The Use of Multiple Correspondence Analysis and K-means to Explore Associations between Risk Factors and Patient Characteristics in Colorectal Cancer (Preprint)

BACKGROUND Previous works have shown that risk factors are associated with an increased risk of colorectal cancer. OBJECTIVE The purpose of this study was to detect these associations in the region of Lleida (Catalonia) using Multiple Correspondence Analysis (MCA) and K-means. METHODS The cross-sectional study was made up of 1,085 colorectal cancer episodes between 2012 and 2015, extracted from the Population-based Cancer Registry (PCR) for the province of Lleida (Spain), the Primary Care Centers database and the Catalan Health Service Register. The relations between risk factors and patient characteristics were identified using MCA and K-means. RESULTS The combination of these techniques helps to detect clusters of patients with similars risk factors. Risk of death is associated with elderly people and obesity or overweight. Stage III is related with people aged ≥65 and rural/semi-urban population while younger people were related with stage 0. CONCLUSIONS MCA and K-means were a significant help for detecting associations between risk factors and patient characteristics. These techniques have proven to be effective tools for analyzing the incidence of some factors in colorectal cancer. The outcomes obtained help to corroborate suspected trends, as well as stimulating new hypotheses about the previous clinical history and how to prevent it.

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A contemporary survival analysis of individuals with cystic fibrosis: a cohort study

European Respiratory Journal ◽

10.1183/09031936.00119714 ◽

2014 ◽

Vol 45 (3) ◽

pp. 670-679 ◽

Cited By ~ 91

Author(s):

Anne L. Stephenson ◽

Melissa Tom ◽

Yves Berthiaume ◽

Lianne G. Singer ◽

Shawn D. Aaron ◽

...

Keyword(s):

Risk Factors ◽

Cystic Fibrosis ◽

Proportional Hazards ◽

Patient Characteristics ◽

Population Based ◽

Forced Expiratory Volume ◽

Cox Proportional Hazards ◽

Risk Of Death ◽

Cox Proportional Hazards Models ◽

Increased Risk

Previously established predictors of survival may no longer apply in the current era of cystic fibrosis (CF) care. Our objective was to identify risk factors associated with survival in a contemporary CF population.We used the Canadian CF Registry, a population-based cohort, to calculate median age of survival and summarise patient characteristics from 1990 to 2012. Clinical, demographic and geographical factors, and survival were estimated for a contemporary cohort (2000–2012) using Cox proportional hazards models.There were 5787 individuals in the registry between 1990 and 2012. Median survival age increased from 31.9 years (95% CI 28.3–35.2 years) in 1990 to 49.7 years (95% CI 46.1–52.2 years) in the most current 5-year window ending in 2012. Median forced expiratory volume in 1 s improved (p=0.04) and fewer subjects were malnourished (p<0.001) over time. Malnourished patients (hazard ratio (HR) 2.1, 95% CI 1.6–2.8), those with multiple exacerbations (HR 4.5, 95% CI 3.2–6.4) and women with CF-related diabetes (HR 1.8, 95% CI 1.2–2.7) were at increased risk of death.Life expectancy in Canadians with CF is increasing. Modifiable risk factors such as malnutrition and pulmonary exacerbations are associated with an increased risk of death. The sex gap in CF survival may be explained by an increased hazard for death in women with CF-related diabetes.

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Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak - a exploratory cross-sectional analysis of a population-based register study

10.1101/2020.09.14.20193987 ◽

2020 ◽

Cited By ~ 1

Author(s):

Martin Maripuu ◽

Marie Bendix ◽

Louise Öhlund ◽

Micael Widerström ◽

Ursula Werneke

Keyword(s):

Risk Factors ◽

Population Based ◽

Control Group ◽

Age Group ◽

Swedish Population ◽

Cross Sectional ◽

Risk Of Death ◽

Increased Risk ◽

Somatic Comorbidity

Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymised tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four potential risk factors, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were fourfold in the age group between 60 and 79 years. Cardiovascular diseases increased the odds by 50%. Individuals with SMD without any of the risk factors under study had three-folds odds of COVID-19 associated death. Conclusion: Our preliminary results suggest that individuals with SMD are a further group at increased risk of COVID-19 associated death. The factors contributing to this increased mortality risk require clarification.

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Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

Scientific Reports ◽

10.1038/s41598-021-00009-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Daniele Melo Sardinha ◽

Rosane do Socorro Pompeu de Loiola ◽

Ana Lúcia da Silva Ferreira ◽

Carmem Aliandra Freire de Sá ◽

Yan Corrêa Rodrigues ◽

...

