Competing risks analysis of patients with Brain Stroke: a comparison of two different approaches

Abstract

Objectives: Cumulative incidence function (CIF) measures the survival time of a particular hazard in the presence of others, while cause-specific (CS) one ignores the competing risks. The present study aimed to fit CIF and CS function for brain stroke (BS) patients and compare the results by the cause of death. Materials and method: In the study, 332 patients with the definitive diagnosis of BS were followed up for 10 years, and their mortality status due to BS or other causes was evaluated. In addition, significance tests and parameters were estimated by using STATA 14 software by considering the CS and CIF-based regression model. Results: Based on the results of CIF and CS analyses concerning the variables with similar significance, the hazard ratio of age at diagnosis (68-59 years (91%,2.61), ≥76 years (2.14,3.03) during diagnosis enhanced in the death for other causes, while an increase was observed in this ratio for sex (38%,2.35%), as well as the history of heart disease (44%,47%) and blood pressure (57%,64%) regarding BS-caused death, respectively. Regarding the significant variables, the correlation strength of CIF model was more in the BS-caused death by considering p-value, while CS one had stronger correlation in the death due to other causes. Conclusion: The estimation of CIF analysis, along with CS one for the competing risks, is suggested to provide more precise information about patients’ status in order to support adopted clinical decisions when aiming at assessing health related to a specific cause economically and determining the probability of occurring an intended event among other causes.

Keywords

• competing risks, cause-specific, cumulative incidence function, brain stroke