• Title/Summary/Keyword: Cohort Analysis

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Application of Poisoning aBIG score for Prediction of Fatal Severity in Acute Adult Intoxications (성인 중증 중독환자 예측을 위한 새로운 지표 개발: aBIG score for poisoning)

  • Choe, Michael Sung Pil;Ahn, Jae Yun;Kang, In Gu;Lee, Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.14-21
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    • 2014
  • Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

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Survival Factors among Medical Intensive Care Unit Patients with Carbapenemas-Producing Enterobacteriaceae (카바페넴분해효소 생성 장내세균속균종(CPE)이 획득된 내과계 중환자실 환자의 생존 영향 요인)

  • Choi, Ji Eun;Jeon, Mi Yang
    • Journal of Korean Biological Nursing Science
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    • v.22 no.4
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    • pp.249-259
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    • 2020
  • Purpose: Carbapenemase-producing Enterobacteriaceae (CPE) are associated with considerable mortality. This study was aimed to identify survival factors among medical care unit patients with CPE. Methods: We conducted a retrospective cohort; data were collected from September 2017 to June 2019 through electronic medical records. The data collected were general characteristics, disease-related characteristics, severity-related characteristics, and treatment-related characteristics. Data were analyzed based on frequency, mean, standard deviation, Chi-square test, Fisher's exact test, t-test, Pearson's correlation coefficient, and Cox proportional hazard model using SPSS/WIN 21.0 program. Results: Seventy-seven patients were included (59 survivors and 18 deceased) in the study. Univariate analysis identified factors for survival associated with acquired CPE as age (t= -1.56, p= .037), simplified acute physiology 3 (SAPS3) score of admission date (t= -2.85, p= .006), Glasgow coma scale (GCS) of CPE acquisition date (t= 2.38, p= .020), artery catheter at CPE acquisition date (χ2= 4.58, p= .032), vasoconstrictor agents use at CPE acquisition date (χ2= 6.81, p= .009), platelet at CPE acquisition date (t= 2.27, p= .025), lymphocyte at CPE acquisition date (t= 2.01, p= .048), calcium at CPE acquisition date (t= 2.68, p= .009), albumin at CPE acquisition date (t= 2.29, p= .025), and creatinine at CPE acquisition date (t= 2.24, p= .028). Multivariate Cox proportional hazard model showed that GCS at CPE acquisition date (HR= 1.14, 95% CI= 1.05-1.22), lymphocyte at CPE acquisition date (HR= 1.05, 95% CI= 1.00-1.10), and creatinine at CPE acquisition date (HR= 1.25, 95% CI= 1.04-1.49) were independent survival factors among medical intensive care unit patients with CPE. Conclusion: Based on the study results, it is necessary to develop nursing interventions that can aid in the management of patients with CPE and identify their effects.

Standardized Breast Cancer Mortality Rate Compared to the General Female Population of Iran

  • Haghighat, S.;Akbari, M.E.;Ghaffari, S.;Yavari, P.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5525-5528
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    • 2012
  • Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (${\pm}10.5$) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer.

Positive Effects of Soy Isoflavone Food on Survival of Breast Cancer Patients in China

  • Zhang, Ya-Feng;Kang, Hong-Bin;Li, Bi-Li;Zhang, Rui-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.479-482
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    • 2012
  • Aim: Soy foods are the major source of isoflavones, which are believed to play important roles in genesis of breast cancer and its progression. We here conducted a prospective study to evaluate the association of soy isoflavone food consumption with breast cancer prognosis. Methods: A prospective study was performed from January 2004 and January 2006 in China. Trained interviewers conducted face-to-face interviews using a structured questionnaire to collect information on dietary habits and potential confounding factors. The relative risk [hazard ratio (HR)] and 95% CI were calculated from the Cox regression model for all significant predictors from cancer diagnosis to the endpoint of the study (event). Results: After a median follow up of 52.1 months (range, 9-60 months), a total of 79 breast cancer related deaths were recorded in our study, risk being inversely associated with a high intake of soy isoflavone. With an average intake of soy isoflavone above 17.3 mg/day, the mortality of breast cancer can be reduced by about 38-36%. We also found the decreased breast cancer death with high soy protein intake, with a HR (95% CI) of 0.71 (0.52-0.98). Stratified analysis with reference to the ER status, further demonstrated a better prognosis of ER positive breast cancer with a high intake of soy isoflavone (HR 0.59, 0.40-0.93). Conclusion: Our study shows the soy food intake is associated with longer survival and low recurrence among breast cancer patients. A cohort study with a larger sample size and long term follow-up is now needed.

