Novel methods of analyzing long-term trends in incidence and survival applied to gastroesophageal cancers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14512-e14512
Author(s):  
Zhensheng Wang ◽  
Michael Goodman ◽  
Hemchandra Mahaseth ◽  
Bassel F El-Rayes
Keyword(s):  
Combined Modality Therapy ◽  
Survival Rates ◽  
Inflexion Point ◽  
Joinpoint Regression ◽  
Distant Disease ◽  
Incidence Trends ◽  
Long Term Trends ◽  
Regional Disease ◽  
One Year

e14512 Background: The incidence of esophageal squamous cell (ESC) carcinoma has been decreasing, while incidence of esophageal adenocarcinoma (EA) keeps increasing. The specific time periods during which incidence trends changed have not been examined. Secular trends in survival and changes of those trends need to be investigated. Methods: Incidence and survival were analyzed using joinpoint regression models, which are designed to examine long-term longitudinal data for a change in trend. We identified 75,497 patients with esophageal cancer and adenocarcinoma of the gastric cardia (GCA) in the Surveillance, Epidemiology, and End Results database between 1973 and 2008. Incidence and one-year survival rates for ESC, EA, and GCA were compared by race, gender and stage. Results were expressed in terms of identifiable inflexion points (joinpoints) with before-and-after estimates of annual percent changes (APC) with 95% confidence intervals (CI). Results: Incidence of ESC has demonstrated a clear inflexion point in the mid 1980s with accelerated decrease across race and gender categories. While incidence of EA has been increasing, the increase slowed down in mid 90s in all groups except blacks. For GCA, there was a clear increase in incidence up until early 80s followed by a plateau although in men there was a significant post-87 decrease. One-year survival of ESC patients has been improving; for local/regional disease the trend became less pronounced in late 80s whereas for distant disease the improvement appears to continue without identifiable inflexion points. The patterns of one-year survival for EA and GCA were similar. Local/regional diseases demonstrated a significant improvement in survival without changes in trend while survival of distant diseases showed an inflexion point in the mid 90s followed by a marked improvement. Conclusions: Joinpoint regression analysis is a valuable tool in assessing long-term trends of incidence and survival. The survival of ESC, EA, and GCA demonstrated significant improvement over the last 35 years. The inflexion points reflected introduction of combined modality therapy for regional disease and availability of newer chemotherapy agents for distant disease.

scholarly journals Long-term trends and drought: spatiotemporal variation in juvenile sex ratios of North American ducks

2021 ◽  
Author(s):  
Sage Ellis ◽  
Madeleine Lohman ◽  
James Sedinger ◽  
Perry Williams ◽  
Thomas Riecke
Keyword(s):  
United States ◽  
North American ◽  
Sex Ratios ◽  
Survival Rates ◽  
The United States ◽  
Avian Communities ◽  
Eastern United States ◽  
Bird Populations ◽  
Long Term Trends

Sex ratios affect population dynamics and individual fitness, and changing sex ratios can be indicative of shifts in sex-specific survival at different life stages. While climate- and landscape-change alter sex ratios of wild bird populations, long-term, landscape scale assessments of sex ratios are rare. Further, little work has been done to understand changes in sex ratios in avian communities. In this manuscript, we analyse long-term (1961-2015) data on five species of ducks across five broad climatic regions of the United States to estimate the effects of drought and long-term trends on the proportion of juvenile females captured at banding. As waterfowl have a 1:1 sex ratio at hatch, we interpret changes in sex ratios of captured juveniles as changes in sex-specific survival rates during early life. Seven of twelve species-region pairs exhibited evidence for long-term trends in the proportion of juvenile females at banding. The proportion of juvenile females at banding increased for duck populations in the western United States and typically declined for duck populations in the eastern United States. We only observed evidence for an effect of drought in two of the twelve species-region pairs, where the proportion of females declined during drought. As changes to North American landscapes and climate continue and intensify, we expect continued changes in sex-specific juvenile survival rates. More broadly, we encourage further research examining the mechanisms underlying long-term trends in juvenile sex ratios in avian communities.

scholarly journals Did the introduction and increased prescribing of antidepressants lead to changes in long-term trends of suicide rates?

