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PubMed1996

Mortality among the population of the city and voivodeship of Lodz contrasted with death rates in other voivodeships and large and medium-sized cities in Poland in 1993.

"The paper presents the problem of mortality in the Lodz area and the city of Lodz in 1993. The basis for this description is comparisons across voivodeships, and these between large and medium-sized cities in Poland. The comparisons were made allowing for the basic demographic features such as sex and age of the dead. Levels of mortality were identified for voivodeships and cities using fractional death rates for five year age groups, with the deaths among infants treated as a separate group."

Age Distribution↗
PubMed1997

Lethal outcome of uterine infection in pregnant but not in nonpregnant rats and increased death rate with inhibition of nitric oxide.

PROBLEM: Limited information is available on potential differences in sensitivity to urogenital infections between pregnant and nonpregnant hosts. METHOD OF STUDY: In this study, we evaluated Escherichia coli infectious complications in pregnant and nonpregnant rats and the effect of nitric oxide (NO) inhibitor, NG-nitro-L-arginine methyl ester (L-NAME), on the outcome of an experimental uterine infection. RESULTS: Of the infected pregnant animals, 31% were found dead in 24-48 hr. The death rate was increased 2-fold (66%) with L-NAME treatment. No deaths occurred in nonpregnant animals with or without L-NAME treatment. The rate of uterine infection in pregnant animals was about 10-fold higher than in nonpregnant animals. CONCLUSION: We propose that infectious complications of pregnancy may be related to gestation-dependent sensitivity to the pathogenic microorganism and the host NO status.

Animals↗
PubMed2003

Decline in the AIDS and death rates in the EuroSIDA study: an observational study.

BACKGROUND: Since the introduction of highly active antiretroviral therapy (HAART), little is known about whether changes in HIV-1 mortality and morbidity rates have been sustained. We aimed to assess possible changes in these rates across Europe. METHODS: We analysed data for 9803 patients in 70 European HIV centres including ones in Israel and Argentina. Incidence rates of AIDS or death were calculated for overall and most recent CD4 count in 6-monthly periods and in three treatment eras (pre-HAART, 1994-1995; early-HAART, 1996-1997; and late-HAART, 1998-2002). FINDINGS: The incidence of AIDS or death fell after September, 1998, by 8% per 6-month period (rate ratio 0.92, 95% CI 0.88-0.95, p<0.0001). When AIDS and death were analysed separately, the incidence of all deaths during the late-HAART era was significantly lower than that during the early-HAART era in patients whose latest CD4 count was 20 cells/microL or less (0.43, 0.35-0.53, p<0.0001), but at higher CD4 counts, did not differ between early-HAART and late-HAART. Incidence of AIDS was about 50% lower in late-HAART than in early-HAART, irrespective of latest CD4 count (p<0.0001). In multivariate Cox's models, with early-HAART as the reference, there was an increased risk of AIDS (relative hazard 1.39; 95% CI 1.16-1.67, p=0.0004) and all deaths (1.29; 1.08-1.56, p=0.0065) in the pre-HAART era, and a reduced risk of AIDS (0.62; 0.50-0.77, p<0.0001) and all deaths (0.66; 0.53-0.82, p=0.0002) in the late-HAART era. INTERPRETATION: The initial drop in mortality and morbidity after the introduction of HAART has been sustained. Potential long-term adverse effects associated with HAART have not altered its effectiveness in treating AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Effects of the choice of age-adjustment method on maps of death rates.

Maps of morbidity or mortality rates, whether considered individually or as a layer in a geographic information system application, invite multiple comparisons of area rates. However, comparisons of rates across different populations require standardization of the age-specific rates to account for differences in population age structures. The indirect standardization method, or equivalently the standardized mortality ratio (SMR), has been recommended for small areas where age-specific rates can be quite variable. Although theoretically equivalent to directly adjusted rates under the assumption of independent age and area effects, indirect summary measures are not comparable across areas when this assumption is violated. We tested the validity of this assumption for the 10 most common causes of death in the United States during 1980-84 and examined the geographic clustering apparent when categorized death rates, adjusted by different methods, are presented as thematic maps. Although overall agreement between the methods was good (rank correlation coefficient > 82 per cent for each cause), when the adjusted rates were classified into quintiles 18 per cent of the states fell into different categories depending on the method of adjustment. Using an internal standard for the indirect method reduced this discrepancy to 4.9 per cent. However, both traditional chi-square tests and a generalized logistic spline model identified significant interactions between age and area for each cause of death, a violation of the assumption required for equivalence of the methods. Potential variation in geographic inferences is illustrated by maps of direct and indirect rates and an empirical Bayes posterior mean, which is a function of these traditionally adjusted rates. Based on these results, we recommend the direct age-adjustment method for rate maps.

