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Results for “multivariate analysis”

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PubMed1983

Use of multivariate analysis to improve the accuracy of radionuclide angiography with stress in detecting coronary artery disease in men.

A multivariate analysis (MVA) system was derived retrospectively from a population of 76 males with coronary artery disease and 18 control subjects. Posterior probabilities were then derived from such a system prospectively in a new male population of 11 subjects with normal coronary arteries and hemodynamics and 63 patients with coronary artery disease. The sensitivity was 84% compared to that for change in ejection fraction (delta EF) greater than or equal to 5 criterion of 71% (p less than 0.01), the specificity was 91% compared to 73% for the delta EF greater than or equal to 5 criterion (p greater than 0.05), and the correct classification rate was 85% compared to 72% for the delta EF greater than or equal to 5 criterion (p less than 0.01). The significant variables were: change in EF with exercise, percent maximal heart rate, change in end-diastolic volume (delta EDV) with exercise, change in R wave, and exercise duration. Application of the multivariate approach to radionuclide imaging with stress, including both exercise and nuclear parameters, significantly improved the diagnostic accuracy of the test and allowed for a probability statement concerning the likelihood of disease.

Adult↗

PubMed1995

Prostate-specific antigen and prognosis in patients with metastatic prostate cancer--a multivariable analysis of prostate cancer mortality.

OBJECTIVE: To analyse the prognostic significance of pre- and post-treatment serum prostate-specific antigen (PSA) levels, together with a variety of other factors, in a multivariable analysis of survival in men with stage D2 prostate cancer. PATIENTS AND METHODS: Cox's proportional hazards model was used to compare survival in 134 men with stage D2 metastatic prostate cancer followed prospectively over a 4 year period, using both univariable and multivariable models. The influence of the following factors on survival was analysed: pre- and post-treatment PSA (both absolute and percentage values), age, treatment, testosterone, pre- and post-treatment alkaline phosphatase (absolute and percentage values), acid phosphatase, haemoglobin, symptom score and performance status and extent of disease on bone scan. RESULTS: Pre-treatment PSA levels did not significantly influence survival. Similarly, a low absolute post-treatment PSA level at 3 months after the start of treatment conferred no survival advantage relative to patients with a high PSA level at this time. A post-treatment percentage PSA of < 10% at 2, 3 and 6 months after commencement of treatment was associated with prolonged survival. Low pre-treatment alkaline phosphatase (less than the upper limit of normal) and high pre-treatment testosterone levels (> or = 10 nmol/L) were similarly associated with prolonged survival. CONCLUSIONS: The strong influence of post-treatment percentage PSA on survival in patients with stage D2 prostate cancer suggests that the percentage change in bulk of metastatic deposits is more important in determining survival than the absolute volume of tumour. Pre-treatment alkaline phosphatase seems to be a better indicator of tumour activity than pre-treatment PSA. These findings have important implications for the design and analysis of clinical trials of new therapies in men with stage D2 prostate cancer and for the future selection of alternative treatments for patients with this stage of the disease.

Aged↗

PubMed1991

[Multivariate analysis on subjective symptoms in forestry workers using chain saw].

This study was conducted to evaluate the relationship between the prevalence of subjective symptoms in workers using vibrating tools and the duration of chain saw operation and to examine whether the symptoms were relevant to factors other than the usage of vibrating tools. The statistical model of multivariate analysis was adapted to analyze individual data on the subjective symptoms of 317 chain saw operators. The obtained results were as follows: 1. In analysis of covariance, age-adjusted operating year in workers with peripheral circulatory, peripheral neurological and musculoskeletal disturbances was significantly longer than that without such disturbances. For these disturbances, partial regression coefficients of operating year were significantly high in multiple regression analysis. These results show that these disturbances and age-adjusted operating year are mutually closely related. 2. Multiple regression analysis showed that the partial regression coefficients of both operating year and age were low for nine symptoms, i.e. dulling sense of touch, joint pain, headache, dizziness and/or tinnitus, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, hearing disturbance and lumbago. These results suggest that such symptoms were not related to either age or chain saw operation. 3. The results of principal component analysis were visualized in three-dimensional space in order to evaluate the relationships among the symptoms. The analysis showed that peripheral circulatory and neurological disturbances appeared independently and that general symptoms such as easy fatigability, headache, forgetfulness, vertigo and/or tinnitus, easy irritability, sleep disorder, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, shoulder stiffness, hearing disturbance and lumbago consisted of four independent groups. Each group has no relationship with duration of chain saw operation. This suggests other harmful factors of the groups play a role in the prevalence of the symptoms.

