Analysis On The Factors Influenced Survival In The Retired Military Cadres

ObjectionTo figure out the aspectsassociate with survival through analyze the correlation between survival time and patients' basic information,life style,treatment and treatment qualification rates of chronic diseases,laboratory blood biochemistry indices and other factors in order to provide scientific proof to improve patients' survival in the retired military cadres from the Second Military Medical University.MethodsBidirectional cohort studies design method was used.Clinical data of 237 retired military cadres hospitalized in our department from January 2000 to October 2013 were collected.The clinical date included:basic information as age,height,body weight,marital staus,educational level and solo livingornot;life styleassmokingand alcohol;laboratory blood biochemistry indices for the first be in hospital;treatment and treatment qualification rates of chronic diseases.All data acquired by browsed medical records and household survey with a self-designed questionnaire.The last follow-up time is October 31,2014.Measurement data was conducted by survival analysis.Kaplan-Meier method was used for univariate survival analysis.When variables in the univariate analysis(P<0.1)considered as the potential relevant factors,we performed multivariate analysis using Cox proportional hazards models.All the statistical analysis was carried out by SPSS,version21.0.Results1.A total of 237 retired cadres completed follow-up,while all were Han race and 87.8%were male.All-cause mortality was 115 subjects when the follow-up ended.Cancer,respiratory system disease,cardiovascular and cerebrovascular diseases were the first three of all the diseases that cause death.The age of the deceased varied from 71 to 99 years and the average age was 83.2±5.2 years.Meanwhile the survival aged from 70 to 101 years and the average age was 85.3±4.4 years.2.Univariate analysis indicated that the factors had potential correlation with survival(P<0.1)involved age,educational level,type of work,body mass index(BMI),milk drinking,smoke,physical excises,systolic pressure,cancer,control of blood pressure,ischemic stroke,coronary heart disease,Parkinson's Disease(PD),Alzheimer's disease(AD),diabetes mellitus,chronic renal failure,white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),fasting blood glucose(FBG),serum creatinine(SCR),alanine transaminase(ALT)and free 3,5,3 triiodothyronine(FT3).3.Multivariate cox regression analysis indicated that the factors influenced survival included age,BMI,smoke,physical excises,cancer,AD,PD,chronic renal failure and HGB.After adjustments for confounders,the correlation between these factors and all-cause mortality was present following.(1)Age:Compared with the retired cadres aged 60-69 years,the all-cause mortality was 4.71 times(HR=4.71,95%CI:1.44-15.43,P<0.05)in the one aged 70-79 years,8.91 times(HR=8.91,95%CI:2.48?32.07,P<0.05)in the 80-89 years and 17.91times(H:R=17.91,95%CI:3.65?87.87,P<0.05)in the 90-99 years;(2)BMI:The all-cause mortality was decreased by 49.0%(HR=0.51,95%CI:0.20?1.28,P=0.151)in normal body weight group,46.0%(HR=0.54,95%CI:0.22?1.34,P=0.1 83)in overweight group and 76.0%(HR=0.24,95%CI:0.08?0.68,P<0.05)in obesity group when compared with underweight group;(3)Smoke:Compared with the non-smokers,the all-cause mortality was 4.51 times(HR=4.51,95%CI:2.96?6.86,P<0.05)for the smokers,but no statistical differences were seen between the ex-smokers and non-smokers(HR=0.45,95%CI:0.14-1.49,P=0.192);(4)Physical excises:The all-cause mortality was decreased by 49.0%(HR=0.51,95%CI:0.31?0.83,P<0.05)in people do regular physical excises when compared with the one who do not;(5)Cancer:The all-cause mortality was 4.70 times(HR=4.70,95%CI:2.64-8.37,P<0.05)in people with cancer when compared with the one who without;(6)AD:The all-cause mortality was 9.93 times(HR=9.93,95%CI:2.82-34.95P<0.05)in people with AD when compared with the one who without;(7)PD:The all-cause mortality was 2.34 times(HR=2.34,95%CI:1.13?4.85,P<0.05)in people with PD when compared with the one who without;(8)Chronic renal failure:The all-cause mortality was 2.32 times(HR=2.32,95%CI:1.18?4.57,P<0.05)in people with chronic renal failure when compared with the one who without;(9)HGB:Compared with the normal HGB group(male 120-160g/L),the all-cause mortality was 1.99 times(HR=1.99,95%CI:1.18?3.35,P<0.05)in the abnormal HGB group(male<120 g/L or>160 g/L).Conclusion1.The independent risk factors influenced survival involved aging;have diseases as cancer,PD,AD and chronic renal failure;and abnormal HGB leval for the retired military cadres;2.BMI>28 kg/m~2 and regular physical excises were independent protect factors influenced survival,and further more,the increase of BMI was associated with the decreased risk of all-cause death in the retired military cadres.