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At least 19 recordsLinked to original sources
PubMed1995

On the MVK stochastic carcinogenesis model with Erlang distributed cell life lengths.

This paper proposes extending the MVK carcinogenesis model by adopting the Erlang distribution for the life length of the intermediate cells. The investigation concentrates on the survival function and the mean value functions. The approach is basically numerical, making use of the Mathematica software system. The paper also provides a closed form expression for the survival function for a variation of the original MVK model, where all the model parameters are piecewise constants.

Algorithms↗
PubMed1991

Valve replacement for calcified aortic stenosis in septuagenarians infers normal life-length.

Aortic valve replacement because of pure or predominant stenosis was performed in 1970-1986 on 101 patients aged 70-78 years, including 80 in NYHA function class III or IV. There were 16 deaths within 30 days, and coronary artery disease (unbypassed in all but 1 case) was found in 11 of the 13 with autopsy or preoperative arteriography. None of the 12 patients without significant coronary artery disease at angiography died perioperatively,but one of 12 with combined valve replacement and coronary artery bypass grafting died. Cumulative 1-year survival among the 101 patients/the 85 survivors of the first 30 days and/a normal population matched for sex, age and year of operation was 75/90/96%. Corresponding percentages for 5 years were 64/75/77, for 10 years 43/52/52, and for 15 years 35/42/27. Advanced disease with kidney failure or left ventricular end-diastolic pressure greater than 20 mmHg independently increased the overall mortality rate. The linearized rat of cerebral events (haemorrhage, embolism) was 2.7/100 patient years (age-specific background rate 1.6-1.9/100 patient years). The 30-day mortality among septuagenarians was reduced to 3% in 1988-1989 by routine revascularization in significant coronary artery disease. The patients who survived the first 30 days had normal life expectancy. Early operation may further improve the results.

Aged↗
PubMed2003

The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer.

The purpose of this study was to evaluate the effects of music therapy on quality of life, length of life in care, physical status, and relationship of death occurrence to the final music therapy interventions of hospice patients diagnosed with terminal cancer. Subjects were adults who were living in their homes, receiving hospice care, and were diagnosed with terminal cancer. A total of 80 subjects participated in the study and were randomly assigned to one of two groups: experimental (routine hospice services and clinical music therapy) and control (routine hospice services only). Groups were matched on the basis of gender and age. Quality of life was measured by the Hospice Quality of Life Index-Revised (HQOLI-R), a self-report measure given every visit. Functional status of the subjects was assessed by the hospice nurse during every visit using the Palliative Performance Scale. All subjects received at least two visits and quality of life and physical status assessments. A repeated measures ANOVA revealed a significant difference between groups on self-report quality of life scores for visits one and two. Quality of life was higher for those subjects receiving music therapy, and their quality of life increased over time as they received more music therapy sessions. Subjects in the control group, however, experienced a lower quality of life than those in the experimental group, and without music, their quality of life decreased over time. There were no significant differences in results by age or gender of subjects in either condition. Furthermore, there were no significant differences between groups on physical functioning, length of life, or time of death in relation to the last scheduled visit by the music therapist or counselor. This study provides an overview of hospice/palliative care, explains the role of music therapy in providing care, and establishes clinical guidelines grounded in research for the use of music therapy in improving the quality of life among the terminally ill.

Adult↗
PubMed2005

QALY maximisation and people's preferences: a methodological review of the literature.

In cost-utility analysis, the numbers of quality-adjusted life years (QALYs) gained are aggregated according to the sum-ranking (or QALY maximisation) rule. This requires that the social value from health improvements is a simple product of gains in quality of life, length of life and the number of persons treated. The results from a systematic review of the literature suggest that QALY maximisation is descriptively flawed. Rather than being linear in quality and length of life, it would seem that social value diminishes in marginal increments of both. And rather than being neutral to the characteristics of people other than their propensity to generate QALYs, the social value of a health improvement seems to be higher if the person has worse lifetime health prospects and higher if that person has dependents. In addition, there is a desire to reduce inequalities in health. However, there are some uncertainties surrounding the results, particularly in relation to what might be affecting the responses, and there is the need for more studies of the general public that attempt to highlight the relative importance of various key factors.

Age Factors↗
PubMed2002

The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost.

