Propensity-Score Analysis Reveals that Sex is Not a Prognosis Factor for Mortality in Intensive Care Unit-Admitted Patients with Sepsis

2021 ◽  
Author(s):  
Manuel Ponce-Alonso ◽  
Borja M Fernández-Félix ◽  
Ana Halperin ◽  
Mario Rodríguez-Domínguez ◽  
Ana M Sánchez-Díaz ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Propensity Score Analysis ◽  
Statistical Significance ◽  
Prognostic Score ◽  
Score Analysis ◽  
Infection Source ◽  
Comorbidity Index ◽  
Univariate Analyses

Abstract Purpose: Classically, men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could condition the prognosis of the infection. The aim of the present work was to explore this assumption in patients admitted to the ICU with sepsis using a robust statistical analysis.Methods: Retrospective analysis (2006-2017) in patients with microbiologically confirmed bacteremia (n=440) by majoritarian bacterial pathogens. Risk of ICU and in-hospital mortality in males respect to females was compared by an univariant analysis and a propensity score correspondence analysis integrating their clinical characteristics. Results: Relevant differences were related to the infection source: urinary origin for females (28.7% vs 19.8%) and abdominopelvic surgery for males (8.8% vs 4.8%). Sepsis occurred more frequently in males (80.2% vs 76.1%) as well as in-hospital (48.0% vs 41.3%) and ICU (39.9% vs 36.5%) mortality. Escherichia coli was 2 times more frequent in survivors whereas Staphylococcus aureus was 3 times more frequent in deceased patients. Univariate analyses showed that males had a higher Charlson comorbidity index, a poorer McCabe prognostic score; however the propensity score in 296 patients demonstrated that females had higher risk of both ICU (OR 0.72; 95% CI 0.46 to 1.13), and in-hospital mortality (OR 0.84; 95% CI 0.55 to 1.30) but without statistical significance. Conclusion: Men with sepsis have worse clinical characteristics when admitted to the ICU, but sex has no influence on the prognosis of mortality. Our data contributes to help reduce the sex-dependent gap present in health care provision.

scholarly journals Association of Direct Helicopter Versus Ground Transport and In-hospital Mortality in Trauma Patients: A Propensity Score Analysis

2011 ◽  
Vol 18 (11) ◽  
pp. 1208-1216 ◽  
Author(s):  
Kenneth E. Stewart ◽  
Linda D. Cowan ◽  
David M. Thompson ◽  
John C. Sacra ◽  
Roxie Albrecht
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Analysis ◽  
Trauma Patients ◽  
Score Analysis

Abstract 13226: Epinephrine versus Norepinephrine in Cardiac Arrest Patients With Postresuscitation Shock

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Wulfran Bougouin ◽  
Kaci Slimani ◽  
Marie Renaudier ◽  
Yannick Binois ◽  
Marine Paul ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Analysis ◽  
Controlled Trial ◽  
Cerebral Performance Category ◽  
Multivariate Regression Analysis ◽  
Sensitivity Analyses ◽  
Score Analysis ◽  
Hospital Cardiac Arrest

Backgound: Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear. Objectives: To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine. Methods: We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses. Results: Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7; P =0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3; P <0.001), as was the proportion of patients with CPC of 3 to 5 at hospital discharge. Sensitivity analyses produced consistent results. The analysis involving adjustment on a propensity score to control for confounders showed similar findings (aOR 2.1; 95%CI 1.1-4.0; P =0.02). Conclusions: Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.

Impact of additional antibiotics on in-hospital mortality in tuberculosis isolated general bacteria: A propensity score analysis

2019 ◽  
Vol 25 (9) ◽  
pp. 714-719 ◽  
Author(s):  
Takamasa Kan ◽  
Kosaku Komiya ◽  
Kokoro Honjo ◽  
Sonoe Uchida ◽  
Akihiko Goto ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Analysis ◽  
Score Analysis

scholarly journals Association between off-hours admission with acute myocardial infarction and in-hospital mortality

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Song ◽  
X Bai ◽  
X Li ◽  
J Li ◽  
X Zheng
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Analysis ◽  
Secondary Analysis ◽  
Development Program ◽  
Score Analysis ◽  
Nationally Representative ◽  
Time Of Admission

