Determinants of Unintended Pregnancies Among Currently Married Women in Uganda

Abstract Background: Unintended pregnancies are no longer bound to teenagers or school going children, married women in Uganda as well experience such pregnancies though little has been investigated on them. This study therefore examines the determinants of unintended pregnancies among currently married women in Uganda.Methods: In this study, we used data from the 2016 Uganda Demographic and Health Survey (UDHS) which comprised of 11,223 married women aged 15-49 years. Analysis was done using descriptive analysis, logistic regression, Poisson regression, log-rank test for survival functions, cox proportional hazards model, and the generalized structural equation model.Results: The study revealed that 45% of the pregnancies were unintended while 3 in 10 married women were not using contraceptives. At the bivariate level; unintended pregnancy was associated with the highest wealth quintile (OR=0.45, 95%CI=0.40-0.49) while contraceptive use was associated with higher education level (OR=4.90, 95% CI=4.10-5.86). Similarly, children ever born were associated with married women from rural areas (IRR=4.34, 95% CI=4.30-4.39). At the multivariate level, married women from northern region (AOR=0.55, 95% CI=0.45-0.64) had lower odds and Muslim married women with more children (AOR=1.04, 95% CI=1.01-1.07) had higher odds of unintended pregnancy.Conclusion: Unintended pregnancies are directly and indirectly influenced by higher fertility and improver use of contraceptive. Married women who had more children and were: from poor households, with lowest education, in Central region, in rural areas, with low age at first birth, with older partners and were Muslim were more likely to have unintended pregnancies. Also, married women who were using contraceptives and were: older age, Anglican, from wealthiest households, in agricultural or domestic sector and higher parity were associated with higher risk of unintended pregnancies. The government should make efforts in reducing the fertility among married women by investing in programs and policies like: sensitization of women on the effectiveness in use of contraceptives, making contraceptives affordable and easily accessible to all people in different regions of the country with emphasis on who already have four or more children. Extension of higher education to all people will lead to reduced risks of unintended pregnancies.

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Determinants of unintended pregnancies among currently married women in Uganda

Journal of Health Population and Nutrition ◽

10.1186/s41043-020-00218-7 ◽

2020 ◽

Vol 39 (1) ◽

Author(s):

Ronald Wasswa ◽

Allen Kabagenyi ◽

Leonard Atuhaire

Keyword(s):

Family Planning ◽

Rural Areas ◽

Structural Equation ◽

Sexual Debut ◽

Household Wealth ◽

Married Women ◽

Age At First Birth ◽

Contraceptive Methods ◽

Unintended Pregnancies ◽

High Age

Abstract Background Unintended pregnancies are no longer bound to teenagers or school-going children, married women in Uganda, as well do experience such pregnancies though little has been investigated on them. This study examines the determinants of unintended pregnancies among currently married women in Uganda. Methods In this study, we used data from the 2016 Uganda Demographic and Health Survey (UDHS) which comprised of 10,958 married women aged 15–49 years who have ever been pregnant. The analysis was done using descriptive analysis, logistic regression, and the generalized structural equation model. Results The study showed that 37% of pregnancies among married women were unintended. Young women, living in poor households, staying in rural areas, women in the Eastern and Northern region, Muslim women, lack of knowledge on ovulation period, discontinuation of contraceptives, non-use of and intention for contraceptives, high age at sexual debut, high age at first birth, and high parity were directly associated with a higher risk of unintended pregnancies. Relatedly, discontinuation of contraceptives regardless of the place of residence, region, woman’s age, education, household wealth, access to family planning messages were associated with higher odds of unintended pregnancies. Older women and those in rural areas who had more children were also at a higher risk of similar pregnancies. However, having more children while using contraceptives, being educated, living in a wealthier household, and having access to family planning messages significantly lowered the risk of unintended pregnancies. Conclusion Increased access to family planning messages, empowering women as well as having improved household incomes are key preventive measures of unintended pregnancies. There is a need to provide quality contraceptive counseling through outreaches so that women are informed about the different contraceptive methods and the possible side effects. Having a variety of contraceptive methods to choose from and making them accessible and affordable will also encourage women to make informed choices and reduce contraceptive discontinuation. All these coupled together will help women have their desired family sizes, increase the uptake of contraceptives and significantly reduce unintended pregnancies.