OBJECTIVE: To measure the impact of orthopedic surgical-site infections (SSIs) on quality of life, length of hospitalization, and cost. DESIGN: A pairwise-matched (1:1) case-control study within a cohort. SETTING: A tertiary-care university medical center and a community hospital. PATIENTS: Cases of orthopedic SSIs were prospectively identified by infection control professionals. Matched controls were selected from the entire cohort of patients undergoing orthopedic surgery who did not have an SSI. Matching variables included type of surgical procedure, National Nosocomial Infections Surveillance risk index, age, date of surgery, and surgeon. MAIN OUTCOME MEASURES: Quality of life, duration of postoperative hospital stay, frequency of hospital readmission, overall direct medical costs, and mortality rate. RESULTS: Fifty-nine SSIs were identified. Each orthopedic SSI accounted for a median of 1 extra day of stay during the initial hospitalization (P = .001) and a median of 14 extra days of hospitalization during the follow-up period (P = .0001). Patients with SSI required more rehospitalizations (median, 2 vs 1; P = .0001) and more total surgical procedures (median, 2 vs 1; P = .0001). The median total direct cost of hospitalizations per infected patient was $24,344, compared with $6,636 per uninfected patient (P = .0001). Mortality rates were similar for cases and controls. Quality of life was adversely affected for patients with SSI. The largest decrements in scores on the Medical Outcome Study Short Form 36 questionnaire were seen in the physical functioning and role-physical domains. CONCLUSIONS: Orthopedic SSIs prolong total hospital stays by a median of 2 weeks per patient, approximately double rehospitalization rates, and increase healthcare costs by more than 300%. Moreover, patients with orthopedic SSIs have substantially greater physical limitations and significant reductions in their health-related quality of life.

Cross Infection↗
PubMedDate not supplied

Modifiable factors for the length of life with disability before death: mortality retrospective study in Japan.

BACKGROUND: Past studies have measured and described the length of life with disability before death, but there has been no study of the relationship between modifiable lifestyle factors and duration of disability. OBJECTIVE: To examine whether there are modifiable factors influencing the length of life with disability before death. METHODS: The study was designed as a retrospective observation of the deceased who had earlier been enrolled in a prospective cohort study. During the follow-up period (1996-1999), we documented 781 deaths among those who were 70-79 years of age at the baseline survey in 1994 (n=10,216). In 2000, we interviewed family members of the deceased about the duration of the subjects' disability before death (n=655). RESULTS: The median duration of disability before death was approximately 6 months. Both higher Body Mass Index (BMI) and shorter time spent walking were significantly associated with an increased risk of long-term disability (more than 6 months). The odds ratios of long-term disability were 1.3 in those with BMI 20-25 and 2.1 in those with BMI>25, compared with BMI<20. The odds ratios of long-term disability were 1.3 in those walking for 0.5-0.9 h/day and 1.7 in those walking for <0.5 h/day, compared with those walking for >1.0 h/day. These relationships were unchanged after stratification for causes of death. CONCLUSION: Weight control and walking in later life may shorten the length of life with disability before death.

Aged↗
PubMed1994

Length of life in the ancient world: a controlled study.

The length of life for a population of ancient Greek and Roman men with quoted dates of birth and death has been compared statistically with three sample populations from different periods. It was found that the ancients who were born before 100 BC lived as long as the moderns who died before 1950; they lived significantly shorter lives than those who have died in the present half century.

Adult↗
PubMed2006

[Value-based medicine in ophthalmology].

PURPOSE: Value-based medicine (VBM) unifies costs and patient-perceived value (improvement in quality of life, length of life, or both) of an intervention. Value-based ophthalmology is of increasing importance for decisions in eye care. METHODS: The methods of VBM are explained and definitions for a specific terminology in this field are given. The cost-utility analysis as part of health care economic analyses is explained. RESULTS: VBM exceeds evidence-based medicine by incorporating parameters of cost and benefits from an ophthalmological intervention. The benefit of the intervention is defined as an increase or maintenance of visual quality of life and can be determined by utility analysis. The time trade-off method is valid and reliable for utility analysis. The resources expended for the value gained in VBM are measured with cost-utility analysis in terms of cost per quality-adjusted life years gained (euros/QALY). Numerous cost-utility analyses of different ophthalmological interventions have been published. CONCLUSION: The fundamental instrument of VBM is cost-utility analysis. The results in cost per QALY allow estimation of cost effectiveness of an ophthalmological intervention. Using the time trade-off method for utility analysis allows the comparison of ophthalmological cost-utility analyses with those of other medical interventions. VBM is important for individual medical decision making and for general health care.

Consumer Behavior↗
PubMed1997

Is length of life predictable?

