Prognostic impact of tumor (T) and lymph node (N) status in metastatic colon cancer (MCC): A validation study using the National Cancer Database (NCDB).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 786-786
Author(s):  
Shiva Kumar Reddy Mukkamalla ◽  
Ponnandai Sadasivan Somasundar ◽  
Bharti Rathore
Keyword(s):  
Poor Prognosis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tumor Grade ◽  
Cox Proportional Hazards ◽  
Survival Outcome ◽  
Cox Proportional Hazards Model ◽  
Prognostic Impact ◽  
Metastatic Colon Cancer ◽  
N Status

786 Background: T and N status are not routinely utilized in prognosis of MCC. We had previously demonstrated that T and N serve as independent predictors for overall survival (OS) in MCC using SEER [Ann Oncol (2014) 25 (suppl 4): iv172-iv173]. The current study is undertaken to validate our findings using the NCDB. Methods: The NCDB was queried for patients diagnosed with MCC from 2004-2008 with survival information up to 2013. Pearson Chi-square test, Kaplan Meier survival curves and Cox proportional hazards model were used for statistical analysis. Results: A cohort of 5,788 patients was identified for analysis. Frequencies of T1, T2, T3 and T4 among the study population were 6.6%, 4.2%, 52.6% and 36.6% respectively, whereas N0, N1 and N2 were noted in 28.5%, 29.9% and 41.6% respectively. 5-year OS worsened with advancing T and N status, with the exception of T1 disease (Table). T1 disease was associated with poor prognosis compared to T2 and T3, but showed better survival outcome than T4 (p < 0.05). Both T and N were identified as independent predictors of OS regardless of age, gender, race, comorbidity index, insurance status, income level, tumor sidedness, tumor grade, surgery, chemotherapy and academic level of treating institution. In multivariate analysis, we found left sided tumors to have better survival outcome compared to right (HR 0.85; p < 0.0001). Conclusions: Similar to our previous findings, in MCC patients, a T1 status portends poor prognosis compared to T2 or T3 disease. It is possible that an overrepresentation of tumors, with a distinct biological subtype characterized by a tendency for early dissemination in T1 disease could be associated with poor outcomes observed in this patient subgroup. In future, we plan to validate this finding through T1 subgroup analysis. Our study also demonstrates poor OS in right sided tumors compared to left sided tumors, similar to prior studies by Schrag et al and Venook et al. [Table: see text]

Tumor sidedness, adjuvant chemotherapy (AC), and other factors affecting survival in patients with stage II colon cancer (CC-II).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 768-768
Author(s):  
Shiva Kumar Reddy Mukkamalla ◽  
Donny V. Huynh ◽  
Ponnandai Sadasivan Somasundar ◽  
Ritesh Rathore
Keyword(s):  
Colon Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tumor Grade ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Metastatic Colon Cancer ◽  
Chi Square ◽  
Factors Affecting ◽  
Academic Level

768 Background: The role of AC in CC-II is not well defined due to lack of conclusive randomized trial data. This updated analysis using National Cancer Database (NCDB) addresses the overall survival (OS) benefit from AC in CC-II using more refined and case appropriate population cohort. Methods: NCDB was queried for patients diagnosed with CC-II from 2004-2008 with survival information through 2013. Only those patients with pathologically confirmed CC diagnosis were included. Patients undergoing any surgical procedure less than a partial colectomy were excluded. Pearson Chi-square test, Kaplan Meier survival curves and Cox proportional hazards model were used for statistical analysis. Results: A cohort of 36,630 patients was identified for analysis. Elderly patients received less frequent AC (p < 0.0001) and AC was associated with an improved 5-year OS with no difference noted in outcomes from single or multi-agent regimens. AC was an independent predictor of OS regardless of age, gender, race, comorbidity index, insurance status, income level, year of diagnosis, tumor sidedness, tumor grade, adequacy of lymph node evaluation, pathologic tumor (pT) status, colectomy type, margin involvement or academic level of treating institution. In multivariate analysis, right-sided cancers had better survival outcomes compared to left-sided cancers (HR 0.91; p < 0.0001). Conclusions: This study validates previous findings of improved OS from AC in CC-II while addressing some of the shortcomings of prior retrospective studies. Only patients with CC-II without any other primary cancer diagnoses were included. To our knowledge this is the most uptodate analysis of AC in CC-II which includes cases diagnosed up to 2008. Our study found similar improvement in 5-year OS irrespective of chemotherapy regimen. Interestingly, improved OS was seen in right sided tumors compared to left sided tumors, in contrary to that seen with metastatic colon cancer (Venook et al). [Table: see text]

