scholarly journals Hospital admissions in children who had pelvicalyceal diltation detected on ultrasound scan during pregnancy: an e-cohort study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Melissa Wright ◽  
Shantini Paranjothy ◽  
David Fone ◽  
Sinead Brophy ◽  
Joanne Demmler
Keyword(s):  
Hospital Admissions ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Ultrasound Scan ◽  
Second Trimester ◽  
Proportional Hazard Model ◽  
Activity Data ◽  
Cox Proportional Hazard ◽  
Uncertain Significance ◽  
The Impact

ABSTRACTObjectiveTo explore whether children with pelvicalyceal dilatation (PCD, a marker detected during the 18-20 week gestation ultrasound scan in which there is enlargement of tubes that collect urine in the kidney) have more hospital admissions for kidney problems in childhood compared to children without the marker. Approach We were funded by NISCHR to study outcomes associated with markers of uncertain significance at the second trimester anomaly scan (Welsh Study of Mothers and Babies). Data collected in the WSMB was uploaded to the Secure Anonymised Information Linkage (SAIL) databank and record linked to hospital activity data. Patterns of hospital admissions for renal causes were described and compared between those with no markers and those with PCD. Children were followed up from birth until 31st December 2014 or until the age of 5. A Cox Proportional Hazard Model was used to investigate the impact of PCD on time to first presentation. Results (Preliminary)Of the WSMB cohort, 20,834 children were eligible for inclusion in analyses. Those with PCD had 6.29 times the hazard of a renal admission compared to those without the marker (95% CI: 3.69 to 10.72). Children with PCD were more likely to have multiple renal admissions to hospital - median (interquartile range) number of renal admissions, 2.5 (1 to 5) compared to 1 (1 , 1) in children without markers. ConclusionPreliminary analysis suggests there is increased childhood renal morbidity associated with the presence of a PCD marker detected on the 18-20 week gestation ultrasound scan. These findings will inform the discussions clinicians have with parents when discussing the implications of this marker for the health of the chid.

scholarly journals Father’s social and economic position has strongest impact on age at menarche in girls from Central India

2019 ◽  
Vol 82 (4) ◽  
pp. 357-371
Author(s):  
Magdalena Kosińska ◽  
Grażyna Liczbińska ◽  
Rajesh K. Gautam ◽  
Pragya Dubey ◽  
Ajay Kumar Ahirwar ◽  
...  
Keyword(s):  
Central India ◽  
Age At Menarche ◽  
Economic Factors ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
The Impact ◽  
Socio Economic Factors

Abstract We assessed the impact of socio-economic factors on age at menarche among the adolescent female population from the state of Madhya Pradesh, Central India. Records such as date of birth, chronological age, caste affiliation, size of place of residence, parents’ level of education and occupation, number of siblings, body height and weight, and age at menarche were collected for 330 students of A Central University, Sagar. The impact of socio-economic factors on age at menarche was analysed using analysis of variance. To establish the probability of menarche occurrence at a given age, time-to-event analysis was carried out using Kaplan-Meier curves and the log-rank test for curve comparison. The association between probability of attaining menarche and the independent variables was investigated using Cox proportional-hazard model. ANOVA and the Kaplan-Meier curves showed statistically significant differences in age at menarche according to size of the place of residence, number of siblings, parental level of education, father’s occupation and females’ BMI. The Cox proportional hazard model revealed that father’s occupation was the strongest factor affecting age at menarche among all SES characteristics under study. Irrespective of rapid economic progress over the past few decades, Indian society is still patriarchal with societal male dominance. This translates into participation of fewer women in the paid workforce and labour market, their lower wage rates and smaller contribution to the household budget compared to their male counterparts.