A random sample of death records of adult males from the period 1967 to 1970 was chosen from the South Australian Registry of Births, Deaths, and Marriages. The natural parents of these individuals were identified by cross-referencing to birth certificates, and an extensive search was made of the death records for these parents. In this manner random families were selected for which, where possible, the cause of death and length of life of each family member were determined. Here, we analyze the association between sons and their parents in length of life and report the statistically useful correlations that were found. These correlations enable the calculation of a life table for a male conditional on his current age and the lifetimes of his parents. Comparisons are made with the uninformed population life table based solely on sex and year of birth.

Adult↗
PubMedDate not supplied

Implementing psychiatric interventions on a medical ward: effects on patients' quality of life and length of hospital stay.

OBJECTIVE: The authors investigated the effects of implementing psychiatric interventions on a general medical ward by means of a stepped detection and treatment strategy conducted by a consultation-liaison (CL) nurse in terms of reducing length of hospital stay (LOS) and improving quality of life (QOL) at discharge. MATERIALS AND METHODS: One hundred ninety-three patients participated in a controlled trial, in which patients were screened with COMPRI and INTERMED. A nurse under supervision of a CL psychiatrist conducted interventions, consisting of simple psychiatric interventions by herself, referral to auxiliary services, or initiation of postdischarge care. Intervention patients were compared with historic controls on LOS and QOL (SF36) at discharge. RESULTS: In multivariate analysis of variance, a significant effect of the intervention on QOL (p = 0.037) was found, which diminished after controlling for confounders (p = 0.28). No significant effect on LOS was found for the whole sample (p = 0.72), but in patients age 65 years or older, a reduction in LOS (p = 0.05) was found. This effect remained after controlling for confounders (p = 0.06). CONCLUSIONS: These data suggest that screening for risk of increased health care might improve outcomes in general medical inpatients. Because of the design of the study, however, these findings should be considered preliminary and confirmed in a larger, multicenter, randomized controlled trial.

Adult↗
PubMed1989

[Educational level as a factor in length of life].

"The paper deals with...the interrelation of the education level and death-rate of the Ukrainian SSR population.... Knowledge [of] the dependence of the death-rate on the educational level may be used to predict the average duration of the forthcoming life and education composition of the population." (SUMMARY IN ENG)

Demography↗
PubMed2002

Quality of life and length of survival in advanced cancer patients on home parenteral nutrition.

BACKGROUND: The use of home parenteral nutrition (HPN) in patients with advanced cancer is controversial because survival is usually short and there are no data regarding the quality of life (QoL). METHODS: Sixty-nine advanced cancer patients enrolled in a program of HPN in six different Italian centers were prospectively studied as regards nutritional status (body weight, serum albumin, serum transferrin and total lymphocyte count), length of survival and QoL through the Rotterdam Symptom Checklist questionnaire. These variables were collected at the start of HPN and then at monthly intervals. All these patients were severely malnourished, almost aphagic and beyond any possibility of cure. RESULTS: Nutritional indices maintained stable until death. Median survival was 4 months (range 1-14) and about one-third of patients survived more than 7 months. QoL parameters remained stable till 2-3 months before death. CONCLUSIONS: HPN may benefit a limited percentage of patients who may survive longer than the time allowed by a condition of starvation and depletion. Provided that these patients survive longer than 3 months, there is some evidence that QoL remains stable for some months and acceptable for the patients.

Adult↗
PubMed1978

A stratified randomized study of intradermal BCG in patients with carcinoma of the bronchus: prolongation of quality but not length of life in inoperable patients.

This paper reports the results of a stratified, randomized trial of monthly intradermal injections of Glaxo BCG in addition to conventional therapy (surgery, radiotherapy or no treatment) in a consecutive series of 75 men with confirmed bronchial carcinoma. BCG treatment did not significantly prolong survival but had consistenly more effect in prolonging the period in good general condition and in "acceptable" clinical condition. These were significantly prolonged among the BCG patients (all histopathologies) treated with a full course of radiotherapy (p = 0.01, p = 0.005) and among the 43 patients with squamous carcinoma after adjustment for treatment and general prognostic factors (ratio of observed to expected deaths (O/E) for BCG 0.65, P = 0.025). There was a tendency for BCG patients with oat cell carcinoma to survive less well than controls (O/E for BCG 1.40 not significant). Within comparable groups of patients with squamous carcinoma the delay in decline of general condition was accompanied by reduced weight loss.

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