.81–0.88). The median years of potential life lost was 35 (IQR 22–45). Cause of death was self-harm in 27%, possible self-harm in 32% and medical disease in 41%. The only factors associated with mortality were male sex, older age and re-admission to ICU with self-harm. Further population studies are required to confirm these findings, and to understand what interventions may improve long-term survival in this relatively young group of critically ill patients.

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