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Age at First Birth in Uttar Pradesh: How Much Has It Actually Changed? Over Inter-NFHS Period?

International Journal of Statistics and Probability ◽

10.5539/ijsp.v11n1p54 ◽

2021 ◽

Vol 11 (1) ◽

pp. 54

Author(s):

Ajay Pandey ◽

Richa Sharma

Keyword(s):

Proportional Hazards Model ◽

Predictor Variable ◽

Uttar Pradesh ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Age At First Birth ◽

First Birth ◽

Survivor Function ◽

Age At Marriage

Culturally, there is always pressure among newly-wed to conceive early and have births in India. Previous studies have documented relationship between age at first birth & fertility, besides the socio-demographic factors that influence age at first birth. The current study aims answering directions and quantum of such relationships using frailty models. The successive rounds of NFHS data (1, 2, 3 & 4) from Uttar Pradesh is used in the study. Fertility in India is characterized as too-early-too-fast. By age-30 majority women would have completed the childbearing. However, the data from NFHS-4 shows some striking changes in the initiation of child bearing in Uttar Pradesh breaking away from the stereotypes of too early too fast characterization. While 44.67 percent of the women aged 30-34 had experienced first birth by age 18 in the year 1992-93 (NFHS-1), the percentages declined during 2015-16 (NFHS-4) to 28.25%. However, by ages 26 majority of women (>95%) aged 30-34 have had experienced first birth. Births at younger age are also a reflection on enforcement of child-marriage restraint act & adherence to legal minimum age at marriage which is 18 for girls & 21 for boys. The data from NFHS-4 have some quality issues. Women aged as low as 5 have shown to have experienced first birth by that age. This may not be possible. The Kaplan Meier survival Graph provided the survival probabilities with respect of each predictor sub groups. The log rank test was used to test the equality of survivor function for each sub group of the predictor variable. The survivor function was significantly different among sub groups of the predictor variables except for the categories of ever use of contraception at NFHS1 and categories of religion across rounds of NFHS data. The Cox Proportional Hazards model was used to study the risk of first birth by socio demographic characteristics. The Frailty model capturing the unobserved heterogeneity in the event time was preferred over standard survival model. For the current study, gamma frailty with Weibull-hazard is used as it fits the data well. Age at marriage and women’s literacy significantly determines the Age at First Birth. The inverse relationship with regard to ever use of contraception needs further analysis. The model also predicts significant frailty with variance parameter (theta) greater than one across the NFHS datasets.

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"I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls

Reproductive Health ◽

10.1186/s12978-021-01078-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Anthony Idowu Ajayi ◽

Sally Atieno Odunga ◽

Clement Oduor ◽

Ramatou Ouedraogo ◽

Boniface Ayanbekongshie Ushie ◽

...

Keyword(s):

Unintended Pregnancy ◽

Adolescent Girls ◽

Rural Areas ◽

Teenage Pregnancy ◽

Formal Education ◽

School Attendance ◽

Clear Understanding ◽

Sexually Active ◽

Unintended Pregnancies ◽

Study Setting

Abstract Background While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15–19 in two Kenya counties with the highest rate of teenage pregnancy. Methods We used the “In Their Hands” (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls’ reasons for having unintended pregnancy. Results Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR 1.64, 95% CI 1.22–2.20), had primary or no formal education (AOR 1.50 95% CI 1.11–2.02), and had never used contraceptive (AOR 1.69 95% CI 1.25–2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies. Conclusion A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.

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Limited role for extended maintenance temozolomide for newly diagnosed glioblastoma

Neurology ◽

10.1212/wnl.0000000000003809 ◽

2017 ◽

Vol 88 (15) ◽

pp. 1422-1430 ◽

Cited By ~ 26

Author(s):

Dorothee Gramatzki ◽

Philipp Kickingereder ◽

Bettina Hentschel ◽

Jörg Felsberg ◽

Ulrich Herrlinger ◽

...

