Factors Influencing the Need for Endoscopic Sinus Surgery in Adult Patients with Cystic Fibrosis

Background Risk factors in adult patients with cystic fibrosis (CF) associated with surgical intervention have not been delineated. Objective To identify characteristics of adult patients with CF and with chronic rhinosinusitis that predict surgical intervention with endoscopic sinus surgery (ESS). Methods Patients were identified in a tertiary sinus center by the International Classification of Diseases, Ninth Revision codes 277.00-277.03, which represent CF. Charts were reviewed for the CF transmembrane conductance regulator (CFTR) gene mutation, Lund-Mackay score (LMS), the 22-item Sino-Nasal Outcome Test (SNOT-22) score, previous ESS, and occurrence of ESS after presentation. The Fisher exact test was used to test frequency of events between the groups, and the Mann Whitney U test and the t-test were used to compare means among LMS, SNOT-22, and age. The Cox proportional hazard analysis was used to calculate hazard ratios (HR) for the impact of LMS, SNOT-22 score, previous ESS, and CFTR gene mutation status on the occurrence of ESS after presentation. Results One hundred and fifteen patients met the inclusion criteria for the study. Patients with a history of surgery more often underwent ESS after presentation (p ≤ 0.01). The LMS and the SNOT-22 score were not significantly different between the groups of previous ESS and no previous ESS (p = 0.23 and p = 0.28, respectively). A severe mutation genotype was predictive of ESS after presentation (p = 0.03). SNOT-22 scores did not differ between the severe and mild groups (36.0 and 32.4, respectively; p = 0.57), but the mean LMS was significantly higher in the severe mutation group (12.5 and 9.7; p ≤ 0.01). Univariate Cox proportional hazard analysis revealed an increased occurrence of ESS for patients with severe mutations (HR, 3.6; p ≤ 0.01) or a history of ESS (HR, 2.3; p ≤ 0.01). Conclusion The occurrence of ESS in adult patients with CF was predicted by previous ESS intervention as well as the severity of CFTR mutation.

Download Full-text

Quality of Life and Impact of Endoscopic Sinus Surgery in Adult Patients With Cystic Fibrosis

American Journal of Rhinology and Allergy ◽

10.1177/1945892419839260 ◽

2019 ◽

Vol 33 (4) ◽

pp. 413-419 ◽

Cited By ~ 2

Author(s):

Maria S. Lazio ◽

Paolo Luparello ◽

Giuditta Mannelli ◽

Giovanni P. Santoro ◽

Silvia Bresci ◽

...

Keyword(s):

Quality Of Life ◽

Cystic Fibrosis ◽

Endoscopic Sinus Surgery ◽

Adult Patients ◽

Sinus Surgery ◽

Conventional Medical Therapy ◽

Chronic Rhino Sinusitis ◽

The Impact ◽

Snot 22

Background Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasian population. Due to its pathological mechanism, chronic rhino sinusitis (CRS) associated or not with nasal polyposis usually occurs in adults and affects close to one-half of all CF patients. The goal of our work was to evaluate the impact of endoscopic sinus surgery (ESS) in the quality of life (QoL) of the CF patients and demonstrate an improvement of the functional outcomes in the patients undergoing the surgical procedure rather than in the not treated ones. Methodology: We studied 54 adult patients affected by CF. Lund–Kennedy, Lund–Mackay scores, and Sino-Nasal Outcome Test-22 (SNOT-22) were analyzed. Results Twenty-two (40.7%) of the 54 CF patients underwent ESS. This group presented more likely complaints consistent with CRS. Lund–Kennedy and Lund–Mackay scores appeared higher in the ESS group: 10 (range of 6–12) and 16 (range of 12–20), respectively. SNOT-22 showed median values for non-ESS and ESS group of 17.5 (range of 3–68) and 44 (range of 10–73), respectively. Conclusions ESS represents the best option to improve clinical QoL of CF patients who do not response to conventional medical therapy.

