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At least 253 records · Page 14Linked to original sources
PubMed1993

The problem of fuzzy cause-specific death rates in mortality context analysis: the case of Panama City.

In studies of mortality, small and fluctuating numbers of deaths are problems which are caused by infrequent reporting and small spatial unit reporting. To use Panama City as an example, the paper will introduce a Monte Carlo simulation which allows for the analysis of mortality even with small absolute numbers. In addition, Panama City will be used as an example where good medical care is available in every city district, so that social class differences between the districts have a negligible effect on most cause-specific death rates and infant mortality.

Adolescent↗
PubMed1999

Is whole grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Women's Health Study.

OBJECTIVES: This study sought to determine whether nutrient-rich whole grains reduce mortality risk. METHODS: The study included 38,740 Iowa women, aged 55 to 69 years. A food frequency questionnaire was used to obtain data on grain intake. RESULTS: Median whole grain intake quintiles ranged from a median of 0.2 to more than 3 servings per day. Women with higher intakes had healthier lifestyles and less baseline disease. The total death rate decreased in increasing quintiles, and the pattern repeated for cancer, cardiovascular disease, and other causes combined. Adjusted for lifestyle and baseline disease, the relative hazard rate ratio for total death was about 0.85 in daily consumers of whole grain. Findings persisted in strata of baseline healthy and diseased and were not explained by dietary fiber. Rates of total mortality, but not cardiovascular disease mortality, were higher among frequent consumers of refined grain. CONCLUSIONS: Total mortality risk was inversely associated with whole grain intake and positively associated with refined grain intake. Refined grains contributed more than 20% of energy intake, and whole grains contributed 1%. Substitution of whole for refined grain may reduce chronic disease risk in the United States.

Aged↗
PubMed1988

Evaluating a pediatric trauma program: effectiveness versus preventable death rate.

We compared effectiveness (E), the proportion of severely injured patients who were salvageable and survived, to the preventable death rate (PDR) over three consecutive 1-year periods. Severely injured patients were those with at least one injury with an Abbreviated Injury Score (AIS) of greater than or equal to 4. Those with one fatal injury (AIS greater than or equal to 6), a critical head injury (AIS greater than or equal to 5) apart from acute epidural hematoma, or massive multiple injuries (Injury Severity Score greater than 59) were considered nonsalvageable; the remainder were considered salvageable. In the first year, six of 74 salvageable patients died, in the second year five of 76, and in the third year one of 69. The PDR rates were 0.32 (6/19), 0.23 (5/22), and 0.06 (1/17), respectively. There was no significant difference in the E of our trauma program over the 3 years. The apparent improvement in PDR in the second and third years resulted from an increased number of deaths among nonsalvageable patients and fewer deaths among salvageable patients. This finding demonstrates that PDR is sensitive to case mix and not just quality of care, and confirms the superiority of E over PDR for assessing a trauma program.

Child↗
PubMed1988

HCFA release of hospital specific death rates: where are we and where are we going?

This article reviews the public release of hospital-specific death rates by the Health Care Financing Administration in 1986 and 1987 and makes projections for the future of such releases. Among the topics covered are the reasons for such public releases, the significant problems associated with the release in 1986, modifications which reduced such problems in 1987, strategies employed by hospitals to anticipate and/or respond to public release, future projections regarding public release,and implications for medical record professionals.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1982

Rising lung cancer death rates among black men: the importance of occupation and social class.

From 1950 to 1977 the age-adjusted cancer death rates for nonwhite men in the United States rose an astonishing 63.2 percent, while rates for white men increased 22.2 percent and fell slightly for women of both races. The bulk of this increase can be accounted for by cancer of the lung. As a serious health problem that is increasing in severity, cancer in black men deserves close attention and definitive action. This discussion focuses on basic epidemiological relationships in the origins of this epidemic, particularly in regard to the relative importance of occupation, cigarette smoking, and social class.

Black or African American↗
PubMed1998

Changes in liver cirrhosis death rates in different countries in relation to per capita alcohol consumption and Alcoholics Anonymous membership.

OBJECTIVE: This study examines how trends in liver cirrhosis relate to per capita alcohol consumption and Alcoholics Anonymous (AA) membership in 33 countries between 1965 and 1991. It was expected that reductions in liver cirrhosis deaths seen in many countries would be related to both decreased consumption and increased AA membership. METHOD: Data on liver cirrhosis death rates, alcohol consumption and AA membership were gathered from a variety of international sources. The data were analyzed with regression analyses (Ordinary Least Squares). RESULTS: Cirrhosis deaths and alcohol consumption levels were positively related in all analyses. In two of the four analyses, the negative relationship between cirrhosis deaths and AA group rates was marginally significant. CONCLUSIONS: Liver cirrhosis rates were strongly related to alcohol consumption and showed some relationship to AA group rates. The modest impact of AA may be due to the weakness of the true relationship but also to incompleteness in the cirrhosis and AA data in some countries.

