Comparison of the Clinical Implications among Five Different Nutritional Indices in Patients with Lupus Nephritis

Systemic lupus erythematosus (SLE) is characterized with aberrant responses in the immune systems and lupus nephritis (LN) is one of the most serious complications of SLE. This study evaluated the clinical significance of different nutritional indices in 207 renal biopsy-proven LN patients. The clinical and laboratory data were reviewed, and five different nutritional indices were calculated: (i) Controlling nutritional status (CONUT) score; (ii) prognostic nutritional index (PNI); (iii) nutritional risk index; (iv) neutrophil-to-lymphocyte ratio; and (v) body mass index. The factors associated with end-stage renal failure (ESRF) were assessed using a Cox-proportional hazard analysis. The patients with ESRF had significantly lower median PNI (31.1 vs. 34.7, p = 0.012) than those without ESRF at baseline. The CONUT score and PNI had the highest correlation between the SLE disease activity index-2000 (r = 0.467 and p = −0.356, all p < 0.001) and was significantly associated with SLE activity-related measures. In the Cox-proportional hazard analysis, PNI (odds ratio 0.925, 95% confidence interval 0.865–0.989, p = 0.022) was independently associated with ESRF along with creatinine and chronicity index, and the renal survival rate was significantly lower in patients with PNI ≤35.41 than in those with PNI >35.41 (p = 0.003). Among nutritional indices, the CONUT score and PNI better correlated with disease activity and PNI was associated with ESRF.

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The spectrum of C4d deposition in renal biopsies of lupus nephritis patients

10.21203/rs.3.rs-126613/v1 ◽

2020 ◽

Author(s):

Ying DING ◽

Xiaojuan YU ◽

Lihua WU ◽

Ying TAN ◽

Zhen QU ◽

...

Keyword(s):

Lupus Nephritis ◽

Disease Activity ◽

Hazard Analysis ◽

Complement Factor ◽

Pathological Features ◽

Peritubular Capillary ◽

Renal Outcomes ◽

Renal Biopsies ◽

C4d Staining

Abstract Objectives This study aims to determine the prevalence and localization of complement factor C4d in renal biopsies of lupus nephritis (LN) patients, as well as its association with the clinico-pathological features of the disease. Especially, the correlation between arteriolar C4d deposition and renal microvascular lesions (RVL) was further analyzed. Methods A total of 325 biopsy-proven lupus nephritis patients were enrolled and their clinico-pathological data were collected. C4d staining in renal biopsies was performed by immunohistochemistry. The association between C4d deposition and the clinico-pathological features was further analyzed. Results C4d deposition was present in most of renal specimens (98.8%) in our cohort. They were localized in the glomeruli (98.2%), tubular basement membrane (TBM) (43.7%), arterioles (31.4%) and peritubular capillary (33.8%), respectively. TBM C4d staining was closely related to the disease activity (SLEDAI) and NIH pathological activity and chronicity indices (P < 0.01). Patients with arteriolar C4d deposition were more likely to develop RVL (91.2%) in comparison to those negative (78.0%; P = 0.004), especially with two or more types of RVL (P < 0.001). During an average follow-up of 55.8 months, the presence of arteriolar C4d was related to worse renal outcomes (HR: 2.074, 95% CI 1.056–4.075, P = 0.034). Co-deposition of arteriolar C4d and C3c was an independent risk factor (HR: 2.539, 95% CI 1.130–5.705, P = 0.024) for predicting renal outcomes by the multivariate stepwise Cox hazard analysis Conclusions C4d deposition was common in renal tissues of lupus nephritis patients. TBM C4d deposition was related to the disease activity and arteriolar C4d deposition was associated with RVL and worse renal outcomes.

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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.

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Abstract 12880: Malnutrition Assessed by Geriatric Nutritional Risk Index Provides the Long-term Prognostic Information in Patients Admitted for Acute Decompensated Heart Failure, Regardless of Reduced or Preserved Left Ventricular Ejection Fraction; A Comparison With Prognostic Nutritional Index and CONUT Score

Circulation ◽

10.1161/circ.132.suppl_3.12880 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Takahisa Yamada ◽

Takashi Morita ◽

Yoshio Furukawa ◽

Shunsuke Tamaki ◽

Yusuke Iwasaki ◽

...

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Risk Index ◽

Left Ventricular ◽

Nutritional Risk ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Nutritional Index ◽

Nutritional Risk Index ◽

Conut Score

Backgrounds: Malnutrition is associated with increased mortality risk in patients (pts) with acute decompensated heart failure(ADHF). Nutritional status is assessed by several indices, such as Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. However, there is no information available on the comparison of prognostic significance of these indices in ADHF pts, relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF). Methods and Results: We studied 303 consecutive pts admitted for ADHF and discharged alive (HFrEF(LVEF<50%);n=163, HFpEF(LVEF≥50%);n=140). Nutritional status was evaluated at the discharge by GNRI calculated as follows: 14.89 • serum albumin (g/dl) + 41.7 • BMI/22, PNI calculated as follows: 10 • serum albumin (g/dl) + 0.005 • total lymphocyte count (/ml) and CONUT score calculated by serum albumin, total cholesterol levels and lymphocyte count. During a follow-up period of 5.0±4.3 yrs, 75 pts had cardiovascular death (CVD). At multivariate Cox analysis, GNRI (p<0.0001) was significantly associated with CVD, independently of systolic blood pressure, serum sodium level and eGFR, although PNI and CONUT score showed a significant association with CVD at univariate analysis. ROC analysis revealed that GNRI of 88 was a fair discriminator for CVD (AUC 0.70(95%CI 0.63-0.77), p<0.0001). In group with HFrEF, CVD was significantly more frequently observed in pts with than without low GNRI <88 (48% vs 25%, p<0.0001, adjusted HR 3.5[1.8-6.6]). Furthermore, in group with HFpEF, pts with low GNRI had the significantly increased risk, compared to those with high GNRI>88 (36% vs 10%, p<0.0001, adjusted HR 3.8[1.4-10.2]). Conclusion: Malnutrition assessed by Geriatric Nutritional Index provides more valuable long-term prognostic information than PNI and CONUT score in pts admitted for ADHF, regardless of HFrEF or HFpEF.

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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.

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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.

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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.

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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.

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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.

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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.

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

10.21203/rs.3.rs-32367/v3 ◽

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.

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