Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 4, April 2025, pages 208-222

Relative, Conditional, and Overall Survival and Causes of Death in Patients With Glioblastoma: A Retrospective Longitudinal Cohort Study

Figures

↓  Figure 1. Causes of death after glioblastoma diagnosis graded by latency period. CNS: central nervous system.
Figure 1.
↓  Figure 2. Non-cancer causes of death in glioblastoma.
Figure 2.

Tables

↓  Table 1. Baseline Characteristics of Patients With Glioblastoma
 
Characteristic Diagnosed cases no. (%) Deaths no. (%)
All patients 45,071 (100) 40,568 (90.01)
Sex
  Male 26,139 (58.00) 23,591 (58.15)
  Female 18,932 (42.00) 16,977 (41.85)
Race
  White 40,037 (88.83) 36,237 (89.32)
  American Indian/Alaska Native 191 (0.42) 165 (0.41)
  Asian or Pacific Islander 2,207 (4.90) 1,857 (4.58)
  Black 2,505 (5.56) 2,231 (5.50)
  Unknown 131 (0.29) 78 (0.19)
Age at diagnosis
  < 18 497 (1.10) 404 (1.00)
  18 - 44 3,936 (8.73) 3,087 (7.61)
  45 - 59 13,507 (29.97) 11,915 (29.37)
  60 - 74 18,217 (40.42) 16,572 (40.85)
  > 75 8,914 (19.78) 8,590 (21.17)

 

↓  Table 2. Survival of Glioblastoma Patients With Conditional Survival According to Age
 
Years No. of patients Observed survival 95% CI (lower - upper) Relative survival 95% CI (lower - upper)
*Significant P value less than 0.05. CI: confidence interval.
Overall
  1 year 45,071 0.40 (0.396 - 0.405) 0.41 (0.402 - 0.411)
  3 years 45,071 0.10 (0.095 - 0.101) 0.10 (0.099 - 0.105)
  5 years 45,071 0.05 (0.049 - 0.054) 0.05 (0.052 - 0.057)
  3 years after 1-year survival 16,751 0.17 (0.163 - 0.175) 0.17 (0.168 - 0.18)
  3 years after 3 years of survival 3,499 0.43 (0.411 - 0.446) 0.44 (0.422 - 0.458)
  3 years after 5 years of survival 1,554 0.60 (0.575 - 0.627) 0.62 (0.59 - 0.644)
Age < 18
  1 year 497 0.55 (0.507 - 0.596) 0.55 (0.507 - 0.596)
  3 years 497 0.21 (0.17 - 0.244) 0.21 (0.17 - 0.244)
  5 years 497 0.16 (0.125 - 0.193) 0.16 (0.125 - 0.193)
  3 years after 1-year survival 260 0.30 (0.246 - 0.361) 0.30 (0.246 - 0.361)
  3 years after 3 years of survival 87 0.73 (0.615 - 0.808) 0.73 (0.615 - 0.809)
  3 years after 5 years of survival 59 0.84 (0.698 - 0.916) 0.84 (0.699 - 0.916)
Age 18 - 44
  1 year 3,936 0.71 (0.699 - 0.728) 0.72 (0.7 - 0.729)
  3 years 3,936 0.30 (0.285 - 0.316) 0.30 (0.287 - 0.317)
  5 years 3,936 0.19 (0.179 - 0.207) 0.20* (0.181 - 0.209)
  3 years after 1-year survival 2,616 0.33 (0.312 - 0.35) 0.33* (0.313 - 0.351)
  3 years after 3 years of survival 953 0.55 (0.517 - 0.584) 0.56* (0.52 - 0.588)
  3 years after 5 years of survival 522 0.67 (0.629 - 0.715) 0.68* (0.633 - 0.719)
Age 45 - 59
  1 year 13,507 0.55 (0.545 - 0.562) 0.56 (0.548 - 0.565)
  3 years 13,507 0.13 (0.124 - 0.136) 0.13 (0.126 - 0.139)
  5 years 13,507 0.07 (0.06 - 0.069) 0.07 (0.062 - 0.072)
  3 years after 1-year survival 6,979 0.16 (0.146 - 0.164) 0.16 (0.149 - 0.167)
  3 years after 3 years of survival 1,420 0.41 (0.382 - 0.436) 0.42 (0.39 - 0.445)
  3 years after 5 years of survival 608 0.59 (0.544 - 0.628) 0.60 (0.556 - 0.642)
Age 60 - 74
  1 year 18,217 0.35 (0.345 - 0.359) 0.36 (0.35 - 0.365)
  3 years 18,217 0.07 (0.063 - 0.071) 0.07 (0.066 - 0.075)
  5 years 18,217 0.03 (0.027 - 0.033) 0.03 (0.029 - 0.035)
  3 years after 1-year survival 5,893 0.12 (0.113 - 0.131) 0.13 (0.119 - 0.138)
  3 years after 3 years of survival 932 0.32 (0.284 - 0.35) 0.34 (0.301 - 0.37)
  3 years after 5 years of survival 332 0.49 (0.43 - 0.547) 0.52 (0.458 - 0.582)
Age > 75
  1 year 8,914 0.12 (0.115 - 0.129) 0.13 (0.121 - 0.136)
  3 years 8,914 0.02 (0.013 - 0.019) 0.02 (0.016 - 0.022)
  5 years 8,914 0.01 (0.004 - 0.008) 0.01* (0.006 - 0.011)
  3 years after 1-year survival 1,003 0.07 (0.056 - 0.091) 0.09 (0.066 - 0.108)
  3 years after 3 years of survival 107 0.27 (0.185 - 0.368) 0.33* (0.223 - 0.446)
  3 years after 5 years of survival 33 0.39 (0.215 - 0.558) 0.48* (0.253 - 0.67)

