• Title/Summary/Keyword: Cox proportional-hazards model

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Does Microinvasive Adenocarcinoma of Cervix Have Poorer Treatment Outcomes than Microinvasive Squamous Cell Carcinoma?

  • Ruengkhachorn, Irene;Hanamornroongruang, Suchanan;Leelaphatanadit, Chairat;Sangkarat, Suthi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4013-4017
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    • 2016
  • Background: To compare the pathological findings and oncologic outcomes of stage IA cervical carcinoma patients, between adenocarcinoma and squamous cell carcinoma cases. Materials and Methods: A total of 151 medical records of stage IA cervical carcinoma patients undergoing primary surgical treatment during 2006-2013 were reviewed. Information from pathological diagnosis and recurrence rates were compared with descriptive statistical analysis. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis. Results: The median age was 48.9 years. There was no significant difference in rates of lymph node, parametrium, uterine, vaginal, or ovarian metastasis, when comparing adenocarcinoma with squamous cell carcinoma. Overall recurrence rates of adenocarcinoma (5.7%) and squamous cell carcinoma (2.6%) were not statistically significant different, even when stratified by stage. When comparing progression free survival with squamous cell carcinoma, adenocarcinoma had an HR of 0.448 (0.073-2.746), p=0.386. Conclusions: Microinvasive adenocarcinoma of cervix has similar rate of extracervical involvement and oncologic outcomes to squamous cell carcinoma.

Risk Factors for Deliberate Self-extubation (기관 내 삽관환자의 의도적 자가발관 위험요인)

  • Cho, Young Shin;Yeo, Jung Hee
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.573-580
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    • 2014
  • Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

Incidence of and Factors for Self-reported Fragility Fractures Among Middle-aged and Elderly Women in Rural Korea: An 11-Year Follow-up Study

  • Ahn, Soon-Ki;Kam, Sin;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.289-297
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    • 2014
  • Objectives: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. Methods: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). Results: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. Conclusions: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

An Empirical Analysis of the Impact of the Institution-based Trust Factors on the Survival of E-commerce Companies in Korea (제도기반 신뢰요소가 한국 전자상거래 기업의 생존에 미치는 영향에 관한 실증 분석 연구)

  • Park, Sho Yun;Kim, Seung Hyun
    • Knowledge Management Research
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    • v.20 no.4
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    • pp.131-148
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    • 2019
  • E-commerce in Korea has grown steadily in recent years. E-commerce has provided firms with an effective method to approach potential customers by overcoming geographical and physical barriers. However, despite the rapid growth, many e-commerce businesses closed their businesses and were not able to survive. This study aims to empirically examine the factors that determine the survival of e-commerce businesses in Korea. In particular, this study focuses on the factors related to the notion of institution-based trust that includes delivery, privacy, and security management. This research used the data set about 31,295 e-commerce businesses that have been registered in Seoul. We found that the e-commerce business that does not require extra personal information beyond the standard terms and conditions or provides a feedback mechanism by having an online board to submit a complaint has a higher chance of survival. In addition, the e-commerce business that has a secured web server, shows the specific information about the date of delivery, or provides escrow services is likely to survive longer than others. The research has extended the extant literature on the importance of trust in e-commerce by empirically examining the effects of the institution-based trust factors on the actual survival of e-commerce businesses.

Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis (상급종합병원 입원환자의 낙상 위험요인: 생존분석으로)

  • Cho, Young Shin;Lee, Young Ock;Youn, Young Sun
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.57-70
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    • 2019
  • Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

Longitudinal Relationships between Cigarette Smoking and Increases Risk for Incident Metabolic Syndrome: 16-year Follow-up of the Korean Genome and Epidemiology Study (KOGES)

  • Sang Shin Pyo
    • Biomedical Science Letters
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    • v.29 no.4
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    • pp.355-362
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    • 2023
  • This study aimed to determine whether smoking affects the metabolic syndrome and its components through long-term follow-up. Of the 10,030 cohort subjects in the community-based Korean Genome and Epidemiology Study (KoGES) from 2001 to 2018, 2,848 people with metabolic syndrome and 4,854 people with insufficient data for analysis were excluded for this study. The study population comprised 2,328 individuals (1,123 men, 1,205 women) who were eligible for inclusion. The mean age of the participants was 49.2±7.5 years, and 21.9% were current smoker. In log rank test, current smoker had a significantly higher cumulative incidence of metabolic syndrome compared with non smoker (P<0.001). In the Cox proportional hazards model adjusted for key variables, metabolic syndrome (hazard ratio [HR] 1.57, P<0.001), high fasting glucose (HR 1.40, P<0.01), hypertriglyceridemia (HR 1.60, P<0.001), low HDL-cholesterol (HR, 1.30, P<0.01), and abdominal obesity (HR 1.32, P<0.01) in current smoker compared with non smoker were statistically significant, respectively, but not hypertension (HR 1.00, P>0.05). After adjustment for confounders, the time (P-time<0.001) and group (P-group<0.001) effects on metabolic syndrome score change were statistically significant. Furthermore, the interaction analysis of time and smoking group on the change in metabolic syndrome score was statistically significant (P-interaction<0.001). In long-term follow-up, smoking worsens metabolic syndrome.

