Books: 'Prediction of survival'

1

Hein, Putter, ed. Dynamic prediction in clinical survival analysis. Boca Raton: CRC Press, 2012.

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2

Science of survival: Prediction of human behavior. Los Angeles, Calif: Bridge Publications, 2001.

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3

Ron, Hubbard L. Science of survival: Prediction of human behavior. Copenhagen K, Denmark: New Era Publications International Aps, 1993.

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4

Peter, Schmidt. Predicting recidivism using survival models. New York: Springer-Verlag, 1988.

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5

Smith, Charles Hugh. Survival +: Structuring prosperity for yourself and the nation. Berkeley, Calif: Oftwominds, 2009.

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6

Cooper, Arnold C. A resource-based prediction of new venture survival and growth. West Lafayette, Ind: Institute for Research in the Behavioral, Economic, and Management Sciences, Krannert Graduate School of Management, Purdue University, 1991.

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7

Cherdanceva, Tat'yana, Vladimir Klimechev, and Igor' Bobrov. Pathological and molecular biological analysis of renal cell carcinoma. Diagnosis and prognosis. ru: INFRA-M Academic Publishing LLC., 2020. http://dx.doi.org/10.12737/1020785.

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The monograph is devoted to the study of pathomorphological and molecular-biological characteristics of renal cell carcinoma and peritumoral zone depending on the degree of malignancy, and determine prognostic significance of criteria for predicting the postoperative survival of patients. Of interest to urologists, oncologists, pathologists, researchers, graduate students, dealing with the diagnosis of renal cell carcinoma and subsequent prediction of postoperative survival of patients.

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8

Schmidt, Peter, and Ann Dryden Witte. Predicting Recidivism Using Survival Models. New York, NY: Springer New York, 1988. http://dx.doi.org/10.1007/978-1-4612-3772-3.

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9

Hurd, Michael D. The predictive validity of subjective probabilities of survival. Cambridge, MA: National Bureau of Economic Research, 1997.

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10

Chow, Edward. A predictive model for survival in metastatic cancer patients attending an out-patient palliative radiotherapy clinic. Ottawa: National Library of Canada, 2001.

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11

Houwelingen, Hans van, and Hein Putter. Dynamic Prediction in Clinical Survival Analysis. Taylor & Francis Group, 2011.

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12

Ron, Hubbard L. Science of Survival: Prediction of Human Behavior. Bridge Pubns, 1990.

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13

Azzam F.G. Taktak (Editor) and Anthony C. Fisher (Editor), eds. Outcome Prediction in Cancer. Elsevier Science, 2007.

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14

G, Taktak Azzam F., and Fischer Anthony C, eds. Outcome prediction in cancer. Amsterdam: Elsevier, 2007.

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15

Outcome prediction in cancer. Amsterdam: Elsevier, 2005.

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16

The Worst Is Yet to Come: A Post-Capitalist Survival Guide. Repeater, 2019.

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17

Fleming, Peter. Worst Is yet to Come: A Survival Guide to Post-Capitalism. Watkins Media Limited, 2019.

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18

Frederickson, Debra Patrice. Survival analyses and prediction models for matched samples of TB, HIV, and TB/HIV infected individuals. [s.n.], 2001.

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19

Survival Skills for the Information Age: A Graphoanalytic Approach to Business in the Twenty-First Century. 2nd ed. Rowman & Littlefield Publishers, Inc., 2002.

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20

Robert, Lanza, ed. One world: The health and survival of the human species in the 21st century. Santa Fe, N.M: Health Press, 1996.

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21

Predicting Recidivism Using Survival Models. Springer, 2012.

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22

Schmidt, P., and A. D. Witte. Predicting Recidivism Using Survival Models. Springer-Verlag Berlin and Heidelberg GmbH & Co. K, 1988.

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23

Glare, Paul, Christian T. Sinclair, Patrick Stone, and Josephine M. Clayton. Predicting survival in patients with advanced disease. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0007.

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Worldwide there are over 50 million deaths per year. In considering the goal of fostering optimal care towards the end of life for these individuals, high-quality population-based data about disease and symptom occurrence as well as health-care needs are essential. Such data are important so that informed planning can underpin policy, service development, and patient care. This chapter discusses epidemiology as it relates to the ‘human experience’ towards the end of life with an emphasis on diseases, symptoms, psychosocial experiences, and access to health services. Some of the methods by which such data are collated in various parts of the world are described. The dramatic variability in experiences towards the end of life across regions and nations is also highlighted. Examples of where information is available that may inform planning for populations are discussed, as are areas where data may be helpful or needed but lacking.