 

↓  Table 3. Univariate and Multivariate Analysis of Age, Race, and Sex as Prognostic Factors
 
Univariate Multivariate
Coefficients 95% CI (lower - upper) P value Coefficients 95% CI (lower - upper) P value
CI: confidence interval.
Age
  60 - 74 Reference
  < 18 0.51 (0.46 - 0.57) 0 0.52 (0.47 - 0.57) 0
  18 - 44 0.42 (0.4 - 0.43) 0 0.42 (0.4 - 0.44) 0
  45 - 59 0.67 (0.65 - 0.69) 0 0.67 (0.65 - 0.68) 0
  ≥ 75 2.09 (2.04 - 2.15) 0 2.1 (2.05 - 2.16) 0
Race
  White Reference
  American Indian/Alaska Native 0.85 (0.73 - 1) 0.044 0.98 (0.84 - 1.14) 0.75
  Asian or Pacific Islander 0.81 (0.78 - 0.85) 0 0.86 (0.82 - 0.9) 0
  Black 0.93 (0.89 - 0.97) 0.001 1.03 (0.98 - 1.07) 0.24
  Unknown 0.7 (0.56 - 0.87) 0.002 0.83 (0.66 - 1.03) 0.1
Sex
  Male Reference
  Female 1.02 (1 - 1.04) 0.05 0.95 (0.94 - 0.97) 0

 