2020 ◽  
Author(s):  
Simone Amendola ◽  
Martin Plöderl ◽  
Michael P Hengartner
Keyword(s):  
General Pattern ◽  
Extended Period ◽  
Joinpoint Regression ◽  
Short Term ◽  
Term Study ◽  
Suicide Rates ◽  
Long Term Study ◽  
Prescription Rates ◽  
Long Term Trends

Abstract Background Ecological studies have explored associations between suicide rates and antidepressant prescriptions in the population, but most of them are limited as they analyzed short-term correlations that may be spurious. The aim of this long-term study was to examine whether trends in suicide rates changed in three European countries when the first antidepressants were introduced in 1960 and when prescription rates increased steeply after 1990 with the introduction of the serotonin reuptake inhibitors (SSRIs). Methods Data were extracted from the WHO Mortality Database. Suicide rates were calculated for people aged 10–89 years from 1951–2015 for Italy, 1955–2016 for Austria and 1951–2013 for Switzerland. Trends in suicide rates stratified by gender were analyzed using joinpoint regression models. Results There was a general pattern of long-term trends that was broadly consistent across all three countries. Suicide rates were stable or decreasing during the 1950s and 1960s, they rose during the 1970s, peaked in the early 1980s and thereafter they declined. There were a few notable exceptions to these general trends. In Italian men, suicide rates increased until 1997, then fell sharply until 2006 and increased again from 2006 to 2015. In women from all three countries, there was an extended period during the 2000s when suicide rates were stable. No trend changes occurred around 1960 or 1990. Conclusions The introduction of antidepressants around 1960 and the sharp increase in prescriptions after 1990 with the introduction of the SSRIs did not coincide with trend changes in suicide rates in Italy, Austria or Switzerland.

The significance of the residual mediastinal mass in treated Hodgkin's disease.

1985 ◽  
Vol 3 (5) ◽  
pp. 637-640 ◽  
Author(s):  
M Jochelson ◽  
P Mauch ◽  
J Balikian ◽  
D Rosenthal ◽  
G Canellos
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Increased Risk ◽  
Additional Chemotherapy ◽  
Long Term Follow Up ◽  
Mediastinal Widening ◽  
Mediastinal Adenopathy ◽  
One Year

The chest roentgenograms of 65 patients treated for Hodgkin's disease with mediastinal adenopathy were analyzed retrospectively to determine the incidence and significance of residual mediastinal abnormality after treatment. All patients were treated with radiation therapy, and 36 patients received additional chemotherapy. On completion of treatment, 57 (88%) of the 65 patients had some residual mediastinal abnormality. These were either minimal changes in the mediastinal shadow in 30 patients or a widening greater than 6 cm in 27 patients. In the latter group, 11 (40%) of 27 patients continued to have residual mediastinal widening one year after completion of therapy. These patients did not have a higher incidence of recurrence. Long-term follow-up (median, 48 months) revealed continued abnormalities in 24 (40%) of the original 57 patients. Mediastinal abnormalities are common at the end of radiation or combined modality therapy for Hodgkin's disease and do not by themselves indicate persistent active disease or an increased risk for relapse. We strongly recommend that additional chemotherapy or higher radiation doses beyond the initially planned course not be used for residual mediastinal widening.

scholarly journals Place of death trends among patients with dementia in Japan: a population-based observational study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Toshihiro Koyama ◽  
Misato Sasaki ◽  
Hideharu Hagiya ◽  
Yoshito Zamami ◽  
Tomoko Funahashi ◽  
...  
Keyword(s):  
Observational Study ◽  
Population Based ◽  
Place Of Death ◽  
Health Concern ◽  
Joinpoint Regression ◽  
Joinpoint Regression Analysis ◽  
Hospital Deaths ◽  
Long Term Trends ◽  
Nationwide Observational Study

AbstractDementia is a major public health concern in ageing societies. Although the population of Japan is among the most aged worldwide, long-term trends in the place of death (PoD) among patients with dementia is unknown. In this Japanese nationwide observational study, we analysed trends in PoD using the data of patients with dementia who were aged ≥65 years and died during 1999–2016. Trends in the crude death rates and PoD frequencies were analysed using the Joinpoint regression model. Changes in these trends were assessed using the Joinpoint regression analysis in which significant change points, the annual percentage change (APC) and average APCs (AAPC) in hospitals, homes, or nursing homes were estimated. During 1999–2016, the number of deaths among patients with dementia increased from 3,235 to 23,757 (total: 182,000). A trend analysis revealed increased mortality rates, with an AAPC of 8.2% among men and 9.3% among women. Most patients with dementia died in the hospital, although the prevalence of hospital deaths decreased (AAPC: -1.0%). Moreover, the prevalence of nursing home deaths increased (AAPC: 5.6%), whereas the prevalence of home deaths decreased (AAPC: -5.8%). These findings support a reconsideration of the end-of-life care provided to patients with dementia.

