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Biomedical subjects

Kenneth D Kochanek

Publications and source records attributed to Kenneth D Kochanek.

7 recordsLinked to original sources

Amyotrophic lateral sclerosis mortality in the United States, 1979-2001.

The etiology of nonfamilial amyotrophic lateral sclerosis (ALS) remains unknown. Earlier studies have suggested an increase in the incidence of ALS over time. We performed a retrospective analysis of ALS-associated death rates and trends in the United States for 1979-2001 using death records from the national multiple cause-of-death database. The US average annual age-adjusted ALS death rate was 1.84 per 100,000 persons for 1979 through 1998. Most deaths were among adults > or =65 years of age and the median age at death was 67 years. A small overall increase in the death rate was observed primarily between 1979 and 1983, with a subsequent plateau. This slight change in the overall rate reflected apparent increases in the rates among those persons > or =65 years of age, particularly women, and persons in the 20- to 49-year-old age group. The ALS-associated death rate appeared to differ by geographic area, with a higher occurrence among most northern states. Our findings suggest that the epidemiology of ALS-associated deaths in the United States demonstrated small increases in the overall age-adjusted death rate and in the death rates among elderly women and adults 20-49 years of age. Subpopulations at higher risk for ALS were males, whites, persons > or =65 years of age, and residents of northern states. This study provides information for further studies to examine the epidemiology and risk factors associated with ALS.

Adolescent↗

Annual summary of vital statistics--2003.

The crude birth rate rose slightly in 2003 to 14.1 births per 1000 population, from 13.9 in 2002. The 2002 rate was the lowest ever reported for the United States. The total number of births and the fertility rate (66.1) also increased. The birth rate for teenaged mothers dropped 3% to another record low in 2003, to 41.7 per 1000 females aged 15 to 19 years. The teenage birth rate has fallen by one third since 1991. The birth rate declined for women 20 to 24 years old but rose for women aged 25 to 44 years. The number, rate, and proportion of births to unmarried women all increased in 2003. Smoking during pregnancy declined to 11%, down from 19.5% in 1989. Prenatal care utilization improved slightly for 2003; 84.1% of women began care in the first trimester of pregnancy. The cesarean delivery rate jumped 6% to 27.6% for another US high. The primary cesarean rate rose 6%, and the rate of vaginal birth after a previous cesarean delivery plummeted 16% from 2002 to 2003. The percent of infants delivered preterm continued to rise (12.3% in 2003). The preterm birth rate is up 16% since 1990. The percentage of children born at low birth weight rose slightly in 2003 to the highest level reported since 1970 (7.9%). The twinning rate increased, but the rate for triplet/+ births declined slightly between 2001 and 2002. Multiple births accounted for 3.3% of all births in 2002. The infant mortality rate rose to 7.0/1000 live births in 2002 from 6.8 in 2001, marking the first increase in this rate in >4 decades. Increases were distributed fairly widely across age, racial/ethnic groups, and geographic areas. The rise in infant mortality was attributed to increases in <750-g births in both singleton and multiple deliveries. Although the downward trend in infant mortality rates in many developed nations may have stabilized, the United States still ranked 27th among these nations in 2001. Expectation of life at birth reached a record high of 77.3 years for all gender and race groups combined in 2002. Death rates in the United States continue to decline. Between 2001 and 2002, death rates declined for the 3 leading causes of death: diseases of heart, malignant neoplasms, and cerebrovascular diseases. Death rates for children 1 to 19 years old decreased by 8% for suicide; the death rate for chronic lower respiratory diseases increased by 33% in 2002. Rates for unintentional injuries and homicide did not change significantly for children aged 1 to 19 years. A large proportion of childhood deaths continues to occur as a result of preventable injuries.

Adolescent↗

Supplemental analyses of recent trends in infant mortality.

U.S. preliminary data for 2002 show a significant increase in the infant mortality rate to 7.0 infant deaths per 1,000 live births, the first rise in the infant mortality rate since 1958. The increase in infant mortality was concentrated in the neonatal period, particularly in deaths occurring within seven days of birth. Partially edited fetal death data suggest that the increase in neonatal mortality was accompanied by a decline in the late fetal mortality rate, and thus it appears that the 2002 perinatal mortality rate will remain level. Potential explanatory factors for the changes in the infant mortality rate are examined, including causes of infant death, percentage of births that are preterm, and low birthweight. Data from the 2002 linked birth and infant death file will allow an assessment of the contribution of maternal and infant factors such as multiple births and management of labor and delivery.

Fetal Death↗

Deaths: final data for 2002.

OBJECTIVES: This report presents final 2002 data on U.S. deaths and death rates according to demographic and medical characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 2002. METHODS: In 2002 a total of 2,443,387 deaths were reported in the United States. This report presents descriptive tabulations of information reported on the death certificates. Funeral directors, attending physicians, medical examiners, and coroners complete death certificates. Original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Causes of death are processed in accordance with the International Classification of Diseases Tenth Revision (ICD-10). RESULTS: The age-adjusted death rate for the United States in 2002 was 845.3 deaths per 100,000 standard population, representing a decrease of 1.1 percent from the 2001 rate and a record-low historical figure. Life expectancy at birth rose by 0.1-year to a record high of 77.3 years. Considering all deaths, age-specific death rates rose only for those under 1 year, and declined for a number of age groups including those 1-4 years, 25-34 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. The 15 leading causes of death in 2002 remained the same as in 2001. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over half of all deaths. The infant mortality rate in 2002 increased to 7.0 compared with a rate of 6.8 in 2001. CONCLUSIONS: Generally, mortality patterns in 2002 were consistent with long-term trends. Life expectancy in 2002 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. However, the infant mortality rate increased in 2002. The infant mortality rate has either decreased or remained level each successive year through 2001 since 1958. Trends for homicide and injury at work were interrupted due to the terrorist deaths that occurred September 11, 2001. The homicide rate decreased significantly from 2001 to 2002 and dropped to the 14th leading cause of death. Deaths due to injury at work also declined significantly during this period.

