scholarly journals Sex Differences in the Survival of Patients Undergoing Maintenance Hemodialysis: A 10-year Outcome of the Q-Cohort Study

2021 ◽  
Author(s):  
Hiroaki Tsujikawa ◽  
Shunsuke Yamada ◽  
Hiroto Hiyamuta ◽  
Masatomo Taniguchi ◽  
Kazuhiko Tsuruya ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Japanese Patients ◽  
Hemodialysis Patients ◽  
Cox Proportional Hazards ◽  
Survival Advantage ◽  
Maintenance Hemodialysis ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Female Survival ◽  
Related Mortality

Abstract Background: A survival advantage of women is observed in the general population. However, inconsistent findings have been reported regarding this advantage in patients undergoing maintenance hemodialysis. The aim of this study was to compare the risk of mortality, especially infection-related mortality, between male and female hemodialysis patients.Methods: A total of 3065 Japanese hemodialysis patients aged ≥18 years old were followed up for 10 years. Primary outcome was all-cause and infection-related mortality. The association between the sex and these outcomes were examined using Cox proportional hazards models.Results: During the median follow-up of 8.8 years, 1498 patients died of any cause, and 387 died of infection. Compared with men, the multivariable-adjusted HRs (95% CIs) for all-cause and infection-related mortality in women were 0.51 (0.45–0.58) and 0.36 (0.27–0.47), respectively. This association remained significant even when the propensity score-matching or inverse probability of treatment weighting adjustment methods were employed. Furthermore, even when the non-infection-related mortality was considered a competing risk, the infection-related mortality rate in women was still significantly lower than that in men.Conclusions: A female survival advantage over men is observed in Japanese patients undergoing maintenance hemodialysis.

scholarly journals Sex differences in the 10-year survival of patients undergoing maintenance hemodialysis in the Q-Cohort Study

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Hiroaki Tsujikawa ◽  
Shunsuke Yamada ◽  
Hiroto Hiyamuta ◽  
Masatomo Taniguchi ◽  
Kazuhiko Tsuruya ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Japanese Patients ◽  
Hemodialysis Patients ◽  
Cox Proportional Hazards ◽  
Maintenance Hemodialysis ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Related Mortality

AbstractWomen have a longer life expectancy than men in the general population. However, it has remained unclear whether this advantage is maintained in patients undergoing maintenance hemodialysis. The aim of this study was to compare the risk of mortality, especially infection-related mortality, between male and female hemodialysis patients. A total of 3065 Japanese hemodialysis patients aged ≥ 18 years old were followed up for 10 years. The primary outcomes were all-cause and infection-related mortality. The associations between sex and these outcomes were examined using Cox proportional hazards models. During the median follow-up of 8.8 years, 1498 patients died of any cause, 387 of whom died of infection. Compared with men, the multivariable-adjusted hazard ratios (95% confidence interval) for all-cause and infection-related mortality in women were 0.51 (0.45–0.58, P < 0.05) and 0.36 (0.27–0.47, P < 0.05), respectively. These findings remained significant even when propensity score-matching or inverse probability of treatment weighting adjustment methods were employed. Furthermore, even when the non-infection-related mortality was considered a competing risk, the infection-related mortality rate in women was still significantly lower than that in men. Regarding all-cause and infection-related deaths, women have a survival advantage compared with men among Japanese patients undergoing maintenance hemodialysis.

scholarly journals Sex is an important prognostic factor for glioblastoma but not for nonglioblastoma

2019 ◽  
Vol 6 (6) ◽  
pp. 451-462 ◽  
Author(s):  
Haley Gittleman ◽  
Quinn T Ostrom ◽  
L C Stetson ◽  
Kristin Waite ◽  
Tiffany R Hodges ◽  
...  
Keyword(s):  
Sex Differences ◽  
Median Survival ◽  
Dna Methyltransferase ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Survival Advantage ◽  
Who Grade ◽  
Cox Proportional Hazards Models ◽  
Female Survival