A Joinpoint regression analysis of long-term trends in cancer mortality in Japan (1958-2004)

2009 ◽  
Vol 124 (2) ◽  
pp. 443-448 ◽  
Author(s):  
Dongmei Qiu ◽  
Kota Katanoda ◽  
Tomomi Marugame ◽  
Tomotaka Sobue
Keyword(s):  
Regression Analysis ◽  
Cancer Mortality ◽  
Joinpoint Regression ◽  
Joinpoint Regression Analysis ◽  
Long Term Trends

Prolonged prophylaxis against venous thromboembolism with enoxaparin in patients undergoing cancer surgery: long-term survival analysis

2006 ◽  
Vol 21 (4) ◽  
pp. 195-198 ◽  
Author(s):  
D Bergqvist ◽  
G Agnelli ◽  
A T Cohen ◽  
P E Nilsson ◽  
A Le Moigne-Amrani ◽  
...  
Keyword(s):  
Survival Rates ◽  
Palliative Surgery ◽  
Curative Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year ◽  
Type Of Surgery

Objective: ENOXACAN II was a randomized, double-blind trial that showed prolonged (four-week) thromboprophylaxis with enoxaparin to be more effective than and as safe as standard (one-week) thromboprophylaxis in patients undergoing surgery with a curative intent for abdominopelvic cancer. This follow-up study compared long-term, all-cause mortality in both groups. Methods: Survival rates were calculated on the randomized, treated population ( n = 501). The primary efficacy endpoint was survival at one year. An exploratory analysis including survival data up to 44 months was performed. Because some patients were deemed to have undergone palliative as opposed to curative surgery, and there was a significant difference between the treatment groups in the percentage of patients undergoing palliative surgery, the survival analyses were adjusted for the type of surgery performed. Results: When adjusted for type of surgery, there was a trend towards reduced mortality among patients undergoing palliative surgery in the prolonged prophylaxis group (hazard ratio [HR] = 0.598, P = 0.3565) that became more pronounced beyond the pre-specified one year follow-up period (HR = 0.469, P = 0.078). This trend may reflect a beneficial effect of prolonged prophylaxis on survival in the palliative surgery group (one-year survival 65.4 versus 50% for standard prophylaxis). In patients undergoing curative surgery, one-year survival rates were equal in the standard and prolonged prophylaxis groups (93.8 and 93.2%, respectively). Conclusion: Prolonged thromboprophylaxis with enoxaparin may affect long-term survival in palliative surgery for cancer, but further investigation is warranted.

scholarly journals Early hemoglobin status is predictive of outcomes and long-term mortality of sepsis

2020 ◽  
Author(s):  
Desheng Qi ◽  
Milin Peng
Keyword(s):  
Protective Factor ◽  
Proportional Hazards ◽  
Critical Role ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Hemoglobin Level ◽  
Survival Group ◽  
Significant Difference ◽  
One Year

Abstract Background: Hemoglobin change plays a critical role in progress of sepsis. However, the contribution of hemoglobin change to outcomes of patients with sepsis is still unknown. The aim of our study is to investigate the effect of early hemoglobin level within 48h after admission to Intensive Care Unit (ICU) on long term prognosis for sepsis. Methods: In this single centered, cohort study, we included patients from different ICU departments of Xiangya hospital from 2016 to 2018. Out of 1800 ICU patients, 199 patients with sepsis matched inclusion criteria. All 199 patients were divided into three groups according to 70, 80, and 90 g/L hemoglobin statuses, respectively. Results: Our study showed seventy-nine patients (39.7%) with ≤90g/L hemoglobin, forty-seven patients (23.6%) with hemoglobin ≤80g/L, and twenty-five (12.6%) with hemoglobin ≤70g/L at 48h after admission. Compared to survival group, there were higher rates of patients with hemoglobin ≤80g/L (33.7% vs. 15.1%, P=0.003), hemoglobin ≤70g/L (18.5% vs. 7.5%, P=0.031) in non-survival group, but similar rate of hemoglobin ≤90g/L patients (46.7% vs. 34.0%, P=0.081). Kaplan-Meier survival analysis showed that significant difference occurred among all three groups with total one-year survival rates. Furthermore, multivariate cox proportional hazards regression analysis showed that serum hemoglobin concentration ≤ 80g/L at 48h admission (Hazard Ratio HR 1.736, 95% CI 1.131-2.665, P=0.012), the occurrence of ARDS (HR 1.814, 95% CI 1.184-2.778, P=0.006), the use of CRRT (HR 1.569, 95% CI 1.030-2.390, P=0.036), and septic shock (HR 1.776, 95% CI 1.124-2.804, P=0.014) were independent risk predictors for one-year mortality in septic patients. Whereas the infection site from abdomen (HR 0.281, 95% CI 0.113-0.697, P=0.006) was the only independent protective factor for mortality in septic patients. Conclusion: ≤80 g/L hemoglobin within 48h after admission to ICU was the independent risk factor for mortality for patients with sepsis. Attention should be raised up to target early hemoglobin level in course of sepsis to achieve better outcomes of sepsis. Future larger researches and randomized controlled trials are needed to validate our results.

