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The American Journal of Medicine May 2017Little is known about the in-hospital mortality of deep venous thrombosis in recent years. This investigation was undertaken to determine trends in in-hospital mortality...
BACKGROUND
Little is known about the in-hospital mortality of deep venous thrombosis in recent years. This investigation was undertaken to determine trends in in-hospital mortality in patients with deep venous thrombosis and mortality according to age.
METHODS
Administrative data were analyzed from the National (Nationwide) Inpatient Sample, 2003-2012. We determined in-hospital all-cause mortality according to year and age among patients with a primary (first-listed) diagnosis of deep venous thrombosis. We analyzed all such patients and we analyzed those who had none of the comorbid conditions listed in the Charlson Comorbidity Index.
RESULTS
From 2003-2012, 1,603,690 hospitalized patients had a primary diagnosis of deep venous thrombosis. All-cause in-hospital mortality decreased from 1.3% in 2003 to 0.6% in 2012. Mortality increased with age from 0.1% in those aged 18-20 years to 1.5% in those over age 80 years. All-cause in-hospital mortality in those with no comorbid conditions according to the Charlson Comorbidity Index (1,094,184 patients) decreased from 1.1% in 2003 to 0.5% in 2012. Presumably, these deaths were from pulmonary embolism. All-cause mortality in those with no comorbid conditions increased with age from 0.1% in those aged 18-20 years to 1.4% in those over aged 80 years.
CONCLUSION
All-cause death and death due to pulmonary embolism in patients hospitalized with a primary diagnosis of deep venous thrombosis decreased from 2003-2012. The death rate increased with age. The decreased mortality over the period of investigation may have resulted from a shift toward use of low-molecular-weight heparins and newer anticoagulants.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cause of Death; Comorbidity; Female; Hospital Mortality; Humans; Male; Middle Aged; Venous Thrombosis; Young Adult
PubMed: 27894736
DOI: 10.1016/j.amjmed.2016.10.030 -
Epidemiology and Health 2022This study aimed to describe the regional avoidable mortality trends in Korea and examine the trends in avoidable mortality disparities between the Seoul Capital Area...
OBJECTIVES
This study aimed to describe the regional avoidable mortality trends in Korea and examine the trends in avoidable mortality disparities between the Seoul Capital Area and non-Seoul-Capital areas, thereby exploring the underlying reasons for the trend changes.
METHODS
Age-standardized mortality rates from avoidable causes between 2001-2020 were calculated by region. Regional disparities in avoidable mortality were quantified on both absolute and relative scales. Trends and disparities in avoidable mortality were analyzed using joinpoint regression models.
RESULTS
Avoidable, treatable, and preventable mortalities in Korea decreased at different rates over time by region. The largest decreases were in the non-Seoul-Capital non-metropolitan area for avoidable and preventable mortality rates and the non-Seoul- Capital metropolitan area for treatable mortality rates, despite the largest decline being in the Seoul Capital Area prior to around 2009. Absolute and relative regional disparities in avoidable and preventable mortalities generally decreased. Relative disparities in treatable mortality between areas widened. Regional disparities in all types of mortalities tended to improve after around 2009, especially among males. In females, disparities in avoidable, treatable, and preventable mortalities between areas improved less or even worsened.
CONCLUSIONS
Trends and disparities in avoidable mortality across areas in Korea seem to have varied under the influence of diverse social changes. Enhancing health services to underserved areas and strengthening gender-oriented policies are needed to reduce regional disparities in avoidable mortality.
Topics: Male; Female; Humans; Republic of Korea; Seoul; Mortality
PubMed: 35989656
DOI: 10.4178/epih.e2022067 -
Frontiers in Public Health 2023Under-five mortality rate (U5MR) and maternal mortality rate (MMR) are important indicators for evaluating the quality of perinatal health and child health services in a...
INTRODUCTION
Under-five mortality rate (U5MR) and maternal mortality rate (MMR) are important indicators for evaluating the quality of perinatal health and child health services in a country or region, and are research priorities for promoting maternal and infant safety and maternal and child health. This paper aimed to analysis and predict the trends of U5MR and MMR in China, to explore the impact of social health services and economic factors on U5MR and MMR, and to provide a basis for relevant departments to formulate relevant policies and measures.