Cause of Death↗

Deaths: preliminary data for 2002.

OBJECTIVES: This report presents preliminary data on deaths for the year 2002 in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Death rates for 2002 are based on population estimates consistent with the April 1, 2000, census. Data on life expectancy, leading causes of death, and infant mortality are also presented. METHODS: Data in this report are based on a large number of deaths comprising approximately 97 percent of the demographic file and 93 percent of the medical file for all deaths in the United States in 2002. The records are weighted to independent control counts of infant deaths and deaths 1 year of age and over received in State vital statistics offices for 2002. Unless otherwise indicated, comparisons are made with final data for 2001. For certain causes of death, preliminary data differ from final data because of the truncated nature of the preliminary file. These are, in particular, unintentional injuries, homicides, suicides, and respiratory diseases. Populations were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics under a collaborative arrangement with the U.S. Census Bureau. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members and also separated the category for Asian or Pacific Islander persons into two groups (Asian and Native Hawaiian or Other Pacific Islander). These changes reflected the Office of Management and Budget's (OMB) 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in death certificate data, the 2000 census populations were "bridged" to the single race categories specified in OMB's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: The age-adjusted death rate in 2002 for the United States decreased from 854.5 deaths per 100,000 population in 2001 to 846.8 in 2002. Declines in age-adjusted death rates occurred for Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Accidents (unintentional injuries), Chronic liver disease and cirrhosis, and Assault (homicide). The decrease in homicide reflects the effect of the terrorist attacks of September 11, 2001, on the rates for that year. Age-adjusted death rates also decreased for alcohol-induced deaths between 2001 and 2002. Age-adjusted death rates increased between 2001 and 2002 for the following causes: Alzheimer's disease, Influenza and pneumonia, Essential (primary) hypertension and hypertensive renal disease, Septicemia, and Nephritis, nephrotic syndrome and nephrosis. Life expectancy at birth rose by 0.2 years to a record high of 77.4 years. The infant mortality rate increased between 2001 and 2002, the first numerical increase in the infant mortality rate since 1957-58. However, supplemental analyses of fetal death records indicate that the perinatal mortality rate remained stable between 2001 and 2002.

Adolescent↗

Deaths: final data for 2001.

OBJECTIVES: This report presents final 2001 data on U.S. deaths and death rates according to demographic and medical characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 2001. METHODS: In 2001 a total of 2,416,425 deaths were reported in the United States. This report presents descriptive tabulations of information reported on the death certificates. Funeral directors, attending physicians, medical examiners, and coroners complete death certificates. Original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Causes of death are processed in accordance with the International Classification of Diseases Tenth Revision (ICD-10). RESULTS: The age-adjusted death rate for the United States in 2001 was 854.5 deaths per 100,000 standard population, representing a decrease of 1.7 percent from the 2000 rate and a record low historical figure. Life expectancy at birth rose by 0.2 years to a record high of 77.2 years. Considering all deaths, age-specific death rates rose only for those 25-44 years, and declined for a number of age groups including those under 1 year, 5-14 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. The 15 leading causes of death in 2001 remained the same as in 2000. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over half of all deaths. Homicide became the 13th leading cause in 2001, rising from the 14th leading cause in 2000 as a result of the September 11, 2001, terrorist attacks. The infant mortality rate remained at a record low level, declining slightly but insignificantly from 6.9 in 2000 to 6.8 in 2001. CONCLUSIONS: Generally, mortality patterns in 2001 were consistent with long-term trends. Life expectancy in 2001 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. Although statistically unchanged from 2000, the trend in infant mortality has shown a steady, although slowing, decline. The declining trend in the homicide death rate was reversed primarily as a result of the September 11, 2001, terrorist attacks.

Adolescent↗

Deaths: final data for 2000.

OBJECTIVES: This report presents final 2000 data on U.S. deaths and death rates according to demographic and medical characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 2000. METHODS: In 2000 a total of 2,403,351 deaths were reported in the United States. This report presents descriptive tabulations of information reported on the death certificates. Funeral directors, attending physicians, medical examiners, and coroners complete death certificates. Original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Causes of death are processed in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10). RESULTS: The age-adjusted death rate for the United States in 2000 was 872.0 deaths per 100,000 standard population, a decrease of 1.1 percent from the 1999 rate and a record-low historical figure. Life expectancy at birth rose by 0.2 year to a record high of 76.9 years. Considering all deaths, age-specific death rates rose only for those 45-54 years and declined for a number of age groups including those 1-4 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. Fourteen of the 15 leading causes of death are the same for 1999 and 2000. Heart disease and cancer continued to be the leading and second leading causes of death, accounting for over one-half of all deaths when combined. Aortic aneurysm, which was the 15th leading cause of death in 1999, dropped from the list in 2000 and, in its place, Pneumonitis due to solids and liquids is the 15th leading cause of death. The infant mortality rate reached a record low value of 6.9 infant deaths per 1,000 live births, declining 2.8 percent from the infant mortality rate in 1999 (7.1 deaths per 1,000 live births). CONCLUSIONS: Generally, mortality continued long-term trends. The slight increase in the age-adjusted death rate that was experienced in 1999 reversed itself in accordance to a longer standing decreasing pattern. Life expectancy increased 0.2 years, and the infant mortality rate decreased statistically to a record low 6.9 deaths per 1,000 live births, thus maintaining the steady decline that has characterized it for the past four decades.

Adolescent↗