Abstract Background Glioblastoma (GBM) is the most common and most malignant glioma. Nonglioblastoma (non-GBM) gliomas (WHO Grades II and III) are invasive and also often fatal. The goal of this study is to determine whether sex differences exist in glioma survival. Methods Data were obtained from the National Cancer Database (NCDB) for years 2010 to 2014. GBM (WHO Grade IV; N = 2073) and non-GBM (WHO Grades II and III; N = 2963) were defined using the histology grouping of the Central Brain Tumor Registry of the United States. Non-GBM was divided into oligodendrogliomas/mixed gliomas and astrocytomas. Sex differences in survival were analyzed using Kaplan–Meier and multivariable Cox proportional hazards models adjusted for known prognostic variables. Results There was a female survival advantage in patients with GBM both in the unadjusted (P = .048) and adjusted (P = .003) models. Unadjusted, median survival was 20.1 months (95% CI: 18.7-21.3 months) for women and 17.8 months (95% CI: 16.9-18.7 months) for men. Adjusted, median survival was 20.4 months (95% CI: 18.9-21.6 months) for women and 17.5 months (95% CI: 16.7-18.3 months) for men. When stratifying by age group (18-55 vs 56+ years at diagnosis), this female survival advantage appeared only in the older group, adjusting for covariates (P = .017). Women (44.1%) had a higher proportion of methylated MGMT (O6-methylguanine-DNA methyltransferase) than men (38.4%). No sex differences were found for non-GBM. Conclusions Using the NCDB data, there was a statistically significant female survival advantage in GBM, but not in non-GBM.

scholarly journals Alcohol-related mortality and all-cause mortality following bereavement in two successive generations

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243290
Author(s):  
David Teye Doku ◽  
Subas Neupane ◽  
Henrik Dobewall ◽  
Arja Rimpelä
Keyword(s):  
Alcohol Abuse ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Conclusive Evidence ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Successive Generations ◽  
Related Mortality

Background and aim Bereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-second generation). Furthermore, these associations can be bi-directional. However, there is no conclusive evidence of these effects, and studies exploring these intergenerational effects are rare. This study investigates these associations. Methods A longitudinal data were constructed by linking participants from the Adolescent Health and Lifestyle Surveys (AHLS) from 1979 to 1997 with census and registry-based data from Statistics Finland containing the socioeconomic status of the survey participants and their parents (N = 78610) to investigate these associations. Multivariate Cox proportional hazards models were used to calculate hazard ratios with 95% confidence intervals to determine the effect of bereavement with alcohol-related mortality and all-cause mortality. Results The findings suggest that bereavement following the death of an offspring increases the risk of both alcohol-related and all-cause mortality among both parents. The magnitude of the risk of mortality following the death of an offspring is higher for mothers than for fathers. There were no clear associations of a parent’s death with an offspring’s alcohol-related or all-cause mortality. However, generally, a father’s death seems to be protective of the risk of mortality among the offspring while a mother’s alcohol-related death slightly increased the risk of alcohol-related mortality among their offspring. Conclusions These findings emphasise the role of bereavement, particularly resulting from the death of an offspring, on alcohol-related and all-cause mortality and therefore inequalities in mortality. Furthermore, the findings highlighting the need for alcohol abuse intervention and emotional support for bereaved persons following the death of an offspring.

scholarly journals History of premorbid depression is a risk factor for COVID-related mortality: Analysis of a retrospective cohort of 1,387 COVID+ patients

2020 ◽  
Author(s):  
Sean Clouston ◽  
Benjamin J Luft ◽  
Edward Sun
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression ◽  
Related Mortality

Background: The goal of the present work was to examine risk factors for mortality in a 1,387 COVID+ patients admitted to a hospital in Suffolk County, NY. Methods: Data were collated by the hospital epidemiological service for patients admitted from 3/7/2020-9/1/2020. Time until final discharge or death was the outcome. Cox proportional hazards models were used to estimate time until death among admitted patients. Findings: In total, 99.06% of cases had resolved leading to 1,179 discharges and 211 deaths. Length of stay was significantly longer in those who died as compared to those who did not p=0.007). Of patients who had been discharged (n=1,179), 54 were readmitted and 9 subsequently died. Multivariable-adjusted Cox proportional hazards regression revealed that in addition to older age, male sex, and heart failure, a history of premorbid depression was a risk factor for COVI-19 mortality. Interpretation: While an increasing number of studies have shown effects linking cardiovascular risk factors with increased risk of mortality in COVID+ patients, this study reports that history of depression is a risk factor for COVID mortality.