Systemic inflammation score (SIS) to predict the effect of the postoperative adjuvant chemotherapy for patients with stage III colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 575-575
Author(s):  
Yoshiyuki Suzuki ◽  
Koji Okabayashi ◽  
Hirotoshi Hasegawa ◽  
Masashi Tsuruta ◽  
Takashi Ishida ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Patient Selection ◽  
Stage Iii ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Postoperative Adjuvant Chemotherapy ◽  
Cox Proportional Hazard ◽  
Selection For ◽  
The Impact

575 Background: Postoperative adjuvant chemotherapy (CTx) is a standardized treatment for patients with Stage III colorectal cancer (CRC). Since previous studies reported that the benefit of adjuvant CTx is estimated up to only 15% in Stage III patients, it is necessary to establish an appropriate patient selection for adjuvant CTx. Recently, systemic inflammation is reported to play a critical role in the progression of cancer and several studies demonstrate the impact of inflammation-based score, such as mGPS and SIS. There however is a lack of evidence for the influence of inflammation on patient requiring adjuvant CTx. The aim of this study is to evaluate the impact of SIS on patient selection of adjuvant CTx for Stage III CRC. Methods: Between 2004 and 2012 a total of 295 patients with Stage III CRC who underwent curative resection were included. The SIS was developed based on serum albumin and lymphocyte-to-monocyte ratio (LMR) levels (SIS = 0; albumin > 4.0 g/dl and LMR > 4.44, SIS = 1; albumin < 4.0 g/dl or LMR < 4.44, SIS = 2; albumin < 4.0 g/dl and LMR < 4.44). Primary endpoint was defined as disease free survival (DFS). DFS rates were compared using Kaplan-Meier curves and Prognostic factors were assessed by Cox proportional hazard model. Results: The median follow-up period was 5.99 years. 75.9% of patients received adjuvant CTx. The distribution of SIS was SIS = 0; 32.6 %, SIS = 1; 43.3 %, and SIS = 2; 24.1 %. In multivariate analysis for overall patients, SIS was not a significant prognostic factor. Subgroup analysis according to each SIS score demonstrated that adjuvant CTx significantly prevented postoperative recurrence just only in patients with SIS = 0 (5-year DFS rate; adjuvant CTx (+) 85.5 % vs. CTx (-) 33.7 %, p < 0.001 ). In Cox proportional hazard model, protective effect of adjuvant CTx decreased in proportion to the increase of SIS (HR of adjuvant CTx (95 % CI): SIS = 0; 0.187 (0.089-0.393), SIS = 1; 0.601 (0.311–1.162), SIS = 2; 0.747 (0.319–1.752)). Conclusions: The SIS can provide an appropriate patient selection for patients with stage III CRC who can benefit from adjuvant CTx. The results from this study might enhance precision medicine for adjuvant CTx for Stage III CRC.

scholarly journals Early Marriages Last Longer: Pre-electoral Coalitions and Government Survival in Europe

2014 ◽  
Vol 50 (2) ◽  
pp. 165-188 ◽  
Author(s):  
Mihail Chiru
Keyword(s):  
Survival Rates ◽  
Data Sets ◽  
Cox Proportional Hazard Model ◽  
Eastern European ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Coalition Governments ◽  
Electoral Coalitions ◽  
Cox Proportional Hazard ◽  
The Impact

While the existence of pre-electoral coalitions fundamentally modifies the bargaining environment in which potential cabinet formulas are negotiated, the survival chances of cabinets that include them follow predictable yet different patterns to those of ‘regular’ coalition governments. This article combines original and existing data sets on Western and Central and Eastern European cabinets with information about pre-electoral coalitions (1944–2008) in order to estimate the impact of such alliances on government survival rates. In doing so, I employ a Cox Proportional Hazard model and a ‘competing risks’ research design which distinguishes between replacement and early election hazards. The findings indicate that both Western and post-communist cabinets formed by pre-electoral coalitions exhibit considerably lower rates of discretionary terminations. This effect is reversed in the case of incumbent pre-electoral coalitions. Last but not least, Western European cabinets that replicate pre-electoral coalitions are significantly less likely to end through dissolution and early elections.

