Cancer patients with ECOG-PS higher than 1: Who are those who benefit of palliative chemotherapy?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9561-9561
Author(s):  
Rafael Caires-Lima ◽  
Bruno Mendonça Protásio ◽  
Inacelli Queiroz de Souza Caires ◽  
Lucila Soares Da Silva Rocha ◽  
Julia Andrade De Oliveira ◽  
...  

9561 Background: Palliative chemotherapy (PC) is a treatment option in pts with metastatic cancer. Although pts with ECOG-PS > 1 are underrepresented in clinical trials, they are often treated with PC in daily practice. We aimed to identify factors associated with poorer survival and lack of benefit of PC in this subset of pts. Methods: We conducted a case-control retrospective analysis of 301 consecutive pts with solid tumors and ECOG-PS > 1 when initiated PC, selected from 2514 pts who died between Aug/2011 and Jul/2012 in a tertiary cancer care institution or its hospice. Cases were defined as those pts who survived < 90d after the first cycle of first line PC, and controls were those who had a longer survival. Frequencies were compared by chi-square test or Fisher exact test. Risks were estimated by odds ratios (OR) and logistic regression analysis. Overall survival (OS) was calculated by Kaplan-Meier method and curves was compared using log-rank test. Results: 142 cases/159 controls were included: median age 58/63 y.o. (p=0.09; t-test) and 49%/50% female (p=0.941; chi-square). Gastrointestinal and lung cancers were the most frequent primaries (31 and 17%, respectively). Factors associated with poorer OS were age > 60 y.o. (OR 1.7; 95%CI 1.0–2.6), ECOG-PS > 2 (1.9; 1.2–3.1), weight loss > 10% (1.8; 1.1-2.8), hemoglobin < 10 g/dL (2.6; 1.6-4.2), albumin < 3 g/dL (2.7; 1.5-5.1), serum creatinine (sCr) > 1 mg/dL (2.8; 1.6-5.0), C-reactive protein ≥ 5 mg/L (8.6; 1.0-72.9), altered mental status (4.2; 1.4-13.2) and in-hospital PC (3.2; 1.9-5.2). Cases were more likely to experience grade ≥ 3 toxicity (43 vs. 28%; p=0.005), die of toxicity (16 vs. 6%; p = 0.0007) and not be offered palliative care only (47 vs. 71%; p<0.0001). mOS was 204 and 34d among controls and cases, respectively (HR 0.177; 95%CI 0.015-0.033, p<0.0001). Median time to death was 39.5d (0-1103). Logistic regression analysis identified ECOG-PS > 2 (OR 2.3, p=0.044) and sCr > 1 mg/dL (OR 11.2, p=0.0002) as independent predictors of 3-mo fatality. Conclusions: ECOG-PS > 2 and elevated sCr were identified as independent predictors of poor OS in these pts. PC needs to be prescribed with caution in ECOG-PS > 1 pts, since it seems to offer no benefit in OS and could lead to abbreviation of life.

2020 ◽  
Vol 27 (5) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Reza Qamruddin ◽  
Ayu Malik

Objectives: To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. Methods: Cross-sectional analysis was carried out looking at all suspected and laboratoryconfirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. Results: The incidence rate for suspected measles showed an increasing trend from 2015–2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. Conclusion: Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.


2019 ◽  
Vol 76 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
Admir Sabanovic ◽  
Natasa Maksimovic ◽  
Mirjana Stojanovic-Tasic ◽  
Marijan Bakic ◽  
Anita Grgurevic

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Asmamaw Atnafu ◽  
Adane Kebede ◽  
Bisrat Misganaw ◽  
Destaw Fetene Teshome ◽  
Gashaw Andargie Biks ◽  
...  

