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Results for “Multivariate Analysis”

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PubMed1996

Colorectal cancer--a multivariate analysis of prognostic factors.

The data from 1050 patients who had undergone colorectal carcinoma resection at the University of Cologne between 1976 and 1990 were studied. The aim of the study was to determine the concomitant effects on survival of several patient characteristics (sex, age, tumour localization, blood transfusion) and histopathological variables (Dukes' staging). We first calculated survival rates, both including and excluding post-operative mortality. We set up a hierarchical log-linear model for the detection of relationships between selected crossclassified categorial variables. We then used Cox's proportional hazard regression method to study the relationship between survival and different prognostic patterns. Dukes' staging was shown to be a highly discriminating factor in survival (P<0.001). Survival rates were better in women (P<0.001), and better for younger patients (<70 years; P<0.001). Tumour site (colon; P = 0.0362) and blood transfusion (P = 0.0857) also correlated with survival.

Aged↗

PubMed2004

Exploratory behavior of F2 crosses of mouse lines selected for different brain weight: a multivariate analysis.

Principal component analysis of behavioural measures together with body and brain weight of hybrid F2 mice crosses between two lines selected for large (LB) and small (SB) brain weight yielded eight-factor solution explaining 75.1% of total variance. Two of eight factors had sufficient loading on brain weight and several behavioural measures. The factor analysis showed that, among F2 hybrids, mice with larger brain weight were characterised, in open-field test, by higher scores of locomotion in the periphery of arena and of rearing, as well as less frequent grooming and freezing than mice with smaller brain weight. F2 hybrids with larger brain weight moved faster and displayed stereotyped behaviour in the cross-maze test more frequently. In general, this diversity is in accord with the behaviour differences between parent LB and SB lines. The results show that, in mice fear-anxiety and stereotypic behaviours, which are known to interfere with normal exploration and learning of the environment, are causally connected with brain weight.

Animals↗

PubMed1999

Transcatheter arterial chemoembolization for hepatocellular carcinoma in patients with Child's grade A or B cirrhosis: a multivariate analysis of prognostic factors.

We evaluated factors affecting long-term survival after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) complicating cirrhosis. One hundred eighty-two patients with Child's class A or B cirrhosis and an HCC, not amenable to surgery or percutaneous ethanol injection, underwent 346 TACEs (mean 1.9) with epirubicin, iodized oil, and gelatin sponge. Many prognostic factors were subjected to univariate analysis and thereafter, when significant, to the Cox's hazard proportional model. Finally, the significant indices in the Cox's model were used to estimate the accuracy of the probability of death with computation of the area under the receiving operative characteristic (ROC) curve. The cumulative survival rates at 1, 2, 3, and 5 years were 0.83, 0.52, 0.40, and 0.16, respectively. According to Cox's model, the factors associated with significantly worse survival were the presence of ascites (p = 0.0027), elevated bilirubin levels (p = 0.0163), elevated alpha-fetoprotein (alphaFP) values (p = 0.0067), a tumor greater than 5 cm in diameter (p = 0.0001), and the absence of a tumor capsule-like rim (p = 0.0278). According to these parameters, the accuracy of the probability of death estimated with ROC analysis was 0.63. Minor and major complications occurred in 82 patients (45%) and caused death in 2 patients. Long-term prognosis after TACE for HCCs in patients with Child's class A or B cirrhosis depends on the presence of ascites, the bilirubin level, the alphaFP value, the diameter of the tumor, and the presence of a tumor capsule-like rim. However, when considered altogether, these variables are poor predictors to evaluate survival, and other factors should be investigated to identify subjects more responsive to TACE. Complications occur in a high percentage of patients, but they do not affect long-term prognosis.

Adult↗

PubMed1994

Luminal narrowing after percutaneous transluminal coronary angioplasty. A multivariate analysis of clinical, procedural and lesion related factors affecting long-term angiographic outcome in the PARK study. Post-Angioplasty Restenosis Ketanserin.