↓  Table 4. SMRs for Each Cancer COD Following Diagnosis of Glioblastoma
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI)
*Significant. CI: confidence interval; CNS: central nervous system; COD: cause of death; SMR: standardized mortality ratio.
All CODs 25,235 (100) 55.64* (54.96 - 56.34) 13,910 (100) 63.85* (62.8 - 64.92) 792 (100) 13.76* (12.81 - 14.75) 39,937 (100) 54.79* (54.25 - 55.33)
Brain and other nervous system 21,833 (86.52) 7,018.98* (6,926.19 - 7,112.72) 12,746 (91.63) 6,981.68* (6,861 - 7,103.96) 656 (82.83) 1,389.83* (1,285.49 - 1,500.38) 35,235 (88.23) 6,515.11* (6,447.26 - 6,583.5)
Non-CNS cancers 427 (1.69) 3.56* (3.23 - 3.91) 203 (1.46) 3.31* (2.87 - 3.79) 27 (3.41) 1.78* (1.17 - 2.58) 657 (1.65) 3.34* (3.09 - 3.61)
Tongue 1 1.93 (0.05 - 10.73) 0 0 (0 - 12.4) 0 0 (0 - 48.7) 1 1.12 (0.03 - 6.24)
Oropharynx 1 4.8 (0.12 - 26.73) 0 0 (0 - 29.72) 0 0 (0 - 112.46) 1 2.74 (0.07 - 15.25)
Other oral cavity and pharynx 1 2.62 (0.07 - 14.58) 0 0 (0 - 17.86) 0 0 (0 - 77.66) 1 1.57 (0.04 - 8.76)
Small intestine 6 22.13* (8.12 - 48.16) 0 0 (0 - 25.48) 1 26.24 (0.66 - 146.2) 7 15.42* (6.2 - 31.77)
Colon excluding rectum 9 1.03 (0.47 - 1.96) 9 2.12 (0.97 - 4.02) 4 3.83* (1.04 - 9.81) 22 1.57 (0.98 - 2.38)
Rectum and rectosigmoid junction 2 0.98 (0.12 - 3.55) 1 0.9 (0.02 - 5.04) 1 3.54 (0.09 - 19.72) 4 1.17 (0.32 - 2.99)
Intrahepatic bile duct 1 0.9 (0.02 - 5.03) 0 0 (0 - 5.79) 1 5.62 (0.14 - 31.3) 2 1.04 (0.13 - 3.76)
Gallbladder 2 4.96 (0.6 - 17.9) 0 0 (0 - 17.6) 0 0 (0 - 67.97) 2 3 (0.36 - 10.82)
Pancreas 6 0.73 (0.27 - 1.6) 4 0.92 (0.25 - 2.35) 0 0 (0 - 3.26) 10 0.73 (0.35 - 1.35)
Lung and bronchus 38 1.05 (0.74 - 1.44) 15 0.82 (0.46 - 1.35) 4 0.93 (0.25 - 2.39) 57 0.97 (0.73 - 1.25)
Bones and joints 2 9.16* (1.11 - 33.07) 2 16.18* (1.96 - 58.44) 0 0 (0 - 109.53) 4 10.65* (2.9 - 27.26)
Soft tissue including heart 7 8.69* (3.49 - 17.91) 0 0 (0 - 8.01) 0 0 (0 - 30.18) 7 5.04* (2.03 - 10.39)
Melanoma of the skin 3 1.56 (0.32 - 4.56) 1 0.97 (0.02 - 5.41) 0 0 (0 - 14.89) 4 1.25 (0.34 - 3.2)
Other non-epithelial skin 2 2.85 (0.35 - 10.29) 0 0 (0 - 10.6) 0 0 (0 - 40.35) 2 1.75 (0.21 - 6.33)
Breast 17 2.67* (1.55 - 4.27) 8 2.17 (0.94 - 4.28) 0 0 (0 - 3.62) 25 2.26* (1.46 - 3.33)
Uterus 1 1.37 (0.03 - 7.63) 0 0 (0 - 8.59) 0 0 (0 - 29.31) 1 0.78 (0.02 - 4.34)
Ovary 6 2.48 (0.91 - 5.39) 2 1.47 (0.18 - 5.31) 1 2.74 (0.07 - 15.27) 9 2.17 (0.99 - 4.12)
Prostate 3 0.46 (0.1 - 1.35) 1 0.38 (0.01 - 2.1) 2 3.22 (0.39 - 11.61) 6 0.61 (0.23 - 1.34)
Urinary bladder 1 0.31 (0.01 - 1.73) 3 2.06 (0.42 - 6.02) 0 0 (0 - 10.07) 4 0.79 (0.22 - 2.03)
Kidney and renal pelvis 3 0.98 (0.2 - 2.87) 2 1.25 (0.15 - 4.52) 0 0 (0 - 9.47) 5 0.99 (0.32 - 2.31)
Other endocrine including thymus 8 52.24* (22.55 - 102.93) 9 98.41* (45 - 186.81) 0 0 (0 - 153.39) 17 63.28* (36.86 - 101.32)
Non-Hodgkin lymphoma 6 1.37 (0.5 - 2.98) 1 0.49 (0.01 - 2.7) 0 0 (0 - 7.37) 7 1.01 (0.41 - 2.08)
Myeloma 1 0.41 (0.01 - 2.31) 1 0.85 (0.02 - 4.72) 0 0 (0 - 12.46) 2 0.51 (0.06 - 1.86)
Acute myeloid leukemia 1 0.5 (0.01 - 2.78) 0 0 (0 - 3.55) 0 0 (0 - 13.95) 1 0.3 (0.01 - 1.68)
Chronic myeloid leukemia 1 4.59 (0.12 - 25.56) 0 0 (0 - 37.18) 0 0 (0 - 148.59) 1 2.92 (0.07 - 16.29)
Other myeloid/monocytic leukemia 1 5.88 (0.15 - 32.74) 1 12.29 (0.31 - 68.47) 0 0 (0 - 170.42) 2 7.32 (0.89 - 26.44)
Miscellaneous malignant cancer 297 32.48* (28.89 - 36.39) 138 30.30* (25.46-35.8) 11 9.76* (4.87 - 17.47) 446 30.09* (27.36 - 33.01)

