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218 results on '"Lin, Shih-Pin"'

26. Perioperative Blood Transfusion Is Dose-Dependently Associated with Cancer Recurrence and Mortality after Head and Neck Cancer Surgery.

Author

Hee, Hui-Zen, Chang, Kuang-Yi, Huang, Chii-Yuan, Chang, Wen-Kuei, Tsou, Mei-Yung, and Lin, Shih-Pin

Subjects
MORTALITY risk factors, SCIENTIFIC observation, CONFIDENCE intervals, BLOOD transfusion, HEAD & neck cancer, CANCER relapse, RETROSPECTIVE studies, REGRESSION analysis, RISK assessment, CANCER patients, SURVIVAL analysis (Biometry), DESCRIPTIVE statistics, RESEARCH funding, ERYTHROCYTES, ODDS ratio, PROPORTIONAL hazards models, OVERALL survival, DISEASE risk factors
Abstract

Simple Summary: In head and neck cancer surgery, blood transfusion is required occasionally due to patients' underlying conditions and perioperative blood loss during surgical resection. However, transfusion is associated with immunosuppression, also known as the term "transfusion-related immune modulation (TRIM)", which could lead to worse cancer prognoses. The purpose of the study is to assess the association between perioperative blood transfusion and head and neck cancer recurrence and mortality. Our findings showed that blood transfusion was significantly associated with both cancer recurrence and mortality after head and neck cancer surgery. Background: The association between perioperative blood transfusion and cancer prognosis in patients with head and neck cancer (HNC) receiving surgery remains controversial. Methods: We designed a retrospective observational study of patients with HNC undergoing tumor resection surgery from 2014 to 2017 and followed them up until June 2020. An inverse probability of treatment weighting (IPTW) was applied to balance baseline patient characteristics in the exposed and unexposed groups. COX regression was used for the evaluation of tumor recurrence and overall survival. Results: A total of 683 patients were included; 192 of them (28.1%) received perioperative packed RBC transfusion. Perioperative blood transfusion was significantly associated with HNC recurrence (IPTW adjusted HR: 1.37, 95% CI: 1.1–1.7, p = 0.006) and all-cause mortality (IPTW adjusted HR: 1.37, 95% CI: 1.07–1.74, p = 0.011). Otherwise, there was an increased association with cancer recurrence in a dose-dependent manner. Conclusion: Perioperative transfusion was associated with cancer recurrence and mortality after HNC tumor surgery. [ABSTRACT FROM AUTHOR]

Published
2023
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50. A-qCPR risk score screening model for predicting 1-year mortality associated with hospice and palliative care in the emergency department.

Author

Wang, Ruei-Fang, Lai, Chao-Chih, Fu, Ping-Yeh, Huang, Yung-Chung, Huang, Sheng-Jean, Chu, Dachen, Lin, Shih-Pin, Chaou, Chung-Hsien, Hsu, Chen-Yang, and Chen, Hsiu-Hsi

Subjects
EXPERIMENTAL design, HOSPICE care, HOSPITAL emergency services, RESEARCH methodology, PALLIATIVE treatment, REGRESSION analysis, RISK assessment, PREDICTIVE validity, RETROSPECTIVE studies, DESCRIPTIVE statistics
Abstract

Background: Evaluating the need for palliative care and predicting its mortality play important roles in the emergency department. Aim: We developed a screening model for predicting 1-year mortality. Design: A retrospective cohort study was conducted to identify risk factors associated with 1-year mortality. Our risk scores based on these significant risk factors were then developed. Its predictive validity performance was evaluated using area under receiving operating characteristic analysis and leave-one-out cross-validation. Setting and participants: Patients aged 15 years or older were enrolled from June 2015 to May 2016 in the emergency department. Results: We identified five independent risk factors, each of which was assigned a number of points proportional to its estimated regression coefficient: age (0.05 points per year), qSOFA ⩾ 2 (1), Cancer (4), Eastern Cooperative Oncology Group Performance Status score ⩾ 2 (2), and Do-Not- R esuscitate status (3). The sensitivity, specificity, positive predictive value, and negative predictive value of our screening tool given the cutoff larger than 3 points were 0.99 (0.98–0.99), 0.31 (0.29–0.32), 0.26 (0.24–0.27), and 0.99 (0.98–1.00), respectively. Those with screening scores larger than 9 points corresponding to 64.0% (60.0–67.9%) of 1-year mortality were prioritized for consultation and communication. The area under the receiving operating characteristic curves for the point system was 0.84 (0.83–0.85) for the cross-validation model. Conclusions: A-qCPR risk scores provide a good screening tool for assessing patient prognosis. Routine screening for end-of-life using this tool plays an important role in early and efficient physician-patient communications regarding hospice and palliative needs in the emergency department. [ABSTRACT FROM AUTHOR]

Published
2021
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