BACKGROUND: Long term luminal renarrowing after successful coronary balloon angioplasty is a major limitation of the technique. Knowledge of factors which influence long term luminal re-narrowing could be very valuable in selecting appropriate patients or lesions for the procedure and may therefore improve the medium term prognosis after angioplasty. Furthermore, modification or control of the identified risk factors could reduce overall restenosis. Additionally, identification of such factors would assist in the selection of high risk patients, who could then constitute the target population for pharmacological intervention studies. Thus the aims of the present study were to find independent patient, lesion and procedural related risk factors for the restenosis process. METHODS AND RESULTS: Quantitative angiography was performed on 742 successfully dilated lesions at angioplasty and 6 months follow-up. Long-term luminal re-narrowing was defined as the absolute change in minimal luminal diameter (MLD) from post PTCA to follow up. Univariate and multiple linear regression analysis of all available clinical, lesion and procedural variables was performed to identify variables with a significant contribution to the prediction of change in MLD. Gain in MLD at angioplasty, pre PTCA MLD, total inflation time and male sex were positively related to change in MLD while a positive smoking history, vessel and maximum balloon size were negatively related. The overall prediction of the model was poor (R2-0.14) suggesting that many factors influencing the process are still outside our understanding. CONCLUSIONS: These results indicate that re-narrowing after successful PTCA is a process which can be influenced by a number of clinical, angiographic and procedural characteristics but cannot yet be accurately predicted by these.

Aged↗

PubMed1992

Hepatocellular carcinoma: a multivariate analysis of prognostic features in patients treated with hepatic arterial embolization.

The prognosis after hepatic arterial chemoembolization was retrospectively analyzed in relation to therapeutic modalities, stage of tumor, and degree of liver cirrhosis in 150 patients with solitary tumors of hepatocellular carcinoma. The analyses of life-table methods revealed that adjunct hepatectomy, tumor size, bilirubin, albumin, globulin, and the 15-min retention rate of indocyanine green are statistically significant prognostic factors for hepatic arterial chemoembolization. Results of Cox's proportional hazard analyses disclosed that adjunct hepatectomy (p = 0.0001), serum albumin level (p = 0.0032), and stage of tumor (p = 0.0194) are statistically significant and independent prognostic factors. These findings suggest that the prognosis after hepatic arterial chemoembolization depends on the hepatic functional reserve and stage of tumor in patients with hepatocellular carcinoma, and adjunct hepatectomy improves the prognosis in these patients.

Adult↗

PubMedDate not supplied

Aortic insufficiency. A multivariate analysis of incremental risk factors for operative mortality and functional results.

The object of this study was to establish which of four chosen preoperative parameters, namely NYHA functional Class, cardio-thoracic ratio (CTR), left ventricular end-diastolic pressure (LVEDP) and ejection fraction (EF), might affect, singly or in combination, the operative risk in isolated, chronic aortic insufficiency (AI). To this purpose we reviewed the records of all adult patients consecutively operated upon in our Department for isolated chronic AI, from 1979 to 1985. Patients with associated cardiac disease, transvalvular aortic gradient, recent endocarditis of a malfunctioning bioprosthesis were excluded from the study, leaving 89 consecutive patients (mean age 47.2 years) for evaluation. St. Jude or Duromedics mechanical prostheses were exclusively used for aortic valve replacement (AVR). Post-operatively all patients received long term anticoagulation. Follow up period ranged from 24 to 109 months (mean 61.8 months). The method of analysis was designed as follows: a) each patient was allocated a positive (+) or a negative (-) variable for the value of each parameter, b) five patient groups were formed on the basis of the free association of parameter variables, c) single variables and their association with early and late mortality, functional results as NYHA Class were compared by statistical methods (chi 2, Student's Test, Wilcoxon Test). The results of the study show: a) only EF significantly influenced early mortality (P less than 0.05), b) late mortality was significantly influenced (P less than 0.001) by NYHA Class and CTR, c) single parameter variables (+ or -) and or their association significantly conditioned functional results.