A promising predictor of mortality— A cohort study (Preprint)

2021 ◽  
Author(s):  
Ji Ha Ling
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Medical Information ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Clinical Biomarker ◽  
Secondary Result

UNSTRUCTURED Severe inflammation leads to poor prognosis for intensive care unit hospitalized patients. The is a biomarker used to monitor inflammation and immune response, which can predict poor prognosis of various diseases. However, it is unclear whether NLR is associated with all-cause mortality in ICU patients. This study investigated the correlation between MLR and ICU results. Extract clinical data from Medical Information Mart for Intensive Care III (MIMIC-III) database, which contains health data of more than 50,000 patients. The main result was 30-day mortality, and the secondary result was 90-day mortality. Use the Cox proportional hazards model to reveal the association between MLR and results. Multivariable analyses were used to control for confounders. NLR is a promising clinical biomarker, which can be used as a available predictor of ICU mortality.

scholarly journals SUN-626 Survival of Patients with Gastroenteropancreatic Neuroendocrine Tumors and Diabetes Mellitus in a Seer-Medicare Cohort

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sahityasri Thapi ◽  
Kiwoon Baeg ◽  
Michelle K Kim ◽  
Emily Jane Gallagher
Keyword(s):  
Diabetes Mellitus ◽  
Neuroendocrine Tumors ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tumor Grade ◽  
Cox Proportional Hazards ◽  
Healthcare Management ◽  
Cox Proportional Hazards Model ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Significant Difference

Abstract Background: The incidence and prevalence of gastroenteropancreatic neuroendocrine tumors (GEP-NET) is increasing globally and has been associated with diabetes mellitus (DM). In this study we aimed to compare tumor characteristics, disease-specific survival (DSS) and overall survival (OS) of GEP-NET patients (pts) with and without DM. Methods: Using the Surveillance, Epidemiology, and End Results registry (SEER) linked to Medicare claims, we identified pts diagnosed with GEP-NET between January 1995 and December 2010, aged ≥65 years at the time of GEP-NET diagnosis. We included patients who were in exclusive Medicare coverage without healthcare management organizations and had Medicare Parts A and B coverage for ≥1year after GEP-NET diagnosis or until death. Within the pts with GEP-NET diagnosis, we identified those without a diagnosis of DM prior to the GEP-NET diagnosis. We compared baseline sociodemographics, co-morbidities, and GEP-NET location, stage, grade and treatment between pts with and without DM using χ 2 analysis. Kaplan Meier (KM) curves were used to compare OS and DSS up to 10 years between the DM and non-DM groups. We used Cox proportional hazards analysis to compare the DSS between the groups, adjusting for confounding variables. Results: We identified a cohort of 1,969 well-characterized GEP-NET patients with accurate tumor stage, grade, comorbidities, and treatment data. 478 (25.7%) had DM and 1,383 (74.3%) did not have DM. There were no statistically significant differences in gender or age at the time of GEP-NET diagnosis in the DM (mean age 74.7±SD 6.6 yrs) and non-DM (74.9±7.4 yrs) groups. Significant differences in race were found in the DM (80.6% white, 13.6% black, 1.3% hispanic) and non-DM (86.8% white, 8.2% black, 1.8% Hispanic) groups (p=0.002). Patients with DM had more gastric (14.7%), duodenal (10.9%) and pancreatic (21.0%), and less jejunal/ ileal (12.8%) NETs compared with the non-DM group (9.7%, 6.4%, 16.9%, 18.2%, respectively, p&lt;0.0001). Patients with DM had earlier stage disease than those without DM (p=0.0012), but no difference in tumor grade or treatment was found. KM curves revealed no differences in OS and DSS in the GEP-NET patients with and without DM across all stages. Multivariate adjusted Cox proportional-hazards model found no significant difference in DSS between those with and without DM (HR=0.97, 95%CI: 0.76–1.24). Compared with pts with pancreatic NETs, pts with colon (HR=1.39, 95%CI: 1.04–1.86) had worse survival, while those with jejunal/ileal (HR = 0.59, 95%CI: 0.42–0.83) NETs had a better survival. Discussion: This is the first study to investigate the effect of DM on survival of pts GEP-NETs. We found a high prevalence of pre-existing DM in pts with GEP-NETs, but no difference in OS or DSS in pts with and without DM. Interestingly, pts with DM had more foregut GEP-NETs which may suggest mechanistic links between DM and GEP-NETs at these sites.