Early Achievement of LDL-C Target in Post ACS and Cardiovascular Outcomes

2021 ◽  
Vol 104 (4) ◽  
pp. 536-543
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Low Density Lipoprotein Cholesterol ◽  
Coronary Syndrome ◽  
Cox Proportional Hazard ◽  
The Impact

Background: Risk factor control may be an essential role to reduce subsequent major cardiovascular events in post-acute coronary syndrome (ACS) patients especially low-density lipoprotein cholesterol (LDL-C). Whether early LDL-C achievement in post ACS can provide additional cardiovascular benefit, the evidence is scared. Objective: To determine the impact of early achievement of LDL-C target and cardiovascular outcome in post ACS. Materials and Methods: A retrospective cohort study of patients with diagnosis of ACS who had been admitted at Ramathibodi Hospital Bangkok, Thailand between January 1, 2013 and December 31, 2017 were enrolled. Early LDL-C achieved was defined by LDL-C level below 70 mg/dL or at least 50% reduction from baseline within 12 weeks. Composite outcomes of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and re-revascularization major adverse cardiovascular event (MACE) had been followed for one year. Multivariable Cox proportional hazard model was used to analyze the impact of the early LDL-C achievement. Results: Of the 352 patients studied, mean baseline LDL-C was 119±45 mg/dL. There were 117 patients (33.2%) in the early LDL-C achieved group and 235 patients (66.8%) in LDL-C non-achieved group at 12 weeks. During the 1-year follow-up, MACE occurred in 25 patients (7.2%) with three patients (2.6%) in early LDL-C achieved group and 22 patients (9.4%) in LDL-C non-achieved group. Multivariable Cox proportional hazard model showed that the early LDL-C achieved group independently associated with reduction of MACE (HR 0.286, 95% CI 0.085 to 0.960, p=0.043). Conclusion: Among post ACS patients who are very high-risk of further cardiovascular event especially within the first year, not only LDL-C target is to be considered but the earlier LDL-C achievement is also associated with better cardiovascular prognosis. To provide the effective LDL-C control, early LDL-C achievement is necessary. Keywords: Acute coronary syndrome, Low density lipoprotein cholesterol

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

scholarly journals POS1329 A COHORT STUDY ON THE RISK OF DEVELOPING OBSTRUCTIVE SLEEP APNEA, TEMPOROMANDIBULAR JOINT DISORDERS AND CRANIOFACIAL DEFORMITIES IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 947.1-947
Author(s):  
K. S. K. MA ◽  
L. T. Wang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Juvenile Idiopathic Arthritis ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Obstructive Sleep ◽  
Subgroup Analyses ◽  
Underlying Mechanisms

Background:Juvenile Idiopathic Arthritis (JIA), an autoimmune disease, has been proposed to be comorbid with obstructive sleep apnea (OSA).Objectives:We aimed at identifying the relationship between JIA and OSA.Methods:We performed a cohort study including JIA and OSA patients from 1999 to 2013. A total of 2791 patients diagnosed with OSA after JIA onset were recruited, which 11,164 eligible individuals without JIA history were selected as matched-controls. A Cox proportional hazard model was developed to estimate the risk of OSA in JIA patients. A cumulative probability model was adopted to assess the time-dependent effect of JIA on OSA development, implying the casual link of the association. To identify whether JIA patients have higher risks for developing temporomandibular joint (TMJ) disorders, craniofacial anomalies and deformities than non-JIA individuals, subgroup analyses was conducted. Finally, Ingenuity Systems Pathway Analysis (IPA) was conducted to identify underlying mechanisms of the above disease correlation among peripheral blood mononuclear cells (PBMCs) from rheumatic factor (RF)-positive and RF-negative JIA patients, and subcutaneous fat tissues from OSA patients, using p-value visualization for RNA-seq analyses.Results:The Cox proportional hazard model showed that JIA patients were more likely to have OSA than non-JIA individuals (adjusted hazard ratio =1.949, 95% CI =1.264–3.005). The incidence of developing OSA was particularly high among patients who developed JIA aged 18-30 years old (aHR= 2.034, 95% CI=1.305-3.169) and males (aHR=1.82, 95% CI=1.121-2.954). The risk of developing OSA increased within 0-36 months (aHR = 2.216, 95% CI = 1.001 – 4.907) and over 60 months (aHR = 2.558, 95% CI = 1.346 – 4.860) of follow-up duration after JIA onset. Subgroup analyses showed that JIA patients were more likely to have TMJ disorders (relative risk = 2.047, 95% CI = 1.446-2.898) and to receive treatment for craniofacial deformities (RR = 1.722, 95% CI = 1.38-2.148) than non-JIA controls. IPA analyses suggested that the underlying mechanisms involved activation of antigen presentation pathway followed by antigen presentation to CD4+ and CD8+ T lymphocytes, as well as B cell development.Conclusion:Our findings identified high risks of developing OSA, TMJ disorders, and craniofacial deformities following JIA onset, which the underlying mechanisms may involve both cellular and humoral immunity.Disclosure of Interests:None declared

scholarly journals Proton pump inhibitor is a risk factor for recurrence of common bile duct stones after endoscopic sphincterotomy – propensity score matching analysis