scholarly journals Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001015 ◽  
Author(s):  
Fernando Pérez Ruiz ◽  
Pascal Richette ◽  
Austin G Stack ◽  
Ravichandra Karra Gurunath ◽  
Ma Jesus García de Yébenes ◽  
...  
Keyword(s):  
Uric Acid ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
First Year ◽  
Cox Proportional Hazards Models ◽  
Crude Mortality ◽  
Risk Patients ◽  
The Impact ◽  
Related Mortality

ObjectiveTo determine the impact of achieving serum uric acid (sUA) of <0.36 mmol/L on overall and cardiovascular (CV) mortality in patients with gout.MethodsProspective cohort of patients with gout recruited from 1992 to 2017. Exposure was defined as the average sUA recorded during the first year of follow-up, dichotomised as ≤ or >0.36 mmol/L. Bivariate and multivariate Cox proportional hazards models were used to determine mortality risks, expressed HRs and 95% CIs.ResultsOf 1193 patients, 92% were men with a mean age of 60 years, 6.8 years’ disease duration, an average of three to four flares in the previous year, a mean sUA of 9.1 mg/dL at baseline and a mean follow-up 48 months; and 158 died. Crude mortality rates were significantly higher for an sUA of ≥0.36 mmol/L, 80.9 per 1000 patient-years (95% CI 59.4 to 110.3), than for an sUA of <0.36 mmol/L, 25.7 per 1000 patient-years (95% CI 21.3 to 30.9). After adjustment for age, sex, CV risk factors, previous CV events, observation period and baseline sUA concentration, an sUA of ≥0.36 mmol/L was associated with elevated overall mortality (HR=2.33, 95% CI 1.60 to 3.41) and CV mortality (HR=2.05, 95% CI 1.21 to 3.45).ConclusionsFailure to reach a target sUA level of 0.36 mmol/L in patients with hyperuricaemia of gout is an independent predictor of overall and CV-related mortality. Targeting sUA levels of <0.36 mmol/L should be a principal goal in these high-risk patients in order to reduce CV events and to extend patient survival.

Comparative analysis of treatments, utilization, and survival benefit in HCC patients: A real-world analysis of SEER Medicare.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 214-214
Author(s):  
Fadia T. Shaya ◽  
Ian Michael Breunig ◽  
C. Daniel Mullins ◽  
Naimish B. Pandya ◽  
Viktor Chirikov ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Health Status ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Cox Proportional Hazards Models ◽  
Severe Liver Dysfunction ◽  
Related Mortality ◽  
Overall Mortality

214 Background: We explore various treatments at all stages of Hepatocellular Carcinoma (HCC), in a SEER (Surveillance, Epidemiology and End-Results Program) Medicare population and assess their impact on HCC-specific and overall survival. Methods: Medicare enrollees, older than 65, with an initial diagnosis of a primary HCC between 2000-07 were followed up through end of 2009. Data are from the SEER and linked Medicare databases, with claims generated from Medicare parts A and B. Using multivariate Cox-proportional hazards models, we assessed overall and HCC-related mortality in relation to receipt of treatment/no treatment, adjusting for demographics, general health status (CCI), cancer stage and liver conditions. Results: Out of the 9054 HCC patients, older than 65, who did not get a liver transplant, 76% were Caucasian, 8% African American (AA), 63% male, and 37% got treatment [12% transarterial chemoembolization (TACE), 12% systemic chemotherapy, 1.5% selective internal radiation therapy (SIRT), 9% external beam radiation therapy (EBRT), 8% surgical resection and 9% ablative therapy]. Treatment was associated with a reduction of overall (HR=0.35, P= <0.001) and HCC-related (0.33, <0.001) mortality. HCC-related mortality was significantly reduced in those getting resection (0.38, <0.001), ablation (0.59, <0.001), TACE (0.76, <0.001), EBRT (0.85, 0.017), or chemotherapy (0.85, 0.013). Significant reduction in overall mortality was seen with resection, ablation and TACE but not with chemotherapy, EBRT or SIRT. No particular treatment was associated with greater mortality reduction in early vs advanced stages. Patients with poor underlying health status (CCI>1) had higher mortality (1.27, <0.001). Alcohol related disease, Hep C, and moderate/severe liver dysfunction were not significantly associated with overall or HCC related mortality. Caucasians and non-African Americans had lower overall mortality (0.87, <0.001). Conclusions: In HCC SEER Medicare patients, all treatments except SIRT were associated with a significant reduction in HCC related mortality. A limitation of this study is that, through the data, we cannot accurately depict the severity of the disease.