Keyword(s):

Dna Methyltransferase ◽

Proportional Hazards Model ◽

Methylation Status ◽

Residual Tumor ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Karnofsky Performance Score ◽

Newly Diagnosed ◽

Clinical Patient ◽

Newly Diagnosed Glioblastoma

Objective:To explore an association with survival of modifying the current standard of care for patients with newly diagnosed glioblastoma of surgery followed by radiotherapy plus concurrent and 6 cycles of maintenance temozolomide chemotherapy (TMZ/RT → TMZ) by extending TMZ beyond 6 cycles.Methods:The German Glioma Network cohort was screened for patients with newly diagnosed glioblastoma who received TMZ/RT → TMZ and completed ≥6 cycles of maintenance chemotherapy without progression. Associations of clinical patient characteristics, molecular markers, and residual tumor determined by magnetic resonance imaging after 6 cycles of TMZ with progression-free survival (PFS) and overall survival (OS) were analyzed with the log-rank test. Multivariate analyses using the Cox proportional hazards model were performed to assess associations of prolonged TMZ use with outcome.Results:Sixty-one of 142 identified patients received at least 7 maintenance TMZ cycles (median 11, range 7–20). Patients with extended maintenance TMZ treatment had better PFS (20.5 months, 95% confidence interval [CI] 17.7–23.3, vs 17.2 months, 95% CI 10.2–24.2, p = 0.035) but not OS (32.6 months, 95% CI 28.9–36.4, vs 33.2 months, 95% CI 25.3–41.0, p = 0.126). However, there was no significant association of prolonged TMZ chemotherapy with PFS (hazard ratio [HR] = 0.8, 95% CI 0.4–1.6, p = 0.559) or OS (HR = 1.6, 95% CI 0.8–3.3, p = 0.218) adjusted for age, extent of resection, Karnofsky performance score, presence of residual tumor, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, or isocitrate dehydrogenase (IDH) mutation status.Conclusion:These data may not support the practice of prolonging maintenance TMZ chemotherapy beyond 6 cycles.Classification of evidence:This study provides Class III evidence that in patients with newly diagnosed glioblastoma, prolonged TMZ chemotherapy does not significantly increase PFS or OS.

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The correlation between gain of chromosome 8q and survival in patients with clear and papillary renal cell carcinoma

Therapeutic Advances in Urology ◽

10.1177/1756287217732660 ◽

2017 ◽

Vol 10 (1) ◽

pp. 3-10 ◽

Cited By ~ 1

Author(s):

Reza Mehrazin ◽

Essel Dulaimi ◽

Robert G. Uzzo ◽

Karthik Devarjan ◽

Jianming Pei ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Cytogenetic Analysis ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Renal Tumors ◽

Rank Test

Background: The proto-oncogene c-MYC, located on chromosome 8q, can be upregulated through gain of 8q, causing alteration in biology of renal cell carcinoma (RCC). The aim of this study was to evaluate the prevalence of c-MYC through chromosome 8q gain and to correlate findings with cancer-specific mortality (CSM), and overall survival (OS). Methods: Cytogenetic analysis by conventional or Chromosomal Genomic Microarray Analysis (CMA) was performed on 414 renal tumors. Nonclear and nonpapillary RCC were excluded. Impact of gain in chromosome 8q status on CSM, OS, and its correlation with clinicopathological variables were evaluated. CSM and OS were assessed using log-rank test and the Cox proportional hazards model. Results: A total of 297 RCC tumors with cytogenetic analysis were included. Gain of 8q was detected in 18 (6.1%) tumors (9 clear cell and 9 papillary RCC), using conventional method ( n = 11) or CMA ( n = 7). Gain of 8q was associated with higher T stage ( p < 0.001), grade ( p < 0.001), nodal involvement ( p = 0.005), and distant metastasis ( p < 0.001). No association between gain of 8q and age ( p = 0.23), sex ( p = 0.46), and Charlson comorbidity index (CCI, p = 0.59) were seen. Gain of 8q was associated with an 8.38-fold [95% confidence interval (CI), 3.83–18.34, p < 0.001] and 3.31-fold (95% CI, 1.56–7.04, p = 0.001) increase in CSM and decrease in OS, respectively, at a median follow up of 56 months. Conclusion: Chromosome 8q harbors the proto-oncogene c-MYC, which can be upregulated by gain of 8q. Our findings suggest that gain of 8q, can predict aggressive tumor phenotype and inferior survival in RCC.

