• Title/Summary/Keyword: Survival outcomes

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Determinants on survival outcomes of sudden out-of-hospital cardiac arrest: a multilevel analysis (병원 밖에서 발생한 급성 심장정지 환자의 생존결과에 영향을 미치는 요인 : 다수준 분석)

  • Kim, Hyo-Sil;Chun, Jin-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.7-26
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    • 2020
  • Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

Postoperative radiotherapy for mucoepidermoid carcinoma of the major salivary glands: long-term results of a single-institution experience

  • Park, Geumju;Lee, Sang-wook
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.317-324
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    • 2018
  • Purpose: This study aimed to evaluate the long-term survival outcomes and prognostic factors that affect the clinical outcomes of patients who underwent surgery and postoperative radiotherapy for major salivary gland mucoepidermoid carcinoma (MEC). Materials and Methods: We retrospectively reviewed the clinical data of 44 patients who underwent surgery followed by radiotherapy for primary MEC of the major salivary glands between 1991 and 2014. The median follow-up period was 9.8 years (range, 0.8 to 23.8 years). Results: The overall outcomes at 5 and 10 years were 81.5% and 78.0% for overall survival (OS), 86.2% and 83.4% for disease-free survival, 90.6% and 87.6% for locoregional recurrence-free survival, and both 90.5% for distant metastasis-free survival (DMFS). Histologic grade was the only independent predictor of OS (low vs. intermediate vs. high; hazard ratio = 3.699; p = 0.041) in multivariate analysis. A poorer survival was observed among patients with high-grade tumors compared with those with non-high-grade tumors (5-year OS, 37.5% vs. 91.7%, p < 0.001; 5-year DMFS, 46.9% vs. 100%, p < 0.001). Conclusion: Surgery and postoperative radiotherapy resulted in excellent survival outcomes for patients with major salivary gland MEC. However, high-grade tumors contributed to poor DMFS and OS. Additional aggressive strategies for improving survival outcomes should be developed for high-grade MEC.

Quality of life, patient preferences, and implant survival and success of tapered implant-retained mandibular overdentures as a function of the attachment system

  • Ilze Indriksone;Pauls Vitols;Viktors Avkstols;Linards Grieznis;Kaspars Stamers;Susy Linder;Michel Dard
    • Journal of Periodontal and Implant Science
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    • v.53 no.3
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    • pp.194-206
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    • 2023
  • Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.

Analyzing Survival Data as Binary Outcomes with Logistic Regression

  • Lim, Jo-Han;Lee, Kyeong-Eun;Hahn, Kyu-S.;Park, Kun-Woo
    • Communications for Statistical Applications and Methods
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    • v.17 no.1
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    • pp.117-126
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    • 2010
  • Clinical researchers often analyze survival data as binary outcomes using the logistic regression method. This paper examines the information loss resulting from analyzing survival time as binary outcomes. We first demonstrate that, under the proportional hazard assumption, this binary discretization does result in a significant information loss. Second, when fitting a logistic model to survival time data, researchers inadvertently use the maximal statistic. We implement a numerical study to examine the properties of the reference distribution for this statistic, finally, we show that the logistic regression method can still be a useful tool for analyzing survival data in particular when the proportional hazard assumption is questionable.

Survival Outcomes after Whole Brain Radiation Therapy and/or Stereotactic Radiosurgery for Cancer Patients with Metastatic Brain Tumors in Korea: A Systematic Review

  • Hyun, Min Kyung;Hwang, Jin Seub;Kim, Jin Hee;Choi, Ji Eun;Jung, Sung Young;Bae, Jong-Myon
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7401-7407
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    • 2013
  • Aim: To compare survival outcomes after whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), and WBRT plus SRS combination therapy in Korea, by performing a quantitative systematic review. Materials and Methods: We searched 10 electronic databases for reports on Korean patients treated with WBRT or SRS for brain metastases published prior to July 2010. Independent reviewers screened all articles and extracted the data. When a Kaplan-Meier survival curve was available, median survival time and standard errors were calculated. Summary estimates for the outcomes in each study were calculated using the inverse variance random-effects method. Results: Among a total of 2,761 studies, 20 studies with Korean patients (n=1,053) were identified. A combination of 12 studies (n=566) with WBRT outcomes showed a median survival time of 6.0 months (95%CI: 5.9-6.2), an overall survival rate of 5.6% (95%CI: 1-24), and a 6-month survival rate of 46.5% (95%CI: 37.2-56.1). For nine studies (n=412) on SRS, the median survival was 7.9 months (95%CI: 5.1-10.8), and the 6-month survival rate was 63.1% (95%CI: 49.8-74.8). In six studies (n=75) using WBRT plus SRS, the median survival was 10.7 months (95%CI: 4.7-16.6), and the overall and 6-month survival rates were 16.8% (95%CI: 6.2-38.2) and 85.7% (95%CI: 28.3-96.9), respectively. Conclusions: WBRT plus SRS showed better 1-year survival outcome than of WBRT alone for Korean patients with metastatic brain tumors. However, the results of this analysis have to be interpreted cautiously, because the risk factors of patients were not adjusted in the included studies.

Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death

  • Chang, Hye Jin;Han, Kyoung Hee;Cho, Min Hyun;Park, Young Seo;Kang, Hee Gyung;Cheong, Hae Il;Ha, Il Soo
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.135-139
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    • 2014
  • Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

Entrepreneurial Learning and Indian Tech Startup Survival: An Empirical Investigation

  • Krishna, HS
    • Asian Journal of Innovation and Policy
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    • v.7 no.1
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    • pp.55-78
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    • 2018
  • This paper investigates the linkage between the mode of transformation of entrepreneurial learning into outcomes and the subsequent impact of these learning outcomes in enhancing the survival of high-tech startups in India. The study uses data from 45 high-tech startups headquartered across different locations in India for the purpose of analysis. Survival Analysis of the data is conducted to determine which mode of learning transformation and what type of en trepreneurial decision making preference have a significant influence on the survival of Indian high-tech startups and to what extent do they impact their survival. The results indicate that entrepreneur's prior startup experience, explorative mode of learning transformation, causal decision making of the entrepreneur and availability of funding for the startup as the key factors that reduce the time to survival of Indian high-tech startups. They also provide key insights on how these factors impact the startup survival in this region.

The Result of Conversion Surgery in Gastric Cancer Patients with Peritoneal Seeding

  • Kim, Se Won
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.266-270
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    • 2014
  • Purpose: Palliative gastrectomy and chemotherapy are important options for peritoneal seeding of gastric cancer. The treatment stage IV gastric cancer patient who respond to induction chemotherapy, is converted to gastrectomy (conversion therapy or conversion surgery). This study explored the clinical outcomes of gastric cancer patients with peritoneal seeding who had undergone conversion therapy. Materials and Methods: Between 2003 and 2012, gastric cancer patients with peritoneal seeding, as determined by preoperative or intraoperative diagnosis were reviewed retrospectively. Clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. Results: Forty-three patients were enrolled. Eighteen patients had undergone conversion surgery and 25 patients continued conventional chemotherapy. Among the 18 conversion patients, 10 received clinically curative resection. The median follow-up period was 28.5 months (range 8 to 60 months) and the total 3-year survival rate was 16.3%. The median survival time of the patients who received clinically curative conversion therapy was 37 months, and the 3-year survival rate was 50%. The median follow-up for non-curative gastrectomy patients was 18 months. No patient treated using chemotherapy survived to 3 years; the median survival time was 8 months. The differences in survival time between the groups was statistically significant (P<0.001). Conclusions: In terms of survival benefits for gastric cancer patients with peritoneal seeding, clinically curative conversion therapy resulted in better clinical outcomes.

Outcomes of the Multimodal Treatment of Malignant Pleural Mesiothelioma: The Role of Surgery

  • Na, Bub-Se;Kim, Ji Seong;Hyun, Kwanyong;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.35-40
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    • 2018
  • Background: The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in Korea have not been reported. We analyzed the outcomes of MPM in the context of multimodal treatment, including surgery. Methods: The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared. Results: The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23). Conclusion: Multimodal treatment incorporating surgery did not show better outcomes than non-surgical treatment. A nationwide multicenter data registry and prospective randomized controlled studies are necessary to optimize the treatment of MPM.

Overall and disease-specific survival outcomes following primary surgery for oral squamous cell carcinoma: analysis of consecutive 67 patients

  • Sim, Yookyeong Carolyn;Hwang, Jong-Hyun;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.83-90
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    • 2019
  • Objectives: This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes. Materials and Methods: A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival. Results: Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039). Conclusion: OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.