Age Factors↗

PubMed1997

p53 is a persistent and predictive marker in advanced ovarian carcinomas: multivariate analysis including comparison with Ki67 immunoreactivity.

p53 mutation and p53 protein overexpression are common findings in ovarian carcinomas. In order to evaluate the prognostic significance of the p53 status and its role in metastasis, we examined 104 ovarian carcinomas, among them 83 cases with follow-up data, and 40 pairs of primary tumors and metastases, by p53 immunohistochemistry and temperature-gradient gel electrophoresis. Comparison of primary tumors and their metastases revealed identical results in 88%-90% of the cases, indicating that, in most cases, mutant p53 occurs prior to metastatic spread and remains clonally conserved. With respect to all tumors, moderate/high p53 expression was significantly more prevalent in serous-papillary types, carcinomas with high grade, and high Ki67 scores, but was not associated with age, stage, or hormone receptor status. Kaplan-Meier analysis of 83 cases, followed-up for 9-96 months, demonstrated that moderate/high p53 overexpression in the group of 66 stage T3/M1 tumors was associated significantly (P = 0.0028 and P = 0.0105) with shorter overall and recurrence-free survival. Multivariate analysis revealed that advanced clinical stage and p53 positivity were the only independent predictive variables. No significance was seen in regard to second-look results and outcome of 50 patients receiving platinum-based chemotherapy. These observations show that p52 immunohistochemistry is an independent prognostic indicator at the given cut-off level, but does not reliably predict chemotherapy response.

Adult↗

PubMed2003

The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients.

BACKGROUND: Limited information exists about risk factors for postoperative hypoparathyroidism after bilateral thyroid surgery. METHODS: Between January 1 and December 31, 1998, bilateral thyroid surgery was performed on 5846 patients for benign and malignant thyroid disease. Data were prospectively collected by questionnaires from 45 hospitals. A logistic regression model was used to determine independent risk factors. RESULTS: The overall incidence of transient and permanent hypoparathyroidism was 7.3% and 1.5%, respectively. On logistic regression analysis, total thyroidectomy (odds ratio [OR], 4.7), female gender (OR, 1.9), Graves' disease (OR, 1.9), recurrent goiter (OR, 1.7), and bilateral central ligation of the inferior thyroid artery (OR, 1.7) constituted independent risk factors for transient hypoparathyroidism. When the multivariate analysis was confined to permanent hypoparathyroidism, total thyroidectomy (OR, 11.4), bilateral central (OR, 5.0) and peripheral (OR, 2.0) ligation of the inferior thyroid artery, identification and preservation of no or only a single parathyroid gland (OR, 4.1), and Graves' disease (OR, 2.4) emerged as independent risk factors. CONCLUSIONS: Extent of resection and surgical technique had a greater impact on the rates of permanent postoperative hypoparathyroidism than thyroid pathologic condition. In bilateral thyroid surgery, peripheral ligation of the inferior thyroid artery at the thyroid capsule should be favored over central ligation, and at least 2 parathyroid glands should be identified and preserved. High-risk procedures, such as total thyroidectomy and Graves' disease, require special surgical training and expertise.

Female↗

PubMed2005

Multivariate analysis of photo-Fenton degradation of the herbicides tebuthiuron, diuron and 2,4-D.

