Questioning the sex-specific differences in the association of smoking on the survival rate of hospitalized COVID-19 patients

Introduction In the absence of a universally accepted association between smoking and COVID-19 health outcomes, we investigated this relationship in a representative cohort from one of the world’s highest tobacco consuming regions. This is the first report from the Middle East and North Africa that tackles specifically the association of smoking and COVID-19 mortality while demonstrating a novel sex-discrepancy in the survival rates among patients. Methods Clinical data for 743 hospitalized COVID-19 patients was retrospectively collected from the leading centre for COVID-19 testing and treatment in Lebanon. Logistic regression, Kaplan-Meier survival curves and Cox proportional hazards model adjusted for age and stratified by sex were used to assess the association between the current cigarette smoking status of patients and COVID-19 outcomes. Results In addition to the high smoking prevalence among our hospitalized COVID-19 patients (42.3%), enrolled smokers tended to have higher reported ICU admissions (28.3% vs 16.6%, p<0.001), longer length of stay in the hospital (12.0 ± 7.8 vs 10.8 days, p<0.001) and higher death incidences as compared to non-smokers (60.5% vs 39.5%, p<0.001). Smokers had an elevated odds ratio for death (OR = 2.3, p<0.001) and for ICU admission (OR = 2.0, p<0.001) which remained significant in a multivariate regression model. Once adjusted for age and stratified by sex, our data revealed that current smoking status reduces survival rate in male patients ([HR] = 1.9 [95% (CI), 1.029–3.616]; p = 0.041) but it does not affect survival outcomes among hospitalized female patients([HR] = 0.79 [95% CI = 0.374–1.689]; p = 0.551). Conclusion A high smoking prevalence was detected in our hospitalized COVID-19 cohort combined with worse prognosis and higher mortality rate in smoking patients. Our study was the first to highlight potential sex-specific consequences for smoking on COVID-19 outcomes that might further explain the higher vulnerability to death from this disease among men.

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Factors Affecting Survival in Patients with Breast Cancer in Hamedan Province from 2001 to 2018

10.30699/ijbd.12.4.31 ◽

2019 ◽

Vol 12 (4) ◽

pp. 31-38

Author(s):

Rasoul Najafi ◽

Fatemeh Amiri ◽

Ghodrat Roshanaei ◽

Mohammad Abbasi ◽

Mahdi Razi

Keyword(s):

Breast Cancer ◽

Survival Rate ◽

Cancer Progression ◽

Tumor Size ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Factors Affecting

Introduction: Breast cancer is the most common cancer and one of the leading causes of death in women. Identification of factors affecting the survival rate of these patients is important for the prevention of breast cancer progression and better treatment. Methods: This retrospective cohort study was performed on 493 women with breast cancer referred to Imam Khomeini clinic in Hamadan between 2001 and 2018. The Kaplan-Meier method and the Cox proportional hazard model were used to estimate the survival rate and factors affecting patient survival. All analyses were performed using SPSS 21. Results: The mean (standard deviation) age of the patients was 49.75 (11.34) years, and the 5- and 10-year survival rates were 61% and86%, respectively. The Cox proportional hazards model showed a significant relationship between age(HR (%95 CI)=1.53(1.23-2.78)) and tumor size (HR (%95 CI)=1.49(1.16-2.89)) and mortality risk (P < 0.05). Conclusion: Age and tumor size are associated with survival in patients with breast cancer. Therefore, increasing women’s awareness of the benefits of periodic examinations and early diagnosis can contribute to early detection of the disease and improved survival.

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Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082825 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2825

Author(s):

Tzu-Wei Yang ◽

Chi-Chih Wang ◽

Ming-Chang Tsai ◽

Yao-Tung Wang ◽

Ming-Hseng Tseng ◽

...