Background. The maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skill birth attendant (SBA), and postnatal care (PNC) within 48 hours of delivery. It is one of the essential strategies for reducing maternal and newborn mortality. This study aimed to assess the factors associated with the completion of a continuum of maternal healthcare services among mothers who gave birth in the past five years. Methods. A community-based cross-sectional study was conducted from May 01 to June 29, 2019, among 565 randomly selected mothers who gave birth in five years before the study in primary healthcare project implementation districts of north Gondar zone, Amhara National Regional State, Ethiopia. Bivariable and multivariable logistic regression analysis were computed, and in the multivariable logistic regression analysis, adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p value of less than 0.05 were used to identify the associated factors with completion of the continuum of maternal healthcare services. Results. The study revealed that the overall completion of the continuum of maternal healthcare services was 21.60% (95% CI: 18.20, 24.90). Women who were able to read and write (AOR: 2.70, 95% CI: 1.22, 6.04), using car/motorcycle as a means of transportation to get the health facility (AOR: 5.59, 95% CI: 2.29, 9.50), travel time less than an hour to get the health facility (AOR: 4.98, 95% CI: 2.97, 8.38), being satisfied with the service delivery (AOR: 1.89, 95% CI: 1.15, 3.11), and getting health education on maternal healthcare services in the last 6 months (AOR: 2.77, 95% CI: 1.52, 5.05) were factors associated with the completion of the continuum of maternal healthcare services. Conclusions. The completion of the continuum of maternal healthcare services was relatively low, indicating that women were not getting the likely health benefit from the present health services. Therefore, interventions should focus on increasing women’s awareness, improving the availability of services at nearby health facilities, and improving service delivery by considering women’s preferences and needs to increase their satisfaction are essential to increase the completion of maternal healthcare services.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Si-Yuan Qin ◽  
Ming-Yang Yin ◽  
Wei Cong ◽  
Dong-Hui Zhou ◽  
Xiao-Xuan Zhang ◽  
...  

Chlamydia abortus, an important pathogen in a variety of animals, is associated with abortion in sheep. In the present study, 1732 blood samples, collected from Tibetan sheep between June 2013 and April 2014, were examined by the indirect hemagglutination (IHA) test, aiming to evaluate the seroprevalence and risk factors ofC. abortusinfection in Tibetan sheep. 323 of 1732 (18.65%) samples were seropositive forC. abortusantibodies at the cut-off of 1 : 16. A multivariate logistic regression analysis was used to evaluate the risk factors associated with seroprevalence, which could provide foundation to prevent and controlC. abortusinfection in Tibetan sheep. Gender of Tibetan sheep was left out of the final model because it is not significant in the logistic regression analysis (P>0.05). Region, season, and age were considered as major risk factors associated withC. abortusinfection in Tibetan sheep. Our study revealed a widespread and high prevalence ofC. abortusinfection in Tibetan sheep in Gansu province, northwest China, with higher exposure risk in different seasons and ages and distinct geographical distribution.


2017 ◽  
Vol 87 (4) ◽  
pp. 583-589 ◽  
Author(s):  
Soonshin Hwang ◽  
Yoon Jeong Choi ◽  
Ji Yeon Lee ◽  
Chooryung Chung ◽  
Kyung-Ho Kim

ABSTRACT Objective: The purpose of this study was to investigate the diagnostic aspects, contributing conditions, and predictive key factors associated with ectopic eruption of maxillary second molars. Material and Methods: This retrospective study evaluated the study models, lateral cephalographs, and panoramic radiographs of 40 adult subjects (20 men, 20 women) with bilateral ectopic eruption and 40 subjects (20 men, 20 women) with normal eruption of the maxillary second molars. Studied variables were analyzed statistically by independent t-tests, univariate and multivariate logistic regression analysis, followed by receiver-operating characteristic analysis. Results: Tooth widths of bilateral lateral incisors, canines, and premolars were wider in the ectopic group, which resulted in greater arch lengths. The ANB angle and maxillary tuberosity distance (PTV-M1, PTV-M2) were smaller in the ectopic group. The long axes of the maxillary molars showed significant distal inclination in the ectopic group. The multivariate logistic regression analysis showed that three key factors—arch length, ANB angle, and PTV-M1 distance—were significantly associated with ectopic eruption of the second molars. The area under the curve (AUC) was the largest for the combination of the three key factors with an AUC greater than 0.75. PTV-M1 alone was the single factor that showed the strongest association with ectopic eruption (AUC = 0.7363). Conclusions: An increase in arch length, decrease in ANB angle, and decrease in maxillary tuberosity distance to the distal aspect of the maxillary first molar (PTV-M1) were the most predictive factors associated with ectopic eruption of maxillary second molars.


