scholarly journals Number of teeth is associated with all-cause and disease-specific mortality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yau-Hua Yu ◽  
Wai S. Cheung ◽  
Bjorn Steffensen ◽  
Donald R. Miller
Keyword(s):  
Density Measurement ◽  
The United States ◽  
Mortality Data ◽  
Mineral Density ◽  
Number Of Teeth ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Functional Dentition ◽  
Disease Specific Mortality ◽  
Disease Specific

Abstract Background Tooth loss has been shown to correlate with multiple systemic comorbidities. However, the associations between the number of remaining natural teeth (NoT) and all-cause mortality have not been explored extensively. We aimed to investigate whether having fewer NoT imposes a higher risk in mortality. We tested such hypotheses using three groups of NoT (20–28,10–19, and 0–9), edentulism and without functional dentition (NoT < 19). Methods The National Health and Nutrition Examination Survey in the United States (NHANES) (1999–2014) conducted dental examinations and provided linkage of mortality data. NHANES participants aged 20 years and older, without missing information of dental examination, age, gender, race, education, income, body-mass-index, smoking, physical activities, and existing systemic conditions [hypertension, total cardiovascular disease, diabetes, and stroke (N = 33,071; death = 3978), or with femoral neck bone mineral density measurement (N = 13,131; death = 1091)] were analyzed. Cox proportional hazard survival analyses were used to investigate risks of all-cause, heart disease, diabetes and cancer mortality associated with NoT in 3 groups, edentulism, or without functional dentition. Results Participants having fewer number of teeth had higher all-cause and disease-specific mortality. In fully-adjusted models, participants with NoT0-9 had the highest hazard ratio (HR) for all-cause mortality [HR(95%CI) = 1.46(1.25–1.71); p < .001], mortality from heart diseases [HR(95%CI) = 1.92(1.33–2.77); p < .001], from diabetes [HR(95%CI) = 1.67(1.05–2.66); p = 0.03], or cancer-related mortality [HR(95%CI) = 1.80(1.34–2.43); p < .001]. Risks for all-cause mortality were also higher among the edentulous [HR(95%CI) = 1.35(1.17–1.57); p < .001] or those without functional dentition [HR(95%CI) = 1.34(1.17–1.55); p < .001]. Conclusions Having fewer NoT were associated with higher risks for all-cause mortality. More research is needed to explore possible biological implications and validate our findings.

Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 320-331
Author(s):  
Junga Lee
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Respiratory Diseases ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Adult Participants ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

scholarly journals Mediating-Moderating Effect of Allostatic Load on the Association between Dietary Approaches to Stop Hypertension Diet and All-Cause and Cause-Specific Mortality: 2001–2010 National Health and Nutrition Examination Surveys

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2311 ◽  
Author(s):  
Hind A. Beydoun ◽  
Shuyan Huang ◽  
May A. Beydoun ◽  
Sharmin Hossain ◽  
Alan B. Zonderman
Keyword(s):  
Cardiovascular Disease ◽  
Allostatic Load ◽  
Moderating Effects ◽  
Dash Diet ◽  
Health And Nutrition ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Cancer Specific Mortality ◽  
Disease Specific

This secondary analysis of survey data examined mediating-moderating effects of allostatic load score (calculated using the Rodriquez method) on the association between nutrient-based Dietary Approaches to Stop Hypertension (DASH) diet score (Mellen Index) and the all-cause and cause-specific mortality risks among 11,630 adults ≥ 30 years of age from the 2001–2010 National Health and Nutrition Examination Surveys with no history of cardiovascular disease or cancer at baseline, and who were followed-up for ~9.35 years. Multivariable models were adjusted for demographic, socioeconomic, lifestyle, and health characteristics. All-cause, cardiovascular disease, and cancer-specific mortality rates were estimated at 6.5%, 1.1%, and 1.9%, respectively. The median DASH total score was 3.0 (range: 1–8) (with 78.3% scoring < 4.5), whereas the median allostatic load score was 3 (range: 0–9). The DASH diet, fiber, and magnesium were negatively correlated with allostatic load, whereas allostatic load predicted higher all-cause mortality, irrespective of the DASH diet. Whereas protein was protective, potassium increased all-cause mortality risk, irrespective of allostatic load. Potassium was protective against cardiovascular disease-specific mortality but was a risk factor for cancer-specific mortality. Although no moderating effects were observed, mediation by the allostatic load on cardiovascular disease-specific mortality was observed for DASH total score and selected component scores. Direct (but not indirect) effects of DASH through the allostatic load were observed for all-cause mortality, and no direct or indirect effects were observed for cancer-specific mortality. From a public health standpoint, the allostatic load may be a surrogate for the preventive effects of the DASH diet and its components on cardiovascular disease-specific mortality risk.

