Joint modeling of forced vital capacity measures with time to onset of polycythemia among chronic obstructive pulmonary outpatients follows-up: A case of University of Gondar Referral Hospital.

Background and Aims: Chronic obstructive pulmonary disease (COPD) causes airflow obstruction and respiratory problems. Thus, the main objective of this study was to determine the risk factors for the progression of COPD using longitudinally measured forced vital capacity with time to onset of polycythemia outpatients follow-up. Methods: A retrospective study design was used to gather the related data on longitudinal change of forced vital capacity and time to onset of polycythemia from the medical charts. The joint model consists of a longitudinal submodel for the change of forced vital capacity and a survival submodel for the time to onset of polycythemia of chronic obstructive pulmonary patients. Results: From the total of 266 patient's estimated value of forced vital capacity of chronic obstructive pulmonary patients was 74.45 years with a standard deviation of 8.59. The estimated value of the association parameter was -0.006, which indicates that the lower value for a forced vital capacity measure was associated with the higher risk of polycythemia and vice versa "Based on the joint model analysis found that the predictor smoking, comorbidities, marital status, weight, and HIV" jointly affected the two responses, which are change of forced vital capacity and time to onset of polycythemia among chronic obstructive pulmonary patients. Conclusion: The overall performance of separate and joint models, joint modeling of longitudinal measures with the time-to-event outcome was the best model due to smaller standard errors and statistical significance of both the association parameters.

Survival of HIV/AIDS patients treated under ART follow-up at the University hospital, northwest Ethiopia.

INTRODUCTION: The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival. METHODS: A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates. RESULTS: In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate. CONCLUSIONS: Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.