 

↓  Table 5. SMRs for Each COD Following Diagnosis of Glioblastoma
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI) Observed no. (%) SMR (95% CI)
*Significant. CI: confidence interval; COD: cause of death; HIV: human immunodeficiency virus; no.: number of glioblastoma patients who died due to each cause of death; SMR: standardized mortality ratio.
All CODs 25,235 (100) 55.64* (54.96 - 56.34) 13,910 (100) 63.85* (62.8 - 64.92) 792 (100) 13.76* (12.81 - 14.75) 39,937 (100) 54.79* (54.25 - 55.33)
Brain and other nervous system 21,833 (86.52) 7,018.98* (6,926.19 - 7,112.72) 12,746 (91.63) 6,981.68* (6,861 - 7,103.96) 656 (82.83) 1,389.83* (1,285.49 - 1,500.38) 35,235 (88.23) 6,515.11* (6,447.26 - 6,583.5)
Non-CNS cancers 427 (1.69) 3.56* (3.23 - 3.91) 203 (1.46) 3.31* (2.87 - 3.79) 27 (3.41) 1.78* (1.17 - 2.58) 657 (1.65) 3.34* (3.09 - 3.61)
Non-cancer causes 2,975 (11.79) 9.00* (8.68 - 9.33) 961 (6.91) 6.21* (5.83 - 6.62) 109 (13.76) 2.60* (2.14 - 3.14) 4,045 (10.13) 7.68* (7.44 - 7.92)
Septicemia 65 (0.26) 9.94* (7.67 - 12.67) 26 (0.19) 8.13* (5.31 - 11.91) 4 (0.51) 4.67* (1.27 - 11.95) 95 (0.24) 8.97* (7.26 - 10.96)
Other infectious and parasitic diseases, including HIV 35 (0.14) 7.26* (5.06 - 10.09) 14 (0.10) 4.86* (2.66 - 8.15) 4 (0.13) 1.41 (0.04 - 7.84) 50 (0.13) 5.94* (4.41 - 7.83)
Diabetes mellitus 37 (0.15) 2.49* (1.76 - 3.44) 6 (0.04) 0.8 (0.29 - 1.73) 3 (0.38) 1.54 (0.32 - 4.51) 46 (0.12) 1.89* (1.39 - 2.52)
Alzheimer’s (ICD-9 and 10 only) 13 (0.5) 1.15 (0.61 - 1.96) 3 (0.02) 0.79 (0.16 - 2.32) 1 (0.13) 0.78 (0.02 - 4.34) 17 (0.04) 1.04 (0.6 - 1.66)
Cardiovascular diseases 427 (1.69) 3.47* (3.15 - 3.81) 120 (0.86) 2.22* (1.84 - 2.65) 22 (2.78) 1.57 (0.98 - 2.38) 569 (1.42) 2.97* (2.73 - 3.23)
Cerebrovascular diseases 133 (0.53) 5.77* (4.83 - 6.84) 37 (0.27) 3.92* (2.76 - 5.41) 9 (1.14) 3.56* (1.63 - 6.76) 179 (0.45) 5.11* (4.39 - 5.92)
Pneumonia and influenza 50 (0.20) 5.51* (4.09 - 7.26) 16 (0.12) 4.35* (2.48 - 7.06) 4 (0.51) 4.02* (1.09 - 10.29) 70 (0.18) 5.09* (3.97 - 6.43)
Chronic obstructive pulmonary disease and allied conditions 50 (0.20) 1.73* (1.29 - 2.29) 10 (0.07) 0.75 (0.36 - 1.39) 3 (0.38) 0.86 (0.18 - 2.51) 63 (0.16) 1.38* (1.06 - 1.77)
Chronic liver disease and cirrhosis 9 (0.4) 1.23 (0.56 - 2.33) 1 (0.01) 0.21 (0.01 - 1.17) 0 (0) 0 (0 - 2.9) 10 (0.03) 0.75 (0.36 - 1.38)
Nephritis, nephrotic syndrome and nephrosis 23 (0.9) 2.83* (1.8 - 4.25) 3 (0.02) 0.82 (0.17 - 2.38) 2 (0.25) 2.03 (0.25 - 7.33) 28 (0.07) 2.19* (1.46 - 3.17)
Accidents and adverse effects 48 (0.19) 2.91* (2.15 - 3.86) 32 (0.23) 3.05* (2.09 - 4.3) 6 (0.76) 1.95 (0.72 - 4.24) 86 (0.22) 2.86* (2.29 - 3.54)
Suicide and self-inflicted injury 18 (0.07) 3.33* (1.98 - 5.27) 5 (0.04) 1.3 (0.42 - 3.03) 2 (0.25) 1.84 (0.22 - 6.66) 25 (0.06) 2.42* (1.57 - 3.57)
Other COD 2,067 (8.19) 28.93* (27.7 - 30.2) 688 (4.95) 20.28* (18.79 - 21.85) 52 (6.57) 5.39* (4.03 - 7.07) 2,807 (7.03) 24.40* (23.51 - 25.32)