METHODS
The JoinPoint regression model was established to conduct time trend analysis and describe the trend of neonatal mortality rate (NMR), infant mortality rate (IMR), U5MR and MMR in China from 1991 to 2020. The linear mixed effect model was used to assess the fixed effects of maternal health care services and socioeconomic factors on U5MR and MMR were explored, with year as a random effect to minimize the effect of collinearity. Auto regressive integrated moving average models (ARIMA) were built to predict U5MR and MMR from 2021 to 2025.
RESULTS
The NMR, IMR, U5MR and MMR from 1991 to 2020 in China among national, urban and rural areas showed continuous downward trends. The NMR, IMR, U5MR and MMR were significantly negatively correlated with gross domestic product (GDP), the proportion of the total health expenditure (THE) to GDP, system management rate, prenatal care rate, post-natal visit rate and hospital delivery rate. The predicted values of national U5MR from 2021 to 2025 were 7.3 ‰, 7.2 ‰, 7.1 ‰, 7.1 ‰ and 7.2 ‰ and the predicted values of national MMR were 13.8/100000, 12.1/100000, 10.6/100000, 9.6/100000 and 8.3/100000.
CONCLUSION
China has made great achievements in reducing the U5MR and MMR. It is necessary for achieving the goals of Healthy China 2030 by promoting the equalization of basic public health services and further optimizing the allocation of government health resources. China's experience in reducing U5MR and MMR can be used as a reference for developing countries to realize the SDGs.
Topics: Infant; Infant, Newborn; Child; Pregnancy; Female; Humans; Child Mortality; Maternal Mortality; Infant Mortality; Socioeconomic Factors; China
PubMed: 37927855
DOI: 10.3389/fpubh.2023.1198356 -
CMAJ : Canadian Medical Association... Feb 2016Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of all-cause and cardiovascular mortality varies across studies. We performed a meta-analysis of prospective cohort studies to quantitatively evaluate the associations in the general population.
METHODS
We searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015. We used a random-effects model to combine study-specific relative risks and 95% confidence intervals (CIs). We used restricted cubic spline functions to assess the dose-response relation.
RESULTS
A total of 46 studies were included in the meta-analysis, involving 1 246 203 patients and 78 349 deaths for all-cause mortality, and 848 320 patients and 25 800 deaths for cardiovascular mortality. The relative risk with 10 beats/min increment of resting heart rate was 1.09 (95% CI 1.07-1.12) for all-cause mortality and 1.08 (95% CI 1.06-1.10) for cardiovascular mortality. Compared with the lowest category, patients with a resting heart rate of 60-80 beats/min had a relative risk of 1.12 (95% CI 1.07-1.17) for all-cause mortality and 1.08 (95% CI 0.99-1.17) for cardiovascular mortality, and those with a resting heart rate of greater than 80 beats/min had a relative risk of 1.45 (95% CI 1.34-1.57) for all-cause mortality and 1.33 (95% CI 1.19-1.47) for cardiovascular mortality. Overall, the results did not differ after adjustment for traditional risk factors for cardiovascular disease. Compared with 45 beats/min, the risk of all-cause mortality increased significantly with increasing resting heart rate in a linear relation, but a significantly increased risk of cardiovascular mortality was observed at 90 beats/min. Substantial heterogeneity and publication bias were detected.
INTERPRETATION
Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population.
Topics: Cardiovascular Diseases; Cause of Death; Heart Rate; Humans; Mortality; Risk Factors
PubMed: 26598376
DOI: 10.1503/cmaj.150535 -
BMC Pediatrics Jan 2021While assessment of sex differentials in child mortality is straightforward, their interpretation must consider that, in the absence of gender bias, boys are more likely... (Review)
Review
BACKGROUND
While assessment of sex differentials in child mortality is straightforward, their interpretation must consider that, in the absence of gender bias, boys are more likely to die than girls. The expected differences are also influenced by levels and causes of death. However, there is no standard approach for determining expected sex differences.
METHODS
We performed a scoping review of studies on sex differentials in under-five mortality, using PubMed, Web of Science, and Scopus databases. Publication characteristics were described, and studies were grouped according to their methodology.
RESULTS
From the 17,693 references initially retrieved we included 154 studies published since 1929. Indian, Bangladeshi, and Chinese populations were the focus of 44% of the works, and most studies addressed infant mortality. Fourteen publications were classified as reference studies, as these aimed to estimate expected sex differentials based upon the demographic experience of selected populations, either considered as gender-neutral or not. These studies used a variety of methods - from simple averages to sophisticated modeling - to define values against which observed estimates could be compared. The 21 comparative studies mostly used life tables from European populations as standard for expected values, but also relied on groups without assuming those values as expected, otherwise, just as comparison parameters. The remaining 119 studies were categorized as narrative and did not use reference values, being limited to reporting observed sex-specific estimates or used a variety of statistical models, and in general, did not account for mortality levels.