Download Full-text

Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

Russian Pulmonology ◽

10.18093/0869-0189-2019-29-3-311-320 ◽

2019 ◽

Vol 29 (3) ◽

pp. 311-320

Author(s):

G. L. Shumkova ◽

E. L. Amelina ◽

V. M. Svistushkin ◽

E. V. Sin’kov ◽

S. A. Krasovskiy ◽

...

Keyword(s):

Cystic Fibrosis ◽

Surgical Treatment ◽

Treatment Group ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Adult Patients ◽

Sinus Surgery ◽

Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS.

Download Full-text

PERBANDINGAN MODEL REGRESI COX PROPORTIONAL HAZARD MENGGUNAKAN METODE BRESLOW DAN EFRON (Studi Kasus: Penderita Stroke di RSUD Tugurejo Kota Semarang)

Jurnal Gaussian ◽

10.14710/j.gauss.v8i1.26624 ◽

2019 ◽

Vol 8 (1) ◽

pp. 93-105

Author(s):

Eri Setiani ◽

Sudarno Sudarno ◽

Rukun Santoso

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Regression Model ◽

Diastolic Blood Pressure ◽

Proportional Hazard ◽

Hazard Regression ◽

Cox Proportional Hazard ◽

History Of ◽

Cox Proportional Hazard Regression ◽

Sugar Levels

Cox proportional hazard regression is a regression model that is often used in survival analysis. Survival analysis is phrase used to describe analysis of data in the form of times from a well-defined time origin until occurrence of some particular even or end-point. In analysis survival sometimes ties are found, namely there are two or more individual that have together event. This study aims to apply Cox model on ties event using two methods, Breslow and Efron and determine factors that affect survival of stroke patients in Tugurejo Hospital Semarang. Dependent variable in this study is length of stay, then independent variables are gender, age, type of stroke, history of hypertension, systolic blood pressure, diastolic blood pressure, blood sugar levels, and BMI. The two methods give different result, Breslow has four significant variables there are type of stroke, history of hypertension, systolic blood pressure, and diastolic blood pressure, while Efron contains five significant variables such as type of stroke, history of hypertension, systolic blood pressure, diastolic blood pressure and blood sugar levels. From the smallest AIC criteria obtained the best Cox proportional hazard regression model is Efron method. Keywords: Stroke, Cox Proportional Hazard Regression model, Breslow method, Efron method.

Download Full-text

Microalbuminuria After Kidney Transplantation Predicts Cardiovascular Morbidity

Frontiers in Medicine ◽

10.3389/fmed.2021.635847 ◽

2021 ◽

Vol 8 ◽

Author(s):

Dana Bielopolski ◽

Ruth Rahamimov ◽

Boris Zingerman ◽

Avry Chagnac ◽

Limor Azulay-Gitter ◽

...

Keyword(s):

Hazard Analysis ◽

Cardiovascular Morbidity ◽

Urine Collection ◽

Proportional Hazard ◽

Cvd Risk ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cardiovascular Morbidity And Mortality ◽

Independent Association

Background: Microalbuminuria is a well-characterized marker of kidney malfunction, both in diabetic and non-diabetic populations, and is used as a prognostic marker for cardiovascular morbidity and mortality. A few studies implied that it has the same value in kidney transplanted patients, but the information relies on spot or dipstick urine protein evaluations, rather than the gold standard of timed urine collection.Methods: We revisited a cohort of 286 kidney transplanted patients, several years after completing a meticulously timed urine collection and assessed the prevalence of major cardiovascular adverse events (MACE) in relation to albuminuria.Results: During a median follow up of 8.3 years (IQR 6.4–9.1) 144 outcome events occurred in 101 patients. By Kaplan-Meier analysis microalbuminuria was associated with increased rate of CV outcome or death (p = 0.03), and this was still significant after stratification according to propensity score quartiles (p = 0.048). Time dependent Cox proportional hazard analysis showed independent association between microalbuminuria and CV outcomes 2 years following microalbuminuria detection (HR 1.83, 95% CI 1.07–2.96).Conclusions: Two years after documenting microalbuminuria in kidney transplanted patients, their CVD risk was increased. There is need for primary prevention strategies in this population and future studies should address the topic.