scholarly journals The Real-World status and risk factors for a poor prognosis in elderly patients with primary central nervous system malignant lymphomas: a multicenter retrospective cohort study of the Tohoku Brain Tumor Study Group 

2021 ◽  
Author(s):  
Kenichiro Asano ◽  
Yoji Yamashita ◽  
Takahiro Ono ◽  
Manabu Natsumeda ◽  
Takaaki Beppu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Poor Prognosis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Pre Treatment

Abstract Introduction The number of elderly patients with primary central nervous system malignant lymphoma(EL-PCNSL) has been increasing. However, due to their poor pre-treatment Karnofsky Performance Status(KPS) and many comorbidities, it is possible that sufficient treatment has not been performed. We therefore conducted a retrospective cohort study to evaluate risk factors associated with a poor prognosis of the Real-World status of EL-PCNSL in the Tohoku Brain Tumor Study Group. Methods Patients aged ≥ 71 years with PCNSL were enrolled from 8 centers. Univariate analysis was performed by the log-rank test. A Cox proportional hazards model was used for multivariate analysis. Results Three of total 142 cases received best supportive care(BSC) from the beginning. Treatment was given to 30 cases without a pathological diagnosis, 3 cases with a cerebrospinal fluid diagnosis, and 100 cases with CD20-positive DLBCL diagnosis. Total 133 cases(median age 76 years) were included. The median pre-treatment KPS was 50%. There were 117(88.0%) patients with 213 pre-treatment comorbidities(1.8 comorbidities per patient). PFS and OS were 16 months and 24 months, respectively. Risk factors associated with poor prognosis on Cox proportional hazards model were pre-treatment cardiovascular disease and central nervous system disease comorbidities, post-treatment pneumonia and other infections, and the absence of radiation or chemotherapy. Conclusions EL-PCNSL was actively treated and BSC was only a few. Pre-treatment comorbidities and post-treatment complications would influence the prognosis. Radiation and chemotherapy were found to be effective, but no conclusions could be drawn regarding the content of chemotherapy and whether additional radiation therapy should be used.

Up-Regulation of Long Non-Coding RNA ZEB2-AS1 in Tissue is Correlated with Tumor Progression and Poor Prognosis in Non-Small Cell Lung Cancer

2020 ◽  
Vol 10 (8) ◽  
pp. 1149-1153
Author(s):  
Jinchen Du ◽  
Dong Chao ◽  
Gawei Hu ◽  
Yulian Ban ◽  
Bin Zhang ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Poor Prognosis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Expression Level ◽  
Normal Lung ◽  
Hazards Model ◽  
Nsclc Patients

Objective: ZEB2-AS1 has been suggested as an oncogene in some types of cancers, and it was also found to be up-regulated in NSCLC tissues compared with corresponding normal lung tissues. However, study on the clinical significance and prognostic value of ZEB2-AS1 in NSCLC is lacking. Patients and Methods: 129 NSCLC patients who underwent surgery between January 2013 to March 2018 were included in the present study. The Chi-square test was used to investigate the significance of tissue ZEB2-AS1 expression level as correlated with clinicopathologic features. The survival curves of the NSCLC patients were plotted and analyzed by Kaplan-Meier method and the survival rates were compared by the log-rank test. The Cox proportional hazards model was used for univariate and multivariate regression analyses. Results : ZEB2-AS1 level was significantly up-regulated in NSCLC tissues compared with matched adjacent lung tissues (P < 0 001). ZEB2-AS1 expression level was significantly correlated with tumor differentiation (P = 0 004), lymph node metastasis (P = 0 003), and TNM stage (P < 0 001). Both univariate and multivariate Cox proportional hazards model analysis showed that ZEB2-AS1 expression was independently associated with overall survival of patients with NSCLC (univariate analysis: HR = 2.117, 95% CI: 1.092–11.885, P = 0 019, multivariate analysis: HR = 1.925, 95% CI: 1.472–10.663, P = 0 036). Conclusions: Our study demonstrates that ZEB2-AS1 is up-regulated in NSCLC tissues and its up-regulation is correlated with tumor progression and poor prognosis in NSCLC.

