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Results for “multivariate analysis”

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PubMed1992

[Portacaval anastomosis in patients with liver cirrhosis. Study of prognostic factors of survival by multivariate analysis].

Seventeen preoperative variables were collected in order to assess their prognostic value on survival in 82 cirrhotic patients who underwent a portosystemic shunt for ruptured esophageal varices. Univariate analysis showed that the presence of encephalopathy, bad nutritional status, elevated serum bilirubin, low serum albumin, the presence of ascites and Child-Turcotte's or Child-Pugh's C class were significantly associated with a reduction of long-term survival. Multivariate analysis according to the Cox model showed that only encephalopathy and nutritional status were independently associated with survival. Six survival curves were proposed to estimate the survival probability with these 2 preoperative data; encephalopathy had a predominant effect on survival during the first 5 years after surgery.

Adult↗

PubMed1999

Curative resection of colorectal adenocarcinoma: multivariate analysis of 5-year follow-up.

The purpose of this study was to evaluate the influence of clinicopathologic factors on colorectal cancer, especially the age factor. From 1986 to 1992 a total of 2082 cases of colorectal cancers underwent operation in our institution. After exclusion of familial adenomatous polyposis, multiple cancer, Dukes' D stage, and nonadenocarcinoma patients, there were 1124 patients with single colorectal adenocarcinoma who had undergone curative operation; 1110 cases were included in the study after exclusion of surgical mortalities (14 cases, 1.2%). Age distribution ranged from 19 to 91 years (mean 58 years). The patients were divided into three age groups: < 40 years (grade 1), 40-69 years (grade 2), >/= 70 years (grade 3); other clinicopathologic factors including gender, tumor gross type, location, pathology, and stage were also evaluated in the study. The colonic/rectal cancer ratio was 1.00:1.74, and that of the male/female distribution was 1.00:0.84. The overall 5-year cancer-free rate was 69.9% after curative resection. The young age (< 40 years) patients comprised more women (53.6%) and had a colon location in 41%. Although they had a higher percentage of scirrhous type lesions (1.8%), worse histology (17%), and more advanced stage (49.1%) than the older groups, their survival rate was only slightly lower than the other two groups (67% vs. 70% and 72%, respectively), which was not statistically significant (p = 0.83). By univariate analysis, the factors that influenced the 5-year cancer-free rate were gender (p = 0.031), tumor location (p = 0.003), gross type (p = 0.000), pathology (p = 0.000), and stage (p = 0.001). The independent factors determined for the 5-year cancer-free rate after multivariate analysis were similar to those assessed by univariate analysis. There 5-year survival of colorectal adenocarcinoma was not poorer in young patients. Poor survival factors were male gender, rectal location, scirrhous type, poor and mucinous histology, and advanced stage (Dukes' C) found at curative resection for colorectal adenocarcinoma.

Adenocarcinoma↗

PubMed2006

Using historical data, expert judgement and multivariate analysis in assessing reference conditions and benthic ecological status, according to the European Water Framework Directive.

The European Water Framework Directive (WFD) establishes a framework for the protection and improvement of estuarine and coastal waters, trying to achieve 'good surface water status at the latest 15 years after the date of entry into force of this Directive'. One of the biological elements that should be analysed is the benthos and, as such, the WFD normative definitions describe the aspects of the benthic communities that must be included in the ecological status assessment of a water body. Therefore, it is essential to include, in the assessment, the different metrics that address those parameters identified in the normative definitions for each of the ecological status classes. In this contribution the use of the AMBI, richness and diversity, combined with the use, in a further development, of factor analysis together with discriminant analysis, is presented as an objective tool (named here M-AMBI) in assessing ecological quality status. This assessment requires previous classification of water bodies and typologies, together with the definition of reference conditions; this is undertaken in this contribution using historical data, expert judgement and multivariate analysis. The study has been undertaken by examining changes in benthic communities in the Basque Country, over the last decade, as a case-study, to demonstrate the accuracy and potential of these methodologies.

Animals↗

PubMed1996

[Prognostic factors of renal cell carcinoma: a multivariate analysis].