Aortic Valve↗

PubMed1993

[Cerebral infarcts and length of stay--a multivariate analysis].

This paper investigates by factor analysis the correlation between kind of ischemic stroke, risk factors, complications of the clinical course and duration of hospitalization of 1105 patients admitted to hospital with acute ischemic stroke in the period of 1.1.86-31.12.90. There was no correlation between increasing age and duration of hospitalization. Especially young men with ischemic stroke combined with carotid artery stenosis and cigarette smoking need the longest time of treatment in hospital. Smoking seems to be a predicting factor for worse prognosis of neurological deficits. Acute strokes in patients with cerebral microangiopathia have the best prognosis and the shortest period of hospitalization. In other patients infectious complications of immobilisation as pneumonia or urinary infections and need of care--especially older women--cause longer periods of hospitalization.

Aged↗

PubMed2002

Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy.

BACKGROUND: The majority of colorectal cancers are still diagnosed in patients who present with symptoms especially in countries where colorectal screening programs are not practised. The aim of our study was to determine the predictive factors for colorectal cancer in patients referred for colonoscopy. METHODS: A prospective study of 485 consecutive patients who underwent colonoscopy during a 22-month period was performed. All patients answered a detailed questionnaire. Indications for colonoscopy and the findings were recorded. RESULTS: The mean age of the study population was 55.7 +/- 14.7 years. There were 221 (45.6%) males and 264 (54.4%) females. Sixty-five (13.4%) were Malays, 298 (61.4%) were Chinese and 112 (23.1%) were Indians. Multiple backward stepwise regression analysis revealed that independent predictors for colorectal cancer (odds ratio [95% CI]) were the presence of rectal bleeding (4.3 [4.0-8.0]) and iron deficiency anemia (4.0 [3.6-10.2]). In those aged 50 and over, male gender (4.5 [2.2-9.3]) and abdominal pain (3.1 [1.4-6.7]) were also significant positive predictors of cancer. CONCLUSIONS: With the ever-increasing demand for gastrointestinal endoscopy, the appropriate utilization of colonoscopy is essential to afford prompt patient evaluation. Our study supports the need to prioritize the use of colonoscopy in patients with rectal bleeding and iron deficiency anemia. In the older patient where the background prevalence of colorectal cancer is higher, referral for colonoscopy is also justified.

Anemia, Iron-Deficiency↗

PubMed2001

[Multivariate analysis as a method of determination of anthropogenic load on the course of Raynaud's disease in patients with systemic scleroderma and systemic lupus erythematosus].

AIM: To determine the effect of high industrial pollution on development of Raynaud's syndrome and impairment of pulmonary hemodynamics in patients with scleroderma systematica (SS) and systemic lupus erythematosus (SLE). Two groups of patients were examined: 20 SS and 33 SLE patients living in highly polluted territories, 15 SS and 27 SLE patients living in moderately contaminated territories. The tests included capillaroscopy, thermography, rheovasography of the fingers, zonal rheopulmonography. Semiquantitative spectral analysis measured content of 3 trace elements (Ti, Ba, Li) and 16 heavy metals (Cu, Zn, Pb, Ni, Mn, Sn, Cr, Y, Ga, Ag, Mo, Bi, Co, Cd, Fe, Zr) in the patients' hair. RESULTS: Patients living in highly polluted areas had a severe course of Raynaud's syndrome. Metal accumulation is decisive in patients of group 1; in development of staging of Raynaud's syndrome the key role belongs to lead, nickel, tin and iron; realization of the factor of the disease activity is related to lowering of zinc, copper concentrations and growing concentration of nickel. CONCLUSION: Vascular disorders in SS and SLE in patients living in heavily contaminated areas aggravate due to direct damage from heavy metals.

Environmental Pollutants↗

PubMed1997

Risk factors, complications, and outcome in surgery: a multivariate analysis.

