Search

Your search keyword '"Competing risk survival analysis"' showing total 2 results
Start Over Descriptor "Competing risk survival analysis" Topic cardiovascular diseases
2 results on '"Competing risk survival analysis"'

1. The risk of major cardiovascular events for adults with transfemoral amputation.

Author

Mundell BF, Luetmer MT, Kremers HM, Visscher S, Hoppe KM, and Kaufman KR

Subjects
Adult, Aged, Amputation, Surgical mortality, Cardiovascular Diseases etiology, Female, Humans, Male, Middle Aged, Risk Factors, Thigh, Amputation, Surgical adverse effects, Amputees, Cardiovascular Diseases epidemiology
Abstract

Background: It is well-known that the risk of cardiac disease is increased for those with lower-limb amputations, likely as a result of the etiology of the amputation. Using a longitudinal population-based dataset, we examined the association between transfemoral amputation (TFA) status and the risk of experiencing a major cardiac event for those undergoing either dysvascular or traumatic amputations. The association of receiving a prosthesis with the risk of experiencing a major cardiac event was also examined., Methods: Study Population: All individuals with TFA (N 162), i.e. knee disarticulation and transfemoral amputation, residing in Olmsted County, MN, between 1987 and 2014. Each was matched (1:10 ratio) with non-TFA adults on age, sex, and duration of residency., Data Analysis: A competing risk Cox proportional hazard model was used to estimate the relative likelihood of an individual with a TFA experiencing a major cardiac event in a given time period as compared to the matched controls. The cohort was divided by amputation etiology: dysvascular vs trauma/cancer. Additional analysis was performed by combining all individuals with a TFA to look at the relationship between prosthesis receipt and major cardiac events., Results: Individuals with a dysvascular TFA had an approximately four-fold increased risk of a cardiac event after undergoing an amputation (HR 3.78, 95%CI: 3.07-4.49). These individuals also had an increased risk for non-cardiac mortality (HR 6.27, 95%CI: 6.11-6.58). The risk of a cardiac event was no higher for those with a trauma/cancer TFA relative to the able-bodied controls (HR 1.30, 95%CI: 0.30-5.85). Finally, there was no difference in risk of experiencing a cardiac event for those with or without prosthesis (HR 1.20, 95%CI: 0.55-2.62)., Conclusion: The high risk of initial mortality stemming from an amputation event may preclude many amputees from cardiovascular disease progression. Amputation etiology is also an important factor: cardiac events appear to be more likely among patients with a dysvascular TFA. Providing a prosthesis does not appear to be associated with a reduced risk of a major cardiac event following amputation.

Published
2018
Full Text
View/download PDF

2. The risk of major cardiovascular events for adults with transfemoral amputation

Author

Benjamin F. Mundell, Marianne T. Luetmer, Hilal Maradit Kremers, Kurtis M. Hoppe, Kenton R. Kaufman, and Sue L. Visscher

Subjects
Adult, Male, 030506 rehabilitation, medicine.medical_specialty, medicine.medical_treatment, Population, Health Informatics, Disease, 030204 cardiovascular system & hematology, Prosthesis, Amputation, Surgical, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, Amputees, Risk Factors, Internal medicine, Competing risk survival analysis, Medicine, Humans, Transfemoral amputation, education, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Aged, education.field_of_study, business.industry, Proportional hazards model, Rehabilitation, Middle Aged, Amputation, Thigh, Cardiovascular Diseases, Cohort, Etiology, Population study, Female, 0305 other medical science, business, Major cardiac event
Abstract

Background It is well-known that the risk of cardiac disease is increased for those with lower-limb amputations, likely as a result of the etiology of the amputation. Using a longitudinal population-based dataset, we examined the association between transfemoral amputation (TFA) status and the risk of experiencing a major cardiac event for those undergoing either dysvascular or traumatic amputations. The association of receiving a prosthesis with the risk of experiencing a major cardiac event was also examined. Methods Study Population: All individuals with TFA (N 162), i.e. knee disarticulation and transfemoral amputation, residing in Olmsted County, MN, between 1987 and 2014. Each was matched (1:10 ratio) with non-TFA adults on age, sex, and duration of residency. Data Analysis: A competing risk Cox proportional hazard model was used to estimate the relative likelihood of an individual with a TFA experiencing a major cardiac event in a given time period as compared to the matched controls. The cohort was divided by amputation etiology: dysvascular vs trauma/cancer. Additional analysis was performed by combining all individuals with a TFA to look at the relationship between prosthesis receipt and major cardiac events. Results Individuals with a dysvascular TFA had an approximately four-fold increased risk of a cardiac event after undergoing an amputation (HR 3.78, 95%CI: 3.07–4.49). These individuals also had an increased risk for non-cardiac mortality (HR 6.27, 95%CI: 6.11–6.58). The risk of a cardiac event was no higher for those with a trauma/cancer TFA relative to the able-bodied controls (HR 1.30, 95%CI: 0.30–5.85). Finally, there was no difference in risk of experiencing a cardiac event for those with or without prosthesis (HR 1.20, 95%CI: 0.55–2.62). Conclusion The high risk of initial mortality stemming from an amputation event may preclude many amputees from cardiovascular disease progression. Amputation etiology is also an important factor: cardiac events appear to be more likely among patients with a dysvascular TFA. Providing a prosthesis does not appear to be associated with a reduced risk of a major cardiac event following amputation.

Published
2018

Catalog

Books, media, physical & digital resources
See catalog results