2017 ◽  
Vol 05 (04) ◽  
pp. E291-E296
Author(s):  
Nobuhiko Fukuba ◽  
Shunji Ishihara ◽  
Hiroki Sonoyama ◽  
Noritsugu Yamashita ◽  
Masahito Aimi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Common Bile Duct Stones ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Bile Duct Stones ◽  
Proportional Hazard Model ◽  
Propensity Score Matching Analysis ◽  
Cox Proportional Hazard

Abstract Background and study aims Recurrence of common bile duct stones (CBDS) in patients treated with endoscopic sphincterotomy (ES) can lead to deterioration in their quality of life. Although the pathology and related factors are unclear, we speculated that proton pump inhibiter (PPI) administration increases the risk of CBDS recurrence by altering the bacterial mixture in the bile duct. Patients and methods The primary endpoint of this retrospective study was recurrence-free period. Several independent variables considered to have a relationship with CBDS recurrence including PPI use were analyzed using a COX proportional hazard model, with potential risk factors then evaluated by propensity score matching analysis. Results A total of 219 patients were analyzed, with CBDS recurrence found in 44. Analysis of variables using a COX proportional hazard model demonstrated that use of PPIs and ursodeoxycholic acid (UDCA), as well as the presence of periampullary diverticula (PD) each had a hazard ratio (HR) value greater than 1 (HR 2.2, P = 0.007; HR 2.0, P = 0.02; HR 1.9, P = 0.07; respectively). Furthermore, propensity score matching analysis revealed that the mean recurrence-free period in the oral PPI cohort was significantly shorter as compared with the non-PPI cohort (1613 vs. 2587 days, P = 0.014). In contrast, neither UDCA administration nor PD presence was found to be a significant factor in that analysis (1557 vs. 1654 days, P = 0.508; 1169 vs. 2011 days, P = 0.121; respectively). Conclusion Our results showed that oral PPI administration is a risk factor for CBDS recurrence in patients who undergo ES.

scholarly journals SMOKING STATUS AFFECTING SURVIVAL OF ADENOCARCINOMA LUNG CANCER PATIENTS IN KUALA LUMPUR, MALAYSIA

2017 ◽  
Vol 10 (9) ◽  
pp. 312
Author(s):  
Nida Sajid Ali Bangash ◽  
Natasha Hashim ◽  
Nahlah Elkudssiah Ismail
Keyword(s):  
Lung Cancer ◽  
Prognostic Significance ◽  
Hazard Model ◽  
Rank Test ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Kuala Lumpur ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Survival Difference

  Objective: Adenocarcinoma (AC) of the lung is now the most common histologic type of non-small cell lung cancer (NSCLC) worldwide since the past 20 years. This study was conducted to investigate survival difference among smoker and non-smoker lung AC patients.Methods: A retrospective observational study was conducted for 81 advanced NSCLC adult Malaysian patients in Radiotherapy and Oncology Clinic at Hospital Kuala Lumpur, Malaysia. A total of adult 30 Malaysian smokers and 51 non-smokers with lung AC were included. Ex-smokers were not included in the study. Demographic and clinical data were collected and described. For survival analysis, Kaplan–Meier test and log-rank test were used to calculate overall survival (OS) and analyse the difference in the survival curve. Cox proportional hazard model was used to identify prognostic significance of smoking status.Results: Non-smokers showed a significant association with female gender and Stage IV NSCLC. The median OS was higher for non-smokers (493 days) as compared to smokers (230 days). The Cox proportional hazard model showed higher hazard ratio for smokers.Conclusion: Non-smoking is an independent positive prognostic factor in lung AC.

Sign in / Sign up

Export Citation Format

Share Document