scholarly journals Multicentre Covariate Adjustment Analysis of Short-Term and 5-Year Outcomes after Endovascular Repair according to Sex

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bibombe P. Mwipatayi ◽  
Rebekah L.W Tan ◽  
Joseph Faraj ◽  
Ali Daneshmand ◽  
Olufemi Oshin ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Endovascular Aneurysm Repair ◽  
Adverse Event Rate ◽  
Short Term ◽  
Term Survival ◽  
Female Patients ◽  
Significant Difference ◽  
Male Patients ◽  
Composite Endpoints

Background. Several studies have reported worse outcomes in women compared to men after endovascular aneurysm repair (EVAR). This study aimed to evaluate sex-specific short-term and 5-year outcomes after EVAR. Methods. A total of 409 consecutive patients underwent elective EVAR from 2004 to 2017 at two tertiary hospitals in Western Australia. Baseline, intraoperative, and postoperative variables were examined retrospectively according to sex. The primary outcome was 30-day mortality (death within 30 days after EVAR). Secondary outcomes were 30-day composite endpoint, length of stay after EVAR, 5-year survival, freedom from reintervention, residual aneurysm size after EVAR, and major adverse event rate at 5-year follow-up. Results. A cohort of 409 patients, comprising 57 women (14%) and 352 men (86%), was analysed. Female patients were older (median age, 76.8 versus 73.5 years, p=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, p=0.005) and have a history of coronary artery bypass grafting (11.2% versus 3.5%, p=0.042) and malignancy (24.1% versus 10.5%, p=0.014). No difference in 30-day mortality or composite endpoints was demonstrated for female patients compared with male patients (3.5% versus 0.3%, p=0.052 and 31.6% versus 27.8%, p=0.562, respectively). The Kaplan–Meier curves demonstrated similar 5-year mortality outcomes amongst male and female patients (p=0.928). Long-term survival analysis adjusting for covariates demonstrated no significant difference in long-term mortality, composite endpoints, and reintervention rate between sexes. Conclusion. This study found no significant differences in 30-day and 5-year outcomes between female and male patients treated with EVAR, implying that EVAR remains a safe treatment choice for female patients.

Short-term efficacy and long-term survival of limited-stage small cell lung cancer treated with large fractionation radiotherapy and conventional fractionation radiotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20586-e20586
Author(s):  
Cheng Chen ◽  
Yingying Jiang ◽  
Ning Jiang ◽  
Kang He ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Dose ◽  
Survival Benefit ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Conventional Fractionation ◽  
Term Efficacy ◽  
Significant Difference

e20586 Background: Hyperfractionation (1.5Gy per dose twice a day, total dose 45Gy) or conventional fractionation (2Gy per dose once a day, total dose 60-70Gy) is the recommended dose fractionation for LS-SCLC. However, the optimal segmentation mode and dose of radiotherapy have not been determined. In this study, we evaluated the short-term efficacy and toxic and side effects of macrofractionation to explore the feasibility of macrofractionation radiotherapy in the treatment of LS-SCLC patients. Methods: From May 2011 to February 2020, 52 patients with LS-SCLC admitted to Jiangsu Cancer Hospital were retrospectively analyzed. The patients were divided into two groups according to the dose separation mode, including 29 cases in the large division group (3-4Gy per dose once a day, total dose 45-60Gy) and 23 cases (2Gy per dose once a day, total dose 50-68Gy) in the conventional division group. The short-term efficacy, 1-year survival rate and some other aspects of the two groups were compared. Results: The short-term overall response rate of large segmentation group was 79.3%, and there was significant difference compared with 52.2% of conventional segmentation group ( χ2 =4.293, P<0. 05) (Table). The 1-year survival rate of the large segmentation group was similar to that of the conventional segmentation group (82.8% vs．82.6%). The median survival time of large segment group was 30 months,which was not significantly different from the 34 months of conventional segment group (χ2=0.417, P>0.05). In terms of the effect of the two fractionated dose modes on long survival, 31.0% of patients in the large fractionation group survived more than 48 months, compared with only 13% in the conventional fractionation group. In addition, in the subgroup analysis of this study, it was found that compared with conventional fractionation radiotherapy, patients aged 45-65 years with ECOG score of 0-1 and lesions less than 5cm before radiotherapy could obtain more significant survival benefit from large fractionation radiotherapy, with statistically significant difference between the two groups (χ2=4.874, P<0.05). Conclusions: Large segmentation radiotherapy in the treatment of patients with LS-SCLC can improve the therapeutic effect and prolong the survival, especially for patients aged 45-65 years with ECOG score of 0-1 and lesions less than 5cm before radiotherapy , the survival benefit is more significant. In addition, large fractionated radiotherapy showed certain advantages in the long-term survival of patients with LS-SCLC, which is worthy of further clinical application.[Table: see text]