Abstract Background The effect of time of admission on clinical outcomes in patients with acute myocardial infarction (AMI) is still a matter of debate. Purpose To investigate the association between off-hours admission and in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Methods We used a two-stage, random sampling method to create a nationally representative sample of patients with AMI in 167 Chinese hospitals in four years (2001, 2006, 2011, and 2015). Off-hours were defined as 20:00–07:59 and on-hours as 08:00–19:59. We used hierarchical logistic regression model to examine whether off-hour admissions were associated with in-hospital mortality and 7-day mortality. Inverse-probability weighting propensity score analysis was also conducted to assess the robustness of the results. Results We identified 25654 patients admitted with AMI (median age 67.0 years; 31.6% women), of whom 20133 (78.5%) were diagnosed as STEMI and 5521 (21.5%) as NSTEMI. There were 5368 (26.7%) admissions for STEMI, and 1356 (24.6%) for NSTEMI occurring during off-hours, respectively. After adjusting for case mix, year of admission, comorbidities, clinical presentation, and in-hospital treatments, a significant association was observed between off-hours admissions and in-hospital mortality among the patients with STEMI (adjusted OR 1.14; 95% CI 1.01 to 1.28). The magnitude of the association became greater in the secondary analysis with 7-day mortality as the outcome (adjusted OR 1.16; 95% CI 1.02 to 1.31). But among patients with NSTEMI, no significant association was observed for in-hospital and 7-day mortality. Propensity score analysis showed similar results to hierarchical logistic model for both outcomes in patients with STEMI and NSTEMI. Conclusion Off-hours admission with STEMI is associated with higher in-hospital mortality. Reducing the disparity of care of STEMI by the time of admission represents a potential opportunity for quality improvement in China. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): National Key Research and Development Program (2017YFC1310803, 2017YFC1310801) from the Ministry of Science and Technology of China

Can Propensity Score Analysis Approximate Randomized Experiments Using Pretest and Demographic Information in Pre-K Intervention Research?

2018 ◽  
Vol 42 (1) ◽  
pp. 34-70 ◽  
Author(s):  
Nianbo Dong ◽  
Mark W. Lipsey
Keyword(s):  
Propensity Score ◽  
Statistical Power ◽  
Propensity Score Analysis ◽  
Statistical Significance ◽  
Randomized Study ◽  
Randomized Experiment ◽  
Randomized Experiments ◽  
Score Analysis ◽  
Demographic Covariates ◽  
Achievement Outcome

Background: It is unclear whether propensity score analysis (PSA) based on pretest and demographic covariates will meet the ignorability assumption for replicating the results of randomized experiments. Purpose: This study applies within-study comparisons to assess whether pre-Kindergarten (pre-K) treatment effects on achievement outcomes estimated using PSA based on a pretest and demographic covariates can approximate those found in a randomized experiment. Methods: Data—Four studies with samples of pre-K children each provided data on two math achievement outcome measures with baseline pretests and child demographic variables that included race, gender, age, language spoken at home, and mother’s highest education. Research Design and Data Analysis—A randomized study of a pre-K math curriculum provided benchmark estimates of effects on achievement measures. Comparison samples from other pre-K studies were then substituted for the original randomized control and the effects were reestimated using PSA. The correspondence was evaluated using multiple criteria. Results and Conclusions: The effect estimates using PSA were in the same direction as the benchmark estimates, had similar but not identical statistical significance, and did not differ from the benchmarks at statistically significant levels. However, the magnitude of the effect sizes differed and displayed both absolute and relative bias larger than required to show statistical equivalence with formal tests, but those results were not definitive because of the limited statistical power. We conclude that treatment effect estimates based on a single pretest and demographic covariates in PSA correspond to those from a randomized experiment on the most general criteria for equivalence.

scholarly journals Clinical Characteristics and Outcomes Until 2 Years of Age in Preterm Infants With Typical Chest Imaging Findings of Bronchopulmonary Dysplasia: A Propensity Score Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qiqi Ruan ◽  
Jianhui Wang ◽  
Yuan Shi
Keyword(s):  
Regression Analysis ◽  
Propensity Score ◽  
Preterm Infants ◽  
Clinical Characteristics ◽  
Propensity Score Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Multivariate Logistic Regression ◽  
Score Analysis

Objective: The goal of the current study was to assess the associations of typical chest imaging findings of bronchopulmonary dysplasia (BPD) in preterm infants with clinical characteristics and outcomes until 2 years of age.Method: This retrospective cohort study enrolled 256 preterm infants with BPD who were admitted between 2014 and 2018. A propensity score analysis was used to adjust for confounding factors. The primary outcomes were the severity of BPD, home oxygen therapy (HOT) at discharge and mortality between 28 days after birth and 2 years of age. A multivariate logistic regression analysis was performed to identify related variables of mortality.Results: Seventy-eight patients with typical chest imaging findings were enrolled, of which 50 (64.1%) were first found by CXR, while 28 (35.9%) were first found by CT. In addition, 85.9% (67/78) were discovered before 36 weeks postmenstrual age (PMA) (gestational age [GA] &lt; 32 weeks) or before 56 days after birth (GA &gt; 32 weeks). After propensity score matching, the matched groups consisted of 58 pairs of patients. Those with typical imaging findings had a remarkably higher mortality rate (29.3 vs. 12.1%, p = 0.022, OR 3.021), higher proportion of severe BPD (32.8 vs. 12.1%, p = 0.003, OR 4.669) and higher rate of HOT at discharge (74.1 vs. 46.6%, p = 0.002, OR 3.291) than those without typical imaging findings. The multivariate logistic regression analysis showed that typical imaging findings ≤ 7 days and typical typical imaging findings &gt;7 days were independent risk factors for mortality in preterm infants with BPD (OR 7.794, p = 0.004; OR 4.533, p = 0.001).Conclusions: More attention should be given to chest imaging findings of BPD, especially in the early stage (within 7 days). Early recognition of the development of BPD helps early individualized treatment of BPD.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04163822.

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