Ahmad Tanvir, Munir Assia, Bhatti Sajjad Haider, Aftab Muhammad, Raza Muhammad Ali
Department of Statistics, Government College University, Faisalabad, Pakistan.
PLoS One. 2017 Jul 20;12(7):e0181001. doi: 10.1371/journal.pone.0181001. eCollection 2017.
This study was focused on survival analysis of heart failure patients who were admitted to Institute of Cardiology and Allied hospital Faisalabad-Pakistan during April-December (2015). All the patients were aged 40 years or above, having left ventricular systolic dysfunction, belonging to NYHA class III and IV. Cox regression was used to model mortality considering age, ejection fraction, serum creatinine, serum sodium, anemia, platelets, creatinine phosphokinase, blood pressure, gender, diabetes and smoking status as potentially contributing for mortality. Kaplan Meier plot was used to study the general pattern of survival which showed high intensity of mortality in the initial days and then a gradual increase up to the end of study. Martingale residuals were used to assess functional form of variables. Results were validated computing calibration slope and discrimination ability of model via bootstrapping. For graphical prediction of survival probability, a nomogram was constructed. Age, renal dysfunction, blood pressure, ejection fraction and anemia were found as significant risk factors for mortality among heart failure patients.
本研究聚焦于2015年4月至12月期间入住巴基斯坦费萨拉巴德心脏病学与联合医院的心力衰竭患者的生存分析。所有患者年龄在40岁及以上,患有左心室收缩功能障碍,属于纽约心脏协会(NYHA)III级和IV级。采用Cox回归模型来模拟死亡率,将年龄、射血分数、血清肌酐、血清钠、贫血、血小板、肌酸磷酸激酶、血压、性别、糖尿病和吸烟状况视为可能导致死亡的因素。使用Kaplan-Meier曲线来研究生存的总体模式,结果显示在最初几天死亡率较高,然后在研究结束时逐渐上升。使用鞅残差来评估变量的函数形式。通过自抽样法计算校准斜率和模型的辨别能力来验证结果。为了对生存概率进行图形预测,构建了一个列线图。研究发现,年龄、肾功能不全、血压、射血分数和贫血是心力衰竭患者死亡的重要危险因素。