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Results for “multivariate analysis”

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PubMed1995

[Analysis of risk factors in a group of patients referred for heart transplantation for refractory heart failure: multivariate analysis].

BACKGROUND: In the absence of evident clinical controindication heart transplantation can be performed in patients with critical degree of cardiac failure. The choice of adequate candidates for transplantation is frequently based on clinical severness but also influenced by factors as body size, blood group and so on. METHODS: To identify the presence of prognostic factors for patients with high risk of death, clinical, hemodynamic and therapeutic features of 70 patients (mean age 44.8 +/- 13.8) with critical cardiac failure (64 patients in IV class N.Y.H.A.) have been reviewed. Most of them were affected by dilated or ischemic cardiomyopathy. RESULTS: All patients were admitted to Cardiac Intensive Care Unit, 13 patients received transplantation, 24 were discharged and 33 died. Univariate analysis evidenced, that in the group of patients who died, sepsis (p = 0.0003), renal (p = 0.04) and liver function impairment (P = 0.007) occurred significantly more frequent. The differentiated use of catecholamines (P = 0.0007) and of vasodilators (P = 0.007), the need of mechanical ventilation (P = 0.0001) and the need of hemodialysis (P = 0.02) resulted significantly higher in the group of dead patients where mean arterial pressure (p = 0.01) and mean systemic resistances (P = 0.04) resulted significantly lower. With multivariate analysis were identified following independent risk factors of death: male sex, infections, mechanical ventilation, differentiated use of vasodilators, mean arterial pressure and mean pressure in pulmonary artery. CONCLUSIONS: As predictive risk factors of death in patients with critical cardiac failure and awaiting transplantation resulted: sex, the presence of infection, mechanical ventilation and differentiated use of vasodilators whereas hemodynamic parameters did not result of important predictive value.

Adult↗

PubMed1991

Prognostic flow cytometric information in cervical squamous cell carcinoma: a multivariate analysis of 307 patients.

In a prospective study of 307 patients with invasive squamous cell carcinoma of the uterine cervix, the prognostic impact of flow cytometric parameters (ploidy level and the fraction of S-phase cells) and clinical variables was evaluated using univariate and multivariate analyses (Cox model). Mean follow-up time as 39 (4-84) months. A total of 93 patients died from their disease during the follow-up. The S-phase fraction was evaluable in 242 cases. By means of univariate models, lethality rate was found to increase significantly with increasing age, postmenopausal status, advancing stage, and increasing S-phase fraction. In a multivariate analysis of the clinical variables of age, stage, and grade, only clinical stage was prognostic. The inclusion of ploidy level in the analysis gave no additive prognostic information. In a multivariate analysis including all variables mentioned above, stage was the strongest predictor of survival. S-phase fraction was significantly related to survival both when studied as a continuous variable (P = 0.006) and when studied as a categorized variable (10, 15, 20% as cutoff points), and in this special analysis ploidy level was of prognostic interest with a poorer survival for near-diploid cases. The outcome was poorer with increasing age. The prognostic impact of the S-phase fraction remained highly significant in separate analyses of the clinically interesting stages Ib-IIb (P less than 0.001). We conclude that measurement of the S-phase fraction is of prognostic interest and may be used for the identification of high-risk patients within a given stage, whereas ploidy level yields little information.

Adult↗

PubMed1995

Thymoma: a multivariate analysis of factors predicting survival.

