Prognostic factors in uterine sarcoma: A clinicopathologic and immunohistochemical (IHC) study of 30 cases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16071-16071
Author(s):  
F. Al-Safi ◽  
A. Al Kushi ◽  
S. Ameeri ◽  
N. Al Merri
Keyword(s):  
Patient Outcome ◽  
Multivariate Analysis ◽  
Tumor Cell ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Uterine Sarcoma ◽  
Low Grade ◽  
Cell Type ◽  
Survival Curves ◽  
P53 Expression

16071 Background: The objective of this study is to examine the prognostic relevance of traditional clinical, pathological and IHC features of uterine sarcoma (US). Methods: The study population consisted of thirty cases of US treated at our institute. Twenty- two cases are HGS (11 leiomyosarcoma, and 11 carcinosarcoma) and eight cases are LGS (5 mullerian adenosarcoma and 3 low grade endometrial stromal sarcoma). Clinical and pathological data including patient's age, parity, menopausal status, tumor cell type, lymphovascular invasion, nuclear grade, stage and mitotic index. Serial sections were immunostained with antibodies for p53, bcl-2, estrogen receptor (ER), Her2 and c-kit. The clinicopathological and IHC features were analysed by using Kaplan-Meier method for constructing survival curves, and log-rank statistic for survival curves comparison. Multivariate analysis was performed using Cox regression modeling. Results: The mean follow-up period of patients is 32 months (range 1- 120). Twelve (55%) patients with HGS died of the disease and none of the LGS group. In the HGS group, stage (p=0.01), myometrial invasion in early stage tumor (p=0.04), and lymphovascular invasion (p=0.043) were significant predicators of patient outcome in univariate analysis. Similarly, tumor cell type, ER, p53 and bcl-2 expression showed statistical significant correlation with tumor-specific survival (p=0.0039, p=0.001, p=0.03, and p=0.04, respectively). ER and bcl-2 expression were associated with better outcome and the opposite for p53 expression. In a multivariate analysis, only the tumor stage and cell type had independent statistical significance (p=0.04, and p=0.035, respectively). Overexpression of p53 and Her2 were observed in 40% and 60% of carcinosracomas respectively and not seen in any of the other tumors. The c-kit immunostain showed focal and weak staining in 40% of carcinosarcoma and only in 33% of leiomyosarcoma. None of LGS had this marker. The ER was expressed only in the LGS group. Conclusions: This study demonstrates that stage and tumor cell type are the most important prognostic indicators of patient outcome in US. IHC markers such as ER, p53, c-kit, and Her2 can be useful ancillary tools to discriminate between HGS and LGS in difficult cases. No significant financial relationships to disclose.

scholarly journals Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 244
Author(s):  
Kei Yoneda ◽  
Naoto Kamiya ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Medical Center ◽  
Univariate Analysis ◽  
The Other ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Positive Results

(1) Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. (2) Methods: We analyzed 216 patients who underwent first TURBT and 64 patients who underwent RC at Toho University Sakura Medical Center. (3) Results: LVI was identified in 22.7% of patients who underwent first TURBT, and in 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p = 0.009) and LVI at first TURBT (HR 9.205, p = 0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, presence of G3 and LVI was significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p < 0.05). (4) Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

Low-Grade Stage III-IV Follicular Lymphoma: Multivariate Analysis of Prognostic Factors in 484 Patients—A Study of the Groupe d'Etude des Lymphomes de l'Adulte

1999 ◽  
Vol 17 (8) ◽  
pp. 2499-2499 ◽  
Author(s):  
Didier Decaudin ◽  
Eric Lepage ◽  
Nicole Brousse ◽  
Pauline Brice ◽  
Jean-Luc Harousseau ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Risk Ratio ◽  
Univariate Analysis ◽  
International Prognostic Index ◽  
Phase Iii ◽  
Stage Iii ◽  
Low Grade ◽  
Number Of Patients ◽  
Follicular Lymphomas

