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PubMedDate not supplied

The influence of distal runoff on patency of infrainguinal vein bypass grafts.

This retrospective study was conducted to analyze a new concept of evaluation of the effect of distal runoff on patency in infrainguinal bypass surgery for arterial insufficiency. Distal runoff was evaluated on postreconstruction angiograms in 191 limbs undergoing femoropopliteal and femorodistal reconstruction. Runoff was characterized as good, fair, or poor. Determination of graft patency was made by clinical examination, ankle-brachial index measurement, or duplex scanning at 1 month and thereafter at 6-month intervals. Cumulative patency rates were calculated according to the actuarial life table method. Patency rates in limbs with good runoff were better than in limbs with fair and poor runoff; at 6 months, patency rates were 88.2%, 70.9%, and 21.8%, respectively (p < 0.01). Similar patency rates were found for good runoff in femoropopliteal and femorodistal reconstructions (84.7% in femoropopliteal and 75% in femorodistal reconstructions) at 6 months. The authors conclude that this method of angiographic evaluation accurately predicts patency in infrainguinal bypass reconstructions.

Adult↗

PubMed2004

Familial risk of lymphoproliferative tumors in families of patients with chronic lymphocytic leukemia: results from the Swedish Family-Cancer Database.

The importance of genetic factors in etiology of chronic lymphocytic leukemia (CLL) is suggested by family and population studies. However, the spectrum of malignancies sharing common genetic factors with CLL and the effects of sex and age on familial risk are unknown. We used the Swedish Family-Cancer Database to test for increased familial risks of CLL and other lymphoproliferative tumors. Cancer diagnoses from 1958 to 1998 were assessed in 14 336 first-degree relatives of 5918 CLL cases and in 28 876 first-degree relatives of 11 778 controls. Cancer risks in relatives of cases were compared with those in relatives of controls using marginal survival models. Relatives of cases were at significantly increased risk for CLL (relative risk [RR] = 7.52; 95% confidence interval [CI], 3.63-15.56), for non-Hodgkin lymphoma (RR = 1.45; 95% CI, 0.98-2.16), and for Hodgkin lymphoma (RR = 2.35; 95% CI, 1.08-5.08). CLL risks were similar in parents, siblings, and offspring of cases, in male and female relatives, and were not affected by the case's age at diagnosis. Anticipation was not significant when analyzed using life table methods. We conclude that the familial component of CLL is shared with other lymphoproliferative malignances, suggesting common genetic pathways. However, because clinically diagnosed CLL is uncommon, absolute excess risk to relatives is small.

Age of Onset↗

PubMed2002

Quantitative risk assessment for lung cancer after exposure to bitumen fume.

An international cohort of asphalt workers was assembled to study cancer risk after bitumen exposure. This article describes the combination of the exposure assessment with the exposure-response for a quantitative risk assessment for lung cancer mortality within the Dutch component of the study. We identified a retrospective cohort of 3,709 workers with at least one season of employment. Semi-quantitative exposure to bitumen fume was estimated by a job-exposure matrix. Exposure-response relations were fitted by Poisson regression, and excess lifetime risks through age 75 were calculated by a life table method. Working lifetime cumulative exposure to bitumen fume was calculated under different scenarios, representing past and future exposures. For workers with exposures accumulated in the past, excess risks for lung cancer varied from 7.8 to 14.3%. Calculations for future exposures resulted in considerably lower excess risks ranging from 0.6 to 2.6%. The calculated excess risks for lung cancer mortality after working lifetime exposure to bitumen fume depend strongly on when exposure was experienced and to some extent on the exposure-response model chosen, while confounding by smoking cannot be ruled out. Nevertheless, the excess lifetime risk for lung cancer in this Dutch cohort of asphalt workers is above benchmark risks as applied by the Dutch Health Council. Current exposure levels have decreased this risk considerably, but further exposure control may be required.

Adult↗

PubMed2005

Endpoints and survival analysis for successful osseointegration of dental implants.