Keyword(s):

Liver Cirrhosis ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Study Groups ◽

Population Based ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Study Cohort ◽

Hazards Model

The prognosis of different etiologies of liver cirrhosis (LC) is not well understood. Previous studies performed on alcoholic LC-dominated cohorts have demonstrated a few conflicting results. We aimed to compare the outcome and the effect of comorbidities on survival between alcoholic and non-alcoholic LC in a viral hepatitis-dominated LC cohort. We identified newly diagnosed alcoholic and non-alcoholic LC patients, aged ≥40 years old, between 2006 and 2011, by using the Longitudinal Health Insurance Database. The hazard ratios (HRs) were calculated using the Cox proportional hazards model and the Kaplan–Meier method. A total of 472 alcoholic LC and 4313 non-alcoholic LC patients were identified in our study cohort. We found that alcoholic LC patients were predominantly male (94.7% of alcoholic LC and 62.6% of non-alcoholic LC patients were male) and younger (78.8% of alcoholic LC and 37.4% of non-alcoholic LC patients were less than 60 years old) compared with non-alcoholic LC patients. Non-alcoholic LC patients had a higher rate of concomitant comorbidities than alcoholic LC patients (79.6% vs. 68.6%, p < 0.001). LC patients with chronic kidney disease demonstrated the highest adjusted HRs of 2.762 in alcoholic LC and 1.751 in non-alcoholic LC (all p < 0.001). In contrast, LC patients with hypertension and hyperlipidemia had a decreased risk of mortality. The six-year survival rates showed no difference between both study groups (p = 0.312). In conclusion, alcoholic LC patients were younger and had lower rates of concomitant comorbidities compared with non-alcoholic LC patients. However, all-cause mortality was not different between alcoholic and non-alcoholic LC patients.

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Disparities in receipt of radiotherapy and survival by age, sex, and race among patients with nonmetastatic squamous cell carcinoma of the anus.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.721 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 721-721

Author(s):

Doug Baughman ◽

Krishna Bilas Ghimire ◽

Binay Kumar Shah

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Relative Survival ◽

Population Based ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

P Value ◽

Hazards Model ◽

To Receive

721 Background: Combination chemoradiotherapy is the standard of care for treatment of non-metastatic squamous cell carcinoma of the anus (SCCA). This population-based study evaluated disparities in receipt of radiotherapy (RT) and its effect on survival in patients with localized and regional SCCA in the United States. Methods: The Surveillance, Epidemiology, and End Results (SEER) 18 database was used to identify patients with localized and regional SCCA diagnosed between 1998 and 2008. We used univariate and multivariate logistic regression to model the relationships between receipt of RT and age, sex, marital status, stage, and race. Relative survival rates were calculated and compared using two sample z-tests. A Cox proportional hazards model was used to find adjusted hazard ratios (HR). Results: A total of 3,971 patients with localized or regional SCCA as the only primary malignancy were included in the study, of which 3,278 (82.6%) received RT. After adjusting for covariates, those 65 years and older (adjusted OR 0.82, p=0.029) were less likely to receive RT. Females were more likely to receive RT compared to males (adjusted OR 1.54, p<0.001). We found no difference in receipt of RT by race. Comparisons of 1- and 5-year relative survival rates showed lower survival for blacks (p-value <0.01 at 1-year and <0.0001 at 5-years), those 65 years and older, and males. A 1-year survival disparity was found for those not receiving RT (p-value <0.0001 at 1-year), but no difference was observed at 5-years. A Cox proportional hazards model adjusting for all covariates showed greater hazard for blacks (adjusted HR 1.36, p=0.001), those not receiving RT (adjusted HR 1.23, p=0.03), patients 65 years or older, and males. Conclusions: This population based study identified older patients as less likely to receive RT and females as more likely to receive RT. Survival analysis identified blacks, males, older patients, and those not receiving RT as having lower rates of survival.

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Comparison of outcomes with pembrolizumab monotherapy (P) versus combination with chemotherapy (P+C) in advanced non-small cell lung cancer (NSCLC).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21579 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21579-e21579

Author(s):

Kartik Sehgal ◽

Ritu R. Gill ◽

Poorva Bindal ◽

Anita Geevarghese Koshy ◽

Danielle C McDonald ◽

...

