Glycemic Variability Is Associated With All-Cause Mortality In COVID-19 Patients With ARDSFindings From The COVAS Cohort

Abstract There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease 19 (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort-study compared several metrics of daily glycemic variability (DGV) for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87-148] mmHg). Continuous HRs showed a proportional increase in mortality risk with DGV. Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P)<0.001, LR(P)<0.001; HR: 1.016, (P)=0.001, LR(P)<0.001, respectively). Kaplan-Meier estimators yielded a shorter median survival (25 vs. 87 days) and higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5mg/dl (P<0.0001). High glycemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, procalcitonin and FPG levels at baseline.

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Comparative efficacy of tocilizumab and baricitinib in COVID-19 treatment: a retrospective cohort study

10.1101/2021.12.13.21267717 ◽

2021 ◽

Author(s):

Yuichi Kojima ◽

Sho Nakakubo ◽

Keisuke Kamada ◽

Yu Yamashita ◽

Nozomu Takei ◽

...

Keyword(s):

Chronic Renal Disease ◽

Secondary Infection ◽

University Hospital ◽

Rank Test ◽

Logistic Regression Models ◽

Respiratory Status ◽

Kaplan Meier ◽

Single Center Study ◽

Significant Difference ◽

All Cause Mortality

SummaryBackgroundAlthough biological agents, tocilizumab and baricitinib, have been shown to improve the outcomes of patients with COVID-19, a comparative evaluation has not been performed.MethodsA retrospective, single-center study was conducted using the data of patients with COVID-19 admitted to the Hokkaido University hospital between April 2020 and September 2021, who were treated with tocilizumab or baricitinib. The clinical characteristics of patients who received each drug were compared. Univariate and multivariate logistic regression models were performed against the outcomes of all-cause mortality and the improvement in respiratory status. The development of secondary infection events was analyzed using the Kaplan–Meier analysis and the log-rank test.ResultsThe use of tocilizumab or baricitinib was not associated with all-cause mortality and the improvement in respiratory status within 28 days of drug administration. Age, chronic renal disease, and comorbid respiratory disease were independent prognostic factors for all-cause mortality, while anti-viral drug use and severity of COVID-19 at baseline were associated with the improvement in respiratory status. There was no significant difference in the infection-free survival between patients treated with tocilizumab and those with baricitinib.ConclusionThere were no differences in efficacy and safety between tocilizumab and baricitinib for the treatment of COVID-19.

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Comparative efficacy of tocilizumab and baricitinib in COVID-19 treatment: a retrospective cohort study

10.21203/rs.3.rs-1199364/v1 ◽

2021 ◽

Author(s):

Yuichi Kojima ◽

Sho Nakakubo ◽

Nozomu Takei ◽

Keisuke Kamada ◽

Yu Yamashita ◽

...

Keyword(s):

Chronic Renal Disease ◽

Secondary Infection ◽

Biological Agents ◽

University Hospital ◽

Rank Test ◽

Respiratory Status ◽

Kaplan Meier ◽

Significant Difference ◽

All Cause Mortality ◽

Severity Of The Disease

Abstract Background Although the biological agents tocilizumab and baricitinib have been shown to improve the outcomes of patients with COVID-19, a comparative evaluation has not been performed. The aim of our study was to evaluate the comparative effect of the use of tocilizumab and baricitinib on patient outcomes in COVID-19. Methods A retrospective, single-center study was conducted using the data of patients with COVID-19 admitted to Hokkaido University hospital between April 2020 and September 2021 and were treated with tocilizumab or baricitinib. The clinical characteristics of the patients who received each drug were compared. Univariate and multivariate logistic regression analyses were performed against the outcomes of all-cause mortality and the improvement in respiratory status. The development of secondary infection events was analyzed using the Kaplan–Meier method and the log-rank test. Results Among the 459 patients hospitalized with COVID-19 during the study, 64 received tocilizumab and 34 received baricitinib, and they were included in the study. Most patients were treated with concomitant steroids, and the severity of the disease at the time of initiation of biological agents was similar. The use of tocilizumab or baricitinib was not associated with all-cause mortality or the improvement in respiratory status within 28 days of drug administration. Age, chronic renal disease, and comorbid respiratory disease were independent prognostic factors for all-cause mortality, whereas anti-viral drug use and severity of COVID-19 at baseline were associated with the improvement in respiratory status. There was no significant difference in the infection-free survival rate between patients treated with tocilizumab and those with baricitinib. Conclusion There were no differences in efficacy and safety between tocilizumab and baricitinib in the treatment of COVID-19. Both these biological agents are expected to be equally safe and clinically effective.

