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Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model

The clinical picture of patients with sickle cell anemia (SCA) is associated with several complications some of which could be fatal. The objective of this study is to analyze the causes of death and the effect of sex and age on survival of Brazilian patients with SCA. Data of patients with SCA who...

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Autores principales: do Nascimento, Emilia Matos, de Castro Lobo, Clarisse Lopes, de Bragança Pereira, Basilio, Ballas, Samir K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402554/
https://www.ncbi.nlm.nih.gov/pubmed/30858960
http://dx.doi.org/10.4084/MJHID.2019.022
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author do Nascimento, Emilia Matos
de Castro Lobo, Clarisse Lopes
de Bragança Pereira, Basilio
Ballas, Samir K.
author_facet do Nascimento, Emilia Matos
de Castro Lobo, Clarisse Lopes
de Bragança Pereira, Basilio
Ballas, Samir K.
author_sort do Nascimento, Emilia Matos
collection PubMed
description The clinical picture of patients with sickle cell anemia (SCA) is associated with several complications some of which could be fatal. The objective of this study is to analyze the causes of death and the effect of sex and age on survival of Brazilian patients with SCA. Data of patients with SCA who were seen and followed at HEMORIO for 15 years were retrospectively collected and analyzed. Statistical modeling was performed using survival analysis in the presence of competing risks estimating the covariate effects on a sub-distribution hazard function. Eight models were implemented, one for each cause of death. The cause-specific cumulative incidence function was also estimated. Males were most vulnerable for death from chronic organ damage (p = 0.0005) while females were most vulnerable for infection (p=0.03). Age was significantly associated (p ≤ 0.05) with death due to acute chest syndrome (ACS), infection, and death during crisis. The lower survival was related to death from infection, followed by death due to ACS. The independent variables age and sex were significantly associated with ACS, infection, chronic organ damage and death during crisis. These data could help Brazilian authorities strengthen public policies to protect this vulnerable population.
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spelling pubmed-64025542019-03-11 Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model do Nascimento, Emilia Matos de Castro Lobo, Clarisse Lopes de Bragança Pereira, Basilio Ballas, Samir K. Mediterr J Hematol Infect Dis Original Article The clinical picture of patients with sickle cell anemia (SCA) is associated with several complications some of which could be fatal. The objective of this study is to analyze the causes of death and the effect of sex and age on survival of Brazilian patients with SCA. Data of patients with SCA who were seen and followed at HEMORIO for 15 years were retrospectively collected and analyzed. Statistical modeling was performed using survival analysis in the presence of competing risks estimating the covariate effects on a sub-distribution hazard function. Eight models were implemented, one for each cause of death. The cause-specific cumulative incidence function was also estimated. Males were most vulnerable for death from chronic organ damage (p = 0.0005) while females were most vulnerable for infection (p=0.03). Age was significantly associated (p ≤ 0.05) with death due to acute chest syndrome (ACS), infection, and death during crisis. The lower survival was related to death from infection, followed by death due to ACS. The independent variables age and sex were significantly associated with ACS, infection, chronic organ damage and death during crisis. These data could help Brazilian authorities strengthen public policies to protect this vulnerable population. Università Cattolica del Sacro Cuore 2019-03-01 /pmc/articles/PMC6402554/ /pubmed/30858960 http://dx.doi.org/10.4084/MJHID.2019.022 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
do Nascimento, Emilia Matos
de Castro Lobo, Clarisse Lopes
de Bragança Pereira, Basilio
Ballas, Samir K.
Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title_full Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title_fullStr Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title_full_unstemmed Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title_short Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model
title_sort survival probability in patients with sickle cell anemia using the competitive risk statistical model
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402554/
https://www.ncbi.nlm.nih.gov/pubmed/30858960
http://dx.doi.org/10.4084/MJHID.2019.022
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