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A full competing risk analysis of hospital-acquired infections can easily be performed by a case-cohort approach

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dc.contributor.author Wolkewitz, M.
dc.contributor.author Palomar Martínez, Mercedes
dc.contributor.author Olaechea-Astigarraga, P.
dc.contributor.author Álvarez Lerma, Francisco
dc.contributor.author Schumacher, Martin
dc.date.accessioned 2016-06-16T10:05:42Z
dc.date.issued 2016
dc.identifier.citation Wolkewitz M, Palomar-Martinez M, Olaechea-Astigarraga P, Alvarez-Lerma F, Schumacher M. A full competing risk analysis of hospital-acquired infections can easily be performed by a case-cohort approach. J Clin Epidemiol. 2016 Jun;74:187-93. doi: 10.1016/j.jclinepi.2015.11.011
dc.identifier.issn 0895-4356
dc.identifier.uri http://hdl.handle.net/10230/26929
dc.description.abstract OBJECTIVES: We provide a case-cohort approach and show that a full competing risk analysis is feasible even in a reduced data set. Competing events for hospital-acquired infections are death or discharge from the hospital because they preclude the observation of such infections. STUDY DESIGN AND SETTING: Using surveillance data of 6,568 patient admissions (full cohort) from two Spanish intensive care units, we propose a case-cohort approach which uses only data from a random sample of the full cohort and all infected patients (the cases). We combine established methodology to study following measures: event-specific as well as subdistribution hazard ratios for all three events (infection, death, and discharge), cumulative hazards as well as incidence functions by risk factor, and also for all three events. RESULTS: Compared with the values from the full cohort, all measures are well approximated with the case-cohort design. For the event of interest (infection), event-specific and subdistribution hazards can be estimated with the full efficiency of the case-cohort design. So, standard errors are only slightly increased, whereas the precision of estimated hazards of the competing events is inflated according to the size of the subcohort. CONCLUSION: The case-cohort design provides an appropriate sampling design for studying hospital-acquired infections in a reduced data set. Potential effects of risk factors on the competing events (death and discharge) can be evaluated.
dc.description.sponsorship This study was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) (grant no WO 1746/1-2). M.W. received funding from Deutsche Forschungsgemeinschaft.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.rights © Elsevier http://dx.doi.org/10.1016/j.jclinepi.2015.11.011
dc.subject.other Infeccions nosocomials
dc.title A full competing risk analysis of hospital-acquired infections can easily be performed by a case-cohort approach
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.jclinepi.2015.11.011
dc.rights.accessRights info:eu-repo/semantics/embargoedAccess
dc.type.version info:eu-repo/semantics/acceptedVersion
dc.embargo.liftdate 2017-06-30
dc.date.embargoEnd info:eu-repo/date/embargoEnd/2017-06-30

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