Keyword(s):

Risk Factors ◽

Brazilian Amazon ◽

The State ◽

Metropolitan Region ◽

Epidemiological Surveillance ◽

Cross Sectional ◽

Factors Associated ◽

Risk Of Death ◽

Increased Risk ◽

Brazilian Amazon Region

AbstractThe Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

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Colorectal cancer survival among Ministry of National Guard-Health Affairs (MNG-HA) population 2009–2017: retrospective study

BMC Cancer ◽

10.1186/s12885-021-08705-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mesnad Alyabsi ◽

Fouad Sabatin ◽

Majed Ramadan ◽

Abdul Rahman Jazieh

Keyword(s):

Colorectal Cancer ◽

Distant Metastasis ◽

Cancer Survival ◽

National Guard ◽

Population Based ◽

Risk Of Death ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Increased Risk ◽

Cox Proportional Hazard Models

Abstract Background Colorectal cancer (CRC) is the most diagnosed cancer among males and third among females in Saudi Arabia, with up to two-third diagnosed at advanced stage. The objective of our study was to estimate CRC survival and determine prognostic factors. Methods Ministry of National Guard- Health Affairs (MNG-HA) registry data was utilized to identify patients diagnosed with CRC between 2009 and 2017. Cases were followed until December 30th, 2017 to assess their one-, three-, and five-year CRC-specific survivals. Kaplan-Meier method and Cox proportional hazard models were used to assess survival from CRC. Results A total of 1012 CRC patients were diagnosed during 2009–2017. Nearly, one-fourth of the patients presented with rectal tumor, 42.89% with left colon and 33.41% of the cases were diagnosed at distant metastasis stage. The overall one-, three-, and five-year survival were 83, 65 and 52.0%, respectively. The five-year survival was 79.85% for localized stage, 63.25% for regional stage and 20.31% for distant metastasis. Multivariate analyses showed that age, diagnosis period, stage, nationality, basis of diagnosis, morphology and location of tumor were associated with survival. Conclusions Findings reveal poor survival compared to Surveillance, Epidemiology, and End Results (SEER) population. Diagnoses at late stage and no surgical and/or perioperative chemotherapy were associated with increased risk of death. Population-based screening in this population should be considered.

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Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1787 ◽

2020 ◽

Author(s):

Katherine E Goodman ◽

Laurence S Magder ◽

Jonathan D Baghdadi ◽

Lisa Pineles ◽

Andrea R Levine ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Mortality Risk ◽

Age Groups ◽

Patient Characteristics ◽

Chronic Complications ◽

Risk Of Death ◽

Relative Risks ◽

Increased Risk ◽

Metabolic Comorbidities

Abstract Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from COVID-19 remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April – June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66,646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12,388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26 – 1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96 – 1.06), and hypertension without chronic complications was only a risk factor in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17 – 2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; p-values ≤ 0.002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.

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The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study

10.21203/rs.3.rs-15642/v1 ◽

2020 ◽

Author(s):

Yi-Fang Chen ◽

Yen-An Lin ◽

Wei-Chung Yeh ◽

Yu-Chung Tsao ◽

Wen-Cheng Li ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Indigenous Population ◽

Elevated Serum ◽

Serum Triglyceride ◽

Population Based ◽

Alanine Transaminase ◽

Cross Sectional ◽

Increased Risk ◽

Northern Taiwan

Abstract Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the indigenous Taiwanese population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (average 31.21±25.00 U/L vs. 23.29±15.98 U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with abnormal ALT levels (>36 U/L) had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with normal ALT levels (≤36 U/L). The adjusted odds ratio (OR) of abnormal ALT levels for MetS was 2.58 (95% CI=1.23-5.44, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.

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Cardiovascular profiling in the diabetic continuum: results from the population-based Gutenberg Health Study

Clinical Research in Cardiology ◽

10.1007/s00392-021-01879-y ◽

2021 ◽

Author(s):

Volker H. Schmitt ◽

Anja Leuschner ◽

Claus Jünger ◽

Antonio Pinto ◽

Omar Hahad ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Regression Analysis ◽

Clinical Outcome ◽

Population Based ◽

Health Study ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Gutenberg Health Study ◽

Increased Risk

Abstract Aims To assess the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in the general population and to investigate the associated cardiovascular burden and clinical outcome. Methods and Results The study sample comprised 15,010 individuals aged 35–74 years of the population-based Gutenberg Health Study. Subjects were classified into euglycaemia, prediabetes and T2DM according to clinical and metabolic (HbA1c) information. The prevalence of prediabetes was 9.5% (n = 1415) and of T2DM 8.9% (n = 1316). Prediabetes and T2DM showed a significantly increased prevalence ratio (PR) for age, obesity, active smoking, dyslipidemia, and arterial hypertension compared to euglycaemia (for all, P < 0.0001). In a robust Poisson regression analysis, prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PRprediabetes 1.20, 95% CI 1.07–1.35, P = 0.002) and represented as a risk factor for asymptomatic cardiovascular organ damage independent of traditional risk factors (PR 1.04, 95% CI 1.01–1.08, P = 0.025). Prediabetes was associated with a 1.5-fold increased 10-year risk for cardiovascular disease compared to euglycaemia. In Cox regression analysis, prediabetes (HR 2.10, 95% CI 1.76–2.51, P < 0.0001) and T2DM (HR 4.28, 95% CI 3.73–4.92, P < 0.0001) indicated for an increased risk of death. After adjustment for age, sex and traditional cardiovascular risk factors, only T2DM (HR 1.89, 95% CI 1.63–2.20, P < 0.0001) remained independently associated with increased all-cause mortality. Conclusion Besides T2DM, also prediabetes inherits a significant cardiovascular burden, which translates into poor clinical outcome and indicates the need for new concepts regarding the prevention of cardiometabolic disorders.

