How does loss to follow-up influence cohort findings on HIV infection? A joint analysis of the French hospital database on HIV, MortalitE 2000 survey and death certificates
How does loss to follow-up influence cohort findings on HIV infection? A joint analysis of the French hospital database on HIV, MortalitE 2000 survey and death certificates
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DOI：
10.1111/j.1468-1293.2008.00678.x
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发表时间：
2009-04-01
期刊：
影响因子：
3
通讯作者：
Costagliola, D.
中科院分区：
文献类型：
--
作者：
Lanoy, E.;Lewden, C.;Costagliola, D.
我们的目的是检索1999年法国国家艾滋病研究所（ANRS CO4）医院艾滋病病毒数据库（ANRS CO4 FHDH）中34835名患者的随访失败（LFU）患者的重要状态，至少12个月没有再就诊，并检查随访失败如何影响生存估计和延迟获得护理（DAC）对生存的影响。LFU患者的状况是通过2006年中期的FHDH更新来确定的，在该更新中，他们在失去随访后12个月的状态（如果有的话）被添加进来，并通过与2000年死亡原因流行病学中心（CEpiDc）的MortalitE数据库相匹配，其中包括2000年死亡的艾滋病毒感染者。我们比较了校正LFU患者状态前后的Kaplan-Meier和风险比（HR）估计值。在2006年中期更新的FHDH中，1999年就诊的患者中，7.5%为LFU：其中2.1%后来返回随访，在FHDH中心中位无随访时间为3.5年，5.4%没有进一步的FHDH就诊，其中29.8%死亡根据MortalitE 2000-CEpiDc。校正后，1999年入组后的估计1年生存率在原始分析和更新分析之间存在差异（分别为97.1 vs 95.9%， P=0.017）；与DAC相关的死亡率hr估计在前6个月没有差异，但在6-18个月期间存在差异。在LFU患者中，28.1%的患者在几年后返回随访，至少21.4%的患者死亡，这导致对生存和DAC对生存的影响的略微高估。
We aimed to retrieve the vital status of patients lost to follow-up (LFU), with no further visits for at least 12 months, for the 34 835 patients in the Agence Nationale de Recherche sur le SIDA CO4 French Hospital Database on HIV (ANRS CO4 FHDH) seen in 1999 and to examine how loss to follow-up might influence estimates of survival and the impact of delayed access to care (DAC) on survival.The status of LFU patients was established by using the mid-2006 update of the FHDH in which their status 12 months after loss to follow-up was added when available and by matching with the MortalitE 2000-Epidemiological Centre for Medical Causes of Death (CEpiDc) database, which included HIV-infected patients dying in 2000. We compared Kaplan-Meier and hazard ratio (HR) estimates before and after correction for the status of LFU patients.In the mid-2006 updated FHDH, of the patients seen in 1999, 7.5% were LFU: of these, 2.1% later returned for follow-up, with a median time without follow-up in an FHDH centre of 3.5 years, and 5.4% had no further FHDH visits whatsoever, of whom 29.8% died according to MortalitE 2000-CEpiDc. After correction, the estimated 1-year survival rates following enrolment in 1999 differed between the original and updated analyses (97.1 vs. 95.9%, respectively; P=0.017); the estimates of mortality HRs associated with DAC did not differ during the first 6 months, but did differ for the 6-18-month period.Among LFU patients, 28.1% returned to follow-up after several years and at least 21.4% died, which led to a slight overestimation of both survival and the impact of DAC on survival.