Off-Pump versus On-Pump Coronary Artery Bypass Grafting in Octogenarians: Comparison of Short-Term Outcomes and Long-Term Survival

Cardiology ◽  
2013 ◽  
Vol 125 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Daniel C. Lee ◽  
Sergio A. Ramirez ◽  
Matthew Bacchetta ◽  
Jeffrey S. Borer ◽  
Wilson Ko
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Short Term ◽  
Term Survival ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals Sex differences in short-and long-term survival among critically ill patients with sepsis: a real-world study using propensity scoring methods

2020 ◽  
Author(s):  
Shan Lin ◽  
Shanhui Ge ◽  
Wanmei He ◽  
Lihong Bai ◽  
Mian Zeng
Keyword(s):  
Sex Differences ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mortality Rates ◽  
Term Survival ◽  
Long Term Survival ◽  
Female Patients ◽  
Short And Long Term ◽  
Male Patients

Abstract Background At present, there have been studies showing a correlation between sex differences and prognosis. Nevertheless, the evidence of short- and long-term survival of sex-based differences among critically ill patients with sepsis is still limited and controversial. The purpose of this study was to evaluate the effect of sex on the short- and long-term survival of critically ill patients with sepsis. Methods We used the Medical Information Mart for Intensive Care III database. Cox proportional hazards models were conducted to determine the relationship of 28-day and 1-year mortality rates with a different sex. Interaction and stratified analyses were conducted to test whether the effect of sex differed across various subgroups. Results A total of 12,321 patients were enrolled in this study. After adjustments, the 28-day and 1-year mortality rates for female patients were reduced by 12% and 10%, respectively (HR = 0.88, 95% CI 0.81–0.96 and HR = 0.90, 95% CI 0.85–0.95) when compared to male patients. The effects of the association between sex and 28-day and 1-year mortality were broadly consistent for all subgroup variables. Only a significant interaction of age was observed in 1-year mortality (P = 0.0091). Compared with male patients, female patients (< 50 years) had better long-term survival advantages (HR 0.76 95% CI 0.62–0.94, P = 0.0124); on the contrary, for older patients (≥ 50 years), we did not find sex-based differences in long-term survival (HR 1.03, 95% CI 0.97–1.09, P = 0.3678). Conclusions In the current retrospective large database review, female patients had a significantly lower 28-day and 1-year mortality rates than did males among critically ill patients with sepsis. Of concern, there was an interaction between age and sex, and whether to suggest that female-associated hormones affect clinical outcomes needs to be further researched.

scholarly journals Short-term outcomes associated with bilateral internal thoracic artery grafting

2016 ◽  
Vol 31 (1) ◽  
pp. 3-9
Author(s):  
Sayedur R Khan ◽  
Abul Kashem ◽  
Mirza AK Mohiuddin ◽  
Jahangir Kabir
Keyword(s):  
Coronary Artery ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Short Term ◽  
Term Survival ◽  
Significant Difference ◽  
Bilateral Internal Thoracic Artery