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P2878Higher all-cause mortality in patients with implanted dual-chamber cardioverter-defibrillators for secondary prevention: an analysis from the Polish ICD Registry

European Heart Journal ◽

10.1093/eurheartj/ehz748.1186 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

I Warchol ◽

A Lubinski ◽

M Sterlinski ◽

O Kowalski ◽

K Goscinska-Bis ◽

...

Keyword(s):

Secondary Prevention ◽

Implantable Cardioverter Defibrillators ◽

Dual Chamber ◽

Single Chamber ◽

Kaplan Meier ◽

Significant Difference ◽

All Cause Mortality ◽

National Cohort ◽

Cardioverter Defibrillators

Abstract Background In the Polish ICD Registry population secondary prevention recipients account for over 27%. Despite the evolution of indications for secondary prevention implantable cardioverter defibrillators (ICDs), recommendations regarding the use of ICDs for secondary prevention of sudden cardiac death (SCD) rely on information from a small number of randomized controlled trials that were performed decades ago, with mixed results. Moreover, research on the outcomes after implantations for secondary prevention of ICDs is limited. While dual-chamber devices offer theoretical advantage over single-chamber devices, dual-chamber ICDs (DC-ICDs) were announced not superior to single-chamber (SC-ICDs) in some research. Purpose Therefore, the aim of the study was to evaluate the all-cause mortality among patients from the Polish ICD Registry receiving either a single- or a dual-chamber device for secondary prevention in contemporary clinical practice. Methods All patients enrolled in the Polish ICD Registry from 1995 to 2016 were identified. Patients were included in the study if they were designated as receiving an ICD for secondary prevention of SCD after documented tachycardic arrest, sustained ventricular tachycardia (VT), or syncope. Kaplan-Meier survival analysis was used to assess all-cause mortality. Results In the study population of 3596 ICD recipients (mean age 69±12 years, 81% male, SC-ICD 61%, DC-ICD 39%), during mean follow-up of 79±43 months all-cause mortality rate was higher in the dual-chamber group than in the single chamber group, with a significant difference between the two groups as depicted in Kaplan-Meier curve (p<0,05). The median survival time was 98 months versus 110 months for SC and DC-ICD, respectively. Conclusions This study is the first to describe the characteristics of a national cohort of patients receiving a secondary prevention ICD in such a long follow-up period in contemporary practice. Implantation of a dual-chamber ICD was associated with higher all-cause mortality compared with single chamber devices.

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Effect of body mass index (BMI) on outcomes after surgical resection and adjuvant therapy for pancreatic cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.185 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 185-185

Author(s):

M. R. Khawaja ◽

N. Zyromski ◽

M. Yu ◽

H. R. Cardenes ◽

C. M. Schmidt ◽

...

Keyword(s):