The degradation of herbicides in aqueous solution by photo-Fenton process using ferrioxalate complex (FeOx) as source of Fe2+ was evaluated under blacklight irradiation. The commercial products of the herbicides tebuthiuron, diuron and 2,4-D were used. The multivariate analysis, more precisely, the response surface methodology was applied to evaluate the role of FeOx and hydrogen peroxide concentrations as variables in the degradation process, and in particular, to define the concentration ranges that result in the most efficient degradation of the herbicides. The degradation process was evaluated by the determination of the remaining total organic carbon content (TOC), by monitoring the decrease of the concentrations of the original compounds using HPLC and by the chloride ion release in the case of diuron and 2,4-D. Under optimized conditions, 20 min were sufficient to mineralize 93% of TOC from 2,4-D and 90% of diuron, including oxalate. Complete dechlorination of these compounds was achieved after 10 min reaction. It was found that the most recalcitrant herbicide is tebuthiuron, while diuron shows the highest degradability. However, under optimized conditions the initial concentration of tebuthiuron was reduced to less than 15%, while diuron and 2,4-D were reduced to around 2% after only 1 min reaction. Furthermore, it was observed that the ferrioxalate complex plays a more important role than H2O2 in the photodegradation of these herbicides in the ranges of concentrations investigated.

2,4-Dichlorophenoxyacetic Acid↗

PubMedDate not supplied

A multivariate analysis of prognostic factors including tumor response after endocrine therapy in advanced breast cancer patients.

Although clinicians want to know how tumor response affects the survival of advanced cancer patients, the direct comparison of response with survival is severely discouraged because of biases essentially involved. In 159 patients with advanced breast cancer treated with adreno-oophorectomy, we analyzed the survival of the patients using the Kaplan and Meier method with the landmark method (landmark time of 3 months after treatment). A multivariate analysis with the Cox proportional hazard model for survival with explanatory variables including response of patients at the landmark time (3 months after therapy) was performed in order to find probable prognostic factors. By the Kaplan and Meier curves with the landmark method, response category showed a significant difference in the survival of the patients (log rank test; p < 0.0001). In the Cox model in the patients of landmark time of 3 months after therapy, we found that response was the most powerful factor for survival out of 10 variables (p = 0.0001), and the dominant site of metastasis significantly and independently modified the survival length (p = 0.001). ER status was indifferent in the analysis; however, when the response category was not included, ER was shown to be most influential. We propose that a combination of the Cox model with the landmark method would be a rational and useful approach to estimate probable prognostic factors including treatment outcome variables such as response for the survival analysis in advanced cancer patients.

Adrenalectomy↗

PubMed1995

Prognostic significance of pathologic features of hepatocellular carcinoma. A multivariate analysis of 278 patients.

BACKGROUND: In patients with hepatocellular carcinoma, surgical resection may offer a chance of cure. However, tumor recurrence is not infrequent after resection. METHODS: To identify the pathologic factors that are of prognostic significance and predictive value in tumor recurrence, the authors studied 278 patients (243 men, 35 women) who had hepatectomy for hepatocellular carcinoma. Disease free and actuarial survival were correlated with 20 pathologic parameters of the resected specimens using multivariate analysis. RESULTS: The median follow-up period was 23.6 months. The overall disease free survival rates at 1, 3 and 5 years were 42%, 23%, and 17%, respectively, and the overall actuarial survival rates for the corresponding time periods were 70%, 39%, and 28%, respectively. The results indicated that tumor encapsulation (P = 0.004) and heavy intratumor inflammatory infiltrates (P = 0.003) were independent favorable factors related to tumor recurrence. Negative resection margins (P = 0.001) and heavy intratumor inflammatory infiltrates (P = 0.003) were independent favorable factors correlated with survival. CONCLUSIONS: From this analysis, it was determined that detailed histologic examination of resected specimens of hepatocellular carcinoma is important in assessing long term prognosis and stratification of patients for treatment.

Actuarial Analysis↗

PubMed2001

Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess.

BACKGROUND: Pyogenic liver abscess is a threatening condition. The purpose of this study was to audit the clinical behavior and to analyze the risk factors. METHODS: One hundred and thirty-three patients treated in five hospitals during the years 1985 to 1997 were studied. By univariate and multivariate analysis we tried to identify any risk factor associated with complicated clinical course and complicated-related clinical course, and with hospital mortality. RESULTS: Sixty-three patients (47%) were subjected to a percutaneous drainage, 45 (34%) were treated by open surgical drainage, and the remaining 25 cases (19%) received antibiotic therapy alone. Prognostic variables for a complicated clinical course were the presence of shock, low hemoglobin level, elevated prothrombin time, and polymicrobial infection. Shock, distress, low hemoglobin level, increased creatinine, and positive blood culture were significant predictors of a complicated-related clinical course. Concerning mortality, a biliary origin, shock, multiple abscesses, low hemoglobin level, and high concentration of blood urea nitrogen were independent predictors. CONCLUSIONS: Treatment of pyogenic liver abscesses should be tailored to each patient, however, the majority of them can be successfully treated with antibiotics and percutaneous methods. Those with signs of organ failure or septicemia should preferably be managed in the intensive care unit.