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24

Townsend, William M., and Emma C. Morris. ICU selection and outcome of patients with haematological malignancy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0374.

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Patients with haematological malignancies require admission to the intensive care unit (ICU) due to the underlying disease, as a consequence of treatment with chemotherapy or after haematopoietic stem cell transplantation. With an increasing numbers of patients being diagnosed with these diseases and longer survival as treatments improve, the burden on ICU is anticipated to increase. There is compelling evidence that patients should not be denied admission to ICU based on the presence of a haematological malignancy. In this chapter the disease- and treatment-related reasons for ICU admission, outcome, and risk prediction scores for patients with haematological malignancies are discussed.

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25

Welsh, Sarah S., Geneviève Dupont-Thibodeau, and Matthew P. Kirschen. Neuroprognostication after severe brain injury in children: Science fiction or plausible reality? Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198786832.003.0010.

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Neuroprognostication is a complex process that spans the resuscitative, acute, and subacute phases of brain injury and recovery. Improvements over time have transitioned the task of outcome prediction after severe brain injury from estimating survival to providing a qualitative prognosis of functional neurologic recovery. This chapter follows the case of an 8-year-old boy who remained comatose following a cardiac arrest due to drowning. We describe and analyze novel applications of current technologies that could be used in the future to improve the accuracy, reliability, and confidence in the neuroprognostication process for physicians and families that are at the heart of ethical decision-making in medicine.

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26

Cheney, Phil, and Andrew Sullivan. Grassfires. CSIRO Publishing, 2008. http://dx.doi.org/10.1071/9780643096493.

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Grassfires: Fuel, Weather and Fire Behaviour presents information from CSIRO on the behaviour and spread of fires in grasslands. This second edition follows over 10 years of research aimed at improving the understanding of the fundamental processes involved in the behaviour of grassfires. The book covers all aspects of fire behaviour and spread in the major types of grasses in Australia. It examines the factors that affect fire behaviour in continuous grassy fuels; fire in spinifex fuels; the effect of weather and topography on fire spread; wildfire suppression strategies; and how to reconstruct grassfire spread after the fact. The three meters designed by CSIRO for the prediction of fire danger and rate of spread of grassfires are explained and their use and limitations discussed. This new edition expands the discussion of historical fires including Aboriginal burning practices, the chemistry of combustion, and the structure of turbulent diffusion flames. It also examines fire safety, including the difficulty of predicting wind strength and direction and the impact of threshold wind speed on safe fire suppression. Myths and fallacies about fire behaviour are explained in relation to their impact on personal safety and survival. Grassfires will be a valuable reference for rural fire brigade members, landholders, fire authorities, researchers and those studying landscape and ecological processes.

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27

Steinhauser, Karen E., and James A. Tulsky. Defining a ‘good’ death. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0008.

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Although any outcome of an advanced illness can be predicted, in palliative care settings the word ‘prognosis’ usually means the estimated time to death. Prognosis is an important but challenging set of clinical skills for palliative medicine clinicians to master. It is important because patients and families want to know what to expect, it influences clinical decision-making, and it may determine eligibility for services. It is challenging because of the inherent uncertainty of making predictions and because dying is not an easy topic to discuss. Advances in statistical computing have allowed the development of mathematical models and predictive tools that are now more accurate than clinical estimates. A large section of this chapter is devoted to presenting and evaluating several of these models, although prognostic uncertainty remains a significant issue even with them, and survival estimates should never drive clinical decision-making alone.

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28

Pinkhasov, Arkadiy, Michael J. Germain, and Lewis M. Cohen. Dialysis withdrawal and palliative care. Edited by Jonathan Himmelfarb. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0261.

