Fig. 1

Proposed Markov model showing all possible transitions. The arrows represent forward or backward progression between transitional (disease severity) states, as well as to the final absorbing states death or discharge. The probabilities of advancing to a more advanced stage or regressing to a less severe stage or to an absorbing state are calculated by the multi-state Markov model with piecewise constant intensities. Forty-three out of a total of 3855 transitions (1%) were from “at risk” directly to “failure” or death or from “failure” directly to “at risk” or discharge and were not estimated due to the insufficient number of events