Adolescent↗
PubMed2001

Recent magnitude of and temporal trends (1994-1997) in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction: the second national registry of myocardial infarction.

BACKGROUND: Limited recent data are available to describe the magnitude of, and temporal trends in, the incidence and case-fatality rates associated with cardiogenic shock complicating acute myocardial infarction. The purpose of this study was to examine recent (1994-1997) trends in the incidence of, and hospital death rates from, cardiogenic shock complicating acute myocardial infarction from a large, multihospital national perspective. METHODS: An observational study was performed of 426,253 patients hospitalized with acute myocardial infarction in 1662 hospitals throughout the United States between 1994 and 1997. RESULTS: The incidence rates of cardiogenic shock averaged 6.2%. There was evidence for a slight decline in these rates between 1994 (6.6%) and 1997 (6.0%). Results of a multivariable regression analysis controlling for factors that might affect the risk of development of cardiogenic shock indicated that patients hospitalized in more recent years were at significantly lower risk for shock. Patients with shock had a markedly increased risk for dying during hospitalization compared with patients not having shock (74% vs 10%). Significant, albeit small, absolute differences were observed in the risk of dying after cardiogenic shock over time (76% dying in 1997, 72% dying in 1994). These improving trends were magnified, however, after potentially confounding prognostic factors were controlled: patients having shock in 1997 were at approximately one fifth lower risk of dying (odds ratio 0.79, 95% confidence interval 0.71-0.87) than those hospitalized in 1994. CONCLUSIONS: Our findings indicate a slight decline in the incidence rates of cardiogenic shock and improving trends in the hospital survival of patients with shock. Despite these trends, it remains of considerable importance to prevent this clinical syndrome, given its high lethality.

Aged↗
PubMed1994

Trends in death rates and registration rates for prostate cancer in England and Wales.

OBJECTIVE: To describe trends in deaths from prostate cancer between 1970 and 1990, and trends in registrations of prostate cancer between 1971 and 1986. METHODS: Data on prostate cancer deaths and registrations were obtained from the Office of Population Censuses and Surveys, and age specific rates were calculated. RESULTS: The number of deaths from prostate cancer rose by 107% between 1970 and 1990, from 3906 to 8098. The number of registrations of prostate cancer rose by 75% between 1971 and 1986, from 5819 to 10,180. Age-specific death rates and registration rates also increased but by a smaller amount than the rise in absolute numbers. CONCLUSIONS: A component of the increase seen in both the number of prostate cancer deaths and registrations can be explained by a concomitant increase in the elderly male population, the group at highest risk, but the rises seen in rates are more difficult to explain. The rises are likely to have had considerable implications for the workload of urologists and should be taken into account when planning future health services. With further increases expected over the next decade in the elderly male population, deaths and registrations from prostate cancer will continue to rise. Research will be required to determine possible reasons for the increase seen in prostate cancer rates over the last 20 years, to determine the true incidence and prevalence of prostate cancer in the general population and to identify possible aetiological factors.

Age Factors↗
PubMed2002

Variations in age-specific homicide death rates: a cohort explanation for charges in the age distribution of homicide deaths.

An age-period-cohort characteristic model previously used to explain age-period-specific rates of homicide arrests for those 15 to 49 from 1960 to 1995 is applied to measures of age-period-specific homicide deaths. The extension of this model to the examination of homicide victimization is significant because we are able to test the utility of the model across a longer time span (1930 to 1995) and a wider range of ages (10 to 79) and disaggregated by sex and race (Whites and non-Whites). Although the results indicate that past and recent shifts in age-period-specific rates of homicide deaths are associated with specific characteristics of cohorts, there are some important differences across race and sex groupings in the effects of these characteristics. The effects of the cohort variables examined in our model are independent of age and period, often substantively large, and last throughout the life course. The results are consistent with Durkheimian explanations of lethal violence, hypotheses from victimization theory, and basic tenets of cohort theory.

History, 20th Century↗
PubMed1988

One-year death rate in 270 patients with suspected acute myocardial infarction, initially treated with intravenous magnesium or placebo.