PURPOSE: To identify the prognostic factors that influence overall survival (OS) in patients with stage III-IV follicular lymphomas and evaluate the clinical usefulness and the prognostic value of the International Prognostic Index (IPI). PATIENTS AND METHODS: Four hundred eighty-four patients with Ann Arbor stage III-IV follicular lymphomas treated in two phase III trials from 1986 to 1995 were screened for this study. All histologic slides were reviewed by two hematopathologists. The influence of the initial parameters on survival was defined by univariate (log-rank test) and multivariate (Cox model) analyses. RESULTS: The poor prognostic factors for OS (age > 60 years, “B” symptom(s), ≥ two extranodal sites, stage IV disease, tumor bulk > 7 cm, at least three nodal sites > 3 cm, liver involvement, serous effusion-compression or orbital/epidural involvement, and erythrocyte sedimentation rate > 30 mm/h) that were significant in univariate analysis were subjected to multivariate analysis. Three factors remained significant: B symptom(s) (risk ratio = 1.80), age greater than 60 years (risk ratio = 1.60), and at least three nodal sites greater than 3 cm (risk ratio = 1.71). When the IPI was applied to these patients, the score was 1, 2, 3, and 4-5 in 49%, 39%, 11%, and 2%, respectively, and it was significant for progression-free survival (P = .002) and OS (P = .0001). CONCLUSION: Three prognostic factors for poor OS were identified: B symptoms, age greater than 60 years, and at least three nodal sites greater than 3 cm. The IPI was prognostic for OS, but in this population, a very low number of patients belonged to the high-risk groups.

The risk of debilitating falls in Manitobans living with prostate cancer (pc).

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 244-244
Author(s):  
Joel Roger Gingerich ◽  
Pascal Lambert ◽  
Malcolm Doupe ◽  
Paul Joseph Daeninck ◽  
Marshall W. Pitz ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cumulative Incidence ◽  
Large Population ◽  
Univariate Analysis ◽  
Population Based ◽  
Community Dwelling ◽  
Low Grade ◽  
Population Based Study ◽  
Increased Risk

244 Background: Falls and fall-related injuries are important patient safety problems. Some studies suggest that pc patients have higher fall rates, however the severity of these falls is unknown. We sought to measure if pc patients are at increased risk of a debilitating fall requiring hospitalization. Methods: This is a retrospective population-based study utilizing the Manitoba Cancer Registry and Manitoba Health administrative databases. Our cohort consists of all community-dwelling patients living in Manitoba Canada who were diagnosed with pc between 2004 and 2008. These individuals were matched by age, sex, and time of diagnosis with up to three cancer-free controls. Debilitating falls were defined as falls/fractures requiring hospitalization and were identified using ICD-9 and -10 billing codes. A competing risk model was used to compare debilitating falls between the pc and cancer-free cohorts and expressed as sub-hazard ratios. Follow-up ended December 31, 2009. Results: 2,903 pc patients were identified along with 8,686 matched controls. The mean age was 69.3 and 68.8 respectively. The median follow-up was 3.05 years. Debilitating falls were identified in 109 patients (3.8%) with pc and 345 (4%) matched controls. The cumulative incidence of debilitating falls for those with pc vs cancer-free controls were: 1.08% vs. 1.13% at 1-year and 5.25% vs. 5.96% at five years of follow-up (SHR = 0.95, 95% CI = 0.77 – 1.18, p = 0.65). On univariate analysis, patients with stage IV pc were at higher risk of falls compared to matched controls. This difference was not significant on multivariate analysis though (SHR = 1.19, 95% CI = 0.74 – 1.89, p = 0.48). On multivariate analysis, patients with a Gleason score of ≤6 experienced a reduced risk of debilitating falls compared to matched controls (SHR = 0.44, 95% CI = 0.27 – 0.72, p = 0.001), whereas patients with other Gleason scores did not. The analysis was similar when patients with fractures were excluded. Conclusions: In this large population-based study, the 1- and 5-year cumulative incidence of debilitating falls did not differ significantly for patients with vs without pc. In fact, compared to matched controls, low grade pc patients were less likely to experience a debilitating fall.

Tumor microvessel density, p53 expression, tumor size, and peritumoral lymphatic vessel invasion are relevant prognostic markers in node-negative breast carcinoma.

