Survival analysis after hip fracture: higher mortality than the general population and delayed surgery increases the risk at any time

Purpose: To estimate survival curves in patients with hip fracture according to gender, age, type of fracture, and waiting time for surgery and to compare them with the life expectancy of the general population. The study hypothesis is that survival after hip fractures is significantly lower than in the general population, especially in cases that underwent delayed surgery, regardless of age and gender. Methods: A survival analysis study was designed and approved by our institutional ethics review board. All patients who were coded with a diagnosis of hip fracture from 2002 to 2018 were included in the study. A total of 1176 patients were included, and the median age was 81 years (18–105 years). Kaplan-Meier curves and log-rank tests were performed to compare survival curves between those who underwent surgery on time and those with surgical delays. An exponential multivariate regression model was estimated, and a hazard ratio (HR) was reported for age, gender, and wait time for surgery. A significance of 5% was used, and a confidence interval level of 95% was reported. Results: The Kaplan-Meier curves for delayed surgery (log-rank, p = 0.00) and the age group (log-rank, p = 0.00) were significantly different. Exponential regression estimated an HR 1.05 (1.05–1.07) for age, HR 1.80 (1.51–2.13) for men, and HR 1.93 (1.61–2.31) for each day of wait for surgery. Conclusions: The 2 significant findings of this study are that hip fracture patients over 40 years old have a higher risk of dying at any time compared to the general population and that the waiting time for surgery (a modifiable factor) decreases survival rates at any time.

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Mortality after hip or knee arthroplasty for osteoarthritis in Chile: A survival analysis

Medwave ◽

10.5867/medwave.2020.11.8088 ◽

2020 ◽

Vol 20 (11) ◽

pp. e8088-e8088

Author(s):

Maximiliano Barahona ◽

Cristian Barrientos ◽

Álvaro Martinez ◽

Julián Brañes ◽

Juan Pablo Prieto ◽

...

Keyword(s):

Survival Analysis ◽

General Population ◽

Knee Arthroplasty ◽

Internal Validity ◽

The United States ◽

Hazard Ratio ◽

Weibull Regression ◽

Institutional Ethics ◽

Kaplan Meier ◽

Hip And Knee Arthroplasty

Background The purpose of this study is to determine if patients with osteoarthritis that undergo hip or knee arthroplasty jeopardize their life expectancy in Chile. Methods A survival analysis study was designed and approved by our institutional ethics review board. Patients were included if they underwent surgery for hip or knee osteoarthritis and were 50 years or older at the time of surgery. Patients were excluded if arthroplasty was performed for fracture, hemophilia arthropathy, or tumor. A multiparametric Weibull regression was estimated, and the hazard ratio was reported. For internal validity, a bootstrap of 200 repetitions was performed. Results A total of 4 094 arthroplasties were included. The Kaplan-Meier curve estimates a higher survival than the general population up to 12 years, after which the median survival is less than the general population. The bootstrap multiparametric Weibull regression estimated a hazard ratio of 1.53 (95% confidence interval: 1.27 to 1.84) for women, 1.09 (1.08 to 1.10) for every year older, and 1.29 (1.07 to 1.53) for hip arthroplasty patients. Conclusion Mortality after hip and knee arthroplasty in Chile follows a bimodal behavior similar to reports from the United States and Europe. At first, mortality is lower than the general population but worsens after 12 to 15 years of surgery

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A simple test of copying ability and sex define survival in patients with early Alzheimer's disease

Psychological Medicine ◽

10.1017/s0033291798007375 ◽

1999 ◽

Vol 29 (2) ◽

pp. 485-489 ◽

Cited By ~ 13

Author(s):

J. J. CLAUS ◽

G. J. M. WALSTRA ◽

P. M. BOSSUYT ◽

S. TEUNISSE ◽

W. A. VAN GOOL

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Function ◽

General Population ◽

Survival Rates ◽

Symptom Duration ◽

Simple Test ◽

Kaplan Meier ◽

Early Alzheimer’S Disease

Background. We studied whether heterogeneous profiles of cognitive function are relevant to survival in patients with early Alzheimer's disease.Methods. CAMCOG subscales of cognitive function were used as predictors of survival, together with gender in 157 consecutively referred patients with early Alzheimer's disease. Statistical analysis was performed with Cox proportional hazards analysis and Kaplan–Meier survival curves. Survival rates were compared with those in the general population.Results. Eighty patients (51%) died during the follow-up that extended to 5·7 years, with a median survival of 4·4 years after entry. Only the praxis subscore was statistically significant related to survival (P<0·0001). Its predictive power was based on only two items, including copying ability for a spiral and a three-dimensional house, independent of age, sex, education, overall CAMCOG score, dementia severity and symptom duration. Kaplan–Meier curves for the combined score of these items (0, 1, or 2) showed three groups with significantly different survival rates for both men and women. Comparison of gender specific survival rates with data from the general population showed that excess mortality was statistically significant (P<0·01) higher in men (51%) than in women (21%) after follow-up extending to 5 years.Conclusions. A simple test of copying ability defines subgroups of AD patients with large differences in survival rates. This suggests that parietal lobe impairment is an important predictor of mortality in AD. Also, the course of AD may be more benign in women than in men.