scholarly journals A JOINPOINT REGRESSION ANALYSIS OF LONG-TERM TRENDS IN LEUKEMIA INCIDENCE AND MORTALITY IN CENTRAL SERBIA AND NIŠAVA DISTRICT (1999-2014)

2019 ◽  
Vol 58 (1) ◽  
pp. 16-23
Author(s):  
Marija Andjelković-Apostolović ◽  
◽  
Aleksandra Ignjatović ◽  
Miodrag Stojanović ◽  
Zoran Milošević ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Joinpoint Regression ◽  
Joinpoint Regression Analysis ◽  
Incidence And Mortality ◽  
Long Term Trends

Plagues and Peoples The Long Demographic Cycle, 1250–1670

2002 ◽  
Author(s):  
Richard Smith ◽  
paul slack
Keyword(s):  
Seventeenth Century ◽  
Population Cycle ◽  
Vital Rates ◽  
Epidemic Disease ◽  
Population Growth Rates ◽  
Annual Population ◽  
Long Term Trends ◽  
One Year ◽  
The Relationship

The following discussion is focused around a consideration of what will be termed a ‘long population cycle’ from the late thirteenth century through to the late seventeenth century. In so far as this consideration is directed towards a society that may be unambiguously categorized as ‘preindustrial’ throughout this era, it is unavoidable that at various stages of the argument it will be necessary to engage with the classical Malthusian model of the relationship between living standards and population growth rates, although some assessment will be made of the role played by epidemic disease in determining both the width and depth of the cycle. In addition an attempt will be made to chart the principal changes to the economy and society relating to shifting numbers and geographical distribution of persons on the land during the extensive phases of demographic decline and recovery. Before engaging with theory and explanations of long-term trends some mundanely empirical steps will be taken so that the broad dimensions of the ‘cycle’ might be established. Empiricism is no straightforward endeavour in the absence of serial census records of any kind, let alone individual census counts for randomly distributed moments, over this extensive fourcentury period. It is at least fortunate that the final 150 years of the cycle yield evidence from parish registers, which in recent years have been exploited by historical demographers in ways that make it possible to establish annual population totals and vital rates from 1541. In attempting to establish population trends and totals before a system of parochial registration of baptisms, marriages, and burials was in place, historians succumb to what Sir Michael Postan (1966: 561) once termed the ‘lure of aggregates’ by engaging in decidedly problematic, although unavoidable, exercises. In this present discussion we are in danger of incurring Postan’s wrath since we employ one central and vital source that relates to demographic conditions in one year only, around which a key argument in this discussion revolves.

scholarly journals Clinical Features and Outcomes of Repeated Endoscopic Therapy for Esophagogastric Variceal Hemorrhage in Cirrhotic Patients: Ten-Year Real-World Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jia-li Ma ◽  
Ling-ling He ◽  
Ping Li ◽  
Yu Jiang ◽  
Ju-long Hu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Variceal Bleeding ◽  
Endoscopic Therapy ◽  
Survival Rates ◽  
Variceal Hemorrhage ◽  
Term Survival ◽  
Long Term Survival ◽  
Cirrhotic Patients ◽  
One Year

Objective. This study is aimed at evaluating the survival of cirrhotic patients with different etiologies after endoscopic therapy for acute variceal bleeding and the effect of repeated endotherapy on patients’ prognosis. Methods. We retrospectively evaluated the clinical features and outcomes between cirrhotic patients with chronic HBV or HCV infections and other etiologies. The 3-year and 5-year survival rates and rehemorrhage rate in one year between the viral and nonviral cirrhosis patients were compared by Kaplan-Meier curves and log-rank test. Cox analysis was used to identify the impact factors that affect the long-term survival of patients with cirrhosis and variceal bleeding after endotherapy. Results. Out of 2665 patients with liver cirrhosis and variceal hemorrhage selected from our medical center between September 2008 and December 2017, a total of 1342 patients were included for analysis. The median follow-up duration was 32.9 months (range 0.16-111.4 months), the 3- and 5-year cumulative survival rates were 75.3% and 52.8%, respectively. The median survival time was significantly longer in viral cirrhosis patients (47.1 months [95% CI: 24.9-69.1]) compared with nonviral cirrhosis patients (37.0 months [95% CI: 25.0-56.0], p=0.001). The 3-year and 5-year survival rates of the viral group were higher than the nonviral group. The rehemorrhage rate at one year was higher in nonviral patients than in viral patients (p<0.001). Conclusion. Repeated endotherapy combined with effective antiviral therapy is helpful for long-term survival of cirrhotic population with variceal hemorrhage and HBV or HCV infection.

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