2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097151
Author(s):  
Daniela Mazzaccaro ◽  
Girolomina Mazzeo ◽  
Gianmarco Zuccon ◽  
Alfredo Modafferi ◽  
Giovanni Malacrida ◽  
...  

Objective This retrospective study was performed to assess the clinical and radiological variables associated with proximal type IA endoleak (EL) in patients treated with elective endovascular repair for abdominal aortic aneurysms. Methods The chi-square test, t-test, and logistic regression analysis were performed as appropriate. A P value of <0.05 was considered statistically significant. Results The data of 79 patients were analyzed. No mortality occurred. During follow-up (median, 28.5 months; interquartile range, 12.8–43.0 months), 10 patients developed type IA EL. In the logistic regression analysis, undersizing of the endograft diameter by <10% significantly affected the occurrence of type IA EL. When the diameter was used for measurements, less oversizing was significantly associated with a higher risk of type IA EL. When the area was used for measurements, oversizing of >20% significantly affected the occurrence of type IA EL. Conclusion When sizing endografts, a discrepancy was noted between the measurements of the diameter and area of the proximal neck. The area might represent a more accurate measurement than the axial diameter to optimize the proximal sealing and lower the risk of developing type IA EL.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S186-S186
Author(s):  
Peter Mazonson ◽  
Theoren Loo ◽  
Jeff Berko ◽  
Sarah-Marie Chan ◽  
Ryan Westergaard ◽  
...  

Abstract Background Frailty is a concern among older people living with HIV (PLHIV). There is a paucity of research characterizing PLHIV who are at risk of becoming frail (pre-frailty). To investigate how HIV impacts older PLHIV in the United States, a new study called Aging with Dignity, Health, Optimism and Community (ADHOC) was launched at ten sites to collect self-reported data. This analysis uses data from ADHOC to identify factors associated with pre-frailty. Methods Pre-frailty was assessed using the Frailty Index for Elders (FIFE), where a score of zero indicated no frailty, 1–3 indicated pre-frailty, and 4–10 indicated frailty. A cross-sectional analysis was performed on 262 PLHIV (age 50+) to determine the association between pre-frailty and self-reported sociodemographic, health, and clinical indicators using bivariate analyses. Factors associated with pre-frailty were then included in a logistic regression analysis using backward selection. Results The average age of ADHOC participants was 59 years. Eighty-two percent were male, 66% were gay or lesbian, and 56% were white. Forty-seven percent were classified with pre-frailty, 26% with frailty, and 27% with no frailty. In bivariate analyses, pre-frailty was associated with depression, low cognitive function, depression, multiple comorbidities, low income, low social support and unemployment (Table 1). In the multiple logistic regression analysis, pre-frailty was associated with having low cognitive function (Odds Ratio [OR] 8.56, 95% Confidence Interval [CI]: 3.24–22.63), 4 or more comorbid conditions (OR 4.00, 95% CI: 2.23–7.06), and an income less than $50,000 (OR 2.70, 95% CI: 1.56–4.68) (Table 2). Conclusion This study shows that commonly collected clinical and sociodemographic metrics can help identify PLWH who are more likely to have pre-frailty. Early recognition of factors associated with pre-frailty among PLHIV may help to prevent progression to frailty. Understanding markers of increased risk for pre-frailty may help clinicians and health systems better target multi-modal interventions to prevent negative health outcomes associated with frailty. Disclosures All authors: No reported disclosures.


