Inadvertent Splenectomy During Resection for Colorectal Cancer Does Not Increase Long-term Mortality in a Propensity Score Model

2016 ◽  
Vol 59 (12) ◽  
pp. 1150-1159 ◽  
Author(s):  
Ida Lolle ◽  
Hans-Christian Pommergaard ◽  
David F. Schefte ◽  
Orhan Bulut ◽  
Peter-Martin Krarup ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Model ◽  
Score Model ◽  
Long Term Mortality

scholarly journals Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kawai ◽  
D Nakatani ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Plasma Volume ◽  
Cox Regression ◽  
Volume Status ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status. Methods To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years. Results During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247). Conclusion Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status. Funding Acknowledgement Type of funding source: None

scholarly journals Increased long‐term mortality after open colorectal cancer surgery; a multicenter population‐based study

2021 ◽  
Author(s):  
Milad Fahim ◽  
Lea M. Dijksman ◽  
Thijs A. Burghgraef ◽  
Paul B. van der Nat ◽  
Wouter J.M. Derksen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Population Based ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery ◽  
Population Based Study ◽  
Long Term Mortality

Should a propensity score model be super? The utility of ensemble procedures for causal adjustment

2018 ◽  
Vol 38 (9) ◽  
pp. 1690-1702 ◽  
Author(s):  
Shomoita Alam ◽  
Erica E. M. Moodie ◽  
David A. Stephens
Keyword(s):  
Propensity Score ◽  
Propensity Score Model ◽  
Score Model

scholarly journals Comparison of Long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis

2020 ◽  
Author(s):  
Yun Xu ◽  
Cong Li ◽  
Charlie Zhi-Lin Zheng ◽  
Yu-Qin Zhang ◽  
Tian-An Guo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Control Group ◽  
Sporadic Colorectal Cancer ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Tumor Stages

Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare,with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year OS rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (p = 0.029). The 5-year PFS rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; p = 0.262). The 5-year TFS rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (p = 0.039). By multivariate analysis, we found that tumor progression of primary CRC and TNM staging were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients. Strict regular follow-up monitoring, detection at earlier tumor stages, and effective treatment are key to ensuring better long-term prognosis.

scholarly journals Causal Subclassification Tree Algorithm and Robust Causal Effect Estimation via Subclassification

2020 ◽  
Vol 10 (1) ◽  
pp. 40
Author(s):  
Tomoshige Nakamura ◽  
Mihoko Minami
Keyword(s):  
Propensity Score ◽  
Propensity Scores ◽  
Causal Effect ◽  
Model Misspecification ◽  
Robust Estimator ◽  
Propensity Score Model ◽  
Confounding Variables ◽  
Score Model ◽  
Effect Estimation ◽  
Weighting Methods

In observational studies, the existence of confounding variables should be attended to, and propensity score weighting methods are often used to eliminate their e ects. Although many causal estimators have been proposed based on propensity scores, these estimators generally assume that the propensity scores are properly estimated. However, researchers have found that even a slight misspecification of the propensity score model can result in a bias of estimated treatment effects. Model misspecification problems may occur in practice, and hence, using a robust estimator for causal effect is recommended. One such estimator is a subclassification estimator. Wang, Zhang, Richardson, & Zhou (2020) presented the conditions necessary for subclassification estimators to have $\sqrt{N}$-consistency and to be asymptotically well-defined and suggested an idea how to construct subclasses.

Abstract 13193: Impact of “Off-Peak” Versus “Peak” Hour Coronary Interventions for ST-Elevation Myocardial Infarction on Adverse Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jae S Lee ◽  
Gabriel Redel-Traub ◽  
Michael Kim ◽  
Perwaiz Meraj ◽  
Christina Brennan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Propensity Score ◽  
Adverse Outcomes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Interventions ◽  
St Elevation ◽  
Peak Versus ◽  
Versus Peak ◽  
Long Term Mortality

Background: In addition to patient-dependent factors, whether the time of arrival of the patient to the hospital with ST-elevation myocardial infarction (STEMI) might play a role in subsequent adverse outcomes following primary percutaneous coronary interventions (PCI) is not well studied. Method: 856 PCI procedures for patients presenting with STEMI from two large hospitals in the health system were analyzed. Peak hours were defined as procedures performed between 7 AM and 7 PM on weekdays. Off-peak hours were defined as procedures performed between 7 PM and 7 PM on weekdays and weekends. Unadjusted and propensity score-adjusted analyses were performed to analyze the following inpatient outcomes: composite of death/MI/stroke, composite of bleeding events, composite of death/MI/stroke/bleeding endpoints, and long-term mortality. Results: Of 856 PCIs, 407 (47.5%) were performed during the peak hours. In both unadjusted and propensity score-adjusted analyses, no significant differences in adverse outcomes and long-term mortality were observed in patients who had PCIs during off-peak and peak hours (see Table). In addition, a separate analysis performed on patients who underwent primary PCIs between 7 AM-7 PM (“Morning”) versus 7 PM-7 AM (“Evening”) on all days showed no difference in the inpatient adverse outcomes and long-term mortality (Adjusted long term mortality: HR 0.79 (95% CI 0.40-1.56), p=0.49). Conclusion: Primary PCIs performed on patients presenting with STEMI during off-peak versus peak hours results in similar inpatient adverse outcomes and long-term mortality.

A Care Bundle Intervention to Prevent Surgical Site Infections After a Craniotomy

2020 ◽  
Author(s):  
Emilio Jiménez-Martínez ◽  
Guillermo Cuervo ◽  
Jordi Carratalà ◽  
Ana Hornero ◽  
Pilar Ciercoles ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Primary Study ◽  
Preventive Strategy ◽  
Propensity Score Model ◽  
Vancomycin Powder ◽  
Score Model ◽  
Control Study

Abstract Background Although surgical site infections after a craniotomy (SSI-CRANs) are a serious problem that involves significant morbidity and costs, information on their prevention is scarce. We aimed to determine whether the implementation of a care bundle was effective in preventing SSI-CRANs. Methods A historical control study was used to evaluate the care bundle, which included a preoperative shower with 4% chlorhexidine soap, appropriate hair removal, adequate preoperative systemic antibiotic prophylaxis, the administration of 1 g of vancomycin powder into the subgaleal space before closing, and a postoperative dressing of the incisional surgical wound with a sterile absorbent cover. Patients were divided into 2 groups: preintervention (January 2013 to December 2015) and intervention (January 2016 to December 2017). The primary study end point was the incidence of SSI-CRANs within 1 year postsurgery. Propensity score matching was performed, and differences between the 2 study periods were assessed using Cox regression models. Results A total of 595 and 422 patients were included in the preintervention and intervention periods, respectively. The incidence of SSI-CRANs was lower in the intervention period (15.3% vs 3.5%; P < .001). Using a propensity score model, 421 pairs of patients were matched. The care bundle intervention was independently associated with a reduced incidence of SSI-CRANs (adjusted odds ratio, 0.23; 95% confidence interval, .13–.40; P < .001). Conclusions The care bundle intervention was effective in reducing SSI-CRAN rates. The implementation of this multimodal preventive strategy should be considered in centers with high SSI-CRAN incidences.

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