Survival methods, including those using competing risk analysis, are not appropriate for intensive care unit outcome studies 英文参考文献.docVIP

Available online /content/10/1/103 Commentary Survival methods, including those using competing risk analysis, are not appropriate for intensive care unit outcome studies David Schoenfeld Professor of Medicine, Harvard Medical School, Massachusetts General Hospital Biostatistics Center, Staniford Street, Boston, MA 02114, USA Corresponding author: David Schoenfeld, dschoenfeld@ Published: 9 December 2005 Critical Care 2006, 10:103 (doi:10.1186/cc3949) This article is online at /content/10/1/103 ? 2005 BioMed Central Ltd See related research by Resche-Rigon et al. in this issue [/content/10/1/R5] Abstract followed after they leave the hospital to make sure that they do not die elsewhere. Survival analysis methods allow us to incorporate non-informative censoring in which a patient is known to be alive at a certain time. The authors correctly point out that when a patient is known to leave the hospital alive, survival methods that consider the patient as censored are not appropriate [1]. The CIF and the Fine and Grey models are also not appropriate when total mortality is the outcome because deaths after the patient leaves the hospital are not included in the CIF. In an analysis of total mortality, censoring is the last time the patient was contacted. Methods to incorporate information about whether or not a patient is in the ICU are available in the literature but would only be useful if many patients were still in the ICU at the time of analysis [3]. The preferred analysis for studies of mortality among patients treated in an intensive care unit should compare the proportions of patients who died during hospitalization. Studies that look for prognostic covariates should use logistic regression. Survival methods, such as the proportional hazards model, or methods based on competing risk analysis are not appropriate because prolonged survival among patients that die du