scholarly journals Patient Age and Survival After Surgery for Esophageal Cancer

2020 ◽  
Vol 28 (1) ◽  
pp. 159-166 ◽  
Author(s):  
Jesper Lagergren ◽  
Matteo Bottai ◽  
Giola Santoni
Keyword(s):  
Esophageal Cancer ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Flexible Parametric Model ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Abstract Background Esophagectomy for esophageal cancer is associated with a substantial risk of life-threatening complications and a limited long-term survival. This study aimed to clarify the controversial questions of how age influences short-term and long-term survival. Methods This population-based cohort study included almost all patients who underwent curatively intended esophagectomy for esophageal cancer in Sweden in 1987–2010, with follow-up through 2016. The exposure was age, analyzed both as a continuous and categorical variable. The probability of mortality was computed using a novel flexible parametric model approach. The reported probabilities are proper measures of the risk of dying, and the related odds ratios (OR) are therefore more suitable measures of association than hazard ratios. The outcomes were 90-day all-cause mortality, 5-year all-cause mortality, and 5-year disease-specific mortality. A novel flexible parametric model was used to derive the instantaneous probability of dying and the related OR along with 95% confidence intervals (CIs), adjusted for sex, education, comorbidity, tumor histology, pathological tumor stage, and resection margin status. Results Among 1737 included patients, the median age was 65.6 years. When analyzed as a continuous variable, older age was associated with slightly higher odds of 90-day all-cause mortality (OR 1.05, 95% CI 1.02–1.07), 5-year all-cause mortality (OR 1.02, 95% CI 1.01–1.03), and 5-year disease-specific mortality (OR 1.01, 95% CI 1.01–1.02). Compared with patients aged < 70 years, those aged 70–74 years had no increased risk of any mortality outcome, while patients aged ≥ 75 years had higher odds of 90-day mortality (OR 2.85, 95% CI 1.68–4.84), 5-year all-cause mortality (OR 1.56, 95% CI 1.27–1.92), and 5-year disease-specific mortality (OR 1.38, 95% CI 1.09–1.76). Conclusions Patient age 75 years or older at esophagectomy for esophageal cancer appears to be an independent risk factor for higher short-term mortality and lower long-term survival.

Development of Pancreatic Cancer, Disease-specific Mortality, and All-Cause Mortality in Patients with Nonresected IPMNs: A Long-term Cohort Study

Radiology ◽  
2016 ◽  
Vol 278 (1) ◽  
pp. 125-134 ◽  
Author(s):  
Naoyoshi Nagata ◽  
Akihito Kawazoe ◽  
Saori Mishima ◽  
Tatsuya Wada ◽  
Takuro Shimbo ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Cancer Disease ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

scholarly journals All-cause mortality among breast cancer patients in a screening trial: support for breast cancer mortality as an end point

2002 ◽  
Vol 9 (4) ◽  
pp. 159-162 ◽  
Author(s):  
L. Tabar ◽  
S.W. Duffy ◽  
M-F. Yen ◽  
J. Warwick ◽  
B. Vitak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
End Point ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Screening Trial ◽  
Disease Specific