1994 ◽  
Vol 12 (3) ◽  
pp. 454-466 ◽  
Author(s):  
G Gasparini ◽  
N Weidner ◽  
P Bevilacqua ◽  
S Maluta ◽  
P Dalla Palma ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Breast Carcinoma ◽  
Protein Expression ◽  
Microvessel Density ◽  
Tumor Size ◽  
Lymphatic Vessel ◽  
P53 Protein ◽  
Univariate Analysis ◽  
P53 Expression ◽  
Node Negative

PURPOSE To determine the absolute and relative value of microvessel density (MVD), p53 and c-erbB-2 protein expression, peritumoral lymphatic vessel invasion (PLVI), and conventional prognosticators in predicting relapse-free (RFS) and overall survival (OS) rates in patients with node-negative breast carcinoma (NNBC). PATIENTS AND METHODS We monitored 254 consecutive patients with NNBC for a median of 62 months. Intratumoral MVD was measured after microvessels were immunostained using anti-CD31 antibody. p53 and c-erbB-2 protein and hormone receptors were also determined immunocytochemically. Results were analyzed by both univariate and multivariate statistical analysis. RESULTS Univariate analysis showed that MVD was significantly predictive of both RFS (odds ratio [OR], 8.30; P = .0001) and OS (OR, 4.50; P = .012) when tested as a continuous or dichotomous variable. Likewise, tumor size (OR, 3.16; P = .0012), PLVI (OR, 4.36; P = .0009), estrogen receptor (ER) status (OR, 2.35; P = .016), progesterone receptor (PR) status (OR, 2.00; P = .017), and expression of p53 protein (OR, 2.82; P = .004) were significantly associated with RFS. Tumor size (OR, 3.80; P = .0038) and expression of p53 protein (OR, 2.58; P = .024) were significantly associated with OS by univariate analysis. Multivariate analysis showed that MVD (P = .0004), p53 protein expression (P = .0063), tumor size (P = .0144), and PLVI (P = .0033) were all significant and independent prognostic factors for RFS. However, only tumor size (P = .004) and MVD (P = .047) were independent predictors for OS. c-erbB2 expression was not associated with outcome by either univariate or multivariate analysis. CONCLUSION MVD, p53 expression, PLVI, and tumor size are independent prognostic indicators of recurrence, which are useful in selection of high-risk NNBC patients who may be eligible to receive adjuvant therapies.

scholarly journals High-dose radiotherapy in newly diagnosed low-grade gliomas with nonmethylated O(6)-methylguanine-DNA methyltransferase

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yanwei Liu ◽  
Yanong Li ◽  
Peng Wang ◽  
Li Chen ◽  
Jin Feng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Dna Methyltransferase ◽  
Univariate Analysis ◽  
High Dose ◽  
Low Grade ◽  
Newly Diagnosed ◽  
Great Resistance ◽  
Low Grade Gliomas ◽  
Methylguanine Dna Methyltransferase ◽  
Significant Difference

Abstract Background Patients with low-grade gliomas (LGGs) harboring O6-methylguanine-DNA methyltransferase promoter nonmethylation (MGMT-non-pM) have a particularly short survival and are great resistance to chemotherapy. The objective of this study was to assess the efficacy of high-dose radiotherapy (RT) for LGGs with MGMT-non-pM. Methods 268 patients with newly diagnosed adult supratentorial LGGs from the multicenter Chinese Glioma Cooperative Group (CGCG) received postoperative RT during 2005–2018. MGMT promoter methylation analysis was conducted by pyrosequencing in all patients. Univariate and multivariate analysis were performed using the Cox regression to determine the prognostic factors for overall survival (OS) and progression-free survival (PFS). RT dose–response on MGMT status defined subtypes was analyzed. Results On univariate analysis, the following were statistically significant favorable factors for both PFS and OS: oligodendrogliomas(p = 0.002 and p = 0.005), high-dose RT (> 54 Gy) (p = 0.021 and p = 0.029) and 1p/19q codeletion (p < 0.001 and p = 0.001). On multivariate analysis, RT dose (> 54 Gy vs. ≤ 54 Gy) and IDH mutation were independently prognostic markers for OS (HR, 0.47; 95%CI, 0.22–0.98; p = 0.045; and HR, 0.44; 95%CI, 0.21–0.96; p = 0.038, respectively) and PFS (HR, 0.48; 95%CI, 0.26–0.90; p = 0.022; and HR, 0.51; 95%CI, 0.26–0.98; p = 0.044, respectively). High-dose RT was associated with longer OS (HR, 0.56; 95%CI, 0.32–0.96; p = 0.036) and PFS (HR, 0.58; 95%CI, 0.35–0.96; p = 0.033) than low-dose RT in MGMT-non-pM subtype. In contrast, no significant difference in either OS (p = 0.240) or PFS (p = 0.395) was observed with high-dose RT in the MGMT-pM subtype. Conclusions High-dose RT (> 54 Gy) is an independently protective factor for LGGs and is associated with improved survival in patients with MGMT-non-pM.