BACKGROUND: Despite complete surgical excision, malignant thymomas often recur with resultant death. We reviewed our series to determine which factors independently predict survival after surgical resection. METHODS: A retrospective analysis of patients operated on for thymoma between 1949 and 1993 at Memorial Sloan-Kettering Cancer Center was performed. Clinical data were collected from chart review. Only patients with a pathology report confirming the diagnosis of thymoma were included in this analysis. Kaplan-Meier survival curves were generated and comparisons of survival analyzed by log rank test. Multivariate analysis was performed by the Cox proportional hazard model. RESULTS: One hundred eighteen patients with thymoma underwent operation. There were 86 complete resections (73%), 18 partial resections (15%), and 14 biopsies (12%). By Masaoka staging, 25 patients were stage I (21%), 41 stage II (35%), 43 stage III (36%), and 9 stage IVa (8%). Overall survival was 77% at 5 years and 55% at 10 years. Tumor recurred in 25 (29%) of 86 completely resected thymomas. Stage of disease (p = 0.03) was the only independent prognostic factor affecting recurrence. By multivariate analysis, stage (p = 0.003), tumor size (p = 0.0001), histology (p = 0.004), and extent of surgical resection (p = 0.0006) were independent predictors of long-term survival. CONCLUSIONS: Patients with stage I disease require no further therapy after complete surgical resection. Neoadjuvant therapy should be considered for patients with large tumors and invasive disease.

Combined Modality Therapy↗

PubMed2003

Anterior skull base surgery for malignant tumors: a multivariate analysis of 27 years of experience.

INTRODUCTION: Few studies have examined prognostic factors that have an impact on outcomes in anterior skull base surgery by multivariate analysis. METHODS: We retrospectively examined our institution's skull base experience from 1973-2000. RESULTS: During this time, 166 patients underwent an anterior skull base resection for malignancy (median age, 53 years; range, 6-92 years). The 5-year relapse-free and disease-specific survival was 41% and 57% (median follow-up, 53 months). Multivariate analysis found that dural invasion, primary histologic diagnosis, and margin status had a significant impact on relapse-free and disease-specific survival. CONCLUSIONS: These data indicate that patients with anterior skull base malignancies are treated successfully with skull base surgery. Patients demonstrating adverse prognostic variables such as dural invasion, adverse histologic findings, and/or positive margins should be considered for the addition of adjuvant therapy or innovative therapies as they become available in the future.

Adenocarcinoma↗

PubMed1989

Superficial bladder cancer treated with bacillus Calmette-Guerin: a multivariate analysis of factors affecting tumor progression.

A multivariate analysis was performed on data from 221 patients with superficial bladder tumors (papilloma in 30, grade II to III stage Ta in 51, grade II to III stage Tis in 111 and grade II to III stage T1 in 29) who were treated with intravesical bacillus Calmette-Guerin and followed for a minimum of 24 months or until progression. The purpose of this analysis was to identify prognostic variables predictive of tumor progression defined as muscle invasion, metastasis or endoscopically uncontrolled superficial bladder carcinoma involving the bladder and/or prostatic urethra. Variables examined before bacillus Calmette-Guerin, and at 3 and 6 months after bacillus Calmette-Guerin included age, sex, race, purified protein derivative reaction, duration of disease, tumor category, tumor grade, multifocality, results of cytology, flow cytometry, cystoscopy, biopsy, prior chemotherapy and bacillus Calmette-Guerin treatment regimen. Significant variables (Cox regression analysis, p less than 0.07) for tumor progression were before bacillus Calmette-Guerin--stage T1 tumors and duration of disease less than 1 year, at 3 months after bacillus Calmette-Guerin--stage T1 tumor, duration of disease less than 1 year, positive cytology studies and multifocality, and at 6 months after bacillus Calmette-Guerin--stage T1 tumor, positive cytology and positive biopsy other than stage T1 tumors. Prognostic risk groups were best defined at 6 months after bacillus Calmette-Guerin, the probability of tumor progression thereafter being at 1, 3 and 5 years, respectively, as follows: for risk group 1 (T1 tumor)--71, 100 and 100 per cent, for risk group 2 (positive biopsy other than T1 plus positive cytology)--25, 79 and 100 per cent, for risk group 3 (either positive biopsy other than stage T1 or positive cytology studies)--18, 40 and greater than 81 per cent, and for risk group 4 (negative biopsy and negative cytology studies)--2, 11 and 26 per cent, respectively. Evaluation of patients with superficial bladder carcinoma at 6 months after intravesical bacillus Calmette-Guerin therapy identifies the probability of tumor progression. Patients at high risk for tumor progression require alternative treatment strategies, whereas low risk patients can be observed for further therapy if necessary.