CONCLUSION
Studies aimed at identifying sex differentials in child mortality should consider overall mortality levels, and report on more than one age group. The comparison of results with one or more reference values, and the use of statistical testing, are strongly recommended. Time trends analyses will help understand changes in population characteristics and interpret findings from a historical perspective.
Topics: Child; Child Mortality; Child, Preschool; Female; Humans; Infant; Infant Mortality; Life Tables; Male; Mortality; Sex Characteristics; Sexism
PubMed: 33499809
DOI: 10.1186/s12887-021-02503-8 -
The Practising Midwife Feb 2017December 7th 2016 saw the launch of the third annual MBRRACE-UK Saving lives, improving mothers' care report; a report which provides us with a picture of maternal...
December 7th 2016 saw the launch of the third annual MBRRACE-UK Saving lives, improving mothers' care report; a report which provides us with a picture of maternal deaths in the UK between 2012-14 and information on the lessons learned from the UK and Ireland confidential enquiries into maternal deaths and morbidities between 2009-14. Globally, maternal deaths have fallen by over half since the introduction of the millennium development goals in 1990. Although short of the global target to reduce such maternal deaths by three quarters by the year 2015 (United Nations (UN) 2015), maternal deaths within the UK are, in fact, a rare event. This year's report calculates reduction in deaths from previous years to a rate 8.5 death per 100,00 maternities compared to last year's nine deaths per 100,000 maternities. Although not a statistically significant decrease, it is a promising reduction. Here, the key recommendations for practice outlined in the report are summarized in an attempt to further reduce such morbidity and mortality rates in the future.
Topics: Adult; Female; Forecasting; History, 20th Century; History, 21st Century; Humans; Ireland; Maternal Mortality; Mortality; Population Surveillance; Pregnancy; Pregnancy Complications; United Kingdom
PubMed: 30462430
DOI: No ID Found -
Population Health Metrics Sep 2017The vital registration system in Myanmar has a long history and geographical coverage is currently high. However, a recent assessment of vital registration systems of...
BACKGROUND
The vital registration system in Myanmar has a long history and geographical coverage is currently high. However, a recent assessment of vital registration systems of 148 countries showed poor performance of the death registration system in Myanmar, suggesting the need for improvement. This study assessed the quality of mortality data generated from the vital registration system with regard to mortality levels and patterns, quality of cause of death data, and completeness of death registration in order to identify areas for improvement.
METHODS
The study used registered deaths in 2013 from the vital registration system, data from the 2014 Myanmar Population and Housing Census, and mortality indicators and COD information for the country estimated by international organizations. The study applied the guidelines recommended by AbouZahr et al. 2010 to assess mortality levels and patterns and quality of cause of death data. The completeness of death registration was assessed by a simple calculation based on the estimated number of deaths.
RESULTS
Findings suggested that the completeness of death registration was critically low (less than 60%). The under-registration was more severe in rural areas, in states and regions with difficult transportation and poor accessibility to health centers and for infant and child deaths. The quality of cause of death information was poor, with possible over-reporting of non-communicable disease codes and a high proportion of ill-defined causes of death (22.3% of total deaths).
CONCLUSION
The results indicated that the vital registration system in Myanmar does not produce reliable mortality statistics. In response to monitoring mortalities as mandated by the Sustainable Development Goals, a significant and sustained government commitment and investment in strengthening the vital registration system in Myanmar is recommended.
Topics: Adult; Cause of Death; Child; Child Mortality; Death; Female; Health Services Accessibility; Humans; Infant; Infant Death; Infant Mortality; Male; Mortality; Myanmar; Quality Improvement; Registries; Reproducibility of Results; Rural Population
PubMed: 28946873
DOI: 10.1186/s12963-017-0153-1 -
European Journal of Pediatrics May 2022Twins involve a higher risk of perinatal complications compared to singletons. We compared the risk of under five mortality between twins and singletons among late...