BACKGROUND: It has recently been suggested that all-cause mortality is a more appropriate end point than disease specific mortality in cancer screening trials, and that disease specific mortality is biased in favour of screening. This suggestion is based partly on supposed inconsistencies between all-cause mortality results and disease specific results in cancer screening trials, and alleged increases in deaths from causes other than breast cancer among breast cancer cases diagnosed among women invited to screening. METHODS: We used data from the Swedish Two-County Trial of mammographic screening for breast cancer, in which 77 080 women were randomised to an invitation to screening and 55 985 to no invitation. We estimated relative risks (RRs) (invited v control) of death from breast cancer, death from other causes within the breast cancer cases, and death from all causes within the breast cancer cases. RRs were adjusted for age and took account of the longer follow up of breast cancer cases in the invited group due to lead time. RESULTS: There was a significant 31% reduction in breast cancer mortality in the invited group (RR 0.69, 95% confidence interval (CI) 0.58–0.80; p<0.001). There was no significant increase in deaths from other causes among breast cancer cases in the invited group (RR 1.12, 95% CI 0.96–1.31; p=0.14). A significant 19% reduction in deaths from all causes was observed among breast cancer cases in the group invited to screening (RR 0.81, 95% CI 0.72–0.90; p<0.001). A more conservative estimation gave a significant 13% reduction (RR 0.87, 95% CI 0.78–0.97; p=0.01). These findings are consistent with the magnitude of the reduction in breast cancer mortality. CONCLUSIONS: Invitation to screening was associated with a reduction in deaths from all causes among breast cancer cases, consistent with high participation rates in screening. There is no significant evidence of bias in cause of death classification in the Two-County Trial, and as breast cancer mortality is the targeted clinical outcome in breast cancer screening, it is the appropriate end point in a breast cancer screening trial. All-cause mortality is a poor and inefficient surrogate for breast cancer mortality.

scholarly journals Anatomic site as prognostic marker of pancreatic neuroendocrine tumors: a cohort study

2019 ◽  
Vol 181 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Muhamad Badarna ◽  
Ruth Percik ◽  
Genya Aharon-Hananel ◽  
Inbal Uri ◽  
Amit Tirosh
Keyword(s):  
Cohort Study ◽  
Multivariable Analysis ◽  
Rank Test ◽  
Pancreatic Neuroendocrine Tumors ◽  
Anatomic Site ◽  
Log Rank Test ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Objective Patients with pancreatic neuroendocrine tumors (PNET) have variable prognosis, even with comparable tumor grade and stage. In the current study we aimed to evaluate the prognostic utility of the intrapancreatic PNET anatomical site. Design Cohort study based on the Surveillance Epidemiology and End Results database. Methods Patients diagnosed with non-functioning PNET between 2004 and 2015 were compared by anatomic site for disease-specific mortality and all-cause mortality, using log-rank test and by multivariable cox regression analysis. Results Overall, 4171 patients (1839 women (44.1%), median age strata 60–64 years, range 10–14 to ≥85 years) were included in our analysis. Patients with PNETs located at the head vs body/tail of the pancreas had comparable tumor diameter, as well as ethnicity, gender and age distributions, but had higher rates of grade III and IV NET (13.2 vs 6.6% and 4.4 vs 1.9%, respectively, P < 0.001). NETs located at the head vs body/tail of pancreas were more likely to be locally advanced (32.2 vs 19.9%) with no difference in distant metastases (36.4 vs 33.5%, respectively, P < 0.001). Patients with NETs of the head vs. body/tail of the pancreas had higher disease-specific mortality risk in univariate (log-rank test, P < 0.001) and multivariable analysis (hazard ratio (HR): 1.34, 95% confidence interval: 1.10–1.65, P = 0.004). Multivariable analysis for all-cause mortality also showed increased risk for patients with pancreatic head vs. body/tail PNET (HR: 1.23, P = 0.013). Conclusions PNET anatomical location is associated with the mortality risk and should be considered as a prognostic factor, and as an additional consideration in directing patients management.

scholarly journals Gender Differences in Prognosis after Primary Resection for Retroperitoneal Liposarcoma