BCG Vaccine↗

PubMed1982

Neonatal seizures. II. A multivariate analysis of factors associated with outcome.

A multivariate analysis of perinatal events occurring in infants with neonatal seizures who were enrolled in the National Collaborative Perinatal Project allowed prediction of outcome. This prediction of death or of mental retardation, cerebral palsy, or epilepsy was empirically confirmed 64% to 83% of the time. In an infant with neonatal seizures, a five-minute Apgar score of less than 7, the need for resuscitation after 5 minutes of age, the onset time of the seizures, and a seizure lasting more than 30 minutes are the best early predictors of which infants will die or will have significant neurologic sequelae. It is hypothesized that neonatal seizures may be a better indicator of the severity or duration of intrauterine asphyxia than the Apgar score. In the neonate with seizures, the use of the formula may allow identification of infants at high risk for adverse outcomes.

Apgar Score↗

PubMed1980

[Prediction of labor onset and difficulty by the multivariate analysis (author's transl)].

Based on the multivariate analysis, we analysed the weekly change of the antepartum cervical ripe (consistency, effacement, dilatation, position) and the station, then predict the labor onset and difficulty retrospectively. 1) According to longterm observation of the internal examination of 210 primipara, in third trimester, the ripe type increased, and the unripe type decreased are found. Because of the intermediate type increased and unmovable in incidence relatively, so based on the former scoring method of mere addition of scores, it appears ineffective to predict the labor onset. 2) We studied primipara 385 and multipara 434 from 6 weeks before labor. Based on the multiple regression analysis, we could predict the labor onset. The predict value is higher in multipara than primipara, on the primipara, 78.2% antepartum 6 weeks, 82.2% 4 weeks, 92.6% 2 weeks, and on the multipara 84.6%, 82.2%, 96.2% respectively. 3) Based on the method of Mahalanobis' generalized distance, we could predict the labor difficulty in the primipara and multipara. Accuracy of abnormal prediction are 77.1% at 4 weeks formula, 77.2% at 2 weeks formula on primipara; 69.0%, 69.2% respectively on multipara. Accuracy of normal prediction 53.3%, 56.9% on primipara; 30.9% (4 weeks formula) on multipara are found. The abnormal prediction is better than the normal prediction. This method can early predict the labor onset and difficulty than the former scoring method of mere additional scores.

Analysis of Variance↗

PubMed1979

Risk assessment of pulmonary embolism by multivariate analysis.

A prospective study of 6,527 hospitalized patients was performed to evaluate the effectiveness of multivariate analysis of risk factors to correctly designate risk for pulmonary embolism. History of previous pulmonary embolism was the single most important factor. In patients without prior history, five factors emerged: inactivity, congestive heart failure, Doppler ultrasound evidence of deep-vein occlusion, female sex, and black race. Used together, these factors permitted a discrimination of risk such that 68.7% of pulmonary embolization was found to occur in 32.2% of the population designated as showing increased risk. Multivariate analysis of clinical factors improved assessment of risk, compared to the use of lower extremity findings alone, and proved to be useful in identifying individuals at increased risk for pulmonary embolism.

Analysis of Variance↗

PubMed2003

Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: a multivariate analysis based on a prospective multicenter study of 4718 patients.