Keyword(s):

Proportional Hazards ◽

Advanced Nsclc ◽

Proportional Hazards Model ◽

Smoking Status ◽

Performance Status ◽

Objective Response ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Phase Iii ◽

Ecog Performance Status

e21579 Background: P and P+C are standard-of-care (SOC) treatment options for advanced NSCLC. However, they have not yet been directly compared in clinical trials. Methods: We conducted a retrospective cohort study of patients with advanced NSCLC who initiated treatment with SOC P±C at our center from 2/11/16 to 10/15/19 (data cutoff 1/15/20). Patient demographic, clinicopathologic, therapeutic and outcomes data were extracted. All radiographic scans were independently evaluated by a thoracic radiologist using iRECIST. Survival time was defined from the start of P±C. Kaplan-Meier and Cox proportional hazards model were utilized. Results: Of 103 patients with median follow up of 17.7 months, 74 (71.8%) had received P, while 29 (28.2%) had received P+C. In PD-L1 tumor proportion score (TPS) unselected population, there were no significant differences in age, sex, smoking status, driver mutation, tumor mutational burden (TMB), line of therapy, ECOG performance status (PS) or immune-related adverse events (irAE) between P and P+C groups. 71.6% in P vs 13.8% in P+C had PD-L1 TPS ≥50% (p < 0.001). There were no significant differences between the two groups in objective response rate (ORR), disease control rate (DCR), unadjusted progression-free survival (PFS) or unadjusted overall survival (OS) (Table). Multivariable adjustment for confounding factors between P+C vs P revealed no differences in OS [hazard ratio (HR) for death, 1.53, 95% CI 0.55 – 4.25] or PFS [HR for progression/death, 1.75, 95% CI 0.63 – 4.91]. Further stratification into PD-L1 TPS ≥50% and < 50% showed no significant differences between P+C vs. P in adjusted OS [HR for death, TPS < 50%- 1.54 (95% CI 0.59 – 4.03); TPS ≥50%- 0.71 (95% CI 0.11 – 4.52)] or PFS [HR for progression/death, TPS < 50%- 1.58 (95% CI 0.72 – 3.48); TPS ≥50%- 0.64 (95% CI 0.06 – 6.93)]. ECOG PS and development of irAE influenced OS in all groups, while TMB was relevant in PD-L1 ≥50% only. Conclusions: Our study shows no significant differences in outcomes with P vs P+C in advanced NSCLC in a real-world setting, albeit with limitations of single-center design, limited sample size, different line settings and lack of disease burden stratification. Ongoing phase III trials comparing front line P vs P+C will definitively address the long-term clinical benefits -if any- of combining cytotoxic chemotherapy with anti-PD-1 drugs. [Table: see text]

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Poor Renal and Cardiovascular Outcomes in Patients with Biopsy-Proven Diabetic Nephropathy

Kidney & Blood Pressure Research ◽

10.1159/000505919 ◽

2020 ◽

Vol 45 (3) ◽

pp. 378-390 ◽

Cited By ~ 1

Author(s):

Yiyun Wang ◽

Ting Zhou ◽

Qiming Zhang ◽

Yang Fei ◽

Ze Li ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Nephropathy ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Left Ventricular ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Diabetic Patients ◽

Family History Of Diabetes

Background: Despite the high mortality of cardiovascular disease (CVD) in diabetic patients with renal injury, few studies have compared cardiovascular characteristics and outcomes between patients with diabetic nephropathy (DN) and non-diabetic renal disease (NDRD). Methods: A total of 326 type 2 diabetes mellitus patients with renal biopsy were assigned to DN and NDRD groups. Echocardiography and Doppler ultrasound were performed to evaluate left ventricular hypertrophy (LVH) and peripheral atherosclerosis disease (PAD). Renal and cardiovascular survival rates were compared between the DN and NDRD groups by Kaplan-Meier analysis. Risk factors for renal and cardiovascular events in DN patients were identified by a Cox proportional hazards model. Results: In total, 179 patients entered the DN group (54.9%) and 147 made up the NDRD group (45.1%). The presence of diabetic retinopathy, family history of diabetes, and dependence on insulin therapy were associated with the presence of DN. DN patients had more CVD with more severe LVH and PAD. Poorer renal (log-rank χ2 = 26.534, p < 0.001) and cardiovascular (log-rank χ2 = 16.257, p < 0.001) prognoses were seen in the DN group. DR (HR 1.539, 95% CI 1.332–1.842), eGFR (HR 0.943, 95% CI 0.919–0.961), and 24-h proteinuria (HR 1.211, 95% CI 1.132–1.387) were identified as risk factors for renal endpoints. Age (HR 1.672, 95% CI 1.487–1.821), HbA1C (HR 1.398, 95% CI 1.197–1.876), and 24-h proteinuria (HR 1.453, 95% CI 1.289–1.672) were associated with cardiovascular endpoints. Conclusion: Patients with DN had more severe CVD along with poorer renal and cardiovascular prognoses than those with NDRD.