In a double-blind, placebo-controlled study, 273 patients with suspected acute myocardial infarction (AMI) were randomized to receive either 48-h magnesium (Mg) or placebo therapy intravenously, initiated immediately on admission to hospital. We describe the results from a 1-year survey in 270 of the patients, who were available for follow-up. Patients were equally divided: 135 received Mg and 135 received placebo. Mg treatment was associated with a marked reduction in 1-year death rate from 32% in the placebo group to 20% in the Mg group (p = 0.018). If only death from ischemic heart disease is considered, the figures were 28% in the placebo group as opposed to 15% in the Mg group (p = 0.006). This reduction was mainly due to a reduction in mortality during the initial 30 days after inclusion in the study (17% vs. 7%), after which the difference in mortality between the two groups did not reach statistical significance (18% vs. 15%, p = 0.56). The beneficial effect of Mg on mortality was partly linked to a reduced incidence of arrhythmias (27% vs. 16%), and partly to a reduced incidence of infarction (63% vs. 48%) during the initial hospitalization. However, factors unknown to us were also involved, as revealed by a remaining statistically significant partial regression coefficient, when sex, age, cardiovascular history, development of AMI, and development of arrhythmias were considered. It is concluded that intravenous Mg treatment is beneficial to patients with acute ischemic heart disease and should be adopted as part of the routine treatment of these patients.

Aged↗
PubMed1997

Comprehensive life table of computer-assisted predictive mathematical relationship between age and life expectancy, survival probability or death rate in US adults.

A microcomputer program in BASIC for predicting life expectancy by age in US adults was designed. Formulas used in this study were derived from the data reported by the National Center for Health Statistics. A comprehensive life table that shows the relationship between age and death rate, survival probability or life expectancy for each year between 25 and 85 years of age was obtained in this study, using a newly designed computer program for predicting life expectancy by age and the program for survival probability previously published by the author. The comprehensive life table may be useful for clinical evaluation of patients and further helpful for biomedical investigation and epidemiological evaluation of US adults.

Adult↗
PubMed1984

Rising death rates among Polish men.

All-causes mortality rates turned sharply upward for Polish men around 1972. Increases of 25 percent or greater were recorded for all five-year age groups between 40 and 59 years. Other indices, including infant mortality and death rates for women, either continued to improve or did not change. The primary causes accounting for this upturn appear to be cardiovascular diseases and cancer of the lung. The epidemiological pattern in Poland reflects in part the long-term trend for consumption of food, alcohol, and tobacco to approximate that found in Western industrialized countries. The role of more generalized social changes associated with Poland's rapid industrialization cannot be evaluated directly. Although it is still too early to see the effect of the social crisis of the last two years, economic disruption and shortages are not the main factors accounting for the upturn in Polish mortality through 1980. In fact, the success of the Polish economic strategy appears to be the underlying social cause.

Adult↗
PubMed1980

Trends in hospital admissions and death rates for peptic ulcer in the United States from 1970 to 1978.

During the period 1970-1978, admissions to short-term nonfederal hospitals in the U.S. for duodenal ulcer decreased by 43%, whereas admissions for gastric ulcer did not change significantly. The decline in admissions for duodenal ulcer was greatest for uncomplicated cases, less for those with hemorrhage, and least (and not significant) in those with perforation. During the period 1970-1977, U.S. Vital Statistics reports of deaths from peptic ulcer decreased 31%, with about equal declines in total deaths, those associated with hemorrhage, and those associated with hemorrhage, and those associated with perforation. The fall in death rate involved both gastric and duodenal ulcer in both men and women. The male/female ratio has been falling steadily, and now stands at about 1.2 for hospitalizations and about 1.5 for deaths. From 1970 to 1978 the percentage of persons over 60 yr of age rose from 14 to 15% in the U.S. population as a whole, from 23 to 29% in persons hospitalized for all causes, from 27 to 36% in those hospitalized for duodenal ulcer, and from 40 to 48% in those hospitalized for gastric ulcer.

Adolescent↗
PubMed2005

Death rates reflect accumulating brain damage in arthropods.

We present the results of the first quantitative, whole-lifespan study of the relationship between age-specific neurolipofuscin concentration and natural mortality rate in any organism. In a convenient laboratory animal, the African migratory locust, Locusta migratoria, we find an unusual delayed-onset neurolipofuscin accumulation pattern that is highly correlated with exponentially accelerating age-specific Gompertz-Makeham death rates in both males (r=0.93, p=0.0064) and females (r=0.97, p=0.0052). We then test the conservation of this association by aggregating the locust results with available population-specific data for a range of other terrestrial, freshwater, marine, tropical and temperate arthropods whose longevities span three orders of magnitude. This synthesis shows that the strong association between neurolipofuscin deposition and natural mortality is a phylogenetically and environmentally widespread phenomenon (r=0.96, p < 0.0001). These results highlight neurolipofuscin as a unique and outstanding integral biomarker of ageing. They also offer compelling evidence for the proposal that, in vital organs like the brain, either the accumulation of toxic garbage in the form of lipofuscin itself, or the particular molecular reactions underlying lipofuscinogenesis, including free-radical damage, are the primary events in senescence.

