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发布于:2019-3-26 20:50:11  访问:0 次 回复:0 篇
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Line demographical data (patient age and sex, procedure undergone) as well
In all multivariate logistic regression analyses, we sought to assess the following: the discrimination of the model with the percentages of appropriately classed patients in the final model; the calibration of the PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27362935 model with Hosmer-Lemeshow test; and the role of multicollinearity with the PG-1016548 inhibitor variance inflation factor. Information on long-term outcome was obtained from the Australian Registry of Deaths.Cumulative mortality was determined using the Kaplan-Meier product limit method of survival estimation, and comparison of survival of patients in the MET and PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25447644 control periods was performed using the log-rank test, censoring survival at 1500 days. We also performed multivariate logistic regression analysis using age (in ten year intervals), sex, unscheduled surgery, unit of admission, operation cluster (1 to 37) and MET period as independent variables, and vital status at 1500 days as the dependent variable. A forward stepwise elimination process was then used to remove covariates whose multivariate P value was > 0.10. The final model contained all predictors of mortality with a multivariate P < 0.10. In all multivariate logistic regression analyses, we sought to assess the following: the discrimination of the model with the percentages of appropriately classed patients in the final model; the calibration of the PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27362935 model with Hosmer-Lemeshow test; and the role of multicollinearity with the variance inflation factor. Every variance inflation factor was less than 5, indicating absence of severe multicollinearity. For all statistical analysis, P < 0.05 was considered statistically significant.ResultsBaseline characteristics of the patient cohorts During the control period, 1,369 procedures were conducted in 1,116 patients, and during the MET period 1,313 procedures were conducted in 1,067 patients (Table 2). The average age and proportion of female patients in the two periods was similar. Patients in the control period were statistically more likely to be admitted under units for cardiac or neurosurgery, and less likely to be admitted under units for orthopaedic surgery, urology, and ear nose and throat/faciomaxillary surgery (Table 2). Differences in surgical procedures performed in the control and MET periods Patients admitted during the MET period were less likely to undergo unscheduled surgery than those admitted during the control period (Table 3). In addition, patients admitted in the MET period were less likely to undergo valvular cardiac and aortic arch surgery, hepatobiliary, pancreatic, or splenic resection, vascular bypass and fistula surgery, and certain forms of neurosurgery (Table 3). In contrast, patients admitted during the MET period were more likely to undergo certain forms of orthopaedic and urological surgery (Table 3). Differences in long-term mortality of patients admitted during the control and MET periods Patients admitted during the MET period had improved 1500day (4.1-year) survival compared with those admitted during the control period (Figure 1). At 1500 days there were 381 deaths in the control period and 303 deaths in the MET period.The number of procedures in each of 83 operative categories for both the control period and the intervention phase was collated to allow comparison. For the purposes of multivariable analysis, these 83 operative categories were then grouped into 37 operation clusters (labeled 1 to 37; Table 1). All collation and grouping was performed by a single investigator (DJ) who was blinded to patient outcome.
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