scholarly journals Serum β-2 microglobulin predicts mortality in people with diabetes

2013 ◽  
Vol 169 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Ching-Lung Cheung ◽  
Karen S L Lam ◽  
Bernard M Y Cheung
Keyword(s):  
Cox Regression ◽  
Threshold Model ◽  
Linear Increase ◽  
Diabetic Patients ◽  
Cox Regression Analysis ◽  
Health And Nutrition ◽  
Risk Of Mortality ◽  
The Relationship ◽  
Related Mortality

ObjectiveSerum β-2 microglobulin (B2M) level predicts mortality in chronic kidney disease. Glycation of B2M is cytotoxic and may contribute to the risk of mortality in diabetic patients. Our objective was to evaluate the relationship between B2M and mortality in diabetic patients.MethodsIn this prospective study, 896 participants of the Third National Health and Nutrition Examination Survey with diabetes were included in the analysis. Serum B2M level was used in multivariate Cox regression analysis to predict all-cause and diabetes-related mortality.ResultsDuring a median follow-up of 11.8 years (range 0.1–18.2 years) and 9220.5 person/years, 541 (42.4%) and 207 (16.8%) participants died from all causes and diabetes-related causes respectively. One natural-log unit of B2M was significantly associated with all-cause (hazard ratio (HR)=6.53, 95% CI 2.07–20.6) and diabetes mortality (HR=7.35, 95% CI 1.01–53.38) after multivariable adjustment. Similar results were obtained when B2M was analyzed as tertiles or in the threshold model (T1+T2 vs T3). Examination of regression splines suggests a linear increase in hazard for mortality with increasing B2M levels.ConclusionsSerum B2M level is a novel predictor of all-cause and diabetes-related mortality in people with diabetes regardless of renal function.

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Cardiology ◽  
2017 ◽  
Vol 138 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Xili Lu ◽  
Wei Wang ◽  
Ling Zhu ◽  
Yilu Wang ◽  
Kai Sun ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cox Regression Analysis ◽  
Fragmented Qrs ◽  
All Cause Mortality ◽  
The Relationship ◽  
Cvd Mortality

Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.

scholarly journals D-dimer daily continuous tendency predicts the short-term prognosis for COVID-19 independently: A retrospective study from Northeast China

2021 ◽  
pp. 1-9
Author(s):  
Yinting Xing ◽  
Wei Yang ◽  
Yingyu Jin ◽  
Chao Wang ◽  
Xiuru Guan
Keyword(s):  
Cox Regression ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Prognosis Group ◽  
The Difference ◽  
Group B ◽  
The Relationship ◽  
Worse Prognosis ◽  
D Dimer

BACKGROUND AND OBJECTIVE: To study whether D-dimer daily continuous tendency could predict the short-term prognosis of COVID-19. PATIENTS AND METHODES: According to the short-term prognosis, 81 COVID-19 patients were divided into two groups, one of worse prognosis (Group W) and the other of better prognosis (Group B). The slope of D-dimer linear regression during hospitalization (SLOPE) was calculated as an indicator of D-dimer daily continuous tendency. The SLOPE difference between Group W and Group B was compared. The difference between the discharge results and the 3-month follow-up results was also compared. COX regression analysis was used to analyze the relationship between SLOPE and short-term prognosis of COVID-19. RESULTS: There were 16 patients in Group W and 65 patients in Group B. Group W had more critical proportion (p <  0.0001), indicating that the symptoms of its patients were more severe during hospitalization. ARDS, the most visible cause of worse prognosis, accounted for up to 68.75%, and many symptoms merged and resulted in worse prognosis. The D-dimer levels of Group W not only were significantly higher (p <  0.0001), but also showed an increasing trend. In addition, the D-dimer levels at discharge were significantly higher than those at follow-up (p = 0.0261), and the mean difference was as high as 0.7474. SLOPE significantly correlated with the short-term prognosis of COVID-19 independently (RR: 1.687, 95% CI: 1.345–2.116, P <  0.0001). The worst prognosis occurred most likely during the first month after COVID-19 diagnosis. CONCLUSION: Our study found that D-dimer daily continuous tendency independently correlates with worse prognosis and can be used as an independent predictor of the short-term prognosis for COVID-19.