Age Factors↗
PubMedDate not supplied

Potassium reduces cerebral hemorrhage and death rate in hypertensive rats, even when blood pressure is not lowered.

In a study of the effects of K+ in stroke prone spontaneously hypertensive rats, adding K+ to normal chow was found to reduce the mortality from 83% to 2%, a 98% reduction. An 86% reduction in mortality occurred even when blood pressure was virtually equal in the two stroke prone spontaneously hypertensive groups being compared. Dietary K+ supplements also reduced mortality in hypertensive Dahl salt-sensitive rats from 55% to 4%, a 93% reduction. There was an 87% reduction in mortality even when blood pressure was equal in the Dahl salt-sensitive groups being compared. The added dietary K+ decreased blood pressure moderately in stroke prone spontaneously hypertensive rats and modestly in Dahl salt-sensitive rats, which probably contributed to the reduced death rate. More importantly, however, the added K+ seemed to prevent severe lesions in cerebral arteries and deaths even when blood pressure lowering was eliminated as a protective factor. In another group of stroke prone spontaneously hypertensive rats, there was a 40% incidence of cerebral hemorrhage in surviving rats not receiving K+ supplements and no incidence of cerebral hemorrhage in similar surviving rats receiving K+ supplements, which suggests that K+ supplements confer protection against brain hemorrhage.

Animals↗
PubMed1999

Twenty year trends (1975-1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction: a community-wide perspective.

OBJECTIVES: To describe from a population-based perspective, recent and temporal (1975-1995) trends in the incidence, in-hospital and postdischarge case-fatality rates of heart failure (HF) complicating acute myocardial infarction (AMI). BACKGROUND: Extremely limited data are available describing the incidence and case-fatality rates associated with HF complicating AMI from a community-wide perspective. METHODS: The medical records of 6,798 residents of the Worcester, Massachusetts metropolitan area with validated MI and without previous HF hospitalized in 10 annual periods between 1975 and 1995 were reviewed. RESULTS: The proportion of AMI patients developing HF during hospitalization declined between 1975-1978 (38%) and 1993-1995 (33%) (p < 0.001). After controlling for potentially confounding factors, the risk of developing HF declined progressively, albeit modestly, over time. In-hospital case-fatality rates of patients with AMI complicated by HF declined by approximately 46% between 1975-1978 (33%) and 1993-1995 (18%) (p < 0.001). Improving trends in hospital survival were observed after adjusting for potentially confounding prognostic factors. The one-year post-discharge mortality rate for hospital survivors of HF did not change over the 20-year period under study, even after controlling for additional prognostic characteristics. CONCLUSIONS: The results of this community-wide study suggest encouraging declines in the incidence and hospital death rates associated with HF complicating AMI. Continued efforts need to be directed towards the prevention of HF given the magnitude of this clinical syndrome. Efforts of secondary prevention are needed to identify and improve the treatment of patients with symptomatic left ventricular dysfunction following AMI given the lack of improvement in the long-term prognosis of these patients.

Aged↗
PubMed1995

In vivo estimates of division and death rates of human T lymphocytes.

We present data on the decay, after radiotherapy, of naive and memory human T lymphocytes with stable chromosome damage. These data are analyzed in conjunction with existing data on the decay of naive and memory T lymphocytes with unstable chromosome damage and older data on unsorted lymphocytes. The analyses yield in vivo estimates for some life-history parameters of human T lymphocytes. Best estimates of proliferation rates have naive lymphocytes dividing once every 3.5 years and memory lymphocytes dividing once every 22 weeks. It appears that memory lymphocytes can revert to the naive phenotype, but only, on average, after 3.5 years in the memory class. The lymphocytes with stable chromosome damage decay very slowly, yielding surprisingly low estimates of their death rate. The estimated parameters are used in a simple mathematical model of the population dynamics of undamaged naive and memory lymphocytes. We use this model to illustrate that it is possible for the unprimed subset of a constantly stimulated clone to stay small, even when there is a large population of specific primed cells reverting to the unprimed state.

Cell Death↗