Análise de sobrevivência - Aplicação do modelo de regressão de Cox
DOI:
https://doi.org/10.5902/2179460X40480Keywords:
Análise de sobrevivência, Kaplan-Meier, Regressão de CoxAbstract
O principal propósito, desta pesquisa, foi realizar um estudo sobre análise de sobrevivência utilizando o modelo semi-paramétrico de riscos proporcionais de Cox. Para essa análise utilizaram-se dados obtidos no Hospital Universitário de Santa Maria, referentes a 69 pacientes com diagnóstico de câncer no aparelho digestivo. Estes pacientes foram acompanhados até a morte, ou o fim do estudo, ou a perda do seguimento. As covariáveis avaliadas foram: idade, tipo de cirurgia, estágio da doença, tipo de tratamento cirúrgico e data de óbito ou de censura. A média de idade dos pacientes foi de 60 anos, sendo que 71% deles tiveram como desfecho o óbito. A análise mostrou pelo modelo de riscos proporcionais de Cox ajustado para os dados, que apenas a covariável estágio da doença foi significativa (p=0,001), verificado pelo teste da razão de verossimilhanças parcial e teste de Wald. Com o modelo encontrado, concluiu-se que o risco relativo de óbito aumenta com o avanço do estágio da doença.
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References
ARMITAGE P, BERRY G. Statistical Methods in Medical Research. 3 ed. Blackwell Science Ltda. USA, 1994.
BUSTAMANTE-TEIXEIRA MT, FAERSTEIN E, LATORRE MR. Técnicas de análise de sobrevida. Cadernos de Saúde Pública, Rio de Janeiro, 2002; 18(3):579-594.
CARVALHO MS, ANDREOZZI VL, CODECO CL, et al. Análise de Sobrevida: Teoria e Aplicações em Saúde. Rio de Janeiro: Editora Fiocruz, 2005. 295p.
CHIESA EMF. Análise de Sobrevivência através de um método não paramétrico [monography]. Santa Maria: Curso de Especialização em Estatística e Modelagem Quantitativa/UFSM; 2002.
COLOSIMO EA. Análise de Sobrevivência Aplicada. In: Anais 9°, SEAGRO, REUNIÃO ANUAL DA RBRAS, 46ª, Piracicaba, SP. Brasil. 2001.
COLOSIMO EA, GIOLO SR. Análise de sobrevivência aplicada. São Paulo: Edgard Blücher, 2006. 370p.
COX DR. Regression Models and Life Tables. Journal of the Royal Statistical Society B, 1972; 34: 187-220.
COX DR. Partial likelihood. Biometrica, 1975; 62, 269-276.
FERRAZ RO, MOREIRA-FILHO DC. Análise de sobrevivência de mulheres com câncer de mama: modelos de riscos competitivos. Ciência & Saúde Coletiva. 2017; 22(11): 3743-3753.
FISCHER LD, BELLE, GV. Bioestatistics – A Methodology for the Heath Sciences. New York: John Wiley & Sons, Inc, 1995.
HOSMER DW, LEMESHOW S. Applied Survival Analysis - Regression Modeling of Time to Event Data. New York: John Wiley & Sons, Inc, 1999.
KAPLAN EL, MEIER P. Nonparametric estimation for incomplete observations. Journal of the American Statistical Association, 1958; 53(282):457-481.
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