HYPOTHESIS: Infectious complications are the main causes of postoperative morbidity in abdominal surgery. Identification of risk factors, which could be avoided in the perioperative period, may reduce the rate of postoperative infectious complications. DESIGN: A database was established from 3 prospective, randomized, multicenter studies. Multivariate analysis was performed using nonconditional logistic regression expressed as an odds ratio (OR). SETTING: Multicenter studies (ie, private medical centers, institutional hospitals, and university hospitals). PATIENTS: From June 1982 to September 1996, a database was established containing the information of 4718 patients who underwent noncolorectal abdominal surgery. MAIN OUTCOME MEASURES: The dependent variables studied included surgical site infection (SSI) (divided into parietal and deep infectious complications with or without fistulas) and global infectious complications (SSI and extraparietal and abdominal infectious complications). RESULTS: The rate of global infectious complications was 13.3%; SSI, 4.05%; parietal infectious complications, 2.2%; deep infectious complications with fistulas, 2.18%; and deep infectious complications without fistulas, 1.38%. In multivariate analysis, the following 7 independent risk factors for global infectious complications have been identified: age (60-74 years, OR, 1.64; >or=75 years, OR, 1.45); being underweight (OR, 1.51); having cirrhosis (OR, 2.45), having a vertical abdominal incision (OR, 1.66); having a suture placed or an anastomis of the bowel (OR, 1.48) in the digestive tract; having a prolonged operative time (61-120 minutes, OR, 1.66; 121 minutes, OR, 2.72); and being categorized as having a class 4 surgical site (ie, obese patients or having a risk factor of a healing defect) (OR, 1.66). Ceftriaxone sodium therapy was identified as a protective factor (OR, 0.43). In multivariate analysis, the following 5 independent risk factors for SSI have been identified: the existence of a preoperative cutaneous abscess or cutaneous necrosis (OR, 4.75), having a suture placed or an anastomosis of the bowel (OR, 1.82) in the digestive tract, having postoperative abdominal drainage (OR, 2.15), undergoing a surgical procedure for the treatment of cancer (OR, 1.74), and receiving curative anticoagulant therapy (OR, 3.33) postoperatively. CONCLUSIONS: Our data show that risk factors for SSI and for global infectious complications are disparate. Indeed, only the placement of a suture or having an anastomosis of the bowel in the digestive tract is a risk factor for both SSI and global infections. Some of these factors may be modifiable before or during the surgical procedure to reduce the infection rate or to prevent postoperative complications.

Adult↗

PubMed2001

Multivariate analysis of regional metabolic differences in normal ageing on localised quantitative proton MR spectroscopy.

We performed multivariate analysis of regional differences and normal age-related changes in metabolites in the lentiform nucleus and frontal lobe, as measured by proton MRS. The cerebrospinal fluid (CSF) in the measurement area was estimated and the metabolite concentration adjusted. The concentration of N-acetylaspartate (NAA) in the lentiform nucleus decreased with ageing (F = 4.11, P < 0.01), but that in the frontal lobe did not change (F = 0.93, P = 0.45). This is in marked contrast with pathological dementia, such as Alzheimer's disease. In this multivariate analysis, the normal change in metabolism with ageing differed depending on the cerebral region, suggesting that metabolite concentrations, especially that of NAA may be useful metabolic indices for discriminate normal ageing from pathological dementia.

Adult↗

PubMed1994

A multivariate analysis of repeated measures: linkage of the albinism gene (Tyr) to a QTL influencing ethanol-induced anesthesia in laboratory mice.

We propose the use of multivariate analysis of variance in order to address linkage relationships between a genetic marker and a phenotype that is specified by multiple variables. Moreover, enhanced power of a linkage model that simultaneously accounts for environmental factors is demonstrated in the present study. This strategy was used to establish linkage of a quantitative trait locus influencing ethanol-induced anesthesia to the albinism gene (Tyr) in mouse. This approach, which can be implemented immediately with most statistical packages, provides the extreme flexibility of multivariate analysis of variance for analyzing complex questions of linkage regarding either animal or human research paradigms.

Albinism↗

PubMed1996

Risk factors for central nervous system involvement in non-Hodgkins-lymphoma--a multivariate analysis.

A consecutive cohort of patients with NHL was examined to identify the factors predictive of CNS-involvement with Cox's proportional hazards model in a multivariate analysis. Twenty-seven cases of CNS-involvement were found among 498 patients with NHL. Only 3 of 96 patients with low-grade lymphomas had CNS involvement, all occurring after transformation into high-grade lymphoma. In univariate analysis of 402 patients with intermediate or high-grade lymphoma, lymphoblastic histology (including Burkitt's lymphoma), age <35 years, B-symptoms, stage IV disease, testis involvement and bone marrow involvement were found to be statistically significant risk factors. Lymphoblastic histology was found to be strongly correlated to age younger than 35 years. In the multivariate analysis only lymphoblastic histology, stage IV disease and B-symptoms were found to be significantly associated with CNS involvement. It is concluded that CNS prophylaxis should be considered in all patients with lymphoblastic histology and in patients with stage IV B lymphomas other than those of low-grade types.