OBJECTIVE: To correlate variables recorded perioperatively with morbidity and mortality in an attempt to assess the predictive value of these variables for the outcome of individual patients. DESIGN: Prospective study. SETTING: Teaching hospital, Germany. SUBJECTS: 6304 consecutive patients admitted for operation. INTERVENTIONS: Recording of American Society of Anesthesiologists (ASA) class, age, sex, operation class (Hoehn), anaemia, hypertension, bronchopulmonary disease, diabetes mellitus, renal failure, major gastrointestinal disease, type of anaesthesia, operation (and whether emergency or elective), and duration of operation. All these factors were subjected to logistic regression analysis. MAIN OUTCOME MEASURES: Odds ratio (OR), sensitivity, specifity, and positive and negative predictive values. RESULTS: We studied 6304 patients of whom 140 died postoperatively and 1432 developed complications from which they survived. The variable that had most influence on the risk of postoperative complications was the ASA class (ASA class 4, OR 4.2, and ASA class 3, OR 2.2) followed by the severity of the operation (OR 1.86). An uncomplicated course was correctly predicted in 96%, but complications were correctly predicted in only 16%. The positive predictive value was 57%, and negative predictive value 80%. CONCLUSIONS: Despite the fact that we considered a large number of variables we were unable to predict the risk of complications for individual patients with any accuracy.

Female↗

PubMed1992

Acute thrombosis of prosthetic valves: a multivariate analysis of the risk factors for a lifethreatening event.

In 3231 prosthetic valves implanted between January 1975 and November 1990, we observed 61 cases of prosthetic obstruction of biological origin with clinical and laboratory findings of severe functional impairment which required surgery as emergency treatment. The hospital mortality was 19.67% (12/61). The obstruction was due to a primary thrombosis in all 5 bioprostheses which were not anticoagulated and in 11/56 (19.64%) mechanical prostheses of which 3 were not anticoagulated and 4 were not properly anticoagulated. The obstruction was due to fibrous tissue overgrowth in the other 45 mechanical prostheses (80.35%) with secondary thrombosis in 34 cases (60.71%) and no thrombosis in 11 (19.64%); 71.11% of these prostheses were adequately anticoagulated. Of the 61 obstructed prostheses, 53 were mitral and 8 were aortic. No tricuspid obstruction was observed. A statistical assessment by multiple correspondence, cluster and chi square analysis was performed in two groups of patients with different models of mechanical mitral prostheses. The 5-year actuarial incidence of obstruction was 6.08%. Significant risk factors were: tilting disc prostheses, prostheses without pyrocarbon coating, large prostheses, tilting disc prostheses with a small orifice posteriorly oriented, atrial fibrillation, enlarged left atrium, time from implant greater than 4 years, age between 40 and 50 years. In our opinion, prosthetic obstruction may be referred to a primary thrombosis only in cases where it may be prevented by adequate anticoagulation. In most cases, the obstruction is produced by periprosthetic fibroblastic proliferation which may develop in spite of adequate anticoagulation in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1999

Relationships between volatile production, fruit quality, and sensory evaluation in Granny Smith apples stored in different controlled-atmosphere treatments by means of multivariate analysis.

Aroma compounds, quality parameters, and sensory evaluation of Granny Smith apples were analyzed after 3, 5, and 7 months of cold storage in three controlled-atmosphere (CA) treatments, in which oxygen and carbon dioxide were held at 1, 2, and 3%. During poststorage ripening, the apples were kept at 20 degrees C for 1, 5, and 10 days before analytical measurements were made. The highest volatile emission was obtained after 5 months of storage in all CA treatments, reaching its highest value when a low-oxygen CA (LO) was used. Ultralow-oxygen CA (ULO) showed the highest ability to maintain apple firmness. The correlation among analytical and sensory parameters suggests that ethyl 2-methylbutyrate, 1-butanol, pentyl acetate, and tert-butyl propionate are the aroma compounds with the highest influence in the sensorial score. Concerning CA treatments, LO and ULO appear to be very valuable technologies for maintaining the sensorial quality even after 7 months of storage.