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Can Payment by Results Improve Hip Fracture Surgery Delays?

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363510x512381 ◽

2010 ◽

Vol 92 (7) ◽

pp. 1-3

Author(s):

T Nunn ◽

W Salloum ◽

D Pinch ◽

S Naima

Keyword(s):

Risk Factor ◽

Hip Fracture ◽

Waiting Time ◽

Independent Risk Factor ◽

Patient Choice ◽

Poor Health ◽

Delayed Surgery ◽

Hip Fracture Surgery ◽

Fracture Surgery ◽

British Orthopaedic Association

Mortality following hip fracture surgery is high, with 7% mortality at 30 days and 18% at 120 days. This reflects the pre-existing poor health of some of those who present with such an injury. Large studies have demonstrated that delayed surgery is an independent risk factor for mortality. The British Orthopaedic Association (BOA) recommends that hip fracture surgery be undertaken within 48 hours in all those medically fit. Payment by Results (PbR) was introduced in July 2000 in the NHS Plan, linking the allocation of funds to hospitals to the activity undertaken. This was designed to 'provide a transparent, rules-based system […] which would reward efficiency, support patient choice and diversity and encourage activity for sustainable waiting time reductions'.

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Competing Risks Models for an Enterprises Duration on the Market

Folia Oeconomica Stetinensia ◽

10.2478/foli-2020-0027 ◽

2020 ◽

Vol 20 (1) ◽

pp. 456-473

Author(s):

Dominika M. Urbańczyk

Keyword(s):

Survival Analysis ◽

Competing Risks ◽

Waiting Time ◽

Research Topic ◽

Business Activity ◽

Full Understanding ◽

Kaplan Meier ◽

Duration Distribution ◽

The Impact ◽

Valuable Result

AbstractResearch background: Enterprises are an important element of the economy, which explains that the analysis of their duration on the market is an important and willingly undertaken research topic. In the case of complex problems like this, considering only one type of event, which ends the duration, is often insufficient for full understanding.Purpose: In this paper there is an analysis of the duration of enterprises on the market, taking into account various reasons for the termination of their business activity as well as their characteristics.Research methodology: A survival analysis can be used to study duration on the market. However, the possibility of considering the waiting time for only one type of event is its important limitation. One solution is to use competing risks. Various competing risks models (naive Kaplan-Meier estimator, subdistribution model, subhazard and cause-specific hazard) are presented and compared with an indication of their advantages and weakness.Results: The competing risks models are estimated to investigate the impact of the causes of an enterprises liquidation on duration distribution. The greatest risk concerns enterprises with a natural person as the owner (regardless of the reason of failure). For each of the competing risks, it is also indicated that there is a section of activity which adversely affects the ability of firms to survive on the market.Novelty: A valuable result is considering the reasons for activity termination in the duration analysis for enterprises from the Mazowieckie Voivodeship.

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Natural history of neuromodulation devices and therapies: a patient-centered survival analysis

Journal of Neurosurgery ◽

10.3171/2019.2.jns182450 ◽

2020 ◽

Vol 132 (5) ◽

pp. 1385-1391

Author(s):

Zoe E. Teton ◽

Daniel Blatt ◽

Amr AlBakry ◽

James Obayashi ◽

Gulsah Ozturk ◽

...

Keyword(s):