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This chapter discusses why dialysis withdrawal is so common in the United States, when dialysis withdrawal and withholding is appropriate, and the role of palliative care in the renal patient. It discusses guidelines that were created to aid in dialysis withdrawal, dialysis initiation, and prognostic calculation. Factors contributing to the phenomenon of dialysis discontinuation include variability in the criteria for initiation of renal replacement therapy, increasing numbers of incident and prevalent geriatric patients, new emphasis on autonomy and quality of life, the development of improved prognostic instruments for prediction of survival, growing acceptance of medical decisions that accelerate dying, and a clearer appreciation of the quality of dying that ensues following the cessation of dialysis. There continues to be a need for further integration of palliative medicine in the clinical management of patients with chronic kidney disease, especially since hospice services are often unavailable unless a decision is made to stop dialysis treatment. The importance of communication between staff and patients and the documentation of the plan of care is critical.

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29

Robert, Clay. Target: Israel: The Book of Revelation. Great predictions about to unfold. The ultimate survival handbook. iUniverse, Inc., 2006.

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30

Stoolmiller, Mike. An Introduction to Using Multivariate Multilevel Survival Analysis to Study Coercive Family Process. Edited by Thomas J. Dishion and James Snyder. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199324552.013.27.

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Multivariate multilevel survival analysis is introduced for studying hazard rates of observed emotional behavior relevant for coercion theory. Finite time sampling reliability (FTSR) and short-term retest reliability (STRR) across two occasions (sessions) of observation during structured problem-solving tasks several weeks apart were determined for hazard rates of emotional behaviors for parent–child dyads. While FTSR was high (.80–.96), STRR was low (.16–.65), suggesting that emotional behaviors in the context of parent–child social interaction are not very stable over a period of several weeks. Using latent variable structural equation models that corrected for the low STRR, two hazard rates were predictive of change in child antisocial behavior over a 3-year period (kindergarten to third grade) net of initial child antisocial behavior. Low levels of parent positive emotion and increases from session 1 to 2 of child neutral behavior both accounted for unique variance in third grade antisocial behavior.

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31

Klimo, Paul, and Nir Shimony. Ependymomas. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0026.

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Pediatric posterior fossa tumors are usually ependymoma, pilocytic astrocytoma, or medulloblastoma. Ependymoma appears well-demarcated with heterogeneous enhancement on magnetic resonance imaging (MRI). Full neural axis MRI is indicated to assess for metastatic disease. Management is typically surgical resection of the tumor, with consideration for cerebrospinal fluid diversion if patients present with severe hydrocephalus. Extent of resection of the tumor is the most important factor in predicting recurrence and overall survival, and gross total resection is ideal. Infratentorial ependymomas have 2 molecular subtypes, which has implications for responsiveness to adjuvant therapy and prognosis. Infratentorial ependymomas are biologically different from supratentorial ependymomas. Postoperative radiation improves local control.

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32

Llewellyn, Sue. What Do Dreams Do? Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198818953.001.0001.

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What is a dream? It’s a complex, non-obvious pattern derived from your experience. But you haven’t actually experienced it. Strange. Revealing complex, hidden patterns makes dreams odd. Dreams associate elements of different experiences to make something new: a pattern you didn’t know was there until you dreamt it. Patterns are discernible forms in the way something happens or is done. Some patterns are easy to spot, being certain and obvious: night follows day. Patterns in human/animal experiences are less obvious because, first, the patterned elements appear at different times or places and, second, the pattern exhibits tendencies not certainties. Spotting such patterns depends on non-obvious associations. If prompted with ‘sea’, while awake, your logical brain makes obvious associations, ‘beach’ or ‘boat’, with a seaside pattern i.e. beach-boat-seaside. But after awakening from dreaming, when your brain is still tuned to non-obvious associations, ‘sick’ may come to mind. A less obvious element of sea experiences. You tend to seasickness when it’s rough. But you also get sick if you eat shellfish, have a migraine, or travel in cars—but only if you read. Sea–rough–car–read–shellfish–migraine. Visualizing these non-obvious associations between elements of different experiences becomes dream-like. Dreaming brains evolved to identify non-obvious associations. Across evolutionary time, you didn’t want to get sick. Survival depended on being well enough to anticipate the non-obvious patterns of predators and human competitors, while securing access to food and water. Making associations drives many, if not all, brain functions. Dream associations support memory, emotional stability, creativity, unconscious decision-making, and prediction, while also contributing to mental illness. This book explains how.

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33

Herbert, Beate M., and Olga Pollatos. The relevance of interoception for eating behavior and eating disorders. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198811930.003.0009.