We review and adapt modern survival analysis adapted for evaluating the success of dental implants is reviewed. A defined composite success criterion is a valuable tool for assessing new developments of dental implants. However, several inaccuracies are detected in the relevant dental literature. The Kaplan-Meier estimator is distinguished from ad-hoc life table methods and crude cumulative percentages, and generally, the usage of confidence intervals is emphasized. This article reviews the definition of implant success also. For the example of longitudinal measurements of the peri-implant bone level, it is shown how to derive success probabilities by time-to-event analysis. It is concluded that advanced statistical methods and well-defined endpoints are needed to achieve meaningful and comparable results. The article is illustrated using the data of a familiar implant system (TPS-SteriOss).

Bone Resorption↗

PubMed2002

Survival of multiple sclerosis in Finland between 1964 and 1993.

The long-term survival of multiple sclerosis (MS) was studied during 1964-1993 in a cohort of 1614 patents in Finland. Survival to death from the initial MS symptoms was analysed by the life-table method, separately for MS related and all causes of deaths. Survival at 40 years was 64% for MS deaths and 53% for all deaths. Higher proportions of violent deaths and neoplasms were observed among MS patients as compared to the general population, whereas the proportion of cardiovascular causes of death was low. MS-related causes accounted for 70% of the recorded 219 deaths. Favourable survival in MS was associated with relapsing-remitting disease course, age at onset below 30 years and optic neuritis or other sensory symptoms at presentation. We were unable to show any significant effect due to calendar time of diagnosis or gender, as the risk of men was similar (risk ratio [RR] = 1.1, confidence interval [CI] 0.8-1.6) as compared to women.

Adult↗

PubMed1976

Lithium carbonate prophylaxis failure.

Data from non-rapid-cycling bipolar (manic-depressive) patients who were receiving long-term treatment with lithium carbonate were analysed by the life table method to determine when lithium carbonate prophylaxis failures occurred. Forty-four of 96 patients failed to keep well in spite of maintenance lithium therapy. The analysis revealed an early, rapid failure rate during the first six months of treatment, which was followed by a slower rate of failure. Several clinical factors were assessed to determine if any of them predicted which patient would experience their initial failure in the early or late interval, but none of these factors, which included age, sex, age of onset, rate of affective attacks, family history, and the nature of the preceding episode, were found to have any predictive value regarding lithium prophylaxis failure. We found, however, that patients who had early failures tended to have a subsequent early failure in spite of continued maintenance with lithium carbonate.

Adult↗

PubMed1983

Risk factors in schizophrenia: season birth in Maryland, USA.

The association between the risk for schizophrenia and season of birth was studied using a standard actuarial life table method. This method of analysis eliminates the possibility of the previously described statistical artifacts from the data. An increased risk for schizophrenia for winter born individuals was demonstrated. The analysis also supported the hypothesis that season of birth is associated with an increased risk for a subtype of schizophrenia.

Actuarial Analysis↗

PubMed1989

Excellent outcome of stage II neuroblastoma is independent of residual disease and radiation therapy.

The optimal management for patients with stage II neuroblastoma has not yet been established. In order to determine the impact of adding chemotherapy and/or radiation therapy to surgery, we reviewed by questionnaire 156 patients with stage II neuroblastoma treated by 28 Childrens Cancer Study Group (CCSG) institutions from 1978 to 1985. Survival and progression-free survival (PFS) were analyzed by life-table methods with respect to age at diagnosis, site and size of primary tumor, spinal cord involvement, extent of initial resection, and treatment in addition to surgery. The overall 5-year survival was 96%; the PFS was 90%, similar to previous CCSG studies. Age at diagnosis had a small impact on PFS, with 92% PFS for patients less than 2 years of age at diagnosis, and 84% for those greater than 2 (P = .10). The only site with an adverse outcome was the head and neck (n = 11), with a PFS of 68% compared with 93% for the remaining sites (P = .02). Size of primary and intraspinal extension of primary did not affect PFS. The extent of resection and subsequent treatment with radiation therapy and/or chemotherapy did not affect the PFS. The outcome for 75 patients treated with surgery alone (6-year PFS, 89%) was not significantly different from that of 66 patients receiving radiation therapy (6-year PFS, 94%). There was no significant difference between 40 patients with gross or microscopic residual disease treated with surgery alone (PFS, 92%) and 59 patients with residual disease who also received radiation (PFS, 90%). Five of seven patients who progressed after surgery alone have been salvaged with further therapy and are now free of disease. One survives with disease, so that the 6-year survival is 98% for those treated initially with surgery alone, compared with 95% for those receiving radiation therapy and/or chemotherapy. These data suggest that surgery alone, even if complete resection is not achieved, is sufficient initial therapy for stage II neuroblastoma. The data also identify another stage of neuroblastoma, in addition to stage IV-S, for which almost all patients have a favorable prognosis because their tumor may be biologically limited in growth.