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Outcomes of Constrained Prostheses in Primary and Revision TKR

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00160 ◽

2017 ◽

Vol 5 (5_suppl5) ◽

pp. 2325967117S0016

Author(s):

Ben Parkinson ◽

Michelle Lorimer ◽

Peter Lewis

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Knee Prostheses ◽

Hazards Model ◽

Kaplan Meier ◽

Hazard Ratios ◽

Total Knee

Introduction: The decision to use varus/valgus constrained or hinge knee prostheses in complex Total Knee Replacement (TKR) cases is difficult. There are few publications that compare survival rates, to aid this decision-making. This study compares the survival rates of unlinked fully constrained and hinge constrained prostheses in the primary and revision settings. Methods: Data from the AOANJRR to 31st of December 2013 was analysed to determine the survival rate of unlinked and hinge constrained TKR in the primary and revision settings (excluding the diagnosis of tumour and infection). Only first-time revisions of a known primary TKR were included in the revision analysis. Kaplan-Meier estimates of survivorship were calculated for the two categories of constraint and were matched for age and diagnosis in both primary and revision TKR situations. Hazard ratios using the Cox proportional-hazards model were used. The survivorship of individual prosthesis models was determined. Results: There were 3237 prostheses implanted during the study period that met the inclusion criteria. Of these, 1896 were for primary TKR and 1341 for revision TKR. There were 1349 unlinked fully constrained and 547 hinge prostheses for primary TKR and 991 unlinked fully constrained and 350 hinge prostheses for revision TKR. In both the primary and revision settings when matched by age, there was no difference in rates of revision for either level of constraint. When matched by indication in the primary setting, there was no difference in the rates of revision for either level of constraint. The rate of revision for both categories of constrained prosthesis was significantly higher in younger patients <55 years of age (p < 0.05). There were no differences in survival rates of individual models of constrained TKR. Conclusions: The survival rates of unlinked constrained and hinge knee prostheses are similar when matched by age or diagnosis. In complex TKR instability cases, surgeons should feel confident in choosing the appropriate prosthesis to gain a stable knee and need not be concerned that a hinge prosthesis may carry a higher revision rate.

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Clinicopathological Characteristics and Prognostic Prediction in Pseudomyxoma Peritonei Originating From Mucinous Ovarian Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.641053 ◽

2021 ◽

Vol 11 ◽

Author(s):

Fengxian Fu ◽

Xulan Ma ◽

Yiyan Lu ◽

Hongbin Xu ◽

Ruiqing Ma

Keyword(s):

Ovarian Cancer ◽

Pseudomyxoma Peritonei ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Clinicopathological Characteristics ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Hazards Model

ObjectiveTo describe the clinicopathological characteristics of mucinous ovarian cancer (MOC)-derived pseudomyxoma peritonei (PMP) and identify prognostic factors for survival.MethodsMedical records from patients with MOC-derived PMP who attended the Aerospace Center Hospital, Beijing, China between January 2009, and December 2019 were retrospectively reviewed. Survival analysis was performed with the Kaplan-Meier method, the log-rank test, and a Cox proportional hazards model.ResultsCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for PMP originating from MOC were performed on 22 patients, who had a median age of 52 years at the time of surgery. At the last follow-up in June 2020, 9 (41%) patients were still alive. Median OS was 12 months (range, 1 to 102 months), and the 2-, 3-, and 5-year survival rates were 23, 9, and 5%, respectively.ConclusionHistopathologic subtype and PCI may be applied as predictors of prognosis in patients with MOC-derived PMP. Patients with high-grade disease could benefit from completeness of cytoreduction (CCR) 0/1.