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The importance of interoception for adaptive and maladaptive behavior, as well as for psychopathology, has gained growing interest, and dysfunctional interoception has been recognized as representing a core impairment across psychosomatic and psychiatric disorders. Eating is intrinsically guided by interoceptive signals and is directly associated with homeostatic psychophysiological needs, well-being, and survival. This chapter provides conceptually and empirically drawn conclusions focusing on the relevance of distinguishable dimensions of interoception for shaping eating behavior and body weight, and for eating disorders. Going beyond eating behavior per se, anorexia and bulimia nervosa are conceptualized as characterized by profound impairment of the self, with dysfunctional interoception at its core. Predictive coding models are addressed to integrate conclusions and empirical findings tentatively.

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34

Kesler, Shelli R., and Jeffrey S. Wefel. Targeted Treatment for Cognitive Impairment Associated with Cancer and Cancer Treatment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190214401.003.0013.

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Cognitive difficulty is one of the most common quality-of-life complaints among cancer patients and survivors. Cancer-related cognitive impairment (CRCI) is a common problem among cancer patients and survivors that extends disease-related morbidity; reduces quality of life; interferes with treatment adherence; and is a significant predictor of health behavior, disease progression, and survival. Several emerging management strategies for CRCI show promise for preventing and/or ameliorating CRCI. This chapter describes the incidence, symptoms, and putative mechanisms of CRCI and then discusses potential approaches for addressing CRCI. The focus of the interventions discussed in this chapter is on directions for future research that will potentially lead to widely accessible, effective, and ecologically valid approaches.

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35

Mehta, Dutt, and Eric Prommer. Factors Associated with Outcomes of Cardiopulmonary Resuscitation (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0049.

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Failed in-hospital resuscitations consume substantial health care resources. Accurate prediction of who will survive an in-hospital arrest is difficult. Identifying pre arrest factors associated with poor resuscitation outcomes facilitates and enhances cardiopulmonary resuscitation (CPR) discussions. Using a large CPR database, several preexisting factors associated with poor CPR outcome were identified and analyzed using statistical methods. The statistical model identifies factors associated with poor outcomes such as black race, advancing age, and multiple pre-existing conditions using the National Registry for Cardiopulmonary Resuscitation. The chapter describes the basics of the study, briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

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36

Wick, Wolfgang, Colin Watts, and Minesh P. Mehta. Oligodendroglial tumours. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199651870.003.0004.

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Concepts of diagnosis and treatment of oligodendroglial tumours have changed through clinical and translational studies over recent years. Diagnosis is now based on histopathological and integrated molecular information. The latter includes mutations in isocitrate dehydrogenase and the co-deletion of 1p/19q in the tumour tissue. In parallel, the long-term evaluation of large randomized trials performed in Europe and North America led to the current standard of a more aggressive chemoradiation regimen with procarbazine, CCNU (lomustine), and vincristine to optimize progression-free and overall survival. The future directions are delineated, which are aiming at further definition of prognostic and predictive subgroups, based on clinical, molecular, and imaging parameters, integrating immunotherapeutic concepts, as well as a closer look at patient-centred outcomes in upcoming trials.

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37

Rubin, Donald, Xiaoqin Wang, Li Yin, and Elizabeth Zell. Bayesian causal inference: Approaches to estimating the effect of treating hospital type on cancer survival in Sweden using principal stratification. Edited by Anthony O'Hagan and Mike West. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780198703174.013.24.

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This article discusses the use of Bayesian causal inference, and more specifically the posterior predictive approach of Rubin’s causal model (RCM) and methods of principal stratification, in estimating the effects of ‘treating hospital type’ on cancer survival. Using the Karolinska Institute in Stockholm, Sweden, as a case study, the article investigates which type of hospital (large patient volume vs. small volume) is superior for treating certain serious conditions. The study examines which factors may reasonably be considered ignorable in the context of covariates available, as well as non-compliance complications due to transfers between hospital types for treatment. The article first provides an overview of the general Bayesian approach to causal inference, primarily with ignorable treatment assignment, before introducing the proposed approach and motivating it using simple method-of-moments summary statistics. Finally, the results of simulation using Markov chain Monte Carlo (MCMC) methods are presented.

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38

Alter, Karen J., and Laurence R. Helfer. Reconsidering What Makes International Courts Effective. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780199680788.003.0010.