Actuarial Analysis↗

PubMedDate not supplied

Differential diagnosis of Krukenberg tumors using multivariate analysis.

AIMS AND BACKGROUND: Krukenberg tumors are ovarian metastases from a gastroenteric malignancy in 90% of cases. At present, diagnostic imaging techniques (US, CT, MRI) do not provide any reliable diagnostic criteria to differentiate these metastases from ovarian primaries. We tried to use multivariate analysis to distinguish malignant ovarian primaries from Krukenberg tumors based on their differential natural history. PATIENTS AND METHODS: We retrospectively compared the CT findings of Krukenberg tumors (47 patients, 79 masses, only from gastroenteric malignancy) with CT findings of primary epithelial ovarian cancers (46 patients, 67 masses). We compared the same independent variables in the two groups: age, morphology, margins, carcinomatosis, bilateral versus unilateral involvement, ascites, lymph node involvement, metastases on the basis of multivariate analysis. RESULTS: According to the best fitted model, clear-cut margins (OR: 3.75; 95% CI: 1.14-9.72) and the presence of carcinomatosis (OR: 4.21; 95% CI: 1.51-11.72) were the strongest predictors of a diagnosis of Krukenberg tumor. In contrast, the presence of ascites was more likely to be a protective factor (OR: 0.22; 95% CI: 0.08-0.62). CONCLUSIONS: We can try to make a differential diagnosis between a metastatic lesion from the gastroenteric tract and a primary adnexal lesion based on the multivariate statistical analysis of intraperitoneal spread of the different types of cancer rather than on morphologic findings at CT.

Adolescent↗

PubMed1989

Prognostic value of histologic grade nuclear components of Scarff-Bloom-Richardson (SBR). An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas.

We did a multivariate analysis of 1262 patients with operable, invasive ductal breast carcinoma to assess the prognostic value of the Scarff-Bloom-Richardson (SBR) histologic grading system. Nodal metastasis and SBR were the two most important factors for metastasis-free survival (MFS), P = 10-9 and P = 10-5, respectively, for total study time. In patients who were node negative, the SBR and International Union Against Cancer (UICC) stages were the most important for MFS (P = 4 X 10-4 and P = 0.03). In order to try to improve the SBR prognostic value, we first studied the three components of the SBR separately: ductoglandular differentiation proved the least predictive and nuclear pleomorphism and mitotic index the most predictive. A rearrangement of the two nuclear scores alone produced higher risk values and better risk separation of patient subpopulations than SBR, and eliminated the SBR from the multivariate model. This rearrangement, modified SBR (MSBR), defined five new risk subgroups with statistically different risk ratios for MFS (P = 3 X 10-8). SBR grade II (55% of patients) was separated into three MSBR groups significantly different according to MFS (P = 0.008). In the patients who were node negative, MSBR replaced the SBR and was the most important factor for prediction of relapse of MFS (P less than 0.00001). The MSBR is more accurate and predictive than the standard SBR grade and is particularly useful when the nodal status of the patient is negative or unknown.

Adult↗

PubMedDate not supplied

[Multivariate analysis of aminoacyl-tRNA synthetase activities of liver and hepatomas (author's transl)].

Data on the aminoacyl-tRNA synthetase activities in normal liver and in three transplantable rat hepatomas, viz Yoshida's AH 130 and Morris's 5123C and 7793, were studied by means of factor analysis, a powerful technique of multivariate analysis particularly suitable foridentifying factors which theoretically may account for the pattern of interrelations between several variables. The analysis has been performed on 51 patterns of enzyme activities, covering 17 out of the 20 aminoacyl-tRNA synthetases; 80% on average of the total variability of the 17 enzyme activities may be accounted for by the first 4 factors extracted. The enzymes seem to fall into different groups, depending on their relationship with the factors thus identified. The results suggest that enzymes belonging to the same group share a common control mechanism, and are independent of the enzymes belonging to different groups, both in normal liver and in hepatomas.