Download Full-text

The Association Between Serum Human Epididymis Protein 4 Level and Cardiovascular Events in Patients with Chronic Obstructive Pulmonary Disease

Laboratory Medicine ◽

10.1093/labmed/lmaa076 ◽

2020 ◽

Author(s):

Hui Lin ◽

Jianhong Xiao ◽

Xianghua Su ◽

Bin Song

Keyword(s):

Blood Pressure ◽

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Hazard Analysis ◽

Chronic Obstructive ◽

Proportional Hazard ◽

Obstructive Pulmonary Disease ◽

Human Epididymis Protein 4 ◽

Human Epididymis ◽

Cox Proportional Hazard

Abstract Objective Serum human epididymis protein 4 (HE4) is associated with immune and inflammatory responses. This study aimed to assess the performance of serum HE4 in the early detection of cardiovascular (CV) events in patients with chronic obstructive pulmonary disease (COPD). Methods Serum HE4 levels were measured in 199 patients with COPD, all of whom were prospectively followed up for a median period of 36 months (range = 3 months–38 months). Logistic regression analysis was performed to assess the association between cardiovascular disease (CVD) history and HE4 in patients with COPD. Cox proportional hazard analysis was performed to assess the prognostic value of serum HE4 for predicting CV events. Results Serum HE4 levels were higher in patients with COPD with CV events than in those without CV events (252.6 pmol/L [186.4–366.8] vs 111.0 pmol/L [84.8–157.1]; P <.001). The multivariate logistic regression model revealed that serum HE4 (odds ratio = 1.639; 95% confidence interval [CI], 1.213–2.317; Ptrend =.009) was independently associated with CVD history after adjusting for age, sex, body mass index, current smoking status, current alcohol consumption status, admission systolic blood pressure and diastolic blood pressure, hyperlipidemia, left ventricular ejection fraction, primary diseases, and laboratory measurements in patients with COPD at baseline. The multivariate Cox proportional hazard analysis revealed that serum HE4 (hazard ratio = 2.012; 95% CI, 1.773–4.469; P <.001) was an independent prognostic factor for CV events in these patients. The Kaplan-Meier analysis showed that the rate of CV events was higher in patients with COPD with HE4 levels above the median (187.5 pmol/L) than in those with HE4 levels below the median. Conclusion Our results showed that serum HE4 was significantly and independently associated with CVD history and had independent predictive value for CV events in patients with COPD. Serum HE4 may enable early recognition of CV complication development among patients with COPD.

Download Full-text

Rising Serum Uric Acid Level Is Negatively Associated with Survival in Renal Cell Carcinoma

Cancers ◽

10.3390/cancers11040536 ◽

2019 ◽

Vol 11 (4) ◽

pp. 536 ◽

Cited By ~ 1

Author(s):

Kendrick Yim ◽

Ahmet Bindayi ◽

Rana McKay ◽

Reza Mehrazin ◽

Omer A. Raheem ◽

...

Keyword(s):