scholarly journals Association between vitamin K1 intake and mortality in the Danish Diet, Cancer, and Health cohort

2021 ◽  
Author(s):  
Claire R. Palmer ◽  
Jamie W. Bellinge ◽  
Frederik Dalgaard ◽  
Marc Sim ◽  
Kevin Murray ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin K ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Population Level ◽  
Cox Proportional Hazards ◽  
Hypertension Status ◽  
Cox Proportional Hazards Models ◽  
Diabetes Status ◽  
Related Mortality

AbstractReported associations between vitamin K1 and both all-cause and cause-specific mortality are conflicting. The 56,048 participants from the Danish Diet, Cancer, and Health prospective cohort study, with a median [IQR] age of 56 [52–60] years at entry and of whom 47.6% male, were followed for 23 years, with 14,083 reported deaths. Of these, 5015 deaths were CVD-related, and 6342 deaths were cancer-related. Intake of vitamin K1 (phylloquinone) was estimated from a food-frequency questionnaire (FFQ), and its relationship with mortality outcomes was investigated using Cox proportional hazards models. A moderate to high (87–192 µg/d) intake of vitamin K1 was associated with a lower risk of all-cause [HR (95%CI) for quintile 5 vs quintile 1: 0.76 (0.72, 0.79)], cardiovascular disease (CVD)-related [quintile 5 vs quintile 1: 0.72 (0.66, 0.79)], and cancer-related mortality [quintile 5 vs quintile 1: 0.80 (0.75, 0.86)], after adjusting for demographic and lifestyle confounders. The association between vitamin K1 intake and cardiovascular disease-related mortality was present in all subpopulations (categorised according to sex, smoking status, diabetes status, and hypertension status), while the association with cancer-related mortality was only present in current/former smokers (p for interaction = 0.002). These findings suggest that promoting adequate intakes of foods rich in vitamin K1 may help to reduce all-cause, CVD-related, and cancer-related mortality at the population level.

Higher parity is associated with lower mortality in a European population of women with high fertility: results from Ireland

2020 ◽  
Author(s):  
Joanna Orr ◽  
Rose Anne Kenny ◽  
Christine A McGarrigle
Keyword(s):  
Early Life ◽  
Proportional Hazards ◽  
Fertility Control ◽  
European Population ◽  
Cox Proportional Hazards ◽  
The Body ◽  
High Fertility ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Parity Level

Abstract Background Research has often found a U or J-shaped association between parity and mortality. Many researchers have suggested repeated pregnancy, childbirth and lactation taxes the body beyond a certain parity level. Available research has concentrated on populations with controlled fertility or historic populations. Ireland presents an opportunity to explore these associations in a modern sample with high fertility. Methods We use data from the Irish Longitudinal Study on Ageing (TILDA) to test whether parity is associated with mortality in women aged 50 or over (n=4,177). We use Cox proportional hazards models to model survival and adjust for demographics and early life circumstances. We test whether a number of health characteristics mediate these effects. Models were also stratified by birth cohort to test possible cohort effects. Results Higher parity was associated with lower risk of mortality, even after adjustment for early life and socioeconomic circumstances. This effect was not mediated by current health characteristics. The effects were largely driven by those born between 1931 and 1950. Conclusions Increasing parity is associated with decreasing mortality risk in this sample. The effects of parity could not be explained through any of the observed health characteristics. These findings are in contrast to much of the literature on this question in similar populations. Lack of fertility control in Ireland may have ‘selected’ healthier women into high parity. Social explanations for these associations should be further explored.