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Spatial Variation of Survival for Colorectal Cancer in Malaysia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031052 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1052

Author(s):

Anis Kausar Ghazali ◽

Thomas Keegan ◽

Benjamin M. Taylor

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Socioeconomic Status ◽

Environmental Factors ◽

Spatial Variation ◽

Survival Data ◽

Proportional Hazards Model ◽

Healthcare Provision ◽

Risk Of Death ◽

Increased Risk

A patient’s survival may depend on several known and unknown factors and it may also vary spatially across a region. Socioeconomic status, accessibility to healthcare and other environmental factors are likely to contribute to survival rates. The aim of the study was to model the spatial variation in survival for colorectal cancer patients in Malaysia, accounting for individual and socioeconomic risk factors. We conducted a retrospective study of 4412 colorectal cancer (ICD-10, C18-C20) patients diagnosed from 2008 to 2013 to model survival in CRC patients. We used the data recorded in the database of the Malaysian National Cancer Patient Registry-Colorectal Cancer (NCPR-CRC). Spatial location was assigned based on the patients’ central district location, which involves 144 administrative districts of Malaysia. We fitted a parametric proportional hazards model in which the spatially correlated frailties were modelled by a log-Gaussian stochastic process to analyse the spatially referenced survival data, which is also known as a spatial survival model. After controlling for individual and area level characteristics, our findings indicate wide spatial variation in colorectal cancer survival across Malaysia. Better healthcare provision and higher socioeconomic index in the districts where patients live decreased the risk of death from colorectal cancer, but these associations were not statistically significant. Reliable measurement of environmental factors is needed to provide good insight into the effects of potential risk factors for the disease. For example, a better metric is needed to measure socioeconomic status and accessibility to healthcare in the country. The findings provide new information that might be of use to the Ministry of Health in identifying populations with an increased risk of poor survival, and for planning and providing cancer control services.

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Prevalence and Risk Factors of Untreated Thyroid Dysfunctions in the Older Caucasian Adults: Results of Polsenior 2 Survey

10.21203/rs.3.rs-735681/v1 ◽

2021 ◽

Author(s):

Piotr Kocelak ◽

Malgorzata Mossakowska ◽

Monika Puzianowska-Kuznicka ◽

Krzysztof Sworczak ◽

Adam Wyszomirski ◽

...

Keyword(s):

Risk Factors ◽

Thyroid Dysfunction ◽

Population Based ◽

Community Dwelling ◽

Medical Services ◽

Design Data ◽

Cross Sectional ◽

Multidisciplinary Study ◽

Increased Risk ◽

Study Participants

Abstract Background: To determine the prevalence of treated and untreated thyroid dysfunction and to identify factors associated with increased risk of undiagnosed thyroid dysfunction in older adults.Methods The population of 5987 community-dwelling Polish Caucasian seniors aged 60 years and above who participated in the PolSenior 2 study (2018 – 2019). Population-based cross-sectional multidisciplinary study in design. Data from structured questionnaires, geriatric tests and scales were obtained from all study participants who underwent anthropometric and blood pressure measurements during three home visits. Assessment of thyroid function was based on TSH serum measurements.ResultsThe prevalence of thyroid dysfunction in the Polish population aged 60 years or above was estimated at 15.5% (21.5% in women and 7.2% in men), with 3.2% of undiagnosed individuals among them. The prevalence of hypothyroidism and hyperthyroidism in the studied group was 13.9% (19.4% in women and 6.3% in men) and 1.6% (2.1% in women and 0.9% in men) respectively. In multiple regression analysis independent risk factors for thyroid disorders being untreated were older age (> 75 years), male sex, a low education level (primary or lower) and low utilization of medical services.Conclusions One-fifth of Polish Caucasian seniors with hypothyroidism and one-third with hyperthyroidism is untreated. Older, poorly educated and rarely utilizing medical services seniors, especially men, are more frequently untreated for thyroid dysfunction and some of them do not benefit from contemporary achievements of medicine.

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The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study

10.21203/rs.3.rs-15642/v2 ◽

2020 ◽

Author(s):

Yi-Fang Chen ◽

Yen-An Lin ◽

Wei-Chung Yeh ◽

Yu-Chung Tsao ◽

Wen-Cheng Li ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Indigenous Population ◽

Elevated Serum ◽

Serum Triglyceride ◽

Population Based ◽

Alanine Transaminase ◽

Cross Sectional ◽

Increased Risk ◽

Northern Taiwan

Abstract Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the northern Taiwanese indigenous population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (24.00 (17-36) U/L vs. 19.00 (15-26) U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with ALT levels>36 U/L had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with ALT levels≤36 U/L. The adjusted odds ratio (OR) of ALT levels >36 U/L for MetS was 2.79 (95% CI=1.24-6.27, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Northern Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.

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