Anti-Bacterial Agents↗

PubMed1996

[The most important prognostic factors for 736 patients with adenocarcinoma of the gastric cardia: a multivariate analysis using COX proportion hazard model].

A prognostic study was done in 736 patients with primary resectable adenocarcinoma of the gastric cardia whose postoperative survival time was longer than three months. The 3-, 5-, and 10-year cumulative survival rate was 32.2%, 20.2% and 12.2%, respectively. Thirty individual variables were evaluated statistically using the cumulative survival rate by the computer's COX multivariate analysis model. The results showed that the most important prognostic variables for predicting overall survival included maximal tumor diameter, type of resection, depth of invasion and paracardial lymph node metastasis. Sex and preoperative radiotherapy did not influence prognosis.

Adenocarcinoma↗

PubMed1999

Short-term significance of DNA ploidy and cell proliferation in breast carcinoma: a multivariate analysis of prognostic markers in a series of 308 patients.

AIM: To determine the importance of tumour DNA ploidy and cell proliferation, as measured by the S phase fraction (SPF), in relation to other established clinicopathological indicators of prognosis in breast cancer. METHODS: A prospective study of 308 patients. Tumours were staged following the TNM system criteria and were classified according to the histological type and grade. DNA flow cytometry was performed on fresh/frozen samples stained with propidium iodide. Hormone receptors were analyzed by immunocytochemistry. A Cox proportional hazards regression model was used for statistical evaluation of the prognostic factors. RESULTS: Median follow up time was 39.6 months (range 3 to 84). A DNA diploid pattern was found in 134 tumours (43.5%) and aneuploid in 174 (56.5%). Median SPF value was 6.1% (range 1% to 27.8%). DNA ploidy and SPF were strongly correlated (p < 0.001), and both were related to histological type (p < 0.001), grade of differentiation (p < 0.001), tumour size (p = 0.006 and p = 0.002), and hormone receptor activity (p < 0.001). DNA ploidy was also related to node status (p = 0.022), but SPF was not. In univariate analysis, there were significant correlations between disease-free survival and age, histological grade, tumour size, node status, DNA ploidy, SPF, and hormone receptor activity; age, tumour size, node status, DNA ploidy, and hormone receptors were predictors of overall survival. In multivariate analysis, only node status (p = 0.001) and DNA ploidy (p = 0.006) retained independent prognostic significance in relation with overall survival, while node status (p < 0.001) and SPF (p < 0.001) were predictors of disease-free survival. DNA ploidy and SPF continued to predict disease-free and overall survival in lymph node positive (pN1) patients but not in the lymph node negative (pN0) group. CONCLUSIONS: DNA ploidy and SPF are strongly intercorrelated and have independent prognostic value for predicting the short term clinical outcome of breast carcinoma patients.

Adult↗

PubMed2003

A multivariate analysis of sex offender recidivism.

Sex offender recidivism risk is a multifaceted phenomenon requiring consideration across multiple risk factor domains. The impact of treatment involvement and subsequent recidivism is given limited attention in comparison to other forensic mental health issues. The present analysis is a retrospective study of sex offenders treated at a secure facility utilizing a cognitive-behavioral program matched with an untreated correctional sample. Variables studied included demographic, criminal history, offense related, and treatment progress. Recidivism was assessed through arrest data. Multivariate analysis suggests that recidivism is significantly related to quality of treatment involvement, offender demographics, offense characteristics, and criminal history. Successfully treated offenders were significantly less likely to subsequently reoffend. Recidivists were also significantly younger, less likely married, had engaged in more victim grooming or less violent offending behavior, and had significantly more prior property charges. The authors discuss the clinical and policy implications of the interrelationship between treatment involvement and recidivism.