Abdominal Neoplasms↗

PubMed1983

Recovery of behavioral abnormalities after right hemisphere stroke.

We studied recovery of function in 41 patients with right hemisphere stroke. Recovery was rapid for left neglect, prosopagnosia, anosognosia, and unilateral spatial neglect on drawing (USN). Recovery was slower for h mianopia, hemiparesis, motor impersistence, and extinction. Rates of recovery were intermediate for constructional apraxia and dressing apraxia. Sex had no influence on the rate of recovery. Younger patients recovered from prosopagnosia more rapidly than older patients. Patients with smaller lesions recovered more quickly from anosognosia, USN, and hemiparesis than patients with larger lesions. Patients with hemorrhages recovered more rapidly from constructional apraxia, neglect, and motor impersistence than patients with infarcts. Recovery of function and the factors influencing recovery can by studied systematically by life table methods.

Age Factors↗

PubMed1994

Risk of dementia after stroke in a hospitalized cohort: results of a longitudinal study.

Stroke is considered the second most common cause of dementia, but the magnitude of the risk posed by stroke has not been fully clarified. The aim of this study was to determine the long-term risk of developing dementia after stroke onset in a hospitalized cohort. We prospectively examined 185 nondemented patients aged > or = 60 years hospitalized with ischemic stroke and 241 age-matched nondemented controls without stroke from the same community using neurologic, neuropsychological, and functional assessments given annually. Using criteria modified from the DSM-III-R, we diagnosed incident dementia based on the annual examination findings. We used life-table methods to estimate incidence in the two groups, Kaplan-Meier analysis to determine the proportion surviving without dementia, and Cox proportional-hazards analysis to compute the relative risk (RR) of dementia after 1 to 4 years of follow-up. The incidence of dementia was 8.4 per 100 person-years in the stroke group and 1.3 per 100 person-years in the control group. After 52 months of follow-up, the cumulative proportion (+/- SE) surviving without dementia was 66.3 +/- 5.5% for stroke and 90.3 +/- 4.3% for control subjects. The RR of dementia associated with stroke compared with controls was 5.5 (95% CI, 2.5 to 11.1) after adjusting for demographic factors. Older age at stroke onset and fewer years of education were significant covariates, but sex and race were not. A low score on the Mini-Mental State Examination at baseline was a significant predictor when added to this model.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1987

Immediate and long-term prognoses of acute myocardial infarction: analysis of determinants of prognosis.

In order to investigate the immediate and long-term prognoses of acute myocardial infarction, we followed up 790 consecutive patients who were admitted to the Sakurabashi Watanabe Hospital within 24 hours after the onset of infarction from January 1975 to December 1984 and evaluated early mortality, cumulative survival rate after discharge, cause of death and occurrence of recurrent myocardial infarction during follow-up. Early mortality (within 30 days after the onset) in all patients was 17.6% and declined serially in the most recent five years. Pump failure was the most common cause of death, followed by cardiac rupture and arrhythmias. Age, gender (female), presence of a previous infarct and anterior infarction were important contributing factors to the immediate prognosis. One hundred and thirty-five of the 651 patients who survived one month after the onset of infarct died during the follow-up period (mean follow-up interval: 41.0 +/- 29.9 (SD) months). Cumulative survival rates calculated by the life-table method at one and 5 years after the onset were 91.0% and 76.0%, respectively, and the average annual mortality in the first 5 years was 4.8%. Age and reinfarction were the important determining factors of long-term prognosis. Recurrent myocardial infarction, pump failure and sudden cardiac death were common causes of late death. One hundred and two reinfarctions in 93 patients occurred during the follow-up period. Thirty-two of 93 patients (34.4%) died due to fatal reinfarction. These results indicate that the immediate prognosis of acute myocardial infarction has improved serially, but the long-term prognosis is still poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2005

The risk of radiation-induced cancer in patients with squamous cell carcinoma of the head and neck and its results of treatment.