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Blood eosinophils on hospital admission for COPD exacerbation do not predict the recurrence of moderate and severe relapses

ERJ Open Research ◽

10.1183/23120541.00543-2020 ◽

2021 ◽

Vol 7 (1) ◽

pp. 00543-2020

Author(s):

Balázs Csoma ◽

András Bikov ◽

Ferenc Tóth ◽

György Losonczy ◽

Veronika Müller ◽

...

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Forced Expiratory Volume ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Full Blood Count ◽

Rank Test ◽

Severe Exacerbation ◽

Increased Risk ◽

Exacerbation Of Copd

Background and objectiveThe relationship between hospitalisation with an eosinophilic acute exacerbation of COPD (AE-COPD) and future relapses is unclear. We aimed to explore this association by following 152 patients for 12 months after hospital discharge or until their first moderate or severe flare-up.MethodsPatients hospitalised with AE-COPD were divided into eosinophilic and non-eosinophilic groups based on full blood count results on admission. All patients were treated with a course of systemic corticosteroid. The Cox proportional hazards model was used to study the association with the time to first re-exacerbation; a generalised linear regression model was applied to identify clinical variables related to the recurrence of relapses.ResultsWe did not find a difference in the time to the next moderate or severe exacerbation between the eosinophilic (≥2% of total leukocytes and/or ≥200 eosinophils·µL−1, n=51, median (interquartile range): 21 (10–36) weeks) and non-eosinophilic groups (n=101, 17 (9–36) weeks, log-rank test: p=0.63). No association was found when other cut-off values (≥3% of total leukocytes and/or ≥300 eosinophils·µL−1) were used for the eosinophilic phenotype. However, the higher number of past severe exacerbations, a lower forced expiratory volume in 1 s (FEV1) at discharge and higher pack-years were related to shorter exacerbation-free time. According to a subgroup analysis (n=73), 48.1% of patients with initial eosinophilic exacerbations had non-eosinophilic relapses on readmission.ConclusionsOur data do not support an increased risk of earlier recurring moderate or severe relapses in patients hospitalised with eosinophilic exacerbations of COPD. Eosinophilic severe exacerbations present a variable phenotype.

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Treatment of metastatic disease with immune checkpoint inhibitors nivolumab and pembrolizumab: Effect of performance status on clinical outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18689 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18689-e18689

Author(s):

Leah Wells ◽

Michael Cerniglia ◽

Audrey C. Jost ◽

Gregory Joseph Britt

Keyword(s):

Disease Control ◽

Proportional Hazards Model ◽

Checkpoint Inhibitors ◽

Performance Status ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Time To Death ◽

Significant Difference ◽

Line Of Therapy

e18689 Background: While guidelines exist for appropriate use of chemotherapy in the metastatic setting based on performance status, such recommendations are less readily available for immune checkpoint inhibitors (ICIs). We sought to determine if there is a relationship between Eastern Cooperative Oncology Group (ECOG) performance status and outcomes on immunotherapy in patients treated for metastatic disease at our community-based oncology practice. Methods: 253 patients were identified as receiving nivolumab or pembrolizumab for stage IV malignancy at Cancer Centers of Colorado-SCL Health, between June 2018 and November 2020. Patients initiated on therapy after May 2020 were excluded from analysis, due to insufficient (less than 6 months) follow-up time. The remaining 183 patients were included in a retrospective cohort study comparing patients with ECOG 0, ECOG 1, and ECOG 2-4. Sex, age, type of cancer, and line of therapy were collected. Time on therapy was also calculated. Best response to therapy was determined (disease control or progressive disease). These baseline factors and outcomes were compared using ANOVA for numeric variables and chi-square tests of association for categorical variables. Time from initiation of ICI to death or hospice was also investigated and compared using a log-rank test. In addition, a multivariate Cox proportional hazards model was developed for the outcome, time to death/hospice, versus the predictors ECOG status, age, gender, and line of therapy. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated. Results: Of the 183 patients included in analysis, 31.7% had an ECOG of 0, 48.6% an ECOG of 1, and 19.7% an ECOG of 2-4. Non-small cell lung cancer and melanoma represented the majority of patients in each group. Gender and line of therapy did not differ between groups. There was a significant difference in age (p = 0.02) with mean age 62, 66, and 70 in ECOG 0,1, and 2-4, respectively. 54.6% of patients remained on therapy for at least 6 months (182 days), and there was no significant difference between groups in ability to complete 6 months of therapy (p = 0.32). For ECOG 0, 1, and 2-4, disease control was achieved in 67.2%, 59.6 %, and 41.7%, respectively (p = 0.048). Analysis of time to death/hospice with a log rank test and Kaplan Meier plot showed a significant difference between groups (p < 0.001). A multivariate Cox proportional hazards model revealed that patients with ECOG 0 had significantly longer time to death/hospice compared to patients in both other groups, after controlling for age, gender, and line of therapy (ECOG 1 vs. 0: HR 2.5, CI 1.27-4.9; ECOG 2-4 vs. 0: HR 2.83, CI 1.31-6.13). Conclusions: In this single institution retrospective study of patients receiving nivolumab or pembrolizumab for metastatic cancer, ECOG 0 was associated with disease control and increased time before death or transition to hospice.