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

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.11028 ◽

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]

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Survival rate of patients with bladder cancer and its related factors in Kurdistan Province (2013–2018): a population-based study

BMC Urology ◽

10.1186/s12894-020-00769-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mozhdeh Amiri ◽

Sofimajidpour Heshmatollah ◽

Nader Esmaeilnasab ◽

Jamshid Khoubi ◽

Ebrahim Ghaderi ◽

...

Keyword(s):

Bladder Cancer ◽

Survival Rate ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Population Based ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Disease Stage ◽

Related Factors ◽

Hazards Model

Abstract Background Bladder cancer is one of the most common urinary tract cancers. This study aims to estimate the survival rate of patients with bladder cancer according to the Cox proportional hazards model based on some key relevant variables. Methods In this retrospective population-based cohort study that explores the survival of patients with bladder cancer and its related factors, we first collected demographic information and medical records of 321 patients with bladder cancer through in-person and telephone interviews. Then, in the analysis phase, Kaplan–Meier method and log-rank test were used to draw the survival curve, compare the groups, and explore the effect of risk factors on the patient survival rate using Cox proportional hazards model. Results The median survival rate of patients was 63.2 (54.7–72) months and one, three and five-year survival rates were 87%, 68% and 54%, respectively. The results of multiple analyses using Cox's proportional hazards model revealed that variables of sex (male gender) (HR = 11.8, 95% CI: 0.4–100.7), more than 65 year of age (HR = 4.1, 95% CI: 0.4–11), occupation, income level, (HR = 0.4, 95% CI: 0.2–0.8), well differentiated tumor grade (HR = 3.2, 95% CI: 1.7–6) and disease stage influenced the survival rate of patients (p < 0.05). Conclusion The survival rate of patients with bladder cancer in Kurdistan province is relatively low. Given the impact of the disease stage on the survival rate, adequate access to appropriate diagnostic and treatment services as well as planning for screening and early diagnosis, especially in men, can increase the survival rate of patients.

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Risk Indicators Affecting the Survival of the Mandibular First Molar Adjacent to an Implant at the Mandibular Second Molar Site: A Retrospective Study

Journal of Clinical Medicine ◽

10.3390/jcm10122543 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2543

Author(s):

Won-Bae Park ◽

Koo-Hyun Kwon ◽

Kyung-Gyun Hwang ◽

Ji-Young Han

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Contralateral Side ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Risk Indicators ◽

Second Molar ◽

Hazards Model ◽

Mandibular Second Molar

This study aimed to compare the survival of mandibular first molars (MnM1s) adjacent to implants placed in mandibular second molar sites (ImM2s) with MnM1s adjacent to mandibular second molars (MnM2s) and to investigate risk indicators affecting the survival of MnM1s adjacent to ImM2s. A total of 144 patients who had MnM1s adjacent to ImM2s and MnM1s adjacent to MnM2s on the contralateral side were included in this study. Clinical variables and radiographic bone levels were evaluated. The survival of MnM1s adjacent to ImM2s or MnM2s was evaluated using a Kaplan–Meier analysis and Cox proportional hazards model. The 5-year cumulative survival rates of MnM1s adjacent to ImM2s and MnM2s were 85% and 95%, respectively. MnM1s adjacent to ImM2s of the internal implant-abutment connection type had higher multivariate hazard ratios (HR) for loss. MnM1s that had antagonists with implant-supported prostheses also had higher HR for loss. The multivariate HR for the loss of MnM1s adjacent to ImM2s with peri-implant mucositis was 3.74 times higher than MnM1s adjacent to healthy ImM2s. This study demonstrated several risk indicators affecting the survival of MnM1s adjacent to ImM2s. It is suggested that supportive periodontal and peri-implant therapy combined with meticulous occlusal adjustment can prolong the survival of MnM1s and ImM2s.

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