De Novo ◽

Hazard Analysis ◽

Stage I ◽

Stage Iii ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Ckd Stage ◽

All Cause Mortality ◽

Statin Use ◽

Significant Factors

Aim and Background: To investigate the association of serum uric acid (SUA) levels along with statin use in Renal Cell Carcinoma (RCC), as statins may be associated with improved outcomes in RCC and SUA elevation is associated with increased risk of chronic kidney disease (CKD). Methods: Retrospective study of patients undergoing surgery for RCC with preoperative/postoperative SUA levels between 8/2005–8/2018. Analysis was carried out between patients with increased postoperative SUA vs. patients with decreased/stable postoperative SUA. Kaplan-Meier analysis (KMA) calculated overall survival (OS) and recurrence free survival (RFS). Multivariable analysis (MVA) was performed to identify factors associated with increased SUA levels and all-cause mortality. The prognostic significance of variables for OS and RFS was analyzed by cox regression analysis. Results: Decreased/stable SUA levels were noted in 675 (74.6%) and increased SUA levels were noted in 230 (25.4%). A higher proportion of patients with decreased/stable SUA levels took statins (27.9% vs. 18.3%, p = 0.0039). KMA demonstrated improved 5- and 10-year OS (89% vs. 47% and 65% vs. 9%, p < 0.001) and RFS (94% vs. 45% and 93% vs. 34%, p < 0.001), favoring patients with decreased/stable SUA levels. MVA revealed that statin use (Odds ratio (OR) 0.106, p < 0.001), dyslipidemia (OR 2.661, p = 0.004), stage III and IV disease compared to stage I (OR 1.887, p = 0.015 and 10.779, p < 0.001, respectively), and postoperative de novo CKD stage III (OR 5.952, p < 0.001) were predictors for increased postoperative SUA levels. MVA for all-cause mortality showed that increasing BMI (OR 1.085, p = 0.002), increasing ASA score (OR 1.578, p = 0.014), increased SUA levels (OR 4.698, p < 0.001), stage IV disease compared to stage I (OR 7.702, p < 0.001), radical nephrectomy (RN) compared to partial nephrectomy (PN) (OR 1.620, p = 0.019), and de novo CKD stage III (OR 7.068, p < 0.001) were significant factors. Cox proportional hazard analysis for OS revealed that increasing age (HR 1.017, p = 0.004), increasing BMI (Hazard Ratio (HR) 1.099, p < 0.001), increasing SUA (HR 4.708, p < 0.001), stage III and IV compared to stage I (HR 1.537, p = 0.013 and 3.299, p < 0.001), RN vs. PN (HR 1.497, p = 0.029), and de novo CKD stage III (HR 1.684, p < 0.001) were significant factors. Cox proportional hazard analysis for RFS demonstrated that increasing ASA score (HR 1.239, p < 0.001, increasing SUA (HR 9.782, p < 0.001), and stage II, III, and IV disease compared to stage I (HR 2.497, p < 0.001 and 3.195, p < 0.001 and 6.911, p < 0.001) were significant factors. Conclusions: Increasing SUA was associated with poorer outcomes. Decreased SUA levels were associated with statin intake and lower stage disease as well as lack of progression to CKD and anemia. Further investigation is requisite.

Download Full-text

Intensive Care Unit Admissions in Patients with Hematologic Malignancies: Outcomes and Prognostic Indicators.

Blood ◽

10.1182/blood.v106.11.752.752 ◽

2005 ◽

Vol 106 (11) ◽

pp. 752-752 ◽

Cited By ~ 1

Author(s):

Diana Rubin-Superfin ◽

Timothy Albertson ◽

Carol M. Richman

Keyword(s):

