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Mortality Hazard Ratio (mortality + hazard_ratio)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study

DIABETIC MEDICINE, Issue 9 2009
Y. Hayashino
Abstract Aims, Whether health-related quality of life (HRQoL) can be accurately predicted in patients with extremely low HRQoL as a result of diabetic complications is unclear. We investigated the impact of HRQoL on mortality risk in patients with diabetes on haemodialysis. Methods, Data from the Dialysis Outcomes Practice Pattern Study (DOPPS) were analysed for randomly selected patients receiving haemodialysis in Japan. Information regarding the diagnosis of diabetes and clinical events during follow-up was abstracted from the medical records at baseline and HRQoL was assessed by a self-reported short form (SF)-36 questionnaire. The association between physical component score and mental component score in the SF-36 and mortality risk was analysed using a Cox proportional hazard model. Results, Data from 527 patients with diabetes on haemodialysis were analysed. The mortality age-adjusted hazard ratio of having a physical component score greater than or equal to the median was 0.27 [95% confidence interval (CI) 0.08,0.96] and the multivariable-adjusted mortality hazard ratio of having an mental component score greater than or equal to the median was 1.21 (95% CI 0.44,3.35). Conclusions, The physical component score derived from the SF-36 is an independent risk factor for mortality in patients with diabetes on haemodialysis who generally had very low HRQoL scores. Baseline mental component score was not predictive of mortality. Patient self-reporting regarding the physical component of health status may aid in risk stratification and clinical decision making for patients with diabetes on haemodialysis. [source]

Serum bilirubin levels and mortality after myeloablative allogeneic hematopoietic cell transplantation,

HEPATOLOGY, Issue 2 2005
Ted A. Gooley
Many patients who undergo hematopoietic cell transplantation experience liver injury. We examined the association of serum bilirubin levels with nonrelapse mortality by day +200, testing the hypothesis that the duration of jaundice up to a given point in time provides more prognostic information than either the maximum bilirubin value or the value at that point in time. We studied 1,419 consecutive patients transplanted from allogeneic donors. Total serum bilirubin values up to day +100, death, or relapse were retrieved,along with nonrelapse mortality by day +200 as an outcome measure,using Cox regression models with each bilirubin measure modeled as a time-dependent covariate. The bilirubin value at a particular point in time provided the best fit to the model for mortality. With bilirubin at a point in time modeled as an 8th-degree polynomial, an increase in bilirubin from 1 to 3 mg/dL is associated with a mortality hazard ratio of 6.42. An increase from 4 to 6 mg/dL yields a hazard ratio of 2.05, and an increase from 10 to 12 mg/dL yields a hazard ratio of 1.17. Among patients who were deeply jaundiced, survival was related to the absence of multiorgan failure and to higher platelet counts. In conclusion, the value of total serum bilirubin at a particular point in time after transplant carries more informative prognostic information than does the maximum or average value up to that point in time. The increase in mortality for a given increase in bilirubin value is larger when the starting value is lower. (HEPATOLOGY 2005,41:345,352.) [source]

Improving survival disparities in cervical cancer between M,ori and non-M,ori women in New Zealand: a national retrospective cohort study

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010
Melissa McLeod
Abstract Objective: M,ori women in New Zealand have higher incidence of and mortality from cervical cancer than non-M,ori women, however limited research has examined differences in treatment and survival between these groups. This study aims to determine if ethnic disparities in treatment and survival exist among a cohort of M,ori and non-M,ori women with cervical cancer. Methods: A retrospective cohort study of 1911 women (344 M,ori and 1567 non-M,ori) identified from the New Zealand Cancer Register with cervical cancer (adenocarcinoma, adenosquamous or squamous cell carcinoma) between 1 January 1996 and 31 December 2006. Results: M,ori women with cervical cancer had a higher receipt of total hysterectomies, and similar receipt of radical hysterectomies and brachytherapy as primary treatment, compared to non-M,ori women (age and stage adjusted). Over the cohort period, M,ori women had poorer cancer specific survival than non-M,ori women (mortality hazard ratio (HR) 2.07, 95% confidence interval (CI): 1.63,2.62). From 1996 to 2005, the survival for M,ori improved significantly relative to non-M,ori. Conclusion: M,ori continue to have higher incidence and mortality than non-M,ori from cervical cancer although disparities are improving. Survival disparities are also improving. Treatment (as measured) by ethnicity is similar. Implications: Primary prevention and early detection remain key interventions for addressing M,ori needs and reducing inequalities in cervical cancer in New Zealand. [source]

Prognostic significance of CD38 and CD20 expression as assessed by quantitative flow cytometry in chronic lymphocytic leukaemia

BRITISH JOURNAL OF HAEMATOLOGY, Issue 6 2003
Eric D. Hsi
Summary. CD38 expression on chronic lymphocytic leukaemia (CLL) cells is a poor prognostic factor, however, methods for measuring this vary. The QuantiBRITETM flow cytometry (FC) system yields an absolute antigen expression value (antibodies bound/cell, ABC) and may be useful in standardizing CD38 expression analysis. We evaluated cryopreserved pretreatment CLL cells for CD20 ABC, CD38 ABC, and percentage of CD38+ B cells from 131 patients requiring therapy. The 92 patients (70%) with , 100 CD38 ABC had worse overall survival (OS; 34% at 5 years) compared with those with <,100 CD38 ABC (70% at 5 years, mortality hazard ratio 2·30, 95% confidence interval 1·28,4·12; two-tailed P = 0·003). Among the 64 patients with <,30% CD38+ cells, OS of the 25 with , 100 ABC was worse than that of the 39 with <,100 ABC (P = 0·018). OS of patients with <,30% CD38+ cells and , 100 ABC was actually similar to that of patients with , 30% CD38+ cells. BrightCD20 expression (, 20 000 ABC) was not associated with a worse OS (P = 0·10). The presence of , 100 CD38 ABC in CLL patients requiring therapy is an unfavourable prognostic factor for OS and quantitative FC may be superior to percentage CD38+ cell assessment. Prospective trials are required to determine more precisely the prognostic significance of absolute expression levels in fresh CLL cells. [source]