Background: Bilateral internal thoracic artery (BITA) grafting is associated with improved long-term survival and graft patency compared to single internal thoracic artery (SITA) graft and saphenous vein graft in coronary artery bypass grafting (CABG). However, BITA grafting may adversely affect early in hospital mortality and morbidity due to deep sternal wound infection. Hence, we carried out this study to evaluate early outcomes of BITA grafting in different configuration in our hospital and to assess safety and applicability of BITA grafting as a routine procedure.Methods: A retrospective cross sectional study was conducted in September 2014 where all 134 patients using bilateral ITA for coronary artery bypass (CABG) at United Hospital, Dhaka, Bangladesh from January 2009 to September 2014 were included. BITA grafting were used in either in-situ or Y-graft technique. We reviewed and evaluated patients’ characteristics and short-term outcomes. The short-term outcomes included in hospital mortality and major morbidities.Results: Out of 134 patients, 129 (96%) patients were male. The mean age was 48.73 ± 8.42 yrs ranging from 28 to 72 yrs. Hypertension and smoking were the most common cardiac risk factors. There was no mortality in both BITA in-situ and BITA Y-graft groups. Most common postoperative complications were fever (26%), and arrhythmia (7.5%). Only one female patient (0.7) had sternal wound complication. Elderly, obesity and COPD were not observed to be associated with sternal wound complication.Conclusion: Short-term outcomes of BITA grafting for CABG is excellent with no significant difference between BITA in-situ and BITA Y-graft groups.Bangladesh Heart Journal 2016; 31(1) : 3-9

scholarly journals Long-Term Outcomes of Coronary Artery Bypass Grafting in Veterans with Ischemic Cardiomyopathy

2020 ◽  
Vol 23 (3) ◽  
pp. E323-E328
Author(s):  
Michael Andrew Napolitano ◽  
K. Benjamin Lee ◽  
Ethan S Rosenfeld ◽  
Sheena W Chen ◽  
Andrew D Sparks ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ischemic Cardiomyopathy ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Short Term ◽  
Term Survival ◽  
Pump Cabg ◽  
Short Term Survival

Background: The Surgical Treatment for Ischemic Heart Failure (STICH) trial showed that surgical revascularization in ischemic cardiomyopathy (ICM) patients improves long-term mortality compared with medical treatment alone. This study examines how veterans with ICM undergoing revascularization fare against patients without ICM; it also examines the outcomes in the veteran population. Methods: This is a retrospective review of a single-center database. From 2000 to 2018, 1,461 patients underwent isolated coronary artery bypass grafting (CABG). Two-hundred-one patients with an ejection fraction less than 35% were classified as the ICM cohort. The primary outcome was mortality. Secondary outcomes included postoperative complications. Subgroup analysis was performed within the ICM cohort comparing off-pump CABG (OPCAB) versus on-pump CABG (ONCAB). Results: ICM patients had a higher incidence of myocardial infarction (MI), diabetes, chronic kidney disease (CKD), and preoperative intra-aortic balloon pump (IABP) use. The non-ICM cohort was more functionally independent. OPCAB was performed in 80.1% of ICM and 66.3% of non-ICM cohorts. There was no statistical difference between ICM and non-ICM cohorts in 30-day mortality (OR 1.94[0.79 – 4.75], P = .15). The ICM cohort had an increased 5-year mortality (OR 1.75[1.14 – 2.69], P = .01) and 10-year mortality (OR 1.71[1.09 - 2.67], P = .02). The ICM cohort showed improved, although not statistically significant, short-term mortality with OPCAB compared with ONCAB (3.1% versus 12.5%, OR 0.31[0.05 – 1.82], P = .20). Conclusion: Veterans with ICM undergoing CABG demonstrated similar short-term survival compared with non-ICM veterans. The long-term survival in the ICM cohort still is inferior to patients without ICM. There is a trend toward improved short-term survival in patients with ICM undergoing OPCAB.

scholarly journals Short-term progression of interstitial lung disease in systemic sclerosis predicts long-term survival in two independent clinical trial cohorts

2018 ◽  
Vol 78 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Elizabeth R Volkmann ◽  
Donald P Tashkin ◽  
Myung Sim ◽  
Ning Li ◽  
Ellen Goldmuntz ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Cox Model ◽  
Short Term ◽  
Term Survival ◽  
Skin Score ◽  
Increased Risk ◽  
Significant Difference