In a series of 104 patients with renal cell carcinoma, a variety of clinical and histological factors were analyzed to establish their value as prognostic factors. In a univariate analysis (log-rank test), the presence or absence of symptoms, tumor size, pT, N, M, pV categories, TNM stage, Robson stage, nuclear grade and cell type were significantly associated with cause-specific survival, while age, sex and tumor side were not. In a multivariate analysis using Cox's proportional hazard model of 73 informative cases, only N (0 vs. 1-3) and M (0 vs. 1) categories of stage and nuclear grade (1-2 vs. 3) proved to be independent prognostic markers.

Aged↗

PubMed1997

[Cox proportion hazard model multivariate analysis of prognosis of 1,484 axillary node-negative breast cancer patients].

OBJECTIVE: To study the prognosis of axillary node-negative breast cancer patients. METHODS: The data were analyzed in 1,484 consecutive axillary node-negative breast cancer patients. Twenty-two individual variables were evaluated statistically using the cumulative survival rate by the computer's Cox multivariate analysis model. RESULTS: Menopausal status, times of pregnancy, duration before diagnosis, pregnancy-associated, tumor size, intramammary lymph node, postoperative radiotherapy and postoperative adjuvant tamoxifen therapy were independent predictors of prognosis. CONCLUSION: Parts of high risk group among axillary node-negative breast cancer patients could be identified by clinical parameters. Postoperative radiotherapy or ovarian ablation was not indicated for axillary node-negative breast cancer patients. Tamoxifen as postoperative adjuvant therapy should not be restricted to postmenopausal or ER-positive patients. The selection of high risk patients with axillary node-negative breast cancer who should receive adjuvant chemotherapy remains to be investigated at present.

Adult↗

PubMed1994

Impact of improved irradiation technique, age, and lymph node sampling on the severe complication rate of surgically staged endometrial cancer patients: a multivariate analysis.

PURPOSE: Limited information is available regarding factors that predispose to complications following postoperative pelvic radiotherapy (RT) for endometrial cancer. To address this issue, patients with clinically staged I/II endometrial cancer who received postoperative RT following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO) with or without lymph node sampling (LNS) were studied. PATIENTS AND METHODS: From 1960 through 1990, 235 patients with adenocarcinoma of the endometrium received postoperative RT after surgical staging. Multiple factors were evaluated to determine associations with severe complications. Pretreatment factors included age, stage, comorbidities. Treatment-related factors consisted of LNS, total RT dose, volume of RT fields, dose per fraction, total number of RT fields, number of RT fields treated per day, machine energy, and addition of vaginal implant. RESULTS: The 5-year actuarial risk of a severe complication was 5.5%. Factors associated with an increased risk of complications in univariate analysis included age more than 65 years (11% v 2%), use of only one portal per day (40% v 3%), use of anteroposterior/posteroanterior fields (23% v 4%), total dose > or = 50 Gy (8% v 2%), and LNS (11% v 3%). In a multivariate analysis, only older age, LNS, and the use of one field per day were significant. Increased risks associated with a total dose > or 50 Gy and the anteroposterior/posteroanterior technique were entirely attributable to the use of one field per day. A subanalysis among patients who had adequate RT techniques (eg, multiple fields treated per day) showed a significant increase in complications (7% v 1%) for those with and without LNS, respectively. CONCLUSIONS: Severe complications associated with adjuvant RT for endometrial cancer were increased among patients who were older or underwent LNS or received suboptimal RT technique. Pelvic RT using proper methods can be delivered with acceptable risks.

Adenocarcinoma↗

PubMedDate not supplied

Determinants of the gonococcal serovar pattern in Edinburgh, Scotland: a multivariate analysis.

The geographical and temporal variety of gonococcal serovar patterns are well described but it remains uncertain what characteristics possessed by the organism, or sexual behaviour pattern in the patients, determine the particular serovar pattern in a given area at a given time. This study was designed to assess the relative contribution of various demographic and clinical features of infection to the observed pattern of serovars in Edinburgh between 1990 and 1993. Five hundred and eight isolates were included in a multivariate analysis model to control for potential interactions between variables. Associations were noted between certain serovars and an asymptomatic clinical presentation, method of acquisition and site of infection. Certain physical characteristics of Neisseria gonorrhoeae in conjunction with the sexual behaviour patterns of patients are partially responsible for observed serovar patterns but more detailed analysis requires further sub-classification of serovars using molecular techniques.

Adult↗

PubMed1991

A multivariate analysis of the risk of pulmonary complications after laparotomy.