Analysis of the GERCOR index in KRAS Exon2 WT patients with mCRC treated with salvage-line cetuximab-based chemotherapy: HGCSG0901.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 781-781
Author(s):  
Ayumu Hosokawa ◽  
Satoshi Yuki ◽  
Hiroshi Nakatsumi ◽  
Kazuteru Hatanaka ◽  
Yasushi Tsuji ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Performance Status ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Prognostic Impact ◽  
Significant Difference

781 Background: The GERCOR index (GI) based on performance status and serum LDH was reported to be useful to predict survival for patients with previously untreated mCRC. However, in the salvage setting, the validity of the GI has not been reported in patients treated with cetuximab (Cmab)-based chemotherapy. Methods: 269 patients with mCRC treated with Cmab contained chemotherapy were retrospectively registered from 27 centers in Japan. This analysis was included in the KRAS Exon2 wild type patients who were refractory to or intolerant of 5-FU / irinotecan/ oxaliplatin and were never administered anti-EGFR-antibody. Univariate and multivariate analysis for overall survival (OS) were performed using patient characteristics. Survival analyses were performed with the Kaplan-Meier method, log-rank test and the Cox proportional hazards model. The analysis was also designed to determine whether the GERCOR index could be extended to progression-free survival (PFS). Results: All data were available for prognostic categorization in 132 patients. Median OS and PFS were 9.8 and 4.3 months. The distribution and median OS / PFS for GI were as follows: low risk (L)(n = 28; 17.9/3.8 months), intermediate risk (I)(n = 52; 12.2/5.0 months), and high risk (H)(n = 52; 7.5/4.1 months). For OS, there was significant difference between L and H (p < 0.001) and between I and H (p < 0.001), but not between L and I (p = 0.076). For PFS, there was significant difference between I and H (p = 0.017), but not between L and I (p = 0.407), and between L and H (p = 0.222). In the Cox multivariate analysis, GI showed an independent prognostic impact (L vs. I ; HR 2.195, p=0.003 / L vs. H ; HR 4.028, p<0.001), but not predictive impact (L vs. I ; HR 0.987, p=0.958 / L vs. H ; HR 1.314, p=0.268). Conclusions: In this analysis, GI might be a prognostic factor in salvage treatment with Cmab-based chemotherapy.

Multi-institutional analysis of outcomes in patients with dedifferentiated chondrosarcoma (DDCS).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11028-11028
Author(s):  
Nam Bui ◽  
Hilary Dietz ◽  
Angela C. Hirbe ◽  
Kristen N. Ganjoo ◽  
Brian Andrew Van Tine ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Kinase Inhibitors ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Nccn Guidelines ◽  
Neo Adjuvant Chemotherapy

11028 Background: DDCS is a rare bone tumor with a poor prognosis. While no standard therapy exists, NCCN guidelines recommend osteosarcoma regimens (ORs). Methods: We performed a retrospective review (January 1, 2007-June 1, 2018) at three sarcoma centers and identified 46 patients (pts) with DDCS to evaluate treatments and outcomes. Results: Median age was 62.5 years (23-83); 61% were male. Median tumor size was 10.5cm (2-34). Most pts had localized disease at diagnosis (dx) (80%), extremity primary (76%), and did not receive neo/adjuvant chemotherapy (70%) or radiotherapy (69%). Local and distant recurrences were frequent (35% and 57%, respectively) and rapid (6.6 months (m) and 5.4 m, respectively). Twenty-eight pts received chemotherapy, 9 neo/adjuvant and 19 for metastasis (met) (Table). Response rate to first line ORs was poor (53% progressed). Notably, 11% had a partial response (D/I). Tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) led to stable disease. Median overall survival was 22.8 m and 7.2 m; 5-year survival rates were 30% and 0% in localized and metastatic disease, respectively. Median follow-up was 12.5 m (1.4-120). A multivariate cox proportional hazards model (age, sex, location, met at dx) identified met at dx as the only risk factor for worse prognosis (HR 2.8, p=0.026). Conclusions: DDCS is an aggressive malignancy with a poor prognosis. Despite guidelines to treat with ORs, the benefit is unclear, illustrating the need for randomized trials comparing standard regimens to novel agents. [Table: see text]

P851Incidence and prognostic impact of acute infection among patients with type 1 and 2 myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Sandoval ◽  
S W Smith ◽  
K Schulz ◽  
A Sexter ◽  
F S Apple
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Acute Infection ◽  
Antibiotic Use ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Prognostic Impact ◽  
Hazards Model ◽  
Acute Mi