ObjectiveTo assess survival and identify predictors of survival in patients with systemic sclerosis-interstitial lung disease (SSc-ILD) who participated in the Scleroderma Lung Studies (SLS) I and II.MethodsSLS I randomised 158 patients with SSc-ILD to 1  year of oral cyclophosphamide (CYC) vs placebo. SLS II randomised 142 patients to 1 year of oral CYC followed by 1 year of placebo vs 2 years of mycophenolate mofetil. Counting process Cox proportional hazard modelling identified variables associated with long-term mortality in SLS I and II. Internal validation was performed using joint modelling.ResultsAfter a median follow-up of 8 years, 42% of SLS I patients died, and when known the cause of death was most often attributable to SSc. There was no significant difference in the time to death between treatment arms in SLS I or II. Higher baseline skin score, older age, and a decline in the forced vital capacity (FVC) and the diffusing capacity for carbon monoxide (DLCO) over 2 years were independently associated with an increased risk of mortality in SLS I. The Cox model identified the same mortality predictor variables using the SLS II data.ConclusionIn addition to identifying traditional mortality risk factors in SSc (skin score, age), this study demonstrated that a decline in FVC and DLCO over 2 years was a better predictor of mortality than baseline FVC and DLCO. These findings suggest that short-term changes in surrogate measures of SSc-ILD progression may have important effects on long-term outcomes.

Surgery in drug use-associated infective endocarditis: long-term survival is negatively affected by recurrence

2019 ◽  
Vol 30 (4) ◽  
pp. 528-534 ◽  
Author(s):  
Vilem Rohn ◽  
Branislav Laca ◽  
Milan Horn ◽  
Lukas Vlk ◽  
Petra Antonova ◽  
...  
Keyword(s):  
Drug Use ◽  
Intravenous Drug ◽  
Long Term Outcomes ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Number Of Patients ◽  
Significant Difference

Abstract OBJECTIVES The prevalence of infectious endocarditis (IE) in intravenous drug users (IDUs) is increasing, and the number of patients who need surgery is also rising. Relatively little is known about the short-term and long-term outcomes of these operations. METHODS This study is a retrospective analysis of our institutional results, focussing on risk factors for perioperative death, major adverse events and long-term survival. A total of 50 of the 66 (75.75%) patients had postoperative follow-up, and the mean follow-up time was 53.9 ± 9.66 months. Patients were divided into 2 groups depending on whether they were having their first operation or were being reoperated for recurrent IE. RESULTS From March 2006 to December 2015, a total of 158 patients underwent surgery for IE; 72 (45.6%) of them were identified as active IDUs. The operative mortality in IDUs was 8.33% (6 patients), with no significant difference between the 2 groups (P = 0.6569). Survival rates at 1 year, at 3 years and at the end of follow-up were 92%, 72% and 64%, respectively. There was significantly worse survival of patients with recurrent IE (log-rank test, P = 0.03). CONCLUSIONS Although the short-term results of operation for IE in IDUs are good, long-term outcomes are not satisfactory. The survival of patients with recurrence of IE caused by return to intravenous drug use is significantly worse.

scholarly journals Short-term clinical outcomes and long-term survival of minimally invasive direct coronary artery bypass grafting

2018 ◽  
Vol 7 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Shahzad G. Raja ◽  
Sheena Garg ◽  
Melissa Rochon ◽  
Siobhan Daley ◽  
Fabio De Robertis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Short Term ◽  
Term Survival

scholarly journals Transfusion of red blood cells: the impact on short-term and long-term survival after coronary artery bypass grafting, a ten-year follow-up

2010 ◽  
Vol 10 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Albert H.M. van Straten ◽  
Margreet W.A. Bekker ◽  
Mohamed A. Soliman Hamad ◽  
André A.J. van Zundert ◽  
Elisabeth J. Martens ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Blood Cells ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Short Term ◽  
Term Survival ◽  
The Impact
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