We evaluated the relationship between PPC and various putative risk factors in a prospective longitudinal study of 1,000 patients undergoing abdominal surgery. Transient subclinical events were excluded by defining PPC as positive clinical findings in combination with either positive sputum microbiology, unexplained pyrexia, or positive chest roentgenographic findings. The overall incidence of PPC was 23.2 percent (232/1,000). Multivariate analysis identified seven factors which were associated with PPC: ASA classification greater than 2, upper abdominal surgery, residual intraperitoneal sepsis, age greater than 59 years, BMI greater than 25, preoperative hospital stay greater than 4 days, and colorectal or gastroduodenal surgery (overall F score = 33.5, p less than 0.0001). The ASA classification was the most powerful indicator of risk in both the univariate and the multivariate analyses. The combination of ASA classification greater than 1 and age greater than 59 years identified 88 percent (205 of 232) of the patients who developed PPC. These findings provide clinicians and clinical investigators with a simple means of identifying patients who are at high risk of PPC after abdominal surgery.

Age Factors↗

PubMed1991

DNA ploidy is a major prognostic factor in advanced gastric carcinoma--univariate and multivariate analysis.

DNA ploidy was determined by cytofluorometric analysis of paraffin-embedded malignant tissue from 96 Japanese patients in whom gastric carcinoma had invaded the serosa. Aneuploidy was found in gastric carcinoma tissue from 63 patients (66%). The postoperative 5-year survival rate of patients with aneuploid malignancy was significantly lower (13%) than those with diploid malignancy (36%) (p less than 0.05). A multivariate analysis of various clinical and pathologic factors showed that tumor size, lymph node metastasis, vascular invasion, and DNA ploidy were significant and independent factors, which correlated with prognosis.

Analysis of Variance↗

PubMed2006

Higher incidence of chemotherapy induced oral mucositis in females: a supplement of multivariate analysis to a randomized multicentre study.

Study on the normal saline vs povidone-iodine mouthwashes for oral mucositis (OM) prophylaxis in patients after high-dose chemotherapy comprising bischloroethyl nitrosourea etoposide ara-C melphalan (BEAM) or high-dose melphalan (HD-L-PAM) followed by autologous peripheral stem cell transplantation indicated that females have higher a incidence of OM compared to men, as reported by [Vokurka et al. 13:554-558, (2005)]. The multivariable analysis of larger cohort of 148 patients compliant with the original study protocol confirmed female gender to be an independent risk factor and predictor for OM. The HD-L-PAM (200 mg/m2) conditioning regimen revealed to be more toxic compared to BEAM as for incidence of OM grades 3-4 World Health Organization score. Body mass index, age, mouthwash solution used, and CD34+ cell number in the autologous graft were verified not to have an impact on OM incidence in this group of patients.

Adolescent↗

PubMed1996

A multivariate analysis of the prognostic factors in severe liver trauma.

To examine the significance of physiologic and biochemical variables in liver trauma quantitatively, and to establish the early predictors of mortality according to the causes of death, 36 consecutive patients who underwent surgery for liver trauma between 1984 and 1993 were retrospectively studied. A univariate analysis revealed that shock, preoperative systolic blood pressure (SBP), preoperative alanine aminotransferase (ALT), the number of associated organ injuries, the Glasgow Coma Score (GCS), blood replacement requirements, and postoperative blood urea nitrogen (BUN) were significant prognostic factors of survival after liver trauma. However, a multivariate analysis indicated that GCS, postoperative BUN, the number of associated organ injuries, preoperative ALT, and SBP were independent prognostic factors. Because the causes of death after liver trauma can be divided into early hemorrhage and late sepsis, a multiple regression analysis of preoperative and postoperative variables was performed for each cause. The prognostic factors for hemorrhagic death were preoperative ALT, base excess, and the platelet count, whereas those for death due to sepsis were preoperative SBP and the presence of gastrointestinal injuries. These results suggest the value of measuring the preoperative serum level of ALT as a new independent prognostic factor for predicting overall and hemorrhagic death following severe liver trauma.

APACHE↗

PubMed1996

Multivariate analysis of prognostic factors in Philadelphia chromosome positive chronic myeloid leukemia: an update of the first series in Thailand.