Survival Analysis ◽

Survival Data ◽

Rapid Development ◽

Survival Rates ◽

Therapeutic Benefit ◽

Patient Centered ◽

Kaplan Meier ◽

History Of ◽

Hardware Failures ◽

First Time

OBJECTIVEDespite rapid development and expansion of neuromodulation technologies, knowledge about device and/or therapy durability remains limited. The aim of this study was to evaluate the long-term rate of hardware and therapeutic failure of implanted devices for several neuromodulation therapies.METHODSThe authors performed a retrospective analysis of patients’ device and therapy survival data (Kaplan-Meier survival analysis) for deep brain stimulation (DBS), vagus nerve stimulation (VNS), and spinal cord stimulation (SCS) at a single institution (years 1994–2015).RESULTSDuring the study period, 450 patients underwent DBS, 383 VNS, and 128 SCS. For DBS, the 5- and 10-year initial device survival was 87% and 73%, respectively, and therapy survival was 96% and 91%, respectively. For VNS, the 5- and 10-year initial device survival was 90% and 70%, respectively, and therapy survival was 99% and 97%, respectively. For SCS, the 5- and 10-year initial device survival was 50% and 34%, respectively, and therapy survival was 74% and 56%, respectively. The average initial device survival for DBS, VNS, and SCS was 14 years, 14 years, and 8 years while mean therapy survival was 18 years, 18 years, and 12.5 years, respectively.CONCLUSIONSThe authors report, for the first time, comparative device and therapy survival rates out to 15 years for large cohorts of DBS, VNS, and SCS patients. Their results demonstrate higher device and therapy survival rates for DBS and VNS than for SCS. Hardware failures were more common among SCS patients, which may have played a role in the discontinuation of therapy. Higher therapy survival than device survival across all modalities indicates continued therapeutic benefit beyond initial device failures, which is important to emphasize when counseling patients.

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A Study on Survival Scenario of COVID-19 patients in India: An Application of Survival Analysis on patient demographics

10.1101/2020.08.01.20162115 ◽

2020 ◽

Author(s):

Sampurna Kundu ◽

Kirti ◽

Debarghya Mandal

Keyword(s):

Survival Analysis ◽

Disease Transmission ◽

Survival Function ◽

Survival Rates ◽

Age Groups ◽

Central India ◽

Kaplan Meier ◽

First Case ◽

The Government ◽

And Gender

The study of transmission dynamics of COVID-19, have depicted the rate, patterns and predictions of the pandemic cases. In order to combat the disease transmission in India, the Government had declared lockdown on the 25th of March. Even after a strict lockdown nationwide, the cases are increasing and have crossed 4.5 lakh positive cases. A positive point to be noted amongst all that the recovered cases are slowly exceeding the active cases. The survival of the patients, taking death as the event that varies over age groups and gender wise is noteworthy. This study aims in carrying out a survival analysis to establish the variability in survivorship among age groups and sex, at different levels, that is, national, state and district level. The open database of COVID-19 tracker (covid19india.org) of India has been utilized to fulfill the objectives of the study. The study period has been taken from the beginning of the first case which was on 30th Jan 2020 till 30th June. Due to the amount of under-reporting of data and dropping missing columns a total of 26,815 sample patients were considered. The entry point of each patient is different and event of interest is death in the study. Kaplan Meier survival estimation, Cox proportional hazard model and multilevel survival model has been used to perform survival analysis. Kaplan Meier survival function, shows that the probability of survival has been declining during the study period of five months. A significant variability has been observed in the age groups, as evident from all the survival estimates, with increasing age the risk of dying from COVID-19 increases. When Western and Central India show ever decreasing survival rate in the framed time period then Eastern , North Eastern and Southern India shows a slightly better picture in terms of survival. Maharashtra, Gujarat, Delhi, Rajasthan and West bengal showed alrmingly poor survival as well. This study has depicted a grave scenario of gradation of ever decreasing survival rates in various regions and shows the variability by age and gender.

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What are the determinants of survival curves of words?

Evolutionary Linguistic Theory ◽

10.1075/elt.00019.vel ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Freek Van de Velde ◽

Alek Keersmaekers

Keyword(s):

Survival Analysis ◽

Statistical Methods ◽

Historical Linguistics ◽

Survival Rates ◽

Evolutionary Approach ◽

Short Paper ◽

Survival Curves

Abstract An evolutionary approach to historical linguistics can be enlightening when not only the mechanisms, but also the statistical methods are considered from neighboring disciplines. In this short paper, we apply survival analysis to investigate what factors determine the lifespan of words. Our case study is on post-classical Greek from the 4th century BC to beginning of the 8th century AD. We find that lower frequency and phonetically longer lexemes suffer earlier deaths. Furthermore, verbs turn out to have higher survival rates than adjectives and nouns survival analysis.