scholarly journals Ultrafiltration rate and diabetes as useful indicators of cardiovascular-related death in hemodialysis patients below 60 years of age

2017 ◽  
Vol 71 (0) ◽  
pp. 0-0
Author(s):  
Marcin Krzanowski ◽  
Katarzyna Krzanowska ◽  
Artur Dziewierz ◽  
Małgorzata Banaszkiewicz ◽  
Artur Jurczyszyn ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Mortality Data ◽  
Cox Regression Analysis ◽  
Time To Death ◽  
All Cause Mortality ◽  
Dm Type 2 ◽  
Related Mortality

Background: The survival rate of elderly hemodialyzed (HD) patients is commonly thought to be poor. In a prospective, single center, non-interventional, observational study, the cause of all-cause and cardiovascular (CV) and heart failure (HF) mortality in this patient group were examined and compared with a younger cohort (below 60 years). Material/Methods: The study included 223 patients (90 women and 133 men) with age ranging from 34.5 to 75.0 years treated with HD. Median duration of HD was 70.0 months (24.0-120.0). Mortality data was collected over a period of six years. We divided patients into groups: <60 (n=123), ≥60 years (n=100), and with (n=33) and without DM type 2 (n=190). Results: During a six-year follow-up, 100 patients (44.8%) died, including 83 (37.2%) patients who died due to CV reasons. Median follow-up was 2015.0 days (946.0-2463.0) with the median time to death of 1166.0 days (654.5-1631.0). The factors negatively affecting patients’ survival in univariate Cox regression analysis included for all-cause mortality were: inter-dialytic weight gain (IDWG) (hazard ratio [HR]=1.60; p=0.01), ultrafiltration (UF) rate (HR=3.63; p=0.012) for group <60 years; for CV death: UF rate (HR=4.20; p=0.03), DM (HR=5.11; p=0.002) for group <60 years; for HF death: mellitus type 2 (DM) (HR=2.93; p=0.027) for group ≥60 years). In a multivariate Cox regression analysis for patients <60 years, the UF rate was the only independent predictor of all-cause mortality (HR 3.63 (1.34-9.67); p=0.011). Both DM (HR 4.91 (1.71-14.10); p=0.003) and UF rate (HR 3.62 (1.04-12.61); p=0.044) were independent predictors of CV-related mortality in patients <60 years. Conclusions: The UF rate can be a simple, useful indicator of higher long-term all-cause and CV mortality in HD patients <60 years of age. Also, DM may be a predictor of CV–related mortality in younger HD patients.

scholarly journals Diabetes as a Risk Factor for Cardiovascular Events in Patients Receiving Permanent Pacemaker – A Propensity Score-Matched Cohort Study

2021 ◽  
Author(s):  
Huang-Chung Chen ◽  
Wen-Hao Liu ◽  
Chien-Hao Tseng ◽  
Yung-Lung Chen ◽  
Wei-Chieh Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Study Groups ◽  
Permanent Pacemaker ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Cox Regression Analysis