The prognostic importance of pretreatment clinical and laboratory features was investigated in a group of 243 patients with Philadelphia chromosome positive chronic phase chronic myeloid leukemia from 1977-1995. Chemotherapy consisted of busulfan before 1993 or hydroxyurea after 1993. The overall median survival from diagnosis was 28 months. The mean age of the patients was 38 years, about 10 years below that of Western populations. Univariate analysis identified 4 poor prognostic features: thrombocytopenia, more than 5% peripheral blasts, more than 5% erythroid precursors and less than 7 g/dl of hemoglobin. The median survival times of patients with these 4 risk factors were 5, 11, 11 and 12 months respectively. Multivariate analysis only identified 2 significant prognostic features: thrombocytopenia and more than 5% peripheral blasts. Splenomegaly of more than 10 cm, basophilia and leukocytosis were associated with a shorter median survival but was not statistically significant. A risk scoring system was developed and used to classify patients into low, intermediate and high risk groups at 30.9%, 30.2% and 38.8% respectively. The median survival time according to the low, intermediate and high risk group was observed at 60, 27 and 14 months respectively. Prognostic factors for Thai patients with chronic myeloid leukemia have both similarities and differences with previously observed factors but the median patient survival time is shorter.

Adolescent↗

PubMed1999

The role of high resolution pulsed and color Doppler ultrasound in the differential diagnosis of benign and malignant lymphadenopathy: results of multivariate analysis.

BACKGROUND: The role of high resolution pulsed and color Doppler ultrasound in the differential diagnosis of benign and malignant lymphadenopathy is still unclear. METHODS: High resolution pulsed and color Doppler ultrasound was used prospectively to investigate superficial lymph node enlargement in 71 patients undergoing surgical biopsy at the onset of lymphadenopathy. The aim of this study was to define, in multivariate analysis, the ultrasonographic parameters useful in the differential diagnosis of benign and malignant lymphadenopathy. RESULTS: Volume, vascularization score, pulsatility index, and resistive index were significantly higher in the 53 malignant lymph nodes studied than in the 18 benign lymph nodes studied. The long-to-short axis ratio was significantly lower in neoplastic lymph nodes than in reactive lymph nodes. Stepwise logistic regression selected only the long-to-short axis ratio and the vascularization score as parameters that independently and significantly contributed to the differentiation of neoplastic from reactive lymph nodes. The diagnostic efficiency of the combined criteria evaluated by the area under the receiver operating characteristic curve was 0.8339. CONCLUSIONS: High resolution pulsed and color Doppler ultrasound may provide information that is useful in making correct differential diagnoses of malignant or benign lymphadenopathy.

Adolescent↗

PubMed2002

Phantom pain and risk factors: a multivariate analysis.

Phantom pain has been given considerable attention in literature. Phantom pain reduces quality of life, and patients suffering from phantom pain make heavy use of the medical system. Many risk factors have been identified for phantom pain in univariate analyses, including phantom sensations, stump pain, pain prior to the amputation, cause of amputation, prosthesis use, and years elapsed since amputation. Multivariate analyses are lacking in the literature and, therefore, no estimation of an overall risk for phantom pain can be made. The aim of this study was to analyze risk factors in a multivariate analysis in 536 subjects (19% upper limb amputees and 81% lower limb amputees). These subjects filled out a questionnaire in which the following items were assessed; side, date, level, and reason of amputation, pre-amputation pain, presence or absence of phantom pain, phantom sensations and or stump pain, and prosthesis use. The prevalence of phantom pain was 72% (95% CI: 68 to 76%) for the total group, 41% (95% CI: 31 to 51%) in upper limb amputees and 80% (95% CI: 76 to 83%) in lower limb amputees. The most important risk factors for phantom pain were "bilateral amputation" and "lower limb amputation." The risk for phantom pain ranged from 0.33 for a 10-year-old patient with a distal upper limb amputation to 0.99 for a subject of 80 years with a bilateral lower limb amputation of which one side is an above knee amputation.

Adult↗

PubMed1992

[Peroperative cholangiography in cholelithiasis. Results of a multivariate analysis].

This study was done to select patients with a low risk of common bile duct (CBD) stones in whom operative cholangiography could be avoided. Operative cholangiography was performed upon 511 patients. Two different groups of patients were identified: patients with CBD stones visualized by CBD exploration (n = 90) and patients with no CBD stones at the time of operative cholangiography (n = 42). Multivariate analysis (stepwise logistic regression) showed that five variables were correlated with the presence of CBD stones: size of CBD equal to or greater than 12 millimeters, gallstones equal to or less than 10 millimeters, advanced age, chronic or acute cholecystitis and pas history of biliary colic. Using a scoring system, a group of patients with a low risk (less than 2%) of CBD stones could be easily determined. In this group of patients, operative cholangiography may be avoided.