Pancreatic Cancer ◽

Adjuvant Therapy ◽

Cancer Patients ◽

Surgical Resection ◽

Survival Rates ◽

Disease Free Survival ◽

University Hospital ◽

Rank Test ◽

Kaplan Meier ◽

Significant Difference

185 Background: Obesity is one of the factors commonly associated with pancreatic cancer risk, but its prognostic role for survival is debatable. This study aimed to determine the role of BMI in treatment outcomes of pancreatic cancer patients (pts) undergoing surgical resection followed by adjuvant therapy. Methods: We retrospectively reviewed 165 consecutive pts with pancreatic cancer undergoing pancreaticoduodenectomy at Indiana University Hospital between 2004 and 2008. Fifty-three pts who received adjuvant treatment [gemcitabine alone (C-group): n=19; gemcitabine + radiotherapy (CRT-group): n=34] at our institution were included in the analysis. The Kaplan-Meier method was used to estimate the disease-free survival (DFS) and overall survival (OS); log-rank test was used to compare these outcomes between BMI groups (normal 18.5-24.99 kg/m2 vs. overweight/obese ≥ 25 kg/m2). Results: The sample comprised 53 pts (28 males; median age 62 yrs) with a median follow-up of 18.6 months (mos). Thirty pts (56.6%) had their BMIs recorded before the date of surgery, and 23 pts prior to starting adjuvant therapy. Two (3.8%) pts were underweight, 21 (39.6%) had a normal BMI and 30 (56.6%) were overweight/obese. There was no statistically significant difference in the median DFS of obese/overweight and normal BMI pts irrespective of adjuvant therapy (C or CRT) (14.47 vs. 11.80 mos; p= 0.111). Obese/overweight pts had a better median OS [25.2 vs. 14.6 mos; p=0.045 overall (25.7 vs. 16.9 mos; p= 0.143 for the CRT-group and 17.3 vs. 13.4 mos; p= 0.050 for the C-group)], 1-year survival [96.7% vs. 61.9%; p < 0.0001 overall (95% vs. 64.3%; p= 0.001 for the CRT-group, and 90% vs. 57.1%; p=0.016 with C)], and 2-year survival [52.6% vs. 25.4%; p < 0.0001 overall (60.0% vs. 30.0%; p=0.0001 for the CRT-group and 37.5% vs. 14.3%; p=0.0002 for the C-group)] than patients with normal BMI. Conclusions: In our experience, overweight/obese pts undergoing surgery followed by adjuvant therapy have better survival rates than patients with normal BMI. [Table: see text] No significant financial relationships to disclose.

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The Significance of Follow-Up Serum Uric Acid Levels in Predicting All-Cause Mortality and Cardiovascular Mortality in Peritoneal Dialysis Patients

10.21203/rs.3.rs-146953/v1 ◽

2021 ◽

Author(s):

Pingping Ren ◽

Qilong Zhang ◽

Yixuan Pan ◽

Yi Liu ◽

Chenglin Li ◽

...

Keyword(s):

Uric Acid ◽

Peritoneal Dialysis ◽

Serum Uric Acid ◽

Cardiovascular Mortality ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Kaplan Meier ◽

Significant Difference ◽

All Cause Mortality

Abstract Background: Studies on the correlation between serum uric acid (SUA) and all-cause mortality in peritoneal dialysis (PD) patients were mainly based on the results of baseline SUA. We aimed to analyze the change of SUA level post PD, and the correlation between follow-up SUA and prognosis in PD patients. Methods: All patients who received PD catheterization and maintaining PD in our center from March 2, 2001 to March 8, 2017 were screened. Kaplan-Meier and Cox proportional-hazards regression models were used to analyze the effect of SUA levels on the risks of death. We graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months post PD by mean of SUA plus or minus a standard deviation as cut-off values, and compared all-cause and cardiovascular mortality among patients with different SUA grades. Results: A total of 1402 patients were included, 763 males (54.42%) and 639 females (45.58%). Their average age at PD start was 49.50±14.20 years. The SUA levels were 7.97±1.79mg/dl at baseline, 7.12±1.48mg/dl at 6 months, 7.05±1.33mg/dl at 12 months, 7.01±1.30mg/dl at 18 months, and 6.93±1.26mg/dl at 24 months. During median follow-up time of 31 (18, 49) months, 173 (12.34%) all-cause deaths occurred, including 68 (4.85%) cardiovascular deaths. There were no significant differences on all-cause mortality among groups with graded SUA levels at baseline, 12 months, 18 months and 24 months during follow-up or on cardiovascular mortality among groups with graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months during follow-up. At 6 months post PD，Kaplan Meier analysis showed there was significant difference on all-cause mortality among graded SUA levels (c2=11.315, P=0.010), and the all-cause mortality was lowest in grade of 5.65mg/dl≤SUA<7.13mg/dl. Conclusion: SUA level decreased during follow up post PD. At 6 months post PD, a grade of 5.65mg/dl≤SUA<7.13mg/dl was appropriate for better patients’ survival.