The purpose of this study was to determine the incidence and the results of treatment of cancer induced by radiotherapy for early stage (stage I and II) squamous cell carcinoma of the head and neck (SCH). The clinical records of 355 patients with early stage malignant lymphoma of the head and neck region treated by radiotherapy were reviewed, and then the records of 1358 patients with early stage SCH (oral cavity, 956; larynx, 154; oropharynx, 110; maxillary sinus, 86; lip, 20; epipharynx, 17; hypopharynx, 15) who underwent radiotherapy were reviewed. The disease-specific 10-year survival rate of the patients with 355 malignant lymphoma was 61%, and 5 cases of radiation-induced cancer occurred more than 8 years after irradiation. The crude incidence of radiation-induced cancer in the malignant lymphoma patients was 1.4%, and the 10-year probability by the actuarial life table method was 0.8%. The 10-year survival rate of the early stage SCH patients was 71%. The crude incidence of a second cancer in a previously irradiated field after an 8-year latent period (SCI) in the SCH patients was 1.8% (25/1358), and the 10-year probability was 1.6%. 12 SCIs were treated by surgery and 8 of those 12 patients (67%) resulted in success, whereas treatment by radiation resulted in failure in every other case. The risk of SCIs in the SCH group was higher than in the early stage malignant lymphoma group, although the difference was not statistically significant. The possibility of radiation-induced cancer in SCH is small, and the advantage of radiation therapy compares favourably with the risks of other treatments.

Adolescent↗

PubMed1977

Results of conservative surgery for middle ear cholesteatoma.

A retrospective study was carried out to analyze treatment results for cholesteatoma at the University of Iowa Hospitals and Clinics. All patients undergoing primary surgical treatment from January 1, 1969 to December 31, 1973 were followed through October 1976. Treatment failures were based on the occurrence of postoperative cholesteatoma. The probability of being disease free for periods up to five years after original surgery was then estimated for each type of operation. Postoperative cholesteatoma occurred after atticotomy in 17%, intact canal wall mastoidectomy in 35%, and modified radical mastoidectomy in 9%. The postoperative cholesteatoma rate in the group having intact canal wall mastoidectomy was more than twice as high for those patients under age nine. The likelihood of being disease free five years after intact canal wall surgery was estimated to be 36% using the life table method. Disease recurrence was significantly higher after intact canal wall surgery compared to other surgical methods. The effectiveness of this method should be evaluated in a randomized, prospective manner to minimize patient selection and treatment bias.

Adolescent↗

PubMed2006

Twins and their health cost: consequences of multiple births on parental health and mortality in Denmark and England and Wales.

The rapid increase in twinning rates in developed countries has increased interest in the question as to whether twin mothers have higher mortality and more health problems than mothers of singletons. Here we use a national survey, the Office for National Statistics Longitudinal Study of England & Wales, and a linkage between the Danish Twin Registry and the Danish population register to examine mortality patterns after age 45 (50 for fathers) for twin parents and the whole population born from 1911 to 1950. For England and Wales, presence of limiting long-term illnesses and self-rated health status was also investigated. Overall similar health and mortality was found for twin parents and the whole population although both life table methods and survival analysis suggested a slight excess mortality among older cohorts of twin mothers in England and Wales.

Adolescent↗

PubMed1995

Long-term survival of patients with coronary artery disease during the 1970s. A cohort study.