Abstract Background The incidence and impact of acute infection among patients with type 1 (T1MI) and 2 myocardial infarction (T2MI) is not well known. Inflammation and increased procoagulant activity can lead to T1MI, whereas cytokine release can cause hemodynamic alterations affecting myocardial oxygen consumption and contribute to T2MI. Purpose Determine the incidence and prognostic impact of acute infection among patients with T1MI and T2MI. Methods Post-hoc analysis of UTROPIA (NCT02060760), a prospective, observational cohort study involving 1,640 consecutive emergency department patients with serial cardiac troponin (cTn) I measurements obtained on clinical indication. The incidence of acute infection, antibiotic use, and/or laboratory evidence of infection were examined among patients with T1MI and T2MI. 5-year cumulative survival curves were plotted using the Kaplan-Meier method, frequencies were compared via Chi-Square, and a multivariate cox-proportional hazards model was used to assess the impact of infection on mortality. Results Among 217 patients with acute MI (T1MI, n=77 and T2MI, n=140), acute infection occurred in 63 (29%) of patients. Acute infection was more common in patients with T2MI than T1MI (35% vs. 18%, p=0.009). The predominant source of infection was pneumonia (59%), followed by urinary tract infections (11%). Patients with T2MI were also more likely than T1MI to have sepsis (11% vs. 1%, p=0.012), bacteremia (30% vs. 18%, p=0.057), and antibiotic use (35% vs. 17%, p=0.005). At 5-years, patients with acute MI and acute infection had a higher mortality rate than patients without infection (49% vs. 25%, p=0.0006) (Figure). Among the 31 deaths in MI patients with acute infection, most deaths were non-cardiac (65%) and occurred in those with T2MI (77%). Following adjustment for age, sex, and comorbidities in a Cox proportional hazards model, acute infection was an independent predictor of death (hazard ratio: 2.2, 95% CI: 1.3–3.5, p=0.0016). Conclusion Acute infection occurs in almost a third of patients that are diagnosed with acute MI during the index hospitalization. Most infections are due to pneumonia and occur most often in patients classified as having T2MI. Acute infection is an independent risk factor for 5-year mortality, with nearly half of all patients with acute MI in whom concomitant acute infection is present during the index hospitalization dead at 5-years. Most deaths are non-cardiac and the vast majority occur in patients with T2MI. Acknowledgement/Funding Abbott Diagnostics and Hennepin Healthcare Research Institute (formerly MMRF)e

scholarly journals Prognostic Impact of the Controlling Nutrition Status Score in Patients With Peripheral T-cell Lymphoma

2021 ◽  
Author(s):  
Nobuhiko Nakamura ◽  
Nobuhiro Kanemura ◽  
Shin Lee ◽  
Kei Fujita ◽  
Tetsuji Morishita ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Independent Prognostic Factor ◽  
Cox Proportional Hazards Model ◽  
Prognostic Impact ◽  
Peripheral T Cell Lymphoma ◽  
Hazards Model ◽  
Conut Score

Abstract The controlling nutritional status (CONUT) is a simplified nutritional index calculated from serum albumin, total cholesterol, and the total lymphocyte count. Although the CONUT score is an independent prognostic factor in several hematological malignancies, the prognostic impact of the CONUT score in peripheral T-cell lymphoma (PTCL) is unclear. This study evaluated the prognostic impact of the CONUT score on overall survival (OS) in patients with PTCL. A multicentre, retrospective, cohort study including 99 patients with PTCL was conducted. The CONUT score was significantly higher in the non-survivor group (median 5, range 0-12) than in the survivor group (median 3, range 0-11) (P = 0.026). The CONUT score was an independent prognostic factor in a multivariable Cox proportional hazards model (hazard ratio 1.118, 95% confidence interval 1.020-1.225, P = 0.017). The Cox proportional hazards model with restricted cubic spline showed an S-shaped relationship between the CONUT score and OS. No significant effect-modification by the International Prognostic Index (IPI) was observed, and the CONUT score affected the prognosis of PTCL regardless of the IPI (P for interaction = 0.208). In conclusion, the CONUT score is an independent prognostic factor in patients with PTCL irrespective of IPI categories.

Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Kuan-Ying Lee ◽  
Chung-Yi Li ◽  
Kun-Chia Chang ◽  
Tsung-Hsueh Lu ◽  
Ying-Yeh Chen
Keyword(s):  
Young People ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Birth Registry ◽  
Data Set ◽  
Parental Suicide ◽  
The Impact ◽  
Age At Exposure

Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-­based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.

Sign in / Sign up

Export Citation Format

Share Document