The Effect of Prenatal Cadmium Exposure on Attention-deficit/Hyperactivity Disorder in 6-Year-old Children in Korea

  • Kim, Woosung;Jang, Yoonyoung;Lim, Youn-Hee;Kim, Bung-Nyun;Shin, Choong Ho;Lee, Young Ah;Kim, Johanna Inhyang;Hong, Yun-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.29-36
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    • 2020
  • Objectives: Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age. Methods: As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age. Results: Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model. Conclusions: Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Risk-Accepting Personality and Associated Factors among Korean Farmers (농업인의 농작업 위험 수용도 및 관련 요인)

  • Youn, Ji Young;Choi, Yeongchull;Lee, Won Jin;Kim, Jaeyoung
    • Journal of Environmental Health Sciences
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    • v.42 no.5
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    • pp.333-344
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    • 2016
  • Objectives: This study aimed to examine risk-accepting personality traits and associated factors among farmers. Methods: Data were collected from farmers aged over 40 living in Goryeong, North Gyeongsang-do Province, Korea. Study participants were enrolled in the Korean Rural Cohort study from 2011 to 2014. Surveys for the risk perception of farming were made through face-to-face interviews. Chi-square tests and logistic regression analysis were conducted adjusting for gender, age, marital status, and education. Results: Several factors such as gender, age, marital status, age first worked as a farmer, duration of farming, and history of pesticide poisoning were associated with risk-accepting personality traits among farmers. Farmers with risk-accepting personalities tend to be older, less educated, and have self-employed health insurance. Farmers who started farming after the age of 50 are likely to be risk averse compared to farmers who started farming before the age of 20 (OR=0.41, 95% CI; 0.21, 0.82). Frequent spraying of pesticides was marginally associated with higher risk acceptance among female farmers (OR=1.61, 95% CI: 0.99, 2.64). Male farmers who had experienced pesticide poisoning in their lifetime showed higher odds of risk-accepting personality traits (OR=2.20, 95% CI: 1.03, 4.72) Conclusion: Risk-acceptors were more likely to spray pesticides frequently and to experience more pesticide poisoning compared to risk-averse individuals. This result suggests that farming hazards are to some degree driven by risk-accepting personality traits. Further investigation of how risk-accepting behaviors influence farming practices and pesticide poisoning is needed.

P53 Polymorphism at Codon 72 is Associated with Keratocystic Odontogenic Tumors in the Thai Population

  • Yanatatsaneejit, Pattamawadee;Boonsrang, Ajaree;Mutirangura, Apiwat;Patel, Vyomesh;Kitkumthorn, Nakarin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1997-2001
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    • 2015
  • Objective: To clarify the association between the p53 polymorphism at codon 72 and susceptibility to the sporadic keratocystic odontogenic tumor (KCOT). Design: One hundred KCOTs and 160 match-group healthy controls were genotyped to ascertain the frequency of the p53 codon 72 polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), confirmed by direct sequencing. Results: The frequencies of the Pro/Pro, Arg/Pro, and Arg/Arg genotypes were 23.8%, 49.4%, and 26.9%, respectively, in the controls, while the KCOT cohort demonstrated 43.0%, 39.0%, and 18.0%, respectively. Further analysis suggested that p53 Pro could be a KCOT-susceptible allele (OR (95%CI)=1.77 (1.22 to 2.59), p=0.0024), with a sex-adjusted OR (95%CI) of 1.71 (1.17-2.50), p=0.0046. Moreover, the results indicated that p53 codon 72 Pro homozygous was associated with a two-fold risk of developing KCOT (adjusted OR (95%CI) =2.17(1.23-3.84), p=0.0062). Conclusions: The C/C genotype of P53 gene codon 72 increases the risk of developing sporadic KCOT and may be a useful tool for screening and diagnostic purposes.

The Effect of Broadcasting Sow Suckling Grunts in the Lactation Shed on Piglet Growth