Preoperative accuracy of gastric cancer staging in patient selection for neoadjuvant therapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 34-34
Author(s):  
Naruhiko Ikoma ◽  
Elena Elimova ◽  
Mariela A. Blum ◽  
Jaffer A. Ajani ◽  
Y. Sabrina Chiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Therapy ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Preoperative Staging ◽  
Neoadjuvant Treatment ◽  
Pathology Report ◽  
T Stage ◽  
N Status

34 Background: Because gastric cancers stage ≥ T2 or ≥ N1 are considered for neoadjuvant treatment, accuracy of preoperative staging is critical. The purpose of this study was to identify preoperative staging accuracies of computed tomography scan (CT) and endoscopic ultrasound (EUS) in gastric cancer and their utilities in selecting patients for neoadjuvant therapy. Methods: Medical records of 8,260 patients with gastric or gastroesophageal adenocarcinoma (presented 1995-2013) were reviewed to identify those who underwent gastrectomy but not neoadjuvant treatment. We reviewed preoperative EUS reports and CT images to identify detailed T stage (based on AJCC 7thedition) and lymph node positivity (short axis diameter ≥ 6mm). T stage and N status were compared with those from the surgical pathology report. Clinicopathologic variables associated with incorrect preoperative staging were also examined. Results: We identified 187 patients who underwent preoperative staging by EUS (n = 145) and/or CT (n = 134) for gastrectomy. The accuracy, sensitivity, and specificity of EUS in distinguishing T1 from more advanced tumors were 82%, 78%, and 85%, respectively. In univariate analysis, tumor location and lymphovascular invasion were associated with incorrect EUS T staging. In multivariate analysis, variables associated with underestimation of EUS T stage was lymphovascular invasion (OR 7.51, 95% CI 1.91-29.5, p < 0.01) and Caucasian race (OR 3.75, 95% CI 1.31-10.75, p = 0.01). The accuracies, sensitivities, and specificities for N status were, respectively, 65%, 49%, and 79% with CT and 66%, 29%, and 95% with EUS. In univariate analysis, poor differentiation and lymphovascular invasion were associated with incorrect diagnosis of CT N status. In multivariate analysis, lymphovascular invasion was associated with false-negative (OR 3.79, 95% CI 1.34-10.7, p = 0.01), and differentiated histology was associated with false-positive CT N status (OR 7.14, 95% CI 2.00-25.44, p < 0.01). Conclusions: EUS has reasonable accuracy in T stage, while both CT and EUS have low sensitivities and high specificities in N status. These accuracies should be considered when selecting patients for neoadjuvant treatment.

Prognostic significance of p53 immunostaining in epithelial ovarian cancer.

1994 ◽  
Vol 12 (1) ◽  
pp. 64-69 ◽  
Author(s):  
L C Hartmann ◽  
K C Podratz ◽  
G L Keeney ◽  
N A Kamel ◽  
J H Edmonson ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Multivariate Analysis ◽  
Epithelial Ovarian Cancer ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Stage I ◽  
Stage Iii ◽  
P53 Expression ◽  
Independent Prognostic Significance ◽  
Grade 3