Alcohol Drinking↗
PubMed1993

Why have child pedestrian death rates fallen?

Pedestrian injuries are a leading cause of childhood mortality and disability. Over the past two decades in Britain child pedestrian death rates have fallen despite large increases in traffic volume. In this paper Roberts examines the likely reasons for this decline. He argues that neither prevention programmes nor improvements in medical care are a plausible explanation and that the decline is most likely the result of a substantial reduction in children's traffic exposure. He believes, however, that restricting children's traffic exposure exacerbates socioeconomic differentials in childhood mortality and denies children their right to mobility. Roberts is convinced that one answer is for British transport policy to be aimed at providing mobility equitably rather than struggling to meet the ever increasing demands of car travel.

Accident Prevention↗
PubMed1977

Recent time-trends of age-specific death rates for breast cancer: Quebec and other provinces, 1965 through 1974.

For the 10-year period 1965 through 1974 the age-specific death rates for cancer of the breast decreased among middle-aged women, especially at ages 40 to 49 years, in Quebec, the Maritimes and the Prairies but not in Ontario or British Columbia. In women under 35 years of age the mortality generally increased, while in women aged 60 to 64 years there was little change except in the Prairies, where the rate increased. It seems probable that the trends reflect changes in incidence rather than in case-fatality. Some, but not all, of the pattern could be explained by changes in fertility over the past 50 years.

Adolescent↗
PubMed1987

Death rates from stroke in England and Wales predicted from past maternal mortality.

Geographical differences in maternal mortality in England and Wales during 1911-4 correlate closely with death rates from stroke in the generation born around that time. The geographical distribution of stroke is more closely related to past maternal mortality than to any leading cause of death, past or present, except ischaemic heart disease, for which correlation coefficients with stroke are similar. This relation is new evidence that poor health and physique of mothers are important determinants of the risk of stroke among their offspring.

Aged↗
PubMed1987

Atrophic gastritis and vitamin C status in two towns with different stomach cancer death-rates.

A survey was conducted of 513 men aged 65 74 years living in two British towns with high and low stomach cancer death-rates. The prevalence of severe atrophic gastritis (defined as a serum pepsinogen I less than 20 micrograms l-1) was significantly higher in the high-risk than in the low-risk town (14.5% and 7.7% respectively); it also tended to be higher in the manual workers, who are known to have a greater risk of stomach cancer than non-manual workers. The manual workers in the high-risk town were particularly likely to have had a partial gastrectomy. Plasma ascorbate concentration and fruit intake were lower in the high-risk area and lower social classes, suggesting a poorer vitamin C status. There was, however, no direct relationship between ascorbate concentration and the presence of severe atrophic gastritis. These findings are consistent with the hypothesis that risk of stomach cancer is determined in two stages--a long-term effect, producing atrophic gastritis; and a short-term effect in which vitamin C is protective.

Aged↗
PubMed1992

Hysterectomy prevalence and death rates for cervical cancer--United States, 1965-1988.

Since the 1960s, hysterectomy has been one of the most frequently performed inpatient surgical procedures in the United States, with an estimated 33% of women undergoing a hysterectomy by 60 years of age. However, rates of cervical cancer mortality that do not allow for the proportion of women with hysterectomies in the population will underestimate the rates in the true at-risk population (i.e., women with intact uteri) and may influence apparent secular trends in rates of cervical cancer mortality. This report uses national mortality and hospital-discharge data to compare death rates, corrected and uncorrected for hysterectomy prevalence, for women who died with an underlying diagnosis of cervical cancer (International Classification of Diseases, Ninth Revision [ICD-9] and ICD-9-Clinical Modification, code 180).

Adult↗
PubMed1996

Reducing accident death rates in children and young adults: the contribution of hospital care. Steering Committee of the Major Trauma Outcome Study Group.

OBJECTIVE: To assess the contribution of trauma care to the recent decline in accident death rates among children and young people. DESIGN: Logistic regression modelling of temporal trends in the probability of death in patients admitted to hospital for the treatment of severe injury. SETTING: Hospitals participating the United Kingdom major trauma outcome study. SUBJECTS: 3230 patients with an injury severity score of 16 or more, who were admitted for more than three days, transferred or admitted to intensive care, or died from their injuries. MAIN OUTCOME MEASURES: Death or survival in hospital within three months of injury. RESULTS: Over the seven year period 1989-95 there was a substantial decline in the probability of death among children and young adults admitted to hospital after severe injury. The overall estimate of the reduction in the odds of death was 16% per year (odds ratio for the yearly trend 0.84; 95% confidence interval 0.79 to 0.89). This decline did not differ significantly between age groups. (0-4 years 0.79; 5-14 years 0.87; 15-24 years 0.83). CONCLUSIONS: Reductions in hospital case fatality have made an important contribution to reaching the Health of the Nation targets. The contribution of hospital care in the reduction of accident mortality should be taken into account in decisions about the allocation of resources to preventive and curative services.