Amino Acyl-tRNA Synthetases↗

PubMed1995

[Multivariate analysis of spinal automatism in neurological diseases].

We investigated the relationship between spinal automatism (SA) and other neurological signs and symptoms (pyramidal, extrapyramidal, cerebellar, autonomic) by multivariate analysis in cervical spondylotic myelopathy (CSM) 112 cases, amyotrophic lateral sclerosis (ALS) 121 cases, and multiple system atrophy (MSA) 115 cases (olivo-ponto-cerebellar atrophy (OPCA) 55 cases, Shy-Drager syndrome (SDS) 42 cases, striato-nigral degeneration (SND) 18 cases). SA elicitation maneuver we used was pinprick stimulation at the dorsal pedal skin, and all cases showed twitched or phasic triple flexion pattern. As SA was elicited in 19 cases in CSM (17.0%), 23 cases (19.0%) in ALS, 36 cases (31.3%) in MSA, SA was more elicited in MSA than in ALS and CSM (p < 0.05, p < 0.01 by chi-squared test). In MSA, SA tended to be elicited more likely in SDS (21 cases, 50.0%) and in SND (8 cases, 44.4%) than in OPCA (7 cases, 12.7%) (p < 0.01 by chi-squared test). In MSA, the longer the duration of the disease became, the more SA was elicited, but not in ALS and CSM. Multivariate analysis (quantification method type II) showed that clinical signs as a statistical contribution factor for SA elicitation ranked Babinski's sign, micturition disturbance in ALS and CSM and Babinski's sign, orthostatic hypotension in MSA in order: In all 3 diseases, Babinski's sign and autonomic disturbance ranked higher. This conclusion suggested that SA was not always related to the pyramidal tract damage and was associated with the damage of small myelinated fibers in and/or around the pyramidal tract.

Adult↗

PubMed1995

A multivariate analysis of childhood abdominal pain in Trinidad.

This is a multivariate analysis of the data recorded in assessing 1158 consecutive admissions presenting to a children's surgical ward with acute abdominal pain. There were 56 binary variables available for entry into the analysis. A statistical software package was used to perform a stepwise discriminant analysis on the data. The program selected 18 variables as having discriminating power in assigning patients to the six diagnostic groups. In order of discriminating power these were, mainly, a positive urine culture, the bowel history, the findings on rectal examination, the location of abdominal tenderness, the presence of a mass, and the white cell count. Lesser discriminating potential was assigned to the presence of dehydration; fluid levels on erect abdominal films, a rise in temperature, an increased pulse rate, the presence of urinary symptoms, and the general appearance of the child. Use of these data led to an overall correct classification of 80.7% of cases. It is concluded that these variables should be included in the assessment of children with acute abdominal pain.

Abdomen, Acute↗

PubMed1988

Multivariate analysis for histologic prognostic factors in soft tissue sarcomas.

To investigate histologic prognostic factors in soft tissue sarcomas (STS), multivariate analysis was performed on 236 patients with complete clinical information. These included 141 males and 95 females with an age range from 1 to 85 years (median, 47.6 years). Histologically, malignant fibrous histiocytoma (33.5%) was the most common type followed by synovial sarcoma (11%), liposarcoma (10%), rhabdomyosarcoma (7%), and leiomyosarcoma (7%). Monofactorial analysis revealed that sex, depth, location, histologic grade, cellularity, frequency of mitosis, and necrosis were significant prognostic factors. By multivariate analysis, only frequency of mitosis and depth of tumors were proved to be of prognostic significance. The prognostic importance of the frequency of mitosis as shown in previous and the present studies indicates that further investigation of the cell proliferation in patients with STS is required.

Age Factors↗