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Blood neutrophil-to-lymphocyte ratio is associated with prognosis in advanced gastrointestinal stromal tumors treated with imatinib

Tumori Journal ◽

10.1177/0300891618765543 ◽

2018 ◽

Vol 104 (6) ◽

pp. 415-422 ◽

Cited By ~ 2

Author(s):

Piotr Rutkowski ◽

Paweł Teterycz ◽

Anna Klimczak ◽

Elżbieta Bylina ◽

Katarzyna Szamotulska ◽

...

Keyword(s):

Disease Progression ◽

Gastrointestinal Stromal Tumors ◽

Proportional Hazards Model ◽

Cox Proportional Hazards Model ◽

Neutrophil To Lymphocyte Ratio ◽

Rank Test ◽

Imatinib Treatment ◽

Stromal Tumors ◽

Lymphocyte Ratio ◽

Advanced Gist

Introduction: Neutrophil-to-lymphocyte ratio (NLR) was shown to be prognostic in several solid malignancies. There are limited data about predictive/prognostic value of NLR during targeted therapy of patients with advanced gastrointestinal stromal tumors (GIST). The aim of this study was to asses a clinical value of this ratio in patients with advanced GIST. Methods: Between 2001 and 2016, 385 patients with metastatic/unresectable GIST treated initially with imatinib were included in the analysis. In all patients, the NLR was assessed at the baseline, after 3 months of treatment, and upon disease progression (or last observation). The cutoff values for NLR were set at 2.7 and 5.4. Kaplan-Meier survival probability estimation with log-rank test and Cox proportional hazards model were used for analysis. Results: Median progression-free survival (PFS) on imatinib treatment was 44.8 months, 5-year rate 43%; median overall survival (OS) 87.2 months, 10-year rate 36.3%. NLR >2.7 at baseline was significantly associated with poorer OS and PFS: median OS was 89.3 months (95% confidence interval [CI] 80.2-115) for NLR ratio ≤2.7 vs 59.4 months (95% CI 48.6-82) for NLR >2.7 ( p < .001); median PFS was 59.4 vs 32.7 ( p < .001), respectively. In multivariate model adjusted for mitotic index and driver mutation in the tumor ( KIT exon 11 mutation versus other), NLR ratio was proven to be statistically significant (hazard ratio 1.09; 95% CI 1.01-1.19; p = .030). Among patients with disease progression, NLR >2.7 assessed at the third month of treatment was linked with significantly shorter median time to progression (7.5 vs 19 months). Conclusions: Our results demonstrate the usefulness of NLR as a prognostic and predictive marker as well as a marker for treatment monitoring in patients with advanced GIST treated with imatinib.

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Subclinical Cognitive Impairment and Listing for Kidney Transplantation

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.11010918 ◽

2019 ◽

Vol 14 (4) ◽

pp. 567-575 ◽

Cited By ~ 10

Author(s):

Aditi Gupta ◽

Robert N. Montgomery ◽

Victor Bedros ◽

John Lesko ◽

Jonathan D. Mahnken ◽

...