2021 ◽  
Author(s):  
Cheng-Xin Weng ◽  
Yu-Han Qi ◽  
Ji-Chun Zhao ◽  
Ding Yuan ◽  
Yi Yang ◽  
...  
Keyword(s):  
Survival Rates ◽  
Radical Resection ◽  
Primary Resection ◽  
Low Grade ◽  
Retroperitoneal Liposarcoma ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Abstract Background: Current evidence regarding gender difference in retroperitoneal liposarcoma (RLPS) is scarce, we sought to investigate whether gender may affect prognosis after primary resection of RLPS.Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify RLPS patients from January 1973 to December 2015. Multivariate cox proportional hazards analysis was adopted to generate adjusted hazard ratio (AHR) and 95% confidence intervals (CI) of survival outcomes.Results: In total, 2108 RLPS patients, including 971 women and 1137 men, were identified, with a median follow-up of 45.0 (17.0-92.0) months. The 5-year and 10-year overall survival rates were 50.5% and 31.5% for men, and 60.4% and 42.5% for women. The 5-year and 10-year disease-specific survival rates for men and women were 71.5%, 57.3% and 76.3%, 62.1%, respectively. We found men were associated with an increased risk of all-cause mortality (AHR 1.3, 95%CI 1.0-1.6, P=.017) but not disease-specific mortality (AHR 1.2, 95%CI 0.9-1.6, P=.246). The subgroup analyses revealed that men were associated with an increased risk of all-cause mortality in patients with low-grade tumors (AHR 1.8, 95%CI 1.3-2.5) or patients received non-radical resection (AHR 1.6, 95%CI 1.2-2.1). Besides, in the subgroup of low-grade tumors, men were also associated with an increased risk of disease-specific mortality (AHR 2.0, 95%CI 1.2-3.3).Conclusion: Men may have worse survival after primary resection of RLPS compared with women, especially in patients with low-grade tumors or patients received non-radical resection. Gender-based disparities may deserve more attention in patients with RLPS.

Association Between Immunosuppression and Outcomes in Oral Cavity Squamous Cell Carcinoma

2020 ◽  
pp. 019459982096014
Author(s):  
Julia Chang ◽  
John B. Sunwoo ◽  
Jennifer Lobo Shah ◽  
Wendy Hara ◽  
Jison Hong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
End Points ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Objective To assess the effect of immunosuppression on recurrence and mortality outcomes in oral cavity squamous cell carcinoma (SCC) after initial surgical treatment. Study Design Retrospective cohort study. Setting A single academic tertiary referral center. Methods Patients with oral cavity SCC treated with initial surgery were included. Immunosuppressed versus nonimmunosuppressed groups were compared. Primary end points were 5-year overall recurrence and all-cause mortality. Secondary end points were recurrence subtypes (local, regional, and distant) and disease-specific mortality. Results Of 803 patients with oral cavity SCC, 71 (9%) were immunosuppressed from therapeutic drug use (n = 48) or systemic disease (n = 23). The immunosuppressed group consisted of patients with a history of transplant (21%), autoimmune or pulmonary disorder (45%), hematologic malignancy or myeloproliferative disorder (30%), and HIV infection (3%). After adjusting for baseline variables of age, sex, comorbidities, pathologic tumor characteristics, and adjuvant treatment, all recurrence and mortality outcomes were worse in the immunosuppressed group. The multivariate-adjusted hazard ratio for overall recurrence was 2.16 (95% CI, 1.50-3.12; P < .01), and all-cause mortality was 1.79 (95% CI, 1.15-2.78; P < .01) in Cox regression analysis. The 2 groups were then matched in a 1:5 ratio according to the same baseline variables. All end points apart from disease-specific mortality were significantly worse in the immunosuppressed group after matching. Conclusion This study demonstrates that immunosuppression is associated with poor outcomes in oral cavity SCC, with an approximate 2-fold increase in rates of recurrence and mortality. Future studies are needed to assess the risks and benefits of adjusting therapeutic immunosuppression in this population.

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