Cognitive Behavioral Therapy↗

PubMed1993

A simplified preinduction scoring method for the prediction of successful vaginal delivery based on multivariate analysis of pelvic and other obstetrical factors.

Most of the popular preinduction scoring methods were created three decades ago, applied to selected populations and based on analysis of each factor separately. In order to overcome these limitations and to try and create a simple and reliable scoring method, 401 inductions of labor were analyzed. Failure was defined as delivery by cesarean section, regardless the indication. Results of multivariate analysis demonstrated that only two of the five factors used by Bishop's method were included (cervical dilatation and fetal head station). Gestational age and parity also constituted important factors and thus the new method incorporates these four factors. The variables among each factor were scored according to their relative risk, obtained from the analysis; dilatation 3 cm or more = 2, dilatation 1-2 cm = 1, fetal head station -1 cm or lower = 1, multiparity = 1, term delivery = 1, closed cervix = 0, station -2 cm or higher = 0, primiparity = 0 and non-term delivery = 0. Comparison of the suggested scoring method and Bishop's method demonstrated that in the low score category our method predicted more accurately cesarean section rate (44.7% and 27.6%, respectively). No difference was noted among the middle or high score groups. More studies among other populations may clarify whether our proposed method really overcomes other methods concerning simplicity, universality and predictability.

Birth Weight↗

PubMed2004

Extended indication criteria for endoscopic mucosal resection of early gastric cancer with special reference to lymph node metastasis--examination by multivariate analysis.

The purpose of this study was to clarify extended indication criteria of endoscopic mucosal resection (EMR) for early gastric cancer (EGC) by analyzing the independent risk factors involved in lymph node metastasis (LNM). Subjects were 422 patients who underwent gastrectomy with lymph node dissection for EGC at the Kurume University Hospital from 1994 to 2001. The EGCs were mucosal cancers (M) in 252 cases and submucosal cancers (SM) in 170 cases. Twelve clinico-pathological factors were assessed for their possible association with LNM. On univariate analysis, EGC with LNM showed the following characteristics: size; 3.1 cm or more, ulceration; present, heterogeneity; present, differentiation; poor, lymphatic vascular invasion; present, and invasion depth; SM2 (cancer penetration of submucosal layer, 0.5 mm or more from the muscularis mucosa). On multivariate analysis, the following four factors were identified as independent risk factors; invasion depth: Odds Ratio (OR) 10.9, lymphatic vascular invasion: OR 10.6, size: OR 3.2, and ulceration: OR 3.2. The incidence of LNM was 0% (0/141) (95% confidence interval, 0-2.6%) when these risk factors met the following four conditions: invasion depth; M or SM1 (cancer penetration of submucosal layer, less than 0.5 mm), lymphatic vascular invasion; absent, size; 3.0 cm or less, and ulceration; absent. It is concluded that EMR is a suitable radical treatment for EGC, and that the indication criteria for EMR can be extended depending on the results of the histological evaluation of the en bloc/total resected specimen concerning the above four factors for LNM.

Aged↗

PubMed2002

[Cadaver renal transplantation and multivariate analysis for graft survival: a clinical review of 2 016 cases].

OBJECTIVE: To review kidney transplantation in the center and analyze the risk factors affecting long-term allograft survival. METHODS: Thirty-two relative variables were analyzed with SAS statistical software. Using Log-rank method, we investigated influence of these variables on short-and long-term survival of grafts. Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-years graft survival rates and half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables. RESULTS: The 1-, 3-, 5-, 10-years graft survival rates were 83%, 75%, 66% and 48%. After excluding the patients died with functioning grafts, the 1-, 3-, 5-, 10 years grafts survival rate increased to 89%, 82%, 75% and 69%, respectively. The mean half-life was 8.78 +/- 0.14 and 14.09 +/- 0.20 years, respectively. By Log-rank analysis, factors affecting short- and long-term graft survival were identified as: renal function, duration of graft function became normal, cold-ischemia time, presence of acute rejection, delayed graft function, immunosuppressive regimen, complication, infection, anti-rejection therapy. Cox model multivariate analysis showed that there were 18 factors affecting graft survival. CONCLUSIONS: New immunosuppressive agents not only significantly increase short-term graft survival, but also have the better long-term outcome tendency. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong graft survival at present.