 

↓  Table 6. SMRs for Each COD Following Glioblastoma Diagnosis in Patients Less Than 18 Years
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI)
*Significant. CNS: central nervous system; CI: confidence interval; COD: cause of death; SMR: standardized mortality ratio.
All CODs 199 1,078.06* (933.47 - 1,238.7) 178 719.51* (617.69 - 833.32) 10 80.32* (38.52 - 147.71) 387 695.44* (627.87 - 768.3)
Brain and other nervous system 175 69,250.02* (59,369.76 - 80,304.56) 162 59,108.81* (50,357.04 - 68,944.38) 8 3,776.22* (1,630.3 - 7,440.66) 345 46,708.06* (41,908.84 - 51,906.22)
Non-CNS cancers 2 298.42* (36.14 - 1,077.98) 1 124.72* (3.16 - 694.91) 1 149.49* (3.78 - 832.9) 4 186.83* (50.91 - 478.37)
Non-cancer causes 22 125.45* (78.62 - 189.94) 15 63.39* (35.48 - 104.55) 1 8.64 (0.22 - 48.16) 38 72.01* (50.96 - 98.84)
Other COD 22 204.81* (128.36 - 310.09) 14 96.30* (52.65 - 161.58) 1 28.39 (0.72 - 158.17) 37 128.47* (90.45 - 177.07)

 

↓  Table 7. SMRs for Each COD Following Glioblastoma Diagnosis in Patients Aged 18 - 44
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI)
Significant P value less than 0.05. CI: confidence interval; CNS: central nervous system; COD: cause of death; HIV: human immunodeficiency virus; SMR: standardized mortality ratio.
All CODs 1,018 178.09* (167.31 - 189.37) 1,759 201.55* (192.24 - 211.19) 231 35.24* (30.84 - 40.09) 3,008 143.24* (138.17 - 148.45)
Brain and other nervous system 892 13,968.74* (13,066.97 - 14,916.35) 1,624 16,662.90* (15,862.25 - 17,493.49) 202 2,606.53* (2,259.46 - 2,991.84) 2,718 11,381.13* (10,957.24 - 11,817.21)
Non-CNS cancers 15 19.95* (11.17 - 32.91) 27 21.37* (14.08 - 31.09) 7 5.44* (2.19 - 11.2) 49 14.83* (10.97 - 19.61)
Non-cancer causes 111 22.65* (18.63 - 27.28) 108 14.66* (12.03 - 17.7) 22 4.24* (2.66 - 6.42) 241 13.80* (12.12 - 15.66)
Septicemia 1 19.06 (0.48 - 106.22) 2 23.20* (2.81 - 83.8) 0 0 (0 - 47.55) 3 13.87* (2.86 - 40.54)
Other infectious and parasitic diseases, including HIV 2 9.96* (1.21 - 35.99) 0 0 (0 - 13.99) 0 0 (0 - 26.11) 2 3.3 (0.4 - 11.93)
Diabetes mellitus 0 0 (0 - 28.35) 1 4.67 (0.12 - 26.04) 0 0 (0 - 18.48) 1 1.84 (0.05 - 10.25)
Cardiovascular diseases 2 2.38 (0.29 - 8.6) 8 5.88* (2.54 - 11.58) 1 0.82 (0.02 - 4.54) 11 3.21* (1.6 - 5.74)
Cerebrovascular diseases 3 24.52* (5.06 - 71.67) 2 10.21* (1.24 - 36.89) 5 30.17* (9.8 - 70.4) 10 20.67* (9.91 - 38)
Pneumonia and influenza 1 16.59 (0.42 - 92.42) 3 31.62* (6.52 - 92.41) 0 0 (0 - 47.06) 4 17.13* (4.67 - 43.85)
Chronic obstructive pulmonary disease and allied conditions 0 0 (0 - 70.67) 1 10.7 (0.27 - 59.64) 0 0 (0 - 27.75) 1 3.59 (0.09 - 20)
Chronic liver disease and cirrhosis 1 5.03 (0.13 - 28) 0 0 (0 - 11.21) 0 0 (0 - 11.9) 1 1.19 (0.03 - 6.65)
Nephritis, nephrotic syndrome and nephrosis 1 23.18 (0.59 - 129.17) 1 14.1 (0.36 - 78.56) 0 0 (0 - 57.98) 2 11.26* (1.36 - 40.66)
Accidents and adverse effects 2 1.37 (0.17 - 4.93) 4 1.88 (0.51 - 4.81) 4 3.35 (0.91 - 8.58) 10 2.09* (1 - 3.84)
Suicide and self-inflicted Injury 1 1.7 (0.04 - 9.46) 0 0 (0 - 4.34) 1 2.07 (0.05 - 11.54) 2 1.04 (0.13 - 3.76)
Other COD 97 84.69* (68.68 - 103.31) 86 51.26* (41 - 63.3) 11 9.86* (4.92 - 17.64) 194 49.25* (42.57 - 56.69)