Confidence Interval ◽

Risk Group ◽

Hazard Analysis ◽

Hematologic Malignancies ◽

Hazard Ratio ◽

Prognostic Indicators ◽

Proportional Hazard ◽

Icu Stay ◽

Cox Proportional Hazard ◽

Life Threatening

Abstract With intensification in treatments of hematologic malignancies (HM), the number of life-threatening complications requiring intensive care unit (ICU) admissions has increased. In general, cancer patients requiring ICU care are considered to have a poor prognosis, but it is a common belief among intensivists that patients with HM have an exceptionally grave prognosis. The aim of the current study was to assess outcomes in patients with HM admitted to the ICU for life-threatening complications. In addition, this study intended to identify early prognostic indicators that would be helpful in determining outcomes of ICU stay in this patient population. We performed a retrospective chart review of 185 consecutive critically ill patients with HM admitted to the ICU at a tertiary university hospital during a 5.5-year period. We collected variables ar admission and during admission and identified predictors of in-hospital mortality by Cox proportional hazard analysis. 88.7% patients had active disease, and 36.2% were bone marrow transplant (BMT) recipients. 24.3% were leukopenic (leukocyte count,<1.0x109/L) at admission. Sepsis (30.3%), respiratory failure (17.3%), and post-surgical complications (16.2%) were the major reasons for ICU admissions. 22.2% required vasopressors at admission. 38.4% required mechanical ventilation (MV) and 9.2% needed hemodialysis during ICU stay. Crude ICU, in-hospital, and 6-month mortality rates were 19.5%, 8.1%, and 9.7%, respectively. MV (hazard ratio, 2.75), blood urea nitrogen (BUN)>22 (hazard ratio, 1.81), pre-existent COPD/Asthma (hazard ratio, 3.24), urine output (UOP)<400 ml/24hr (hazard ratio, 2.8) were associated with poor outcome, while high albumin (hazard ratio, 0.54) was associated with better prognosis in multivariate Cox proportional hazard analysis. Using an univariate logistic regression model, diagnosis of acute leukemia (odds ratio, 2.42; 95% confidential interval, 1.23–4.75) or allogeneic BMT (odd ratio, 4.33; 95% confidence interval, 1.17–16.06) were associated with poor outcome, whereas diagnosis of lymphoma (odd ratio, 0.34; 95% confidence interval, 0.16–0.72) or APACHE II<22 (odd ratio, 0.33; 95% confidence interval, 0.17–0.65) were associated with better prognosis. Using these variables, we categorized our population into 4 groups: a very low risk group (lymphoma or other non-leukemia in combination with no need for MV and good UOP/normal BUN), a low risk group (lymphoma or other non-leukemia in combination with either MV, or low UOP/high BUN, or both), an intermediate risk group (leukemia or post-BMT in combination with either MV, or low UOP/high BUN, or neither negative factors), and a high risk group (leukemia or post-BMT in combination with MV and low UOP/high BUN). Survival probabilities at 6 months were 85%, 50%, 47%, and 16%, respectively (p<0.0001). The survival of patients with HM in the ICU was compatible with overall ICU survival at our institution, contrary to prevailing opinion. However, we identified several early predictors of outcome that may be important in deciding on prolonged ICU stay.

Download Full-text

The oncologic impact of pancreatic fistula after pancreatectomy in patients with pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.426 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 426-426

Author(s):

Manabu Kawai ◽

Yoshiaki Murakami ◽

Seiko Hirono ◽

Ken-Ichi Okada ◽

Fuyuhiko Motoi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Fistula ◽

Hazard Analysis ◽

High Volume ◽

Postoperative Management ◽

Proportional Hazard ◽

Term Survival ◽

Long Term Survival ◽

Cox Proportional Hazard

426 Background: There is a few reports that evaluates the association between pancreatic and long-term survival after pancreatectomy in patients with pancreatic cancer. The aim of this study was to elucidate the oncological impact of pancreatic fistula (PF) on long-term survival after pancreatectomy in patients with pancreatic cancer by performing a survey of high volume centers for pancreatic resection in Japan. Methods: Between January 2001 and December 2012, 1,369 patients who underwent pancreatectomy for pancreatic cancer at 7 high-volume centers in Japan were retrospectively reviewed. Results: Pancreatic fistula(PF) occurred in 320 of 1,369 patients (23.5%), and these were classified based ISGPF as follows; grade A in 10.2%, grade B in 10.7%, and grade C in 2.6% of the patients. Median survival time (MST) in no fistula/grade A, grade B and grade C were 24.0, 26.3 and 11.0 months, respectively. MST in grade B PF was similar with that in no fistula/grade A. However, patients with grade C PF had a significantly poorer survival than those without (P<0.001). In the multivariate cox proportional hazard analysis, grade C PF was detected as an independent prognostic factor after pancreatectomy for pancreatic cancer (hazard ratio (HR) 2.15; 95% confidence interval (CI) 1.40-3.29; P< 0.001). Conclusions: Grade C PF adversely affects long-term survival of patients with pancreatic cancer undergoing pancreatectomy, although patients with grade B PF have similar prognosis with no fistula/grade A. Postoperative management to prevent grade C PF is important to improve prognosis in patients with pancreatic cancer undergoing pancreatectomy.

Download Full-text

Prognosis of hemodialysis patients with progressive aortic stenosis: a prospective cohort study

Renal Replacement Therapy ◽

10.1186/s41100-021-00367-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yoriko Horiguchi ◽

Kaoru Uemura ◽

Naoyoshi Aoyama ◽

Shinichi Nakajima ◽

Tomoki Asai ◽

...