Twins involve a higher risk of perinatal complications compared to singletons. We compared the risk of under five mortality between twins and singletons among late preterm and term births. The national birth data of South Korea pertaining to the years 2010-2014 linked with the mortality record of children aged under 5 years in 2010-2019 was analyzed. The final study population was 2,199,632 singletons and 62,351 twins. We conducted a survival analysis of under-five mortality with adjustment for neonatal and familial factors. Overall under-five mortality rates during the study period were 3.6 and 2.0 for twins and singletons, respectively. Although the unadjusted overall under-five mortality was higher in twins (hazard ratio [HR] = 1.80, 95% confidence interval [CI]: 1.57, 2.06, overall risk), twin birth was associated with comparable or lower risk (HR = 0.70, 95% CI: 0.58, 0.85, overall; 0.70, 95% CI: 0.56, 0.87, excluding neonatal mortality; 0.59, 95% CI: 0.40, 0.86, excluding infant mortality) after controlling for both neonatal and familial factors. Twins born at a gestational age of 34-35 weeks showed a generally lower risk of under-five mortality than their singleton counterparts, regardless of model specification.Conclusion: Among late preterm and term birth, under-5-year mortalities for twins were lower than singleton births when adjusted for neonatal and familial risk factors. This highlights the differential implication of gestational age at birth between twin and singleton in the child mortality.
Topics: Child; Child Mortality; Female; Gestational Age; Humans; Infant; Infant Mortality; Infant, Newborn; Pregnancy; Term Birth; Twins
PubMed: 35166933
DOI: 10.1007/s00431-022-04410-1 -
Health Economics Sep 2023The government of Peru amended its constitution to increase compulsory education from six to 11 years in 1993. This constitutional amendment provides a natural...
The government of Peru amended its constitution to increase compulsory education from six to 11 years in 1993. This constitutional amendment provides a natural experiment to investigate the impact of maternal education on child mortality. Exploiting differences in the reform exposure by age, I find that mothers who were exposed to the reform were less likely to experience the death of a child. There is also evidence that the reform caused a decline in infant mortality. These results are not driven by the age difference between mothers who were treated by the reform and those who were not treated. Additional analyses reveal that the reform increased age at first birth, decreased desired fertility, reduced smoking, and improved economic opportunities for women. The results demonstrate that compulsory schooling may be a useful policy tool to improve women's education, which can, in turn, enhance the survival of their children.
Topics: Infant; Child; Female; Humans; Child Mortality; Peru; Educational Status; Infant Mortality; Mothers; Mortality; Socioeconomic Factors
PubMed: 37182225
DOI: 10.1002/hec.4696 -
International Journal For Equity in... Dec 2020Increasing mortality among men from drugs, alcohol and suicides is a growing public health concern in many countries. Collectively known as "deaths of despair", they are...
BACKGROUND
Increasing mortality among men from drugs, alcohol and suicides is a growing public health concern in many countries. Collectively known as "deaths of despair", they are seen to stem from unprecedented economic pressures and a breakdown in social support structures.
METHODS
We use high-quality population wide Scottish data to calculate directly age-standardized mortality rates for men aged 15-44 between 1980 and 2018 for 15 leading causes of mortality. Absolute and relative inequalities in mortality by cause are calculated using small-area deprivation and the slope and relative indices of inequality (SII and RII) for the years 2001-2018.
RESULTS
Since 1980 there have been only small reductions in mortality among men aged 15-44 in Scotland. In that period drug-related deaths have increased from 1.2 (95% CI 0.7-1.4) to 44.9 (95% CI 42.5-47.4) deaths per 100,000 and are now the leading cause of mortality. Between 2001 and 2018 there have been small reductions in absolute but not in relative inequalities in all-cause mortality. However, absolute inequalities in mortality from drugs have doubled from SII = 66.6 (95% CI 61.5-70.9) in 2001-2003 to SII = 120.0 (95% CI 113.3-126.8) in 2016-2018. Drugs are the main contributor to inequalities in mortality, and together with alcohol harm and suicides make up 65% of absolute inequalities in mortality.
CONCLUSIONS
Contrary to the substantial reductions in mortality across all ages in the past decades, deaths among young men are increasing from preventable causes. Attempts to reduce external causes of mortality have focused on a single cause of death and not been effective in reducing mortality or inequalities in mortality from external causes in the long-run. To reduce deaths of despair, action should be taken to address social determinants of health and reduce socioeconomic inequalities.
Topics: Adolescent; Adult; Cause of Death; Health Status Disparities; Humans; Male; Mortality; Scotland; Socioeconomic Factors; Substance-Related Disorders; Suicide; Young Adult
PubMed: 33276793
DOI: 10.1186/s12939-020-01329-7