Accidents↗
PubMed2005

The death rate among hospitalized heart failure patients with normal and depressed left ventricular ejection fraction in the year following discharge: evolution over a 10-year period.

AIMS: To investigate whether changes in clinical characteristics and treatment strategies between 1991 and 2001 have had an impact on the survival of patients hospitalized with congestive heart failure (CHF) and whether those with normal left ventricular ejection fraction (LVEF> or =50%) differ in this respect from those with depressed LVEF. METHODS AND RESULTS: We studied 1482 patients who had been admitted to the Cardiology Service of a tertiary Spanish hospital in the last 10 years with CHF. Among the 1110 for whom LVEF was evaluated, the prevalence of normal LVEF rose from 37% in the period 1991-96 (Period 1) to 47% in the period 2000-2001 (Period 3). The intensity of both diagnostic and therapeutic measures also increased during this 10-year period. The 1-year survival rate remained virtually unchanged in the whole group of patients, being 82, 84, and 82% in Periods 1, 2 (1997-99), and 3, respectively, even though the prognosis of patients with depressed LVEF (<50%) improved significantly, with 1-year survival rates of 76, 77, and 84% in Periods 1, 2, and 3, respectively; the normal LVEF group had decreasing 1-year survival rates of 88, 86, and 81% in Periods 1, 2, and 3, respectively, although the increased risk of death was not statistically significant. CONCLUSION: Although in our centre the death rate among hospitalized CHF patients with depressed LVEF during the first year after discharge has tended to fall over the past 10 years, application of current clinical guidelines has led to no such decrease for patients with normal LVEF. This situation points to a need to reconsider the diagnostic and therapeutic strategy to be employed with this latter group of patients.

Aged↗
PubMed1990

Parkinsonism death rates by race, sex and geography: a 1980s update.

To evaluate temporal changes in the geographic distribution of Parkinson's disease (PD) mortality in the United States, we reviewed death rates for PD in the nine regions of the United States for 1980-1984. Age-adjusted mortality for all ages and for the elderly (65 years of age and older) was analyzed. Variation in PD mortality was observed among the regions for all demographic groups. The patterns were different from those reported during 1959-1961. Changing geographic patterns in mortality provide evidence for an environmental etiology for PD.

Cause of Death↗
PubMed1977

Why do human cancer death rates increase with age? A new method of analysis of the biology of cancer.

1. Cancers, viewed as escape from the normal "contact inhibition" of cells in tissues, can be considered to start at some given time and then to require a period of incubation before they cause death. The probability of a start may depend on age, described by a start function. The incubation period may be described by a lethality function of the period between start and the age at which death rates are measured. 2. It can be shown that, provided the loss of tumour-bearers (where cancer has started) in the population by deaths from other causes than cancer is in the same ratio as the loss of total population, the differential curve (dR/dA) of the rate versus age curves must give the product of these two functions (start function X lethality function). 3. The differential curves dR/dA for major sites of cancers are examined for WHO data on deaths. The differential curves prove to be well described by normal Gaussian curves. The presence of more than one type of tumour or of physiological environment, included in a single category, is shown by multiple peaks in the differential curves. The outstanding exception is tumours of the "brain and other CNS" where the rate curve itself is Gaussian. 4. The results are consistent with a start rate that is random and independent of age (not exceeding three per 1,000 per year for the commonest tumour), and an astonishingly long incubation period of at least 20-50 years. For most sites, the curves indicate that from 20 to 40% of the cancers that have started do not cause death, because other causes supervene. 5. The implications as to the possibilities of control of cancer and of the relevance of experimental cancer research are discussed.

Adolescent↗
PubMed1994

Advanced stage at diagnosis: an explanation for higher than expected cancer death rates in Louisiana?

Data from the Louisiana Tumor Registry, Louisiana Vital Statistics Division, and the SEER program of the National Cancer Institute were explored to evaluate reasons for elevated cancer death rates in the absence of elevated cancer incidence in Louisiana. The results indicate that cancer patients in South Louisiana are more likely to be diagnosed with advanced stage disease than SEER patients. The Louisiana-SEER differences are greater for blacks than whites, and black patients are more likely to have advanced stage cancer than whites in Louisiana as well as in the SEER program. Of particular interest and concern is the finding that the increased risk of advanced stage disease in Louisiana is significant for cancers which can be detected early and, if so, effectively treated: colon, breast, and cervix. The findings reinforce the need for cancer control programs.

Adult↗