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This chapter revisits the arguments and predictions in Toward a Theory of Effective Supranational Adjudication, the 1997 study by Laurence Helfer and Anne-Marie Slaughter. The article was among the first to analyze the rise of international courts as a global phenomenon and to theorize about the factors contributing to their effectiveness. Helfer and Slaughter were motivated to write the article by the expanding legal and political footprint of two European tribunals — the European Union's Court of Justice (ECJ) and the European Court of Human Rights (ECtHR). Hence the first part of this chapter revisits several propositions asserted in the 1997 article, considers how well they have survived the test of time, and offers new conjectures about the future. The second part considers what the relative success of the Andean Tribunal of Justice (ATJ) reveals about the limits of the effectiveness of international courts.

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39

Schwitter, Juerg. Coronary artery disease. Edited by Dudley Pennell. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0105.

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In the work-up of suspected or known coronary artery disease (CAD), cardiovascular magnetic resonance (CMR) is an established technique and it is recommended by most recent guidelines. Stress dobutamine and stress perfusion CMR yield sensitivities and specificities to detect anatomically defined CAD (>50% coronary stenoses) ranging from 83% to 91% and from 83% to 86%, respectively, with areas under the receiver operating characteristic curve (AUCs) of 0.80–0.93. Multicentre trials report AUCs of 0.75–0.91 to detect CAD and showed superiority over scintigraphic techniques. Increasing evidence in thousands of patients demonstrates the highly predictive value of CMR. Exclusion of ischaemia by CMR goes along with excellent event-free survival rates of 0.5–0.9%/year. Cost analyses in large data sets (e.g. in the European CMR registry), suggest considerable cost savings for CMR over first-line invasive strategies in suspected CAD. Tissue characterization by CMR to detect scar, necrosis, oedema, microvascular obstruction, or haemorrhage is of particular importance in the setting of acute coronary syndromes and this application is emerging as the number of centres offering CMR increases.

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40

Daleiden, Joseph L. The American Dream: Can It Survive the 21st Century? Prometheus Books, 1999.

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41

Immunobiologic prognostic factors in aggressive non-Hodgkin's lymphoma: The role of proliferative index, host-immune response, and continuous lactate dehydrogenase level in predicting survival in 148 consecutive subjects. Ottawa: National Library of Canada, 2000.

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42

Patel, Sameer, and Julia Wendon. Diagnosis and assessment of acute hepatic failure in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0195.

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Establishing the aetiology of acute hepatic failure is essential for correct and timely management. An exhaustive history and examination is crucial in targeting investigations and initiating management. Clinical assessment allows risk stratification, identifying those patients who can be managed locally from those best served in a specialist centre with liver transplantation capability. History should focus on the presenting problem, time of onset and speed of deterioration, and establish features consistent with hyperacute, acute or subacute ALF to guide prognostication. Examination should initially focus on rapid assessment and resuscitation before searching for signs leading to more specific differential diagnoses. Investigations should encompass the variety of potential causes, ranging from basic to more specialist studies. Prognostication is critical for stratification of those patients who may benefit from a potentially life-saving transplantation. Several risk stratification and predictive tools exist to differentiate those patients likely to recover, those unlikely to survive despite maximal intervention, and those who would potentially benefit from transplantation.

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43

Raghunathan, Karthik, and Andrew Shaw. Crystalloids in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0057.

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‘Crystalloid’ refers to solutions of crystalline substances that can pass through a semipermeable membrane and are distributed widely in body fluid compartments. The conventional Starling model predicts transvascular exchange based on the net balance of opposing hydrostatic and oncotic forces. Based on this model, colloids might be considered superior resuscitative fluids. However, observations of fluid behaviour during critical illness are not consistent with such predictions. Large randomized controlled studies have consistently found that colloids offer no survival advantage relative to crystalloids in critically-ill patients. A revised Starling model describes a central role for the endothelial glycocalyx in determining fluid disposition. This model supports crystalloid utilization in most critical care settings where the endothelial surface layer is disrupted and lower capillary pressures (hypovolaemia) make volume expansion with crystalloids effective, since transvascular filtration decreases, intravascular retention increases and clearance is significantly reduced. There are important negative consequences of both inadequate and excessive crystalloid resuscitation. Precise dosing may be titrated based on functional measures of preload responsiveness like pulse pressure variation or responses to manoeuvres such as passive leg raising. Crystalloids have variable electrolyte concentrations, volumes of distribution, and, consequently variable effects on plasma pH. Choosing balanced crystalloid solutions for resuscitation may be potentially advantageous versus ‘normal’ (isotonic, 0.9%) saline solutions. When used as the primary fluid for resuscitation, saline solutions may have adverse effects in critically-ill patients secondary to a reduction in the strong ion difference and hyperchloraemic, metabolic acidosis. Significant negative effects on immune and renal function may result as well.