1996 ◽  
Vol 37 (1P1) ◽  
pp. 299-304 ◽  
Author(s):  
G. Sandbæk ◽  
L. E. Staxrud ◽  
L. Rosen ◽  
D. Bay ◽  
M. Stiris ◽  
...  

Purpose: To determine the association between successful intraarterial thrombolysis and the following factors: sex, age, symptoms, duration of symptoms, length of occlusion, conduit type, runoff, and catheter localization. Material and Methods: Forty-six patients with acute or subacute occlusions of peripheral native arteries and grafts were treated with continuous intraarterial infusion of streptokinase or urokinase. A univariate chi-square test and logistic regression analysis were used. Results: Successful lysis was achieved in 27 of 46 patients (59%). The logistic regression analysis revealed a significant association between successful thrombolysis and good runoff (p<0.01). A catheter position above the occlusion resulted in lysis in only one of 11 patients. The variables rest pain and claudication were slightly significant (p=0.07). None of the other variables were significant, but a trend toward a separate effect of duration of occlusion was found. Conclusion: Good runoff and intrathrombotic infusion are virtual necessities in obtaining a positive immediate outcome in peripheral arterial and graft occlusions. In our study, other factors were less important.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jinluan Wang ◽  
Mingyue Xue

Abstract Objective To explore the social and psychological factors associated with male Temporary Ejaculation Failure (TEF) during In Vitro Fertilization (IVF), with the goal of providing a theoretical basis for clinical intervention and treatment. Methods The study included 75 TEF patients and 223 non-TEF patients undergoing IVF treatment at the center of reproduction and genetics of Integrated Chinese and Western medicine in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2019 to May 2020. A questionnaire survey was then administered to the study subjects. The questionnaires included general information, Perceived Stress Scale (PSS), Stigma Questionnaire, Perceived Social Support Scale (PSSS), and Positive Psychological Capital Questionnaire (PPQ). Logistic regression analysis was then used to analyze the social psychological factors associated with the research objectives. Results Comparison of social demographic factors and clinical data between TEF group and non-TEF group: there were significant differences in the age and educational level between the two groups (P< 0.05), and the average age of the TEF group (37.01±7.11) was significantly higher than that of the non-TEF group (34.89±6.24). In addition, patients with high school or technical secondary school education levels had the lowest probability of TEF(X2=7.662, P=0.022). 2. The difference of related social and psychological factors between the two groups: the scores of perceived stress (17.57±6.51) and stigma (4.52±3.87) in the TEF group were significantly higher than those in the non-TEF group, which were (15.50±5.00, P< 0.05) and (2.61±3.52, P< 0.05), respectively. On the other hand, the scores of social support (55.31±14.04) and psychological capital (121.73±25.93) in the TEF group were significantly lower than those in the non-TEF group, which were (60.74±10.93, P< 0.05) and (130.31±17.32, P< 0.05), respectively. Results Obtained after conducting univariate logistic regression analysis indicated that age (OR=1.051, P=0.016), perceived stress (OR=1.073, P=0.005), stigma (OR=1.139, P< 0.001), family support (OR=0.901, P< 0.001), friend support (OR=0.932, P=0.023), other support (OR=0.915, P=0.004), self-efficacy (OR=0.947, P=0.009), resilience (OR=0.947, P=0.013), hope (OR=0.930, P=0.002), and optimism (OR=0.953, P=0.032) can all significantly affect male TEF.4. Moreover, the multivariate logistic regression analysis results indicated that age (OR=1.071, P=0.002) and stigma (OR=1.132, P=0.003) can positively predict TEF, while family support (OR=0.877, P=0.012) can negatively predict TEF. Conclusions The results obtained in this study have indicated that age and stigma are independent risk factors for male TEF, while family support is a protective factor of TEF. Analyzing the treatment of TEF from a socio-psychological perspective provides a new intervention target for effectively reducing its incidence, thereby helping to improve the success rate of IVF.


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