Standardized multi-institutional data analysis of fixed and removable prosthesis: estimation of life expectancy with regards to variable risk factors

  • Hae-In Jeon;Joon-Ho Yoon;Jeong Hoon Kim;Dong-Wook Kim;Namsik Oh;Young-Bum Park
    • The Journal of Advanced Prosthodontics
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    • v.16 no.2
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    • pp.67-76
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    • 2024
  • PURPOSE. This study aims to assess and predict lifespan of dental prostheses using newly developed Korean Association of Prosthodontics (KAP) criteria through a large-scale, multi-institutional survey. MATERIALS AND METHODS. Survey was conducted including 16 institutions. Cox proportional hazards model and principal component analysis (PCA) were used to find out relevant factors and predict life expectancy. RESULTS. 1,703 fixed and 815 removable prostheses data were collected and evaluated. Statistically significant factors in fixed prosthesis failure were plaque index and material type, with a median survival of 10 to 18 years and 14 to 20 years each. In removable prosthesis, factors were national health insurance coverage, antagonist type, and prosthesis type (complete or partial denture), with median survival of 10 to 13 years, 11 to 14 years, and 10 to 15 years each. For still-usable prostheses, PCA analysis predicted an additional 3 years in fixed and 4.8 years in removable prosthesis. CONCLUSION. Life expectancy of a prosthesis differed significantly by factors mostly controllable either by dentist or a patient. Overall life expectancy was shown to be longer than previous research.

Expression Profiles of Loneliness-associated Genes for Survival Prediction in Cancer Patients

  • You, Liang-Fu;Yeh, Jia-Rong;Su, Mu-Chun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.185-190
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    • 2014
  • Influence of loneliness on human survival has been established epidemiologically, but genomic research remains undeveloped. We identified 34 loneliness-associated genes which were statistically significant for high-lonely and low-lonely individuals. With the univariate Cox proportional hazards regression model, we obtained corresponding regression coefficients for loneliness-associated genes fo individual cancer patients. Furthermore, risk scores could be generated with the combination of gene expression level multiplied by corresponding regression coefficients of loneliness-associated genes. We verified that high-risk score cancer patients had shorter mean survival time than their low-risk score counterparts. Then we validated the loneliness-associated gene signature in three independent brain cancer cohorts with Kaplan-Meier survival curves (n=77, 85 and 191), significantly separable by log-rank test with hazard ratios (HR) >1 and p-values <0.0001 (HR=2.94, 3.82, and 1.78). Moreover, we validated the loneliness-associated gene signature in bone cancer (HR=5.10, p-value=4.69e-3), lung cancer (HR=2.86, p-value=4.71e-5), ovarian cancer (HR=1.97, p-value=3.11e-5), and leukemia (HR=2.06, p-value=1.79e-4) cohorts. The last lymphoma cohort proved to have an HR=3.50, p-value=1.15e-7. Loneliness-associated genes had good survival prediction for cancer patients, especially bone cancer patients. Our study provided the first indication that expression of loneliness-associated genes are related to survival time of cancer patients.

Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study

  • Nah, Min-Ah;Lee, Kyeong Soo;Hwang, Tae-Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.56-63
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    • 2020
  • Objectives: The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly. Methods: A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders. Results: In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants. Conclusions: Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

Prognostic Value of Peritoneal Washing Cytology in Gynecologic Malignancies: a Controversial Issue

  • Binesh, Fariba;Akhavan, Ali;Behniafard, Nasim;Zabihi, Somayeh;Hosseinizadeh, Elhamsadat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9405-9410
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    • 2014
  • Purpose: To evaluate the prognostic impact of peritoneal washing cytology in patients with endometrial and ovarian cancers. Materials and Methods: We retrospectively identified 86 individuals with ovarian carcinomas, ovarian borderline tumors and endometrial adenocarcinomas. The patients had been treated at Shahid Sadoughi Hospital and Ramazanzadeh Radiotherapy Center, Yazd, Iran between 2004 and 2012. Survival differences were determined by Kaplan-Meier analysis. Multivariate analysis was performed using the Cox regression method. A p<0.05 value was considered statistically significant. Results: There were 36 patients with ovarian carcinomas, 4 with borderline ovarian tumors and 46 with endometrial carcinomas. The mean age of the patients was $53.8{\pm}15.2years$. In patients with ovarian carcinoma the overall survival in the negative cytology group was better than the patients with positive cytology although this difference failed to reach statistical significance (p=0.30). At 0 to 50 months the overall survival was better in patients with endometrial adenocarcinoma and negative cytology than the patients with positive cytology but then it decreased (p=0.85). At 15 to 60 months patients with FIGO 2009 stage IA-II endometrial andocarcinoma and negative peritoneal cytology had a superior survival rate compared to 1988 IIIA and positive cytology only, although this difference failed to reach statistical significance(p=0.94). Multivariate analysis using Cox proportional hazards model showed that stage and peritoneal cytology were predictors of death. Conclusions: Our results show good correlation of peritoneal cytology with prognosis in patients with ovarian carcinoma. In endometrial carcinoma it had prognostic importance. Additional research is warranted.