Alcohols↗

PubMed1994

The prognostic significance of c-erbB-2 and p53 protein expressions in gastric carcinoma--a multivariate analysis of prognostic factors.

152 curative gastrectomy specimens from patients with gastric carcinoma were examined in an attempt to assess the prognostic value of c-erbB-2 and mutant p53 protein expressions. The labeled streptavidin-biotin method was applied to routinely fixed and paraffin-embedded tissue sections, using the polyclonal and monoclonal antibodies against the c-erbB-2 protein and the mutant form p53 protein, respectively. In this examination, staining of c-erbB-2 protein was found in 9.2% of these carcinomas. The c-erbB-2 stained tumors were significantly associated with the tumors whose diameters were smaller than 5cm, and were more likely to be associated with serosal invasion and nodal involvement than the unstained ones. However, there was little association between staining of c-erbB-2 protein and clinicopathologic findings such as age, sex, location, histology, gross type, lymph node status, depth of invasion, and stage. The survival analysis of 104 patients with stage III gastric carcinoma revealed no significant association between c-erbB-2 staining status and survival duration. The 5-year survival rates of the c-erbB-2 positive group and its negative group were 21% and 28%, respectively. Positive p53 protein expression was observed in 46% of 152 carcinomas. There was no significant association between p53 expression and parameters such as age, sex, location, histology, gross type, and size. The p53 stained tumors were more likely to be associated with lymph node metastasis, serosal invasion than p53 unstained ones; but this did not reach significance. The 5-year survival rates of the p53 positive group and counter part group were 27% and 31%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2000

Antenatal predictors of the neurologic sequelae at 3 years of age: a multivariate analysis.

OBJECTIVE: To study the association between fetal blood flow abnormalities and the occurrence of long-term neurologic sequelae. STUDY DESIGN: Umbilical, aortic and middle cerebral artery blood flow parameters were obtained by Doppler examination and retrospectively analyzed in 128 high-risk singleton pregnancies, followed by neurologic examination of the surviving children at 3 years of age. Traditional parameters of neurologic outcome (Apgar scores, intrauterine growth retardation (IUGR), umbilical artery pH and base deficit, gestational age, birth weight, newborn encephalopathy, mode of delivery, fetal heart rate, neurosonographic examination) were included as possible confounding factors. Mann-Whitney U-test, Student's t-test, analysis of variance or Fisher's exact test, where applicable, were used for the univariate analysis. A stepwise logistic regression procedure was conducted to test the independent association of selected perinatal risk factors on neurological outcome. Statistical significance was assumed at P<0.05. RESULTS: Eighteen out of 114 surviving children suffered neurologic illness at 3 years of age. Four children had major neurologic dysfunction and the remaining 14 suffered minor or mild form of the disease. Although blood flow parameters and various perinatal parameters did not differ significantly between the group of children with major neurologic dysfunction and healthy children, aortic resistance index showed an independent association with occurrence of minor or mild neurologic disabilities. CONCLUSION: Antenatal evaluation of the aortic blood flow might be an important predictive variable for permanent neurologic disturbances.

Apgar Score↗

PubMed1994

Acute and chronic nicotine effects on measures of activity in rats: a multivariate analysis.

Nicotine has been reported to increase or decrease measures of activity in rats, including locomotor activity and rearing. Nicotine dose and repeated exposure to nicotine are known to be important factors in determining the effects on locomotor behavior. Less information has been gathered on rearing and other measures of activity. Rats were tested repeatedly, once per day, in Digiscan automated activity analyzers that reported 19 measures of activity. Each rat was given the same drug and dose each day, either saline or 0.1, 0.2, or 0.4 mg/kg nicotine. The 19 measures were combined or modified to produce 14 measures that were examined using factor analysis to help select the most independent measures. Four measures were selected to describe the effects of dose and to compare day 1 results with day 5 results. Total distance moved was increased in a dose-related fashion and was greater on day 5 than on day 1. Rearing was increased at low doses and decreased at high doses on both days. Stereotypy was increased approximately the same amount by all three doses, and was greater on day 5 than on day 1. Center time was increased by the highest dose on both days. These results once again point out the influences of repeated testing and repeated nicotine exposure on behavior. They may also help to clarify why some studies have reported that both ambulation and rearing are increased after nicotine whereas others find opposite effects.