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Application of Peak Glucose Range and Diabetes Status in Mortality Risk Stratification in Critically Ill Patients with Sepsis

Diagnostics ◽

10.3390/diagnostics11101798 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1798

Author(s):

Kai-Yin Hung ◽

Yi-Hsuan Tsai ◽

Chiung-Yu Lin ◽

Ya-Chun Chang ◽

Yi-Hsi Wang ◽

...

Keyword(s):

Risk Stratification ◽

Critically Ill ◽

Glucose Level ◽

Mortality Risk ◽

Sofa Score ◽

Goodness Of Fit ◽

Human Leukocyte ◽

Kaplan Meier ◽

Hla Dr ◽

Diabetes Status

The effects of diabetes and glucose on the outcomes of patients with sepsis are somewhat conflicting. This retrospective study enrolled 1214 consecutive patients with sepsis, including a subpopulation of 148 patients with immune profiles. The septic patients were stratified according to their Diabetes mellitus (DM) status or peak glucose level (three-group tool; P1: ≤140 mg/dL, P2: 141–220 mg/dL, P3: >220 mg/dL) on day 1. Although the DM group had a lower hazard ratio (HR) for 90-day mortality compared to non-DM patients, the adjusted HRs were insignificant. The modified sequential organ failure assessment-glucose (mSOFA-g) score can predict 90-day survival in patients with and without diabetes (β = 1.098, p < 0.001; β = 1.202, p < 0.001). The goodness of fit of the mSOFA-g score was 5% higher than the SOFA score of the subgroup without diabetes. The SOFA score and human leukocyte antigen-D-related (HLA-DR) expression were comparable between the groups. The P3 group had lower HLA-DR expression on days 1 and 3 and a higher 90-day mortality. The three-group tool was useful for predicting 90-day mortality in patients with separate Kaplan-Meier survival curves and mortality HRs in the construction and validation cohorts. The peak glucose level, instead of diabetes status, can be used as an easy adjunctive tool for mortality risk stratification in critically ill septic patients.

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P1647Prognostic significance of circulating leukocyte subtype counts in patients with chronic heart failure

European Heart Journal ◽

10.1093/eurheartj/ehz748.0406 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Takae ◽

E Yamamoto ◽

F Oike ◽

T Nishihara ◽

K Fujisue ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Events ◽

Hazard Analysis ◽

Left Ventricular ◽

University Hospital ◽

Left Ventricular Ejection ◽

Monocyte Count ◽

Ventricular Ejection Fraction ◽

Kaplan Meier ◽

Significant Difference

Abstract Background Inflammation, characterized by early leukocyte recruitment, is known to be associated with vascular endothelial dysfunction and atherosclerosis. Previous studies have reported that an increased leukocyte count is a risk factor for the progression of atherosclerosis in cardiovascular diseases, and we previously reported that a high monocyte count was an independent and incremental of cardiovascular events in patients with coronary artery disease. Furthermore, previous study also reported that inflammation play a role in the pathophysiology of heart failure (HF), but few studies have evaluated the prognostic role of monocyte in patients with HF. Purpose To elucidate the prognostic value of monocyte in HF, we investigated the association of monocyte counts in patients with HF with their future cardiovascular events, and compared them among new categories of HF in this study. Methods Consecutive HF patients referred for hospitalization at Kumamoto University Hospital between 2006 and 2015 were registered. Finally, a total of 678 HF patients were enrolled in the study, and were followed prospectively until 2016 or until the occurrence of cardiovascular events. We defined high monocyte group as monocyte counts ≥360/mm3 according to previous clinical reports. We further divided HF patients into three types according to left ventricular ejection fraction (LVEF) (HF with reduced LVEF (HFrEF), HF with mid-range LVEF (HFmrEF), and HF with preserved LVEF (HFpEF)). Results In this study, HFrEF was 82 patients, HFmrEF was 118 patients and HFpEF was 478 patients, respectively. The average of total monocyte counts were 397±136 in HFrEF and 375±172 in HFmrEF, and 341±138 in HFpEF patients. Kaplan-Meier analysis revealed that both HFrEF and HFmrEF patients with high monocyte group (≥360 /mm3) had a significant higher risk of HF-related events (P=0.03 and P=0.02, respectively) but not of total cardiovascular events compared with those with low monocyte groups (<360/mm3) (P=0.001). By contrast, high and low monocyte groups in HFpEF patients had no significant difference in both total cardiovascular and HF-related events. Multivariate Cox hazard analysis identified a high monocyte count as an independent and significant predictor of future HF-related events in HFrEF and HFmrEF patients (hazard ratio: 3.02, 95% confidence interval: 1.20–7.59, p=0.018). Next, by whether they had ischemic heart disease (IHD), we divided HFrEF and HFmrEF patients into two groups. Non-ischemic HF group with high monocyte counts had a significant higher risk of HF-related events compared to those with low monocyte counts (P=0.014). By contrast, there was no statistically significant difference of the occurrences of future HF-related events between in ischemic HF group with high and low monocyte counts. Conclusion A high monocyte count was an independent and incremental predictor of HF-related events in HFrEF and HFmrEF especially with IHD, but not in HFpEF patients.