PURPOSE To evaluate the prognostic significance of p53 expression in epithelial ovarian cancer, including a subset of stage I patients, and to look for correlations between p53 expression and other disease parameters, including stage, grade, age, histologic subtype, second-look results, ploidy, and percent S phase. PATIENTS AND METHODS We analyzed p53 expression in 284 patients with epithelial ovarian cancer using immunohistochemical techniques in paraffin-embedded specimens. There were 36 patients with stage I disease, 20 with stage II disease, 186 with stage III disease, and 42 with stage IV disease. RESULTS p53 immunoreactivity was present in 177 cases (62%). p53 expression was associated with grade 3 to 4 disease (P = .003). The following factors were associated with a decrease in overall survival in a univarate analysis: stage III or IV disease (P = .0001), grade 3 or 4 disease (P = .0001), age above the median (P = .0002), and p53 reactivity (P = .04). In a multivariate analysis, stage, grade, and age retained independent prognostic significance. In the subset of 36 stage I patients, p53 positively approached statistical significance (P = .10) as a negative prognostic factor in a univariate analysis. CONCLUSION Abnormalities of p53 expression occur commonly in epithelial ovarian cancer. Although associated with decreased survival in a univariate analysis, this biologic marker did not retain independent prognostic significance in a multivariate analysis. p53 expression should be studied in a larger cohort of early-stage patients, where accurate prognostic information is needed to direct therapy.

Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis

2010 ◽  
Vol 13 (5) ◽  
pp. 589-593 ◽  
Author(s):  
Charles A. Sansur ◽  
Davis L. Reames ◽  
Justin S. Smith ◽  
D. Kojo Hamilton ◽  
Sigurd H. Berven ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Surgical Approach ◽  
Complication Rate ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Low Grade ◽  
Complication Rates ◽  
High Grade ◽  
Previous Surgery ◽  
History Of

Object This is a retrospective review of 10,242 adults with degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) from the morbidity and mortality (M&M) index of the Scoliosis Research Society (SRS). This database was reviewed to assess complication incidence, and to identify factors that were associated with increased complication rates. Methods The SRS M&M database was queried to identify cases of DS and IS treated between 2004 and 2007. Complications were identified and analyzed based on age, surgical approach, spondylolisthesis type/grade, and history of previous surgery. Age was stratified into 2 categories: > 65 years and ≤ 65 years. Surgical approach was stratified into the following categories: decompression without fusion, anterior, anterior/posterior, posterior without instrumentation, posterior with instrumentation, and interbody fusion. Spondylolisthesis grades were divided into low-grade (Meyerding I and II) versus high-grade (Meyerding III, IV, and V) groups. Both univariate and multivariate analyses were performed. Results In the 10,242 cases of DS and IS reported, there were 945 complications (9.2%) in 813 patients (7.9%). The most common complications were dural tears, wound infections, implant complications, and neurological complications (range 0.7%–2.1%). The mortality rate was 0.1%. Diagnosis of DS had a significantly higher complication rate (8.5%) when compared with IS (6.6%; p = 0.002). High-grade spondylolisthesis correlated strongly with a higher complication rate (22.9% vs 8.3%, p < 0.0001). Age > 65 years was associated with a significantly higher complication rate (p = 0.02). History of previous surgery and surgical approach were not significantly associated with higher complication rates. On multivariate analysis, only the grade of spondylolisthesis (low vs high) was in the final best-fit model of factors associated with the occurrence of complications (p < 0.0001). Conclusions The rate of total complications for treatment of DS and IS in this series was 9.2%. The total percentage of patients with complications was 7.9%. On univariate analysis, the complication rate was significantly higher in patients with high-grade spondylolisthesis, a diagnosis of DS, and in older patients. Surgical approach and history of previous surgery were not significantly correlated with increased complication rates. On multivariate analysis, only the grade of spondylolisthesis was significantly associated with the occurrence of complications.

scholarly journals Predictive Value of Platelet-to-Lymphocyte Ratio and Systemic Immune‐Inflammation Index in Adverse Pathology at Radical Prostatectomy in Patients with Low-Grade Prostate Cancer

2021 ◽  
Author(s):  
jiatong zhou ◽  
ranlu liu
Keyword(s):  
Prostate Cancer ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Radical Prostatectomy ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Low Grade ◽  
Lymphocyte Ratio ◽  
Immune Inflammation