  • Cronin, G.M.;Leeson, E.;Cronin, J.G.;Barnett, J.L.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.7
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    • pp.1019-1023
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    • 2001
  • An on-farm trial was conducted in temperature-controlled lactation rooms at a commercial pig farm to investigate the efficacy of broadcasting sow suckling grunts from day 4 of lactation, on increasing piglet growth to weaning. In the Broadcast treatment, sows and litters were exposed to a 3-min broadcast from loud-speakers every 42 min. The Control treatment was not exposed to the broadcast. All sows and litters had similar husbandry and piglets were provided with creep feed on the floor twice daily. In each of the three replicates in time, the Broadcast and Control treatments were allocated to different lactation rooms at random and there were 12 sows and litters per treatment per replicate. A total of four identical lactation rooms were available for the trial, each containing 28 conventional sow and litter crates with piglet heater in the creep area. A non-trial room separated the two treatment rooms in each replicate to minimise the chance that the broadcast grunt stimulation was audible to the Control treatment litters. Five "normal and average-looking" piglets from the trial litters were weighed twice, 7 d apart. The cohort of five piglets was identified by ear-tags and formed the experimental unit for the statistical analysis. The average (${\pm}SD$) age of piglets at initial weighing was 7.7(${\pm}2.22$) days. For each litter, mean piglet live weight at day 14 of lactation was estimated by linear regression of the two weights recorded seven days apart, when on average, the Broadcast treatment had been exposed to the stimulation for 10 days. Piglets in the Broadcast treatment were heavier (p<0.01) at day 14 of lactation compared to Control treatment (4.24 and 3.92 kg, respectively) and tended to have a greater average daily weight gain over the 7-d period (245 and 228 g/day, respectively; p<0.08). The results suggest piglet growth was improved by about 8% in response to the regular, timed broadcast of sow suckling grunts in the lactation shed. The independent contributions of milk and creep feed to the improved growth remain to be determined.

Incidence Trend for Non-Hodgkin Lymphoma in the North Tunisian Population, 1998-2009

  • Benhassine, Adel;Khadhra, Hajer Ben;Khiari, Houyem;Hsairi, Mohamed;Elgaaied, Amel Benammar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2513-2518
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    • 2016
  • Background: In 2008, non-Hodgkin lymphoma ranked tenth among other malignancies worldwide with an incidence of around 5 cases per 100,000 in both genders. The latest available rates in Tunisia are from 2006. Materials and Methods: This study aimed to provide an update about NHL incidence for 2009 and its trend between 1998 and 2009 as well as a projection until 2024, using data from the Salah Azaiz Institute hospital registry and the Noth Tunisia cancer registry. Results: In 2009, the NHL incidence in the north of Tunisia was 4.03 cases per 100,000, 4.97 for men and 3.10 for women. Diffuse large B-cell lymphoma (DLBCL) accounted for 63.2% of all NHL subtypes. Between 1998 and 2009, the overall trend showed no significant change. When we compared the trend between two periods (1998-2005 and 2005-2009), joinpoint regression showed a significant decrease of NHL incidence in the first period with an annual percentage change (APC) of -6.7% (95% CI:[-11.2%;-2%]), then the incidence significantly increased from 2005 to 2009 with an APC of 30.5% (95% CI: [16.1%; 46.6%]. The analyses of the different subtype trends showed a significant decrease in DLBCL incidence between 1998 and 2000 (APC:-21.5; 95% CI: [-31.4%;-10.2%]) then the incidence significantly increased between 2004 and 2007 (APC: 18.5; 95% CI: [3,6%;35.5%]). Joint point analysis of the age-period-cohort model projection showed a significant increase between 2002 and 2024 with an APC of 4.5% (%95 CI: [1.5%; 7.5%]). The estimated ASR for 2024 was 4.55/100 000 (95% CI: [3.37; 6.15]). Conclusions: This study revealed an overall steady trend in the incidence of NHL in northern Tunisia between 1998 and 2009. Projection showed an increase in the incidence in NHL in both genders which draw the attention to the national and worldwide burden of this malignancy.

Fitting competing risks models using medical big data from tuberculosis patients (전국 결핵 신환자 의료빅데이터를 이용한 경쟁위험모형 적합)

  • Kim, Gyeong Dae;Noh, Maeng Seok;Kim, Chang Hoon;Ha, Il Do
    • The Korean Journal of Applied Statistics
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    • v.31 no.4
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    • pp.529-538
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    • 2018
  • Tuberculosis causes high morbidity and mortality. However, Korea still has the highest tuberculosis (TB) incidence and mortality among OECD countries despite decreasing incidence and mortality due to the development of modern medicine. Korea has now implemented various policy projects to prevent and control tuberculosis. This study analyzes the effects of public-private mix (PPM) tuberculosis control program on treatment outcomes and identifies the factors that affecting the success of TB treatment. We analyzed 130,000 new tuberculosis patient cohort from 2012 to 2015 using data of tuberculosis patient reports managed by the Disease Control Headquarters. A cumulative incidence function (CIF) compared the cumulative treatment success rates for each factor. We compared the results of the analysis using two popular types of competition risk models (cause-specific Cox's proportional hazards model and subdistribution hazard model) that account for the main event of interest (treatment success) and competing events (death).