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Procalcitonin and N-Terminal Pro-B-Type Natriuretic Peptide for Prognosis in Septic Acute Kidney Injury Patients Receiving Renal Replacement Therapy

Blood Purification ◽

10.1159/000501388 ◽

2019 ◽

Vol 48 (3) ◽

pp. 262-271 ◽

Cited By ~ 1

Author(s):

Xiaohua Sheng ◽

Jingye Yang ◽

Gang Yu ◽

Yang Fei ◽

Hongda Bao ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Hospital Mortality ◽

Replacement Therapy ◽

Natriuretic Peptide ◽

Kidney Injury ◽

University Hospital ◽

Kaplan Meier ◽

Septic Acute Kidney Injury ◽

Significant Difference

Background: Sepsis is a complex clinical syndrome leading to severe sepsis and septic shock. It is very common in the intensive care unit with high mortality. Thus, judging its prognosis is extremely important. Procalcitonin (PCT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels are commonly elevated in sepsis patients, but only a few are discussed in the septic acute kidney injury patients (AKI) who received renal replacement therapy (RRT). Our study is aimed at investigating the prognostic value of PCT and NT-proBNP in septic AKI patients who received RRT. Methods: This was a retrospective study of septic AKI patients who underwent RRT in a Chinese university hospital. All enrolled patients tested PCT and NT-proBNP at RRT initiation. PCT and NT-proBNP levels were compared between the survivors and non-survivors. Receiver operating characteristic (ROC) curves of the 2 biomarkers were performed for predicting in-hospital mortality. According to the median value of PCT (16.2 ng/mL) and NT-proBNP (10,271 pg/mL), patients were divided into 4 groups (low PCT and low NT-proBNP; high PCT and low NT-proBNP; low PCT and high NT-proBNP; high PCT and high NT-proBNP). The Kaplan-Meier survival curves were used to analyze the 28-day survival rate in the 4 groups. Results: A total of 81 patients were enrolled in the study. Of which, 48 (59.3%) patients died during hospitalization. The median of NT-proBNP in non-survivors was significantly higher than in survivors (p = 0.001), while PCT had no significant difference (p = 0.412). The area under the ROC curve of PCT and NT-proBNP for predicting in-hospital mortality was 0.561 (95% CI 0.426–0.695) and 0.729 (95% CI 0.604–0.854). Kaplan-Meier survival curve analysis showed that increased NT-proBNP level was associated with 28-day mortality while combined with PCT there was no statistical difference in 4 different level groups. Conclusion: NT-proBNP has a certain predictive value for the prognosis in septic AKI patients who received RRT. It seems that the initial PCT value for prognosis is limited. The combination of PCT and NT-proBNP to evaluate the prognosis in these critically ill patients is currently unclear.