 

↓  Table 8. SMRs for Each COD Following Glioblastoma Diagnosis in Patients Aged 45 - 59
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI)
*Significant P value less than 0.05. CI: confidence interval; CNS: central nervous system; COD: cause of death; SMR: standardized mortality ratio.
All CODs 5,514 91.06* (88.67 - 93.49) 5,854 105.85* (103.16 - 108.6) 338 16.37* (14.67 - 18.21) 11,706 85.75* (84.2 - 87.32)
Brain and other nervous system 4,908 6,990.19* (6,795.98 - 7,188.54) 5,398 8,538.69* (8,312.41 - 8,769.57) 282 1,296.23* (1,149.34 - 1,456.69) 10,588 6,822.78* (6,693.43 - 6,953.99)
Non-CNS cancers 87 5.04* (4.04 - 6.22) 82 5.03* (4 - 6.24) 12 1.86 (0.96 - 3.26) 181 4.52* (3.89 - 5.23)
Non-cancer causes 519 12.18* (11.16 - 13.28) 374 9.75* (8.79 - 10.79) 44 3.14* (2.28 - 4.22) 937 9.87* (9.25 - 10.52)
Septicemia 12 15.12* (7.81 - 26.4) 10 13.09* (6.28 - 24.07) 2 6.3 (0.76 - 22.74) 24 12.80* (8.2 - 19.04)
Other infectious and parasitic diseases including HIV 10 6.59* (3.16 - 12.12) 9 7.19* (3.29 - 13.66) 1 2.92 (0.07 - 16.27) 20 6.43* (3.93 - 9.93)
Diabetes mellitus 4 1.87 (0.51 - 4.78) 1 0.5 (0.01 - 2.77) 2 2.48 (0.3 - 8.95) 7 1.41 (0.57 - 2.91)
Cardiovascular diseases 61 4.25* (3.25 - 5.46) 46 3.55* (2.6 - 4.74) 9 1.84 (0.84 - 3.49) 116 3.60* (2.98 - 4.32)
Cerebrovascular diseases 35 18.64* (12.98 - 25.92) 14 8.00* (4.37 - 13.43) 2 2.74 (0.33 - 9.88) 51 11.70* (8.71 - 15.39)
Pneumonia and influenza 6 8.22* (3.02 - 17.9) 3 4.31 (0.89 - 12.61) 2 6.85 (0.83 - 24.75) 11 6.41* (3.2 - 11.46)
Chronic obstructive pulmonary disease and allied conditions 5 2.45 (0.79 - 5.71) 2 0.93 (0.11 - 3.37) 1 0.91 (0.02 - 5.07) 8 1.51 (0.65 - 2.98)
Chronic liver disease and cirrhosis 2 0.76 (0.09 - 2.74) 1 0.44 (0.01 - 2.43) 0 0 (0 - 5.54) 3 0.54 (0.11 - 1.57)
Nephritis, nephrotic syndrome and nephrosis 4 5.51 (1.5 - 14.1) 2 2.83 (0.34 - 10.22) 0 0 (0 - 11.46) 6 3.42* (1.25 - 7.44)
Accidents and adverse effects 8 1.61 (0.7 - 3.18) 13 3.15* (1.68 - 5.39) 1 0.95 (0.02 - 5.29) 22 2.17* (1.36 - 3.28)
Suicide and self-inflicted injury 5 2.3 (0.75 - 5.37) 0 0 (0 - 2.08) 1 2.38 (0.06 - 13.26) 6 1.37 (0.5 - 2.99)
Other COD 367 42.86* (38.59 - 47.48) 273 35.01* (30.98 - 39.42) 23 7.81* (4.95 - 11.72) 663 34.34* (31.78 - 37.06)