Keyword(s):

Aortic Stenosis ◽

Cardiac Death ◽

Hazard Analysis ◽

Hemodialysis Patients ◽

Proportional Hazard ◽

Cardiac Events ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

All Cause Mortality

Abstract Background Whether progressive mild to moderate aortic stenosis in hemodialysis patients influences their prognosis has not been elucidated. This prospective cohort study explored whether progressive aortic stenosis predicted the rate of cardiac events and mortality in those patients. Methods A total of 283 consecutive hemodialysis patients (no aortic stenosis, 248; progressive aortic stenosis, 35) underwent echocardiography for assessment of aortic stenosis, with a median follow-up period of 4.1 years. Study endpoints were cardiac events, all-cause mortality, and cardiac death. Kaplan–Meier analysis and multivariate Cox proportional hazard analysis were performed to estimate cardiac events, all-cause mortality, and cardiac death. Results Cumulative cardiac event rate, all-cause mortality rate, and the rate of cardiac death at 3-year follow-up were 44.9%, 40.5%, and 26.4% in patients with progressive aortic stenosis and 22.1%, 19.0%, and 7.5% in those without aortic stenosis, respectively. Kaplan–Meier analysis demonstrated the cumulative rates of cardiac events and all-cause mortality. And cardiac death was significantly higher in patients with progressive aortic stenosis than in those without aortic stenosis. Multivariate Cox proportional hazard analysis revealed that progressive aortic stenosis was predictive of cardiac events (adjusted hazard ratio 2.47; 95% confidence interval 1.38–4.39) and cardiac death (adjusted hazard ratio 4.21; 95% confidence interval 2.10–8.46). Age, physical activity, C-reactive protein, and serum albumin levels—but not progressive aortic stenosis—predicted all-cause mortality. Conclusions The rates of cardiac events and cardiac death were higher in hemodialysis patients with progressive aortic stenosis than in those without aortic stenosis. Furthermore, progressive aortic stenosis predicted cardiac events and cardiac death. Compared with those without aortic stenosis, patients with progressive aortic stenosis had higher all-cause mortality, which was related to their comorbidities. Trial registration This study was retrospectively registered with University Hospital Medical Information Network Clinical Trials Registry (registration number, UMIN 000024023) at September 12th, 2016.

Download Full-text

Relationship between social support status and mortality in a community-based population: a prospective observational study (Yamagata study)

10.21203/rs.3.rs-32367/v4 ◽

2020 ◽

Author(s):

Tsutomu Uzuki ◽

Tsuneo Konta ◽

Ritsuko Saito ◽

Ri Sho ◽

Tsukasa Osaki ◽

...

Keyword(s):

Social Support ◽

Social Relationships ◽

Cardiovascular Mortality ◽

Prospective Observational Study ◽

Hazard Analysis ◽

Vital Role ◽

Proportional Hazard ◽

Community Based ◽

Cox Proportional Hazard

Abstract Background: Social support, defined as the exchange of support in social relationships, plays a vital role in maintaining healthy behavior and mitigating the effects of stressors. This study investigated whether functional aspect of social support is related to 5-year mortality in health checkup participants.Methods: This study recruited 16,651 subjects (6,797 males, 9,854 females). Social support was evaluated using five-component questions: Do you have someone 1) whom you can consult when you are in trouble? 2) whom you can consult when your physical condition is not good? 3) who can help you with daily homework? 4) who can take you to hospital when you don't feel well? and 5) who can take care of you when you are ill in bed? The association between the component of social support and all-cause and cardiovascular mortality was examined using Cox proportional hazard analysis.Results: The percentage of subjects without social support components was 7.7%-15.0%. They were more likely to be male, non-elderly, and living alone. During the follow-up period, there were 166 all-cause and 38 cardiovascular deaths. Cox proportional analysis adjusted for confounders showed that only the lack of support for transportation to hospital was significantly associated with all-cause (hazard ratio [HR] 2.01, 95% confidence interval [CI] 1.26-3.05) and cardiovascular mortality (HR 3.30, 95% CI 1.41-6.87). These associations were stronger in males than females.Conclusion: This study showed that the lack of social support for transportation to the hospital was independently associated with all-cause and cardiovascular mortality in a community-based population.

Download Full-text