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Internal Migration and Fertility in Turkey: Kaplan-Meier Survival Analysis

International Journal of Population Research ◽

10.1155/2012/329050 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 10

Author(s):

Mehmet Ali Eryurt ◽

İsmet KOÇ

Keyword(s):

Survival Analysis ◽

Internal Migration ◽

Family Formation ◽

Migrant Women ◽

Survival Curves ◽

Total Period ◽

Rural Migrant ◽

Kaplan Meier ◽

Analysis Technique ◽

And Migration

Starting from the mid-twentieth century, Turkey has experienced a remarkable fertility decline. Total period fertility declined from the level of 6 or 7 to the almost replacement level by 2003. Similarly, in the 1950s onwards internal migration gathered speed and transformed Turkey from a predominantly rural country to a mainly urban one in less than half a century. Fertility and migration were mutually reinforcing processes in Turkey. Considering this relationship, the study aims to compare fertility behaviours of migrants with those of nonmigrants at both origin and destination areas. The data source is the 2003 Turkey Demographic and Health Survey. A nonparametric descriptive survival analysis technique, Kaplan-Meier survival analysis, was employed. Kaplan-Meier survival curves of transition to first, second and subsequent births were compared by migration status. Survival curves of second and subsequent births for rural-to-urban and urban-to-rural migrant women are similar to the curves at the place of destination rather than place of origin. This result reveals that adaptation theory, rather than socialization theory, is more explanatory in the case of Turkey. Kaplan-Meier survival estimates showed that rural native and rural-to-rural migrant women experience all the events related with family formation earlier in their life cycle.

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Analysis of survival in patients with brain metastases treated surgically: Impact of age, gender, oncologic status, chemotherapy, radiotherapy, number and localization of lesions, and primary cancer site

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.64.08.717 ◽

2018 ◽

Vol 64 (8) ◽

pp. 717-722

Author(s):

José Marcus Rotta ◽

Daniella Brito Rodrigues ◽

Juliete Melo Diniz ◽

Bianca Medeiros de Abreu ◽

Fernanda Kamimura ◽

...

Keyword(s):

Survival Analysis ◽

Brain Metastases ◽

Statistical Significance ◽

Survival Rates ◽

Primary Site ◽

Cancer Site ◽

Kaplan Meier ◽

Curve Method ◽

Primary Cancer Site

SUMMARY OBJECTIVE To evaluate the survival of patients with brain metastases treated surgically according to the potentially involved factors. METHODS 71 patients treated surgically were analyzed with the diagnosis of brain metastases during the period from January 2011 to November 2014, totaling 47 months of follow-up. The Kaplan-Meier curve method was used for survival analysis. Results We evaluated 71 patients with brain metastases treated surgically, 44 female and 27 male, mean age of 60.1 years. According to the Karnofsky scale, 44 patients were classified with Karnofsky greater than or equal to 70 and 27 patients with Karnofsky inferior to 70. Lung was the primary site most commonly found. Death occurred in twenty patients (28%), and lung tumors were responsible for the most deaths. Twelve patients had supra and infratentorial metastases, fifty-nine only had supratentorial lesions, and lesions were multiple in twenty-eight patients and single in forty-three. Thirty patients were also treated with chemotherapy, eighteen with chemotherapy and radiation therapy, while only three received just radiotherapy. Survival analysis by Kaplan-Meier curve showed no statistical significance regarding age, histological type, location, Karnofsky, chemotherapy, and radiotherapy. There was statistical significance regarding gender. CONCLUSION The factors analyzed did not change survival rates, except for gender. This fact may probably be explained due to the systemic and diffuse behavior of cancer.

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The Long-Term Results of Lubinus Interplanta Hemiarthroplasty in 228 Acute Femoral Neck Fractures. A Retrospective Six-Year Follow-Up

Scandinavian Journal of Surgery ◽

10.1177/145749690209100409 ◽

2002 ◽

Vol 91 (4) ◽

pp. 357-360 ◽

Cited By ~ 6

Author(s):

K. Isotalo ◽

J. Rantanen ◽

V. Äärimaa ◽

E. Gullichsen

Keyword(s):

Survival Analysis ◽

Hip Fracture ◽

Femoral Neck ◽

Femoral Neck Fractures ◽

Long Term Results ◽

Dislocation Rate ◽

Kaplan Meier ◽

The Mean

Background and Aims: We retrospectively studied survival of patients treated with Lubinus interplanta (IP) semiendoprosthesis in acute hip fracture. Materials and Methods: The long-term results of Lubinus interplanta (IP) hemiarthroplasty in 228 acute medial fractures of the femoral neck in 222 patients were reviewed. Results and Conclusions: The mean age of the patients was 80.3 years. The mean duration of post-operative follow-up was 6.3 years (range 5–8 years). There were 12 reoperations (5.3 %), of which 8 were revisions (3.5 %). Dislocation rate was 3.5 %. Survival was 93 % at three years and 88 % at six years (Kaplan-Meier-survival analysis). Conclusions: These results surpass those previously published after Thompson and Moore hemiarthroplasties. The Lubinus prosthesis has a greater CCD (caput, collum, diaphyse) angle and a longer stem compared to Thompson and Moore implants. The need for resection of calcar cortex is also limited. These biomechanical facts may explain the good long-term results of Lubinus hemiarthroplasty.

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