 

↓  Table 9. SMRs for Each COD Following Glioblastoma Diagnosis in Patients Aged 60 - 74
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI)
*Significant P value less than 0.05. CI: confidence interval; CNS: central nervous system; COD: cause of death; SMR: standardized mortality ratio.
All CODs 10,980 59.65* (58.54 - 60.78) 5,168 48.97* (47.65 - 50.33) 190 8.41* (7.26 - 9.7) 16,338 52.34* (51.54 - 53.14)
Brain and other nervous system 9,612 5,860.12* (5,743.54 - 5,978.46) 4,723 5,127.27* (4,982.08 - 5,275.63) 150 943.46* (798.52 - 1,107.1) 14,485 5,324.62* (5,238.26 - 5,412.05)
Non-CNS cancers 179 2.96* (2.54 - 3.42) 75 2.21* (1.74 - 2.77) 7 1.1 (0.44 - 2.26) 261 2.59* (2.28 - 2.92)
Non-cancer causes 1,189 9.76* (9.21 - 10.33) 370 5.24* (4.72 - 5.8) 33 2.06 (1.41 - 2.89) 1,592 7.63* (7.26 - 8.02)
Septicemia 31 11.24* (7.64 - 15.95) 12 7.32* (3.78 - 12.78) 2 5.56 (0.67 - 20.08) 45 9.46* (6.9 - 12.65)
Other infectious and parasitic diseases, including HIV 14 7.59* (4.15 - 12.73) 4 3.80* (1.04 - 9.74) 0 0 (0 - 20.24) 18 5.85* (3.47 - 9.24)
Diabetes mellitus 17 2.43* (1.42 - 3.9) 3 0.76 (0.16 - 2.21) 1 1.3 (0.03 - 7.24) 21 1.79* (1.11 - 2.74)
Alzheimer (ICD-9 and 10 only) 4 2.29 (0.62 - 5.86) 0 0 (0 - 2.81) 1 1.57 (0.04 - 8.75) 5 1.35 (0.44 - 3.16)
Cardiovascular diseases 180 3.85* (3.31 - 4.46) 44 1.70* (1.23 - 2.28) 7 1.27 (0.51 - 2.62) 231 2.95* (2.59 - 3.36)
Cerebrovascular diseases 46 6.04* (4.42 - 8.05) 17 3.82* (2.22 - 6.11) 2 1.8 (0.22 - 6.5) 65 4.93* (3.8 - 6.28)
Pneumonia and influenza 20 7.06* (4.31 - 10.91) 7 4.15* (1.67 - 8.56) 2 4.88 (0.59 - 17.63) 29 5.89* (3.94 - 8.45)
Chronic obstructive pulmonary disease and allied conditions 22 1.70* (1.06 - 2.57) 6 0.78 (0.29 - 1.69) 2 1.1 (0.13 - 3.98) 30 1.33 (0.9 - 1.9)
Chronic liver disease and cirrhosis 4 1.15 (0.31 - 2.95) 0 0 (0 - 1.95) 0 0 (0 - 13.37) 4 0.71 (0.19 - 1.82)
Nephritis, nephrotic syndrome and nephrosis 9 2.88* (1.32 - 5.47) 0 0 (0 - 1.97) 1 2.28 (0.06 - 12.7) 10 1.84 (0.88 - 3.38)
Accidents and adverse effects 24 4.55* (2.92 - 6.78) 14 4.64* (2.54 - 7.79) 1 1.72 (0.04 - 9.6) 39 4.40* (3.13 - 6.01)
Suicide and self-inflicted injury 11 5.65* (2.82 - 10.11) 4 3.82* (1.04 - 9.78) 0 0 (0 - 25.31) 15 4.78* (2.67 - 7.88)
Other COD 807 32.84* (30.61 - 35.18) 259 17.19* (15.16 - 19.42) 14 3.66* (2 - 6.13) 1,080 24.85* (23.39 - 26.37)