Adult↗

PubMed1993

Relationship between paraaortic lymph node involvement and intraperitoneal spread in patients with ovarian cancer--a multivariate analysis.

In 125 patients with epithelial ovarian cancer (FIGO stages I-IV), 32 (26%) had paraaortic lymph node (PAN) metastases. The estimated 5-year survival rate of PAN-negative patients was 71%, while that of PAN-positive patients was 17% (P < 0.0001). Positive rates of PAN metastasis at each stage level, based only on intraperitoneal spread of the disease, were 2% for stage I, 9% for stage II, 43% for stage III, and 87% for stage IV. According to univariate analysis, histological grade, and all disease site parameters examined, such as subdiaphragmatic surface, liver and spleen capsule, intestines and mesentery, omentum, pelvic peritoneum, sigmoid colon and rectum, uterus and tubes, and peritoneal cytology, showed a statistically significant correlation to the presence of PAN metastasis. Multivariate analysis using the logistic regression model revealed that the omental involvement, uterine and tubal involvement, and histological grade were independently correlated with PAN metastasis. The relative risk of PAN metastasis in the patients with these three factors is 18.5 times higher than that in patients without these factors. The present data suggested that, for the disease with omental and/or uterine and tubal involvement, surgical evaluation of PAN is mandatory in order to perform correct FIGO staging.

Abdominal Neoplasms↗

PubMed1997

A multivariate analysis of anatomic success of recurrent retinal detachment treated with pneumatic retinopexy.

PURPOSE: The purpose of the study is to determine the success rate of pneumatic retinopexy (PR) after failed scleral buckling and to elucidate the predictors for anatomic failure by multiple logistic regression analysis. METHODS: Thirty-six eyes with recurrent retinal detachment after failed scleral buckling underwent PR. Intraocular tamponade was attained with SF6 (20 eyes), C3F8 (13 eyes), and air (3 eyes). Median follow-up was 14 months. RESULTS: Retinal reattachment was obtained in 69.4%. Multivariate analysis identified two risk factors for failure: location of retinal break either on the posterior slope or posterior to buckle (P = 0.01) and extent of retinal detachment greater than two quadrants (P = 0.02). CONCLUSIONS: Pneumatic retinopexy is an effective alternative to revision surgical operations if the leaking retinal break is located on the buckle.

Adolescent↗

PubMed1987

Multivariate analysis of risk factors impacting on immediate and eventual cadaver allograft survival in cyclosporine-treated recipients.

A multivariate analysis dissected the impact of donor procurement variables, immunologic risk factors, and alternate cyclosporine and prednisone induction immunosuppressive regimens on the early and eventual function of 303 consecutive cadaveric renal allografts. Primarily warm, but to a slight extent cold, ischemia time had an adverse impact on allograft function, as did the requirement for vasopressor or diuretic therapy. The occurrence of initial graft non-function adversely affected the probability of three-month graft survival, but did not alter either the longevity of organs, which subsequently recovered function, or patient mortality rate. The major immunologic risk factor was a second or multiple transplant, which was associated with an increased incidence of early graft failure, and impaired renal function in successful transplants. Correlations with HLA-B and DR matching were reflected in the quality of renal function, but not in graft survival rates. Cyclosporine (CsA) administration by continuous intravenous infusion, in order to avert initial elevated mean three-day, serum radioimmunoassay drug levels reduced the incidence of initial graft non-function. High levels were also associated with impaired early and eventual renal function. Rapid posttransplant taper of corticosteroids to 30 mg prednisone by day six was associated with a greater incidence of rejection episodes and early graft failure than a taper that achieved 30 mg prednisone at 60 days. Both the serum creatinine value and the degree of hypertension observed at one month afforded good prognostic indices of eventual graft survival. Therefore, renal allografts in CsA-treated patients were sensitive not only to adverse donor and immunologic risk factors, but also to excessive CsA drug levels in the early postoperative period. These findings suggest an induction immunosuppressive strategy utilizing slightly higher initial doses of steroids for CsA-sparing during the first three days, followed by increased, but judicious, administration of CsA to achieve steroid-sparing by virtue of effective rejection prophylaxis.

Cyclosporins↗