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Prognostic value of CAD-RADS classification by coronary CTA in patients with suspected CAD

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02286-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zengfa Huang ◽

Shutong Zhang ◽

Nan Jin ◽

Yun Hu ◽

Jianwei Xiao ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Prognostic Value ◽

Goodness Of Fit ◽

Time Dependent ◽

Goodness Of Fit Test ◽

Coronary Cta ◽

Kaplan Meier ◽

All Cause Mortality ◽

Artery Disease

Abstract Background The study sought to compare Coronary Artery Disease Reporting and Data System (CAD-RADS) classification with traditional coronary artery disease (CAD) classifications and Duke Prognostic CAD Index for predicting the risk of all-cause mortality in patients with suspected CAD. Methods 9625 consecutive suspected CAD patients were assessed by coronary CTA for CAD-RADS classification, traditional CAD classifications and Duke Prognostic CAD Index. Kaplan–Meier and multivariable Cox models were used to estimate all-cause mortality. Discriminatory ability of classifications was assessed using time dependent receiver-operating characteristic (ROC) curves and The Hosmer–Lemeshow goodness-of-fit test was employed to evaluate calibration. Results A total of 540 patients died from all causes with a median follow-up of 4.3 ± 2.1 years. Kaplan–Meier survival curves showed the cumulative events increased significantly associated with CAD-RADS, three traditional CAD classifications and Duke Prognostic CAD Index. In multivariate Cox regressions, the risk for the all-cause death increased from HR 0.861 (95% CI 0.420–1.764) for CAD-RADS 1 to HR 2.761 (95% CI 1.961–3.887) for CAD-RADS 4B&5, using CAD-RADS 0 as the reference group. The relative HRs for all-cause death increased proportionally with the grades of the three traditional CAD classifications and Duke Prognostic CAD Index. The area under the time dependent ROC curve for prediction of all-cause death was 0.7917, 0.7805, 0.7991for CAD-RADS in 1 year, 3 year, 5 year, respectively, which was non-inferior to the traditional CAD classifications and Duke Prognostic CAD Index. Conclusions The CAD-RADS classification provided important prognostic information for patients with suspected CAD with noninvasive evaluation, which was non-inferior than Duke Prognostic CAD Index and traditional stenosis-based grading schemes in prognostic value of all-cause mortality. Traditional and simplest CAD classification should be preferable, given the more number of groups and complexity of CAD-RADS and Duke prognostic index, without using more time consuming classification.

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The Association between Allostatic Load and Mortality among Chinese Older Adults: The Chinese Longitudinal Health and Longevity Study

10.21203/rs.3.rs-31124/v1 ◽

2020 ◽

Author(s):

Tianhang Zhang ◽

Lijing Yan ◽

Huashuai Chen ◽

Haiyu Jin ◽

Chenkai Wu

Keyword(s):

Older Adults ◽

Allostatic Load ◽

Adverse Outcomes ◽

Cox Models ◽

Chinese Older Adults ◽

Healthy Longevity ◽

Increased Risk ◽

Significant Difference ◽

All Cause Mortality ◽

Wear And Tear

Abstract Background Allostatic load, as multiple biomarker measures of ‘wear and tear’ on physiological systems, has shown some promise that high burden of AL is associated with increased risk of adverse outcomes, but little attention has been paid to China with largest aging population in the world. This study is to examine the association between allostatic load (AL) and all-cause mortality among Chinese adults aged at least 60 years. Methods Data were from 2,439 participants in the Chinese Longitudinal Healthy Longevity Survey. The final analytic sample consisted of 1,519 participants. Cox models were used to examine the association between AL and mortality among men and women, separately. Analysis were also adjusted for potential confounders including age, ethnicity, education, and marital status, smoking and exercise. Results In the fully adjusted model, males with a medium AL burden (score: 2–4) and high AL burden (score: 5–9) had a 34% and 128% higher hazard of death, respectively, than those with a low AL burden (score: 0–1). We did not find significant difference between females with different levels of AL burden. Discussion Higher AL burden was associated with increased all-cause mortality among Chinese men aged at least 60 years. However, we did not find strong evidence about Allostatic load was associated with specific causes of death over the same follow-up period among women. In conclusion Intervention programs targeting modifiable components of the AL burden may help prolong lifespan for older adults, especially men, in China.

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