scholarly journals The U-Shape Relationship Between Glycated Hemoglobin Level and Long-Term All-Cause Mortality Among Patients With Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Liwei Liu ◽  
Jianfeng Ye ◽  
Ming Ying ◽  
Qiang Li ◽  
Shiqun Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Proportional Hazards ◽  
Glycated Hemoglobin ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Models ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Artery Disease

Background: Although glycated hemoglobin (HbA1c) was considered as a prognostic factor in some subgroup of coronary artery disease (CAD), the specific relationship between HbA1c and the long-term all-cause death remains controversial in patients with CAD.Methods: The study enrolled 37,596 CAD patients and measured HbAlc at admission in Guangdong Provincial People's Hospital. The patients were divided into 4 groups according to HbAlc level (Quartile 1: HbA1c ≤ 5.7%; Quartile 2: 5.7% &lt; HbA1c ≤ 6.1%; Quartile 3: 6.1% &lt; HbA1c ≤ 6.7%; Quartile 4: HbA1c &gt; 6.7%). The study endpoint was all-cause death. The restricted cubic splines and cox proportional hazards models were used to investigate the association between baseline HbAlc levels and long-term all-cause mortality.Results: The median follow-up was 4 years. The cox proportional hazards models revealed that HbAlc is an independent risk factor in the long-term all-cause mortality. We also found an approximate U-shape association between HbA1c and the risk of mortality, including increased risk of mortality when HbA1c ≤ 5.7% and HbA1c &gt; 6.7% [Compared with Quartile 2, Quartile 1 (HbA1c ≤ 5.7), aHR = 1.13, 95% CI:1.01–1.26, P &lt; 0.05; Quartile 3 (6.1% &lt; HbA1c ≤ 6.7%), aHR = 1.04, 95% CI:0.93–1.17, P =0.49; Quartile 4 (HbA1c &gt; 6.7%), aHR = 1.32, 95% CI:1.19–1.47, P &lt; 0.05].Conclusions: Our study indicated a U-shape relationship between HbA1c and long-term all-cause mortality in CAD patients.

Comparative effectiveness and survival benefit of various treatment modalities in HCC: A SEER-Medicare analysis.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 319-319
Author(s):  
Nader Hanna ◽  
Ian Michael Breunig ◽  
C. Daniel Mullins ◽  
Brian S. Seal ◽  
Viktor Chirikov ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Treatment Modalities ◽  
Treatment Groups ◽  
Cox Proportional Hazards Models ◽  
Severe Liver Disease ◽  
Comorbidity Index ◽  
Related Mortality

319 Background: In the United States, the incidence of HCC has increased from 1.6 per 100,000 in 1975 to 4.9 per 100,000 in 2005. Care for HCC patients remains specialized and complex with transplant and surgery offering the only potential for long survival. However no comparative effectiveness of various treatment modalities across various stages of HCC exists. Methods: Medicare enrollees, older than 65 with an initial diagnosis of primary HCC between 2000-2007 were followed up through the end of 2009. For patients with stages I, II, III, and unstaged, data were obtained from the SEER and linked Medicare databases, with claims generated from Medicare parts A and B. Multivariate Cox proportional hazards models were used to assess overall and HCC related mortality in relation to receipt of various/no treatments, adjusting for concomitant therapies, demographics, general health status (Charlson comorbidity index), and liver conditions, moderate-severe liver disease. Results: Distributions across stages: males 64-71%, Caucasians 72-77%, African Americans 8-10%, Hispanics 12-14%; a majority (72-75%) was age 65-84; Hepatitis C was the most prevalent (17-41%). Conclusions: Compared to untreated patients, improved all-cause and HCC-related mortality was observed in all stages in the following order: transplant, surgical resection, liver directed therapy, and chemotherapy. Greater impact on HHC-related mortality was seen across all treatment groups. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document