STUDY OBJECTIVE: This study was undertaken to determine the effects of altered risk factors and treatment modalities on the short- and long-term survival of patients with documented coronary artery disease whose conditions were diagnosed from 1972 through 1982. STUDY DESIGN: The study was a retrospective database analysis of clinical, angiographic, and follow-up information. SETTING: Data from all patients referred for cardiac catheterization at the Baptist Memorial Hospital, Memphis, Tenn, were studied. PATIENTS: Risk factors and survival of patients who underwent cardiac catheterization from 1972 through 1982 and who were followed up for at least 5 years were evaluated. Cohort A included 1,821 patients studied from 1972 through 1977; cohort B included 5,369 patients studied between 1977 and the end of 1982. Each cohort was subdivided based on type of therapy (medical or surgical) that the patients received. MEASUREMENTS AND RESULTS: The 30-day (short-term) and 5-year (long-term) survival rates were compared by life table methods. Short-term survival improved significantly in both medical (from 94.9% to 97.5%, p < 0.001) and surgical (from 95.5% to 97.6%, p < 0.001) groups from cohort A to cohort B. Long-term survival, however, did not differ significantly between the two cohorts. In the medical group, 5-year survival in cohort A was 86.3% and in cohort B it was 86.9% (p = NS); in the surgical group, cohort A it was 89.1% while in cohort B it was 89.4% (p = NS). Prevalence of both cigarette smoking and hypercholesterolemia declined significantly from cohort A to cohort B in both surgical and medical groups. However, advanced age, female gender, and previous myocardial infarction were significantly more common in cohort B than in cohort A for both treatment groups. CONCLUSIONS: These results indicate that during the study period, a significant decline in short-term mortality occurred for patients with angiographically documented coronary artery disease. Long-term survival did not, however, improve possibly due to a complex interplay between factors that promote coronary artery disease, eg, cigarette abuse and hypercholesterolemia, and factors that determine survival, eg, increase in age and history of prior infarction and advances in medical and surgical therapy.

Aged↗

PubMed1988

Long-term effect of occupational dust exposure.

In 1950-1960, a cohort of dust-exposed workers and a cohort of multiple matched unexposed subjects was set up from the files of preventive medical checkups performed in 1,089 Viennese plants. Male workers with a history of long-term exposure to nonfibrous particulates in different industries (metal, ceramics, brick, glass, stone etc.) aged greater than or equal to 40, and male workers without dust exposure (matched for residency, start of observation, age, and smoking) were followed up to 1980 or death (48,960 person yr). By life table methods, dust-exposed workers compared to unexposed workers showed a reduced survival of age 60 (p less than 0.0001), due to lung cancer (123 exposed, 87 controls, p = 0.001), stomach cancer (48/27, p = 0.003), silicosis (40/0), emphysema, bronchitis and asthma (41/23, p = 0.007). No difference in mortality from cardiovascular diseases was observed (p greater than 0.50). We concluded that heavy and long term exposure to respirable particulates is related to increased lung cancer mortality after age 60. A comparison of 2,212 deaths among Austrian silicotics, with deaths in the corresponding population showed a relation between lung cancer and silicosis (p less than 0.001), fairly independent of age and time-period. The estimated relative lung cancer risk of Austrian silicotics in the period 1955-79 averaged 1.41 (95% confidence 1.21-1.64).

Actuarial Analysis↗

PubMed2002

[Survival of patients treated with hemodialysis and estimated expenses in the municipality of Ribeirao Preto - SP].

Using Life Table Method the present study estimated the survival of patients gone under hemodialysis, according to age group, from 1997 to 2000, in the Ribeirão Preto County. Based in probability of survival it was also estimated the expenses referred to the sessions of hemodialysis for patients that are beginning treatment. Nearly 60% of patients followed were alive after four years of study, show high survival. The results of this study show that the high expenditure with hemodialysis refers to the increase of survival of patients and not specifically the increase of demand of the therapy.

Adolescent↗

PubMed2001

[Employment "survival" among nursing workers at a public hospital].

This study aimed at estimating the employment "survival" time of nursing workers after their admission to a public hospital as a turnover index. The Life Table method was used in order to calculate the employment survival probability by X years for each one of the categories of workers. The results showed an accentuated turnover of the work force in the studied period. The categories nursing auxiliary and nurse presented low stability in employment while the category nursing technician was more stable.

Brazil↗