Keyword(s):

Cognitive Impairment ◽

Kidney Transplant ◽

Cognitive Assessment ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Montreal Cognitive Assessment ◽

Rank Test ◽

Assessment Score ◽

Lower Likelihood

Background and objectivesCognitive impairment is common in patients with kidney disease and can affect physicians’ perception and/or patients’ ability to complete the pretransplant evaluation. We examined whether cognitive impairment influences the likelihood for transplant listing and whether patients with cognitive impairment take longer to be listed.Design, setting, participants, & measurementsWe conducted a single-center longitudinal cohort study. Patients presenting for their index kidney transplant evaluation were screened for cognitive impairment using the Montreal Cognitive Assessment. A score <26 indicated cognitive impairment. The transplant selection committee was blinded to the scores. Kaplan–Meier analysis assessed time to active listing by level of cognition. A Cox proportional hazards model that included age, sex, race/ethnicity, smoking, coronary artery disease, and diabetes was constructed to evaluate the association between Montreal Cognitive Assessment score and listing for transplant.ResultsIn total, 349 patients who underwent Montreal Cognitive Assessment testing at their initial visit were included in the analysis. Patients with cognitive impairment were more likely to be older, black, and smokers. The time to listing in patients with cognitive impairment was longer than the time to listing in those with no cognitive impairment (median time, 10.6 versus 6.3 months; log rank test P=0.01). Cognitive impairment was independently associated with a lower likelihood of being listed for transplant (hazard ratio, 0.93 per unit lower Montreal Cognitive Assessment score; 95% confidence interval, 0.88 to 0.99; P=0.02). A lower proportion of patients with cognitive impairment were listed compared with patients without cognitive impairment at 1 month (2% versus 11%), 6 months (17% versus 37%), and 1 year (23% versus 41%), (P<0.001 for all).ConclusionsCognitive impairment is associated with a lower likelihood of being listed for kidney transplant, and is associated with longer time to transplant listing.

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Serum Endocan as a Survival Predictor for Patients with Liver Cirrhosis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/153805 ◽

2015 ◽

Vol 29 (8) ◽

pp. 427-430 ◽

Cited By ~ 5

Author(s):

Nobuyuki Toshikuni ◽

Kazuaki Ozaki ◽

Joseph George ◽

Mikihiro Tsutsumi

Keyword(s):

Liver Cirrhosis ◽

Proportional Hazards Model ◽

Survival Rates ◽

Elevated Serum ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Hepatic Decompensation ◽

Cumulative Survival ◽

Kaplan Meier ◽

Survival Predictor

BACKGROUND: The relationship between endocan expression and outcome in patients with chronic liver disease is not fully understood.OBJECTIVE: To examine whether serum endocan level is predictive of outcome in patients with liver cirrhosis.METHODS: A total of 68 patients with liver cirrhosis were enrolled. Outcome predictors were analyzed using the Cox proportional hazards model. The overall survival rates were calculated using the Kaplan-Meier method, and differences were evaluated using the log-rank test.RESULTS: During the median follow-up period (7.1 years), nine patients had hepatocellular carcinoma (HCC) and 10 patients died. Of the deceased patients, nine died due to hepatic decompensation or associated conditions. No significant factors were found to be predictive of the occurrence of HCC. In contrast, an elevated serum endocan level (≥2.0 ng/mL; HR 2.34 [95% CI 1.05 to 7.03]; P=0.037) and high Child-Pugh grade B/C (HR 2.65 [95% CI 1.30 to 6.89; P=0.006) were predictive of poor survival. Kaplan-Meier analysis revealed that the respective cumulative survival rates at five and 10 years were 97.1% and 87.4% in patients with serum endocan levels <2.0 ng/mL and 85.8% and 64.4% in patients with levels ≥2.0 ng/mL (P=0.009), respectively. Moreover, the cumulative survival rates were significantly different among the patient groups divided according to serum endocan level and Child-Pugh grade (P=0.002).CONCLUSION: These findings suggest that serum endocan level may be a survival predictor for patients with liver cirrhosis.

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