Abstract：
OBJECTIVE:To show the impact of competing risks of death on survival analysis. METHOD:We provide an example of survival time without chronic rejection after heart transplantation, where death before rejection acts as a competing risk. Using a computer simulation, we compare the Kaplan-Meier estimator and the multiple decrement model. RESULTS:The Kaplan-Meier method overestimated the probability of rejection. Next, we illustrate the use of the multiple decrement model to analyze secondary end points (in our example: death after rejection). Finally, we discuss Kaplan-Meier assumptions and why they fail in the presence of competing risks. CONCLUSIONS:Survival analysis should be adjusted for competing risks of death to avoid overestimation of the risk of rejection produced with the Kaplan-Meier method.
journal_name
Gac Sanitjournal_title
Gaceta sanitariaauthors
Llorca J,Delgado-Rodríguez Mdoi
10.1016/s0213-9111(04)71850-6subject
Has Abstractpub_date
2004-09-01 00:00:00pages
391-7issue
5eissn
0213-9111issn
1578-1283pii
13067398journal_volume
18pub_type
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