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44

Eisen, Tim. The patient with renal cell cancer. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0172.

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Renal cancer is the commonest malignancy of the kidney and worldwide, accounts for between 2% and 3% of the total cancer burden. The mainstay of curative treatment remains surgery. There have been significant advances in surgical technique, the most important ones being nephron-sparing surgery and laparoscopic nephrectomy. The medical treatment of advanced renal cell cancer has only improved markedly in the last decade with the development of antiangiogenic tyrosine-kinase inhibitors, inhibitors of mammalian target of rapamycin, and a diminished role for immunotherapy.Tyrosine-kinase inhibitor therapy results in reduction of tumour volume in around three-quarters of patients and doubles progression-free survival, but treatment is not curative. The management of side effects in patients on maintenance tyrosine-kinase inhibitors has improved in the last 3 years, although still presents difficulties which have to be actively considered.The molecular biology of renal cell carcinoma is better understood than for the majority of solid tumours. The commonest form of renal cancer, clear-cell carcinoma of the kidney, is strongly associated with mutations in the von Hippel–Lindau gene and more recently with chromatin-remodelling genes such as PBRM1. These genetic abnormalities lead to a loss of control of angiogenesis and uncontrolled proliferation of tumour cells. There is a very wide spectrum of tumour behaviour from the extremely indolent to the terribly aggressive. It is not currently known what accounts for this disparity in tumour behaviour.A number of outstanding questions are being addressed in scientific and clinical studies such as a clearer understanding of prognostic and predictive molecular biomarkers, the role of adjuvant therapy, the role of surgery in the presence of metastatic disease, how best to use our existing agents, and investigation of novel targets and therapeutic agents, especially novel immunotherapies.

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45

Harper, Lorraine, and David Jayne. The patient with vasculitis. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0160.

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The goals of treatment in renal vasculitis are to stop vasculitic activity and recover renal function. Subsequent strategies are required to prevent vasculitis returning and to address longer-term co-morbidities caused by tissue damage, drug toxicity, and increased cardiovascular and malignancy risk.Cyclophosphamide and high-dose glucocorticoids remain the standard induction therapy with alternative immunosuppressives, such as azathioprine, to prevent relapse. Plasma exchange improves renal recovery in severe presentations. Refractory disease resulting from a failure of induction or remission maintenance therapy requires alternative agents and rituximab has been particularly effective. Replacement of cyclophosphamide by rituximab for remission induction is supported by recent evidence. Methotrexate is effective in non-renal vasculitis but difficult to use in patients with renal impairment. Mycophenolate mofetil seems to be effective but there is less long-term evidence.Drug toxicity contributes to co-morbidity and mortality and has led to newer regimens with reduced cyclophosphamide exposure. Glucocorticoid toxicity remains a major problem with controversy over the rapidity with which glucocorticoids can be reduced or withdrawn.Disease relapse occurs in about 50% of patients. Early detection is less likely to lead to an adverse affect on outcomes. Rates of cardiovascular disease and malignancy are higher than in control populations but strategies to reduce their risk, apart from cyclophosphamide-sparing regimens, have not been developed. Thromboembolic events occur in 10% and may be linked to the recently identified autoantibodies to plasminogen and tissue plasminogen activator.Renal impairment at diagnosis is a strong predictor of patient survival and renal outcome. Other predictors include patient age, antineutrophil cytoplasmic antibody subtype, disease extent and response to therapy. Chronic kidney disease can stabilize for many years but the risks of end-stage renal disease are increased by acute kidney injury at presentation or renal relapse. Renal transplantation is successful with similar outcomes to other causes of end-stage renal disease.

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Books on the topic 'Prediction of survival'

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