Abstract Background: Type 2 diabetes was associated with higher risk for permanent pacemaker (PPM) implantation. We aimed to compare the clinical outcomes between diabetic and non-diabetic patients receiving PPM treatment. Methods: Between January 2003 and December 2017, 1742 patients receiving naïve PPM treatment comprised this retrospective cohort study and were categorized into two groups by the presence or absence of diagnosis of diabetes: diabetic group (n=632, 36.3%) and non-diabetic group (n=1110, 63.7%). The primary outcome was cardiovascular events including heart failure (HF) hospitalization and acute myocardial infarction (AMI). Propensity score matching (PSM) was applied to reduce selection bias between the study groups. Results: During a mean follow-up of 7.8 ± 4.8 years, there were 264 cardiovascular events. A total of 746 patients with a 1:1 paired ratio between diabetic and non-diabetic groups were analyzed in the propensity score-matched series. After PSM, the incidence of cardiovascular events was higher in the diabetic group compared to the non-diabetic group (18.8% vs. 12.3%, P=0.015). Moreover, the incidence of HF hospitalization was higher in the diabetic patients compared to the non-diabetic patients (15.3% vs. 10.2%, P=0.037), whereas the incidence of AMI did not differ between the diabetic and non-diabetic groups (3.5% vs. 2.1%, P=0.268). After adjustments for covariates in multiple Cox regression analysis, diabetes remained as an independent predictor for cardiovascular events [hazard ratio, 1.54; 95% confidence interval, 1.04-2.29; P=0.031].Conclusions:In this cohort study of patients with naïve PPMs implantation, diabetes increased 1.54-fold risk of cardiovascular events in PPM recipients, especially for HF hospitalization.

The effect of marital status on endometrial cancer-related diagnosis and prognosis: a Surveillance Epidemiology and End Results database analysis

2019 ◽  
Vol 15 (34) ◽  
pp. 3963-3976 ◽  
Author(s):  
Jia Dong ◽  
Qinjin Dai ◽  
Fan Zhang
Keyword(s):  
Endometrial Cancer ◽  
Marital Status ◽  
Cox Regression ◽  
Significant Prognostic Factor ◽  
Cox Regression Analysis ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
The Relationship ◽  
End Results

Aim: Marital status has been proved a significant prognostic factor for diagnosis and prognosis in various cancers, but the effect in endometrial cancer (EMC) is controversial. The research was designed to clarify the relationship between marital status and EMC. Methods: We identified 39,387 patients with EMC between 2004 and 2010 from the Surveillance Epidemiology and End Results database. Patients were categorized into four groups according to marital status. We used the logistic regression, the Kaplan–Meier method and Cox regression analysis to analyze the effect of marital status on EMC-related diagnosis and prognosis. Results: The study suggests that marriage benefits the diagnosis and prognosis of EMC. Widowed and unmarried patients had higher risk of mortality than other marital status.

scholarly journals 0048 The Association Between REM Sleep and Risk of Mortality in Three Independent Cohorts

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A19-A20
Author(s):  
E B Leary ◽  
K T Watson ◽  
S Ancoli-Israel ◽  
S Redline ◽  
K Yaffe ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Mortality Risk ◽  
Rem Sleep ◽  
Cox Regression ◽  
Older Men ◽  
Sensitivity Analyses ◽  
Sample Mean ◽  
Risk Of Mortality ◽  
Related Mortality

Abstract Introduction Sleep disorders and sleep characteristics have been linked to higher risk of mortality. Despite the emerging evidence of a sleep-mortality association, the relationship between sleep architecture and mortality aren’t well understood. We hypothesize that reduced REM is associated with increased mortality risk. Methods The Osteoporotic Fractures in Men (MrOS) study is a population-based study of 2,675 older men. Cox regression was used to evaluate the association between %REM and mortality rate. Potential covariates were evaluated using 6-fold cross validation. Sensitivity analyses were performed to rule out alternative explanations. Wisconsin Sleep Cohort (WSC) and Sleep Heart Health Study (SHHS) data were used to replicate the findings. Results The MrOS sample mean age was 76.3 years (SD=5.51) and the median follow-up time was 12.1 years. There was a 13% higher rate of mortality for every absolute 5% reduction in REM sleep (HR=1.13, 95%CI, 1.08–1.19) after adjusting for multiple demographic, sleep, and health covariates. The association persisted for cardiovascular disease-related mortality (CVD) (HR=1.18, 95%CI, 1.09–1.28), cancer-related mortality (HR=1.14, 95%CI, 1.03–1.26), and other mortality (HR=1.19, 95%CI, 1.10–1.28). The WSC included 45.7% women. The mean age of the 1,388 individuals analyzed was 51.5 (SD=8.5); the median follow-up time was 20.8 years. The effect size for 5% reduction in REM on rate of all-cause mortality was similar in this cohort despite the younger age, inclusion of women, and longer follow-up period (HR=1.17, 95%CI, 1.03–1.34). SHHS data is still being analyzed; however the unadjusted model is consistent with the other cohorts. Conclusion We found an association between reduced REM and mortality in two, possibly three independent cohorts, which persisted across different causes of death and multiple sensitivity analyses. Mechanistic studies are needed and strategies to preserve REM may influence clinical therapies and reduce mortality risk. Support NHLBI provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839. Wisconsin Sleep Cohort was supported by R01HL62252, RR03186, and R01AG14124 from the NIH. Dr. Redline was partially supported by NHLBI R35 HL135818.

Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients

2019 ◽  
Vol 96 (1133) ◽  
pp. 128-133
Author(s):  
Yu-Qing Huang ◽  
Jia-Yi Huang ◽  
Lin Liu ◽  
Chao-Lei Chen ◽  
Yu-Ling Yu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Elderly Patients ◽  
Ischaemic Stroke ◽  
Cox Regression ◽  
Interaction Analysis ◽  
Interactive Effect ◽  
Cox Regression Analysis ◽  
Elderly Hypertensive ◽  
The Relationship

BackgroundAlthough hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.ObjectivesThe present study attempted to explore the relationship between triglyceride and first ischaemic stroke in a Chinese community elderly patients with hypertension.Methods and resultsThis was a retrospective cohort study. We enrolled 3249 consecutive elderly patients with hypertension from a community in China between January 2010 and December 2011. Patients were divided into four groups based on the quartiles of triglyceride. Multivariate Cox regression analysis, subgroup and interaction test were performed to evaluate the relationship between triglyceride and first ischaemic stroke. There were a total of 3249 participants including 1455 male and 1794 female, with a mean age of 71.36±7.18 years. At an average follow-up of 5.5 years, 205 patients were identified to have first ischaemic stroke. After adjustment for potential confounders, using the lowest quartiles of triglyceride as the reference, multivariable HR (95% CI) for first ischaemic stroke increased in parallel with the quartiles of triglyceride (HRs were 1.56 (95% CI 1.07 to 2.51), 1.74 (95% CI 1.07 to 2.84) and 1.85 (95% CI 1.05 to 2.89)) from the second to the fourth quartiles, respectively (p=0.002 for trend). Subgroup and interaction analysis showed that there was no interactive effect on triglyceride and first ischaemic stroke.ConclusionTriglyceride was an independent risk factor for first ischaemic stroke among Chinese elderly patients with hypertension.

scholarly journals Comparison of the effects of primary somatostatin analogue therapy and pituitary adenomectomy on survival in patients with acromegaly: a retrospective cohort study

2013 ◽  
Vol 169 (3) ◽  
pp. 367-376 ◽  
Author(s):  
Fausto Bogazzi ◽  
Annamaria Colao ◽  
Giuseppe Rossi ◽  
Martina Lombardi ◽  
Claudio Urbani ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Cox Regression ◽  
Diabetic Patients ◽  
Somatostatin Analogue ◽  
Primary Therapy ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk

ObjectiveAcromegalic patients have an increased risk of mortality. The objective of this study was to compare the effect of different therapies for acromegaly on mortality.Design and methodsThe mortality rate of 438 consecutive acromegalic patients was compared with that of the general population using the standardized mortality ratio (SMR); the effect of different therapies on survival was evaluated using Cox regression analysis.ResultsTwenty patients (4.5%) died between 1999 and 2009. Age- and sex-adjusted SMR was 0.70 (95% CI 0.43–1.08). The Cox regression analysis revealed that, in the whole population, both general risk factors (age and physical status) and specific factors for acromegaly (macroadenoma, hypopituitarism and uncontrolled disease) were associated with death. The most compromised patients at diagnosis had a higher mortality rate (P=0.001), which also occurred in patients with controlled acromegaly. Death occurred in 2.4% (adenomectomy), 2.6% (adenomectomy followed by somatostatin analogue (SSA) therapy) and 11.4% (SSA therapy as the primary therapy) of the patients. The risk of death was higher in patients receiving SSA therapy as the primary therapy (hazard ratio (HR) 5.52, 95% CI 1.06–28.77,P=0.043) than in all patients submitted to adenomectomy; however, a higher risk of death occurred only in diabetic patients treated with SSAs alone (HR 21.94, 95% CI 1.56–309.04,P=0.022). Radiotherapy was associated with an increased risk of mortality, which occurred in patients with the more locally advanced disease.ConclusionsTherapies for acromegaly and comorbidities have lowered the risk of mortality to the level of the general population; the effect of SSA therapy alone or that following pituitary adenomectomy was comparable to that of curative neurosurgery on survival in non-diabetic patients; on the contrary, SSA therapy as the primary therapy may be less effective than adenomectomy in reducing mortality rate in diabetic patients.

scholarly journals Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Peng ◽  
Si Lei ◽  
Quan Zhang ◽  
Yanjun Zhong ◽  
Shangjie Wu
Keyword(s):  
Risk Factor ◽  
Cox Regression ◽  
Laboratory Data ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
Underlying Diseases ◽  
Relationship Of ◽  
The Relationship

BackgroundCigarette smoking has been proven to be a risk factor in the development of many diseases. However, it remains controversial with respect to the relationship of smoking with COVID-19. The purpose of this study was to explore the role of smoking in COVID-19.MethodsA total of 622 patients with COVID-19 in China were enrolled in the study. Corresponding clinical and laboratory data were collected and analyzed. Meanwhile, Kaplan-Meier curve and Cox regression analysis were employed to analyze the association of smoking with survival in patients with COVID-19.ResultsSmoking was statistically significant comparing non-survivors and survivors of patients with COVID-19 (P = 0.007). Males had higher proportion of smoking than females (91.9% vs. 8.1%, P &lt; 0.001). Compared with the non-smoker, there was significant statistical difference in the incidence of cerebrovascular disease in smoking patients with COVID-19 (9.7% vs. 3.4%, P = 0.017). White blood cell count (6.3 vs. 5.4; P = 0.037), hemoglobin level (139.0 vs. 127.0; P &lt; 0.001), and creatinine level (77.3 vs. 61.0; P &lt; 0.001) were significantly increased in COVID-19 patients who smoked. Moreover, smoking patients showed a worse survival compared with non-smoking patients (Log Rank P = 0.045). After adjustment for age, gender and underlying diseases, patients with smoking still had higher risk of mortality than that of non-smoking patients (hazard ratio[HR] 1.897, 95% confidence interval [CI]1.058–3.402, P = 0.032).ConclusionSmoking was thought to be a risk factor in predicting the prognosis of COVID-19 and smoking patients might have a higher risk of mortality than that of the non-smoking patients.

scholarly journals Arterial lactate levels and their prognostic value in patients undergoing pulmonary thromboendarterectomy

2021 ◽  
Vol 2 (2) ◽  
pp. 123-129
Author(s):  
Cristhian Felipe Ramirez Ramos ◽  
Clara Inés Saldarriaga-Giraldo ◽  
Manuela Yepes-Calderón ◽  
Gustavo Adolfo Castilla-Agudelo ◽  
Mateo Aránzazu Uribe ◽  
...  
Keyword(s):  
Cox Regression ◽  
Rapid Change ◽  
Area Under The Curve ◽  
Pulmonary Thromboendarterectomy ◽  
Arterial Lactate ◽  
Cox Regression Analysis ◽  
The People ◽  
Lactate Levels ◽  
The Relationship

Objective.  Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods. Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results. Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regression of COX, no relationship with mortality was found. The area under the curve shows regular performance on both day 1 and day 2 in predicting mortality outcomes. Conclusions. The behavior of the lactate in patients undergoing pulmonary thromboendarterectomy shows a rapid change during the first hours after the procedure. No role was found as a predictor of mortality neither in-hospital nor in follow-up.

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