Adult↗

PubMedDate not supplied

Multivariate analysis for prognostic significance of histologic subtype, GST-pi, MDR-1, and p53 in stages II-IV ovarian cancer.

It has been suggested that histologic subtype of ovarian cancer is a factor that determines the chemoresponsiveness of tumor. In this study, we wanted to clarify the prognostic significance of histologic subtype and its correlation to expression of chemoresistance-related proteins (CRPs) in ovarian cancer. A total of 93 stage II-IV ovarian cancers, where the proportion of serous, endometrioid, mucinous, and clear cell subtype was 61.3%, 14.0%, 7.5%, and 17.2%, respectively, were investigated for glutathione S-transferase-pi (GST-pi), MDR (multidrug resistance)-1, and p53 expression using immunohistochemistry. GST-pi expression was detected in 62.4% of the tumors and was not related to histologic subtype of tumor. MDR-1 expression was observed in 12.9% of the tumors tested and was more frequently detected in clear cell adenocarcinomas than other histologic subtypes of tumor (10/ 16 vs. 2 / 77, P < 0.001). P53 expression was found in 49.1% of serous, 53.8% of endometrioid, and 50% of mucinous adenocarcinomas. In contrast, none of 16 clear cell adenocarcinomas showed positive p53 staining. In univariate analysis, no direct correlations were found between CRPs and overall survival. Histology of mucinous/clear cell tumors (P = 0.0063), as well as FIGO stage III/IV (P = 0.0091) and residual tumor >or= 2 cm (P = 0.0045), was found to have independent prognostic value in multivariate analysis. In conclusion, histologic subtype proved to be the significant independent prognostic factor in addition to FIGO stage and residual tumor in stage II-IV ovarian cancer. GST-pi, MDR-1, and p53 expression pattern is closely related to histologic subtype of ovarian cancer, although they are not significant predictors of survival.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2003

[Patients under 45 years of age "young adults" with head and neck squamous cell carcinoma. Retrospective, multivariable analysis--preliminary report ].

There is a clear tendency to diagnose squamous cell carcinoma of the head and neck more frequently in patients below 45 years of age. These neoplasms in "young adults" seem to be more aggressive with rapid progression, frequent reappearance after treatment and worse prognosis than is observed in older patient population. This preliminary report presents results of retrospective, multivariable analysis of patients below 45 years of age with squamous cell carcinoma of the head and neck. The special focus of the study were: disease progression (T), regional node and distant metastases (N,M), tobacco and alcohol consumption, environmental factors, concomitant diseases, kind of surgical technique and tumour histology.

Adolescent↗

PubMed2002

Breast cancer risk in healthy and symptomatic women: results of a multivariate analysis. A case-control study.

Several risk factors for breast cancer (BC) have been investigated in different reports, but none has been really useful in preventing BC development. The aim of this study was to evaluate the risk of BC in self-selected symptomatic women in comparison with the healthy population residing in an urban area of Italy. A group of 404 women (median age 59 years, range 26-89 years) with confirmed BC (cases) were age-matched with 389 healthy women (Group A), and 391 (Group B) symptomatic non-screened patients without BC, who were referred to our Breast unit. The results of univariate analysis showed a significant (P < 0.01) difference between cases and controls in (1) age at menarche, (2) number of birth and age at first births, (3) lactation and months of lactation, and (4) estrogen replacement therapy (ERT) and duration of ERT. Multivariate analysis using a logistic regression model adjusted for age showed that five independent parameters (no pregnancy, age at first birth > 30 years, no lactation, use of ERT, ERT > 40 months) significantly (P < 0.01) correlated with BC onset. The relative odds ratios (ORs) at 95% confidence interval (95% CI) were 5.25, 2.47, 2.82, 2.80, and 5.56, respectively. The cumulative OR (95% CI) calculated from the observed vs. predicted values was 7.15. No differences (P = NS) were found between groups A and B. In conclusion, in our study population, the prolonged use (> 40 months) of ETR in menopausal women resulted in an increased risk of BC, and represented the only risk factor that could be removed.

Adult↗