Animals↗

PubMed1992

Donor hyperglycemia as a minor risk factor and immunologic variables as major risk factors for pancreas allograft loss in a multivariate analysis of a single institution's experience.

The impact of multiple donor and recipient variables on functional survival of 307 cadaveric pancreas allografts transplanted in 253 recipients at the authors' institution between July 25, 1978 and September 4, 1990 was determined using the Cox proportional hazards regression model. Relative risk of graft loss was calculated for all cases as well as for technically successful (TS) ones. Factors with an impact in descending order of significance for TS cases were immunosuppression (RR = 3.9 for double-drug versus triple-drug maintenance, p less than 0.0001); recipient category (RR = 2.4 for pancreas alone versus simultaneous pancreas/kidney, p = 0.009); retransplantation (RR = 1.8 for retransplants versus primary grafts, p = 0.007); donor hyperglycemia (RR = 1.7 for blood glucose greater than or equal to 200 versus less than 200 mg/dL, p = 0.02); human leukocyte antigen (HLA) matching (RR = 2.1 for poor versus a good match, p = 0.04). A logistic regression analysis also was performed to determine which factors predisposed to technical failure; none were identified. To make the model as relevant as possible to their current program, the authors analyzed only the bladder-drained cases (n = 221; 1984 to 1990). All patients received triple therapy. Recipient category, retransplantation, donor hyperglycemia, and degree of HLA matching remained as significant risk factors. Construction of estimated survival curves showed that the results of retransplantation were significantly improved, and the penalty incurred by using hyperglycemic donors was partially ameliorated by using well-matched donors. Because preservation times up to 30 hours did not exert an adverse effect on outcome, an argument is made to share pancreata between centers to achieve good matches.

Female↗

PubMed2004

Risk factors for erosive esophagitis: a multivariate analysis based on the ProGERD study initiative.

OBJECTIVES: Gastroesophageal reflux disease can be divided into three categories: nonerosive GERD (NERD), erosive GERD (ERD), and Barrett's esophagus. A shift among these categories rarely occurs. The aim of the present study was to elucidate potential patient-associated risk factors associated with ERD. METHODS: A total of 6,215 patients with troublesome heartburn were recruited to a large, prospective, multicenter open cohort study comprising an initial treatment phase and a 5-yr follow-up phase. Each center planned to recruit an equal number of patients with NERD and ERD. All patients underwent an interview based on standardized questionnaires, a physical examination, and endoscopy with biopsies. Data were analyzed by multiple logistic regression analysis. RESULTS: Risk factor analysis was performed on 5,289 patients (NERD: n = 2,834; ERD: n = 2,455), which was the intent-to-treat population excluding patients with suspected/proven complicated reflux disease. Stepwise regression analysis identified the following independent predictors of ERD: male gender, overweight, regular use of alcohol, a history of GERD >1 yr, and smoker or ex-smoker. A higher level of education and a positive Helicobacter pylori (H. pylori) status were associated with a lower risk of ERD. CONCLUSIONS: Some patient-associated factors increase the risk of erosive esophagitis as opposed to nonerosive reflux disease. However, no single factor or combination of factors is capable of predicting mucosal damage with clinically sufficient certainty. Thus, endoscopy is still required in all GERD patients if valid information on the state of the esophageal mucosa is needed.

Adult↗

PubMed1990

A multivariate analysis of risk factors for cytomegalovirus infection in liver-transplant recipients.

Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.

Adolescent↗