Abstract Purpose: To determine the potential role of several biochemical and clinical markers in predicting adverse pathology (AP) and ISUP GG upgrading at radical prostatectomy (RP) with low-grade (ISUP Gleason Group (ISUP GG) 1 and 2) prostate cancer (PCa). Methods: We retrospectively reviewed the patients who underwent radical prostatectomy following criteria: clinical stage T2a or less,and were identified low-grade PCa (ISUP GG 1−2, prostate-specifific antigen (PSA) <20 ng/ml) through prostate biopsy, univariate and multivariate analyses were performed to evaluate the association of patient and tumor characteristics with reclassification, AP was defined as stage ≥T3 and/or ISUP GG ≥3.Results: A total of 155 patients were eligible for this study. AP at RP occurred in 20 of 97 (20.62%) patients with ISUP GG 1, and 28 of 58 (48.28%) with ISUP GG 2. At univariate analysis, bioptic ISUP GG emerged as significant factors of AP(p＜0.001). Platelets to lymphocyte ratio(PLR) might be the risk factor of the incidence of AP(p=0.059). At multivariate analysis, we found PLR and bioptic ISUP were independent significantly factors in predicting AP. The area under the curve for PLR was 0.592. And also, we showed that systemic immune inflammation index(SII) and bioptic ISUP GG were significantly associated with ISUP GG upgrading after RP in multivariate analysis. Conclusions: We found that SII could not be a significant risk factor of AP at low-grade prostate cancer (PCa) after RP.While SII might be a predict factor for ISUP GG upgrading. PLR might be used as an independent predictor which was inversely correlated with presence of AP in low-grade PCa after RP.

scholarly journals P1361IS THE INFLAMMATORY STATE A DETERMINING FACTOR OF THE PRIMARY PERMEABILITY OF ARTERIOVENOUS FISTULES?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
LUIS GUILLERMO PICCONE SAPONARA ◽  
MARIA PAZ CASTRO FERNÁNDEZ ◽  
NANCY GIOVANNA URIBE HEREDIA ◽  
Agustin Carreno ◽  
SARA ANAYA FERNANDEZ ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Vascular Access ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Statin Treatment ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Low Grade ◽  
Cross Sectional ◽  
Inflammatory Parameters

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis and are associated with a lower incidence of morbidity and mortality. However, primary vascular access (AV) failure is not uncommon. Low-grade inflammation is present in ERCT. We identify the inflammatory parameters that influence the primary permeability of vascular access for hemodialysis. Method Cross-sectional study; We include all the AVs performed in the HGUCR. We evaluate the initial operation after the creation of the AV. Demographic variables (age, sex), aetiology of CKD and associated comorbidity were collected. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 Test. Quantitative variables are expressed as mean ± standard deviation and the t-student was used to compare them. We performed a multivariate analysis to determine those factors involved in the primary failure of the VA. Statistical significance for a value of p &lt;0.05. Results 600 VA performed on 466 patients were reviewed between October 2009 and December 2019. 492 autologous VA (86.8%) and 75 prosthetic VA (13.2%) were performed. The mean age of the patients was 65.3 ± 14.2 years and 66.2% were male. The most frequent etiology of CKD was diabetic nephropathy (29.9%), followed by non-affiliated (18%) and glomerulonephritis (16.5%). 90.8% of the patients had arterial hypertension (HT), diabetes mellitus (DM) 48%. 77.2% of AV presented primary permeability. In the univariate analysis using Chi2 and T student, statistical age (p = 0.017), HT (p = 0.002), statin treatment (p = 0.002), antiplatelet therapy (p = 0.001), low ferritin levels (p = 0.011) and PCR (p = 0.019). When performing a multivariate analysis, the high CRP figures (OR: 0.64 95% CI 0.42-0.98 p = 0.043) and ferritinemia (OR: 1.04 95% CI 1.01-1.06 p = 0.013) are predictive factors of primary AV failure. Conclusion In our study, high CRP decreases the probability of primary functioning of AVFs by 36% and elevated ferritin levels are predictors of primary failure after adjusting for age and sex in the multivariate model.

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