Modelling survival in acute severe illness: Cox versus accelerated failure time models

Journal of Evaluation in Clinical Practice
John L MoranAustralian and New Zealand Intensive Care Society Clinical Trials Group

Abstract

The Cox model has been the mainstay of survival analysis in the critically ill and time-dependent covariates have infrequently been incorporated into survival analysis. To model 28-day survival of patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), and compare the utility of Cox and accelerated failure time (AFT) models. Prospective cohort study of 168 adult patients enrolled at diagnosis of ALI in 21 adult ICUs in three Australian States with measurement of survival time, censored at 28 days. Model performance was assessed as goodness-of-fit [GOF, cross-products of quantiles of risk and time intervals (P > or = 0.1), Cox model] and explained variation ('R2', Cox and ATF). Over a 2-month study period (October-November 1999), 168 patients with ALI were identified, with a mean (SD) age of 61.5 (18) years and 30% female. Peak mortality hazard occurred at days 7-8 after onset of ALI/ARDS. In the Cox model, increasing age and female gender, plus interaction, were associated with an increased mortality hazard. Time-varying effects were established for patient severity-of-illness score (decreasing hazard over time) and multiple-organ-dysfunction score (increasing hazard over time). The Cox model was w...Continue Reading

References

May 1, 1990·Statistics in Medicine·E L Korn, R Simon
Sep 1, 1988·The American Review of Respiratory Disease·J F MurrayM R Flick
Jan 1, 1988·Statistics in Medicine·T A Louis
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Sep 8, 1993·JAMA : the Journal of the American Medical Association·W A KnausT H Grasela
Dec 1, 1995·American Journal of Respiratory and Critical Care Medicine·R L DoyleM A Matthay
Jan 15, 1996·Statistics in Medicine·S G Hilsenbeck, G M Clark
Jun 1, 1997·The European Respiratory Journal·M Ferring, J L Vincent
May 1, 1998·American Journal of Respiratory and Critical Care Medicine·M D Zilberberg, S K Epstein
Oct 14, 1998·American Journal of Respiratory and Critical Care Medicine·M MonchiF Brunet
Jun 3, 1999·Annual Review of Public Health·L D Fisher, D Y Lin
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Oct 12, 2001·JAMA : the Journal of the American Medical Association·F L FerreiraJ L Vincent
Jan 16, 2002·JAMA : the Journal of the American Medical Association·Andrés EstebanUNKNOWN Mechanical Ventilation International Study Group
Feb 19, 2002·American Journal of Respiratory and Critical Care Medicine·Andrew D BerstenUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Oct 31, 2002·Statistics in Medicine·Jesus OrbeVicente Núñez-Antón
Feb 26, 2004·Statistics in Medicine·Patrick Royston, Willi Sauerbrei
Jul 22, 2004·Anaesthesia and Intensive Care·J L MoranA D Bersten
Sep 1, 2005·Statistics in Medicine·H PutterJ C van Houwelingen

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.