 

↓  Table 10. SMRs for Each COD Following Glioblastoma Diagnosis in Patients Older Than 75
 
Deaths by time after diagnosis Total deaths
< 1 year 1 - 5 years > 5 years
Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI) Observed no. SMR (95% CI)
*Significant P value less than 0.05. CI: confidence interval; CNS: central nervous system; COD: cause of death; no.: number of glioblastoma patients who died due to each cause of death; SMR: standardized mortality ratio.
All CODs 7,524 37.07* (36.23 - 37.92) 951 19.80 (18.56 - 21.1) 23 3.00* (1.9 - 4.51) 8,498 32.85* (32.16 - 33.56)
Brain and other nervous system 6,246 8,899.80* (8,680.44 - 9,123.31) 839 4,875.13* (4,550.79 - 5,216.48) 14 883.76* (483.16 - 1,482.79) 7,099 7,978.62* (7,794.09 - 8,166.42)
Non-CNS cancers 144 3.48* (2.93 - 4.09) 18 1.82* (1.08 - 2.88) 0 0 (0 - 3.34) 162 3.09* (2.64 - 3.61)
Non-cancer causes 1,134 7.05* (6.64 - 7.47) 94 2.47* (2 - 3.03) 9 1.38 (0.63 - 2.61) 1,237 6.02* (5.69 - 6.37)
Septicemia 21 7.17* (4.44 - 10.96) 2 2.83 (0.34 - 10.21) 0 0 (0 - 36.47) 23 6.15* (3.9 - 9.23)
Other infectious and parasitic diseases, including HIV 9 7.16* (3.27 - 13.59) 1 3.18 (0.08 - 17.74) 0 0 (0 - 83.7) 10 6.19* (2.97 - 11.39)
Diabetes mellitus 16 2.87* (1.64 - 4.66) 1 0.75 (0.02 - 4.18) 0 0 (0 - 22.31) 17 2.40* (1.4 - 3.85)
Alzheimer (ICD-9 and 10 only) 9 0.95 (0.43 - 1.8) 3 1.27 (0.26 - 3.7) 0 0 (0 - 6.8) 12 0.97 (0.5 - 1.69)
Cardiovascular diseases 184 3.00* (2.59 - 3.47) 22 1.58 (0.99 - 2.4) 5 2.09 (0.68 - 4.88) 211 2.72* (2.37 - 3.11)
Cerebrovascular diseases 49 3.65 (2.7 - 4.82) 4 1.32 (0.36 - 3.38) 0 0 (0 - 7.12) 53 3.12* (2.34 - 4.08)
Pneumonia and influenza 23 4.21* (2.67 - 6.32) 2 1.66 (0.2 - 6.01) 0 0 (0 - 17.23) 25 3.64* (2.35 - 5.37)
Chronic obstructive pulmonary disease and allied conditions 23 1.67* (1.06 - 2.51) 1 0.3 (0.01 - 1.69) 0 0 (0 - 8.38) 24 1.37 (0.88 - 2.04)
Chronic liver disease and cirrhosis 2 1.98 (0.24 - 7.14) 0 0 (0 - 14.91) 0 0 (0 - 179.64) 2 1.56 (0.19 - 5.64)
Nephritis, nephrotic syndrome and nephrosis 9 2.13 (0.98 - 4.05) 0 0 (0 - 3.6) 1 6.22 (0.16 - 34.64) 10 1.85 (0.89 - 3.4)
Accidents and adverse effects 14 2.96* (1.62 - 4.96) 1 0.86 (0.02 - 4.78) 0 0 (0 - 18.45) 15 2.46* (1.38 - 4.06)
Suicide and self-inflicted injury 1 1.47 (0.04 - 8.19) 1 6.07 (0.15 - 33.82) 0 0 (0 - 227.31) 2 2.32 (0.28 - 8.39)
Other COD 774 20.89 (19.44 - 22.41) 56 6.06* (4.57 - 7.86) 3 1.74 (0.36 - 5.1) 833 17.34* (16.19 - 18.56)