Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORTALITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed2005

Are the acute effects of particulate matter on mortality in the National Morbidity, Mortality, and Air Pollution Study the result of inadequate control for weather and season? A sensitivity analysis using flexible distributed lag models.

Time-series studies have linked daily variations in nonaccidental deaths with daily variations in ambient particulate matter air pollution, while controlling for qualitatively larger influences of weather and season. Although time-series analyses typically include nonlinear terms for weather and season, questions remain as to whether models to date have completely controlled for these important predictors. In this paper, the authors use two flexible versions of distributed lag models to control extensively for the confounding effects of weather and season. One version builds on the current approach to controlling for weather, while the other version offers a new approach. The authors conduct a comprehensive sensitivity analysis of the particulate matter-mortality relation by applying these methods to the recently updated National Morbidity, Mortality, and Air Pollution Study database that comprises air pollution, weather, and mortality time series from 1987 to 2000 for 100 US cities. They combine city-specific estimates of the short-term effects of particulate matter on mortality using a Bayesian hierarchical model. They conclude that, within the broad classes of models considered, national average estimates of particulate matter relative risk are consistent with previous estimates from this study and are robust to model specification for weather and seasonal confounding.

Aged↗
PubMed2003

Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival?

PURPOSE: This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences among old and old-old people, and (c) to address the question of whether this association is based on the accuracy of poor SRH as a predictor of future decline, and/or of better SRH as a predictor of longevity. DESIGN AND METHODS: The study is based on an Israeli nationally representative sample of 622 women and 730 men who were interviewed about their SRH, as well as sociodemographic information and other measures of health, physical functioning, cognitive status, and depression. RESULTS: For both genders, SRH was associated only with shorter term mortality (within the next 4 years) and not with longer-term mortality (9 years of follow-up). This association was strongest among the old (ages 75-84) women, compared with the old men and with the old-old (85-94) women and men. A possible explanation may be related to differences in the accuracy of excellent SRH at very old age. IMPLICATIONS: The SRH-mortality association may differ among age and gender groups. Identifying the conditions under which it is more accurate will enable researchers and practitioners to know when it can be utilized. It is important to assess differences in the accuracy of poor SRH as well as of excellent SRH as predictors of future health outcomes.

Aged↗
PubMed1983

Birthweight and perinatal mortality: II. On weight-specific mortality.

The study of perinatal mortality requires a sound understanding of the influence of birthweight on perinatal mortality. This paper discusses one aspect of this problem--the pattern of weight-specific mortality. Mortality is very high at the lowest birthweights, falls to a minimum within the range of the most frequent birthweights, but rises again for the heaviest birthweights. Such a curve is best displayed and modelled by plotting the ratio of deaths to survivors on a logarithmic scale. Transformed in this way, perinatal risk may be regarded as the sum of three components--one independent of birthweight, one which decreases linearly with birthweight and one which increases linearly with birthweight. These two lines appear to have slopes of equal magnitude. Each is shown to represent general susceptibility to perinatal problems, rather than the cumulative effect of diseases specific to low birthweight or to high birthweight.

Birth Weight↗
PubMed1999

Classification differences and maternal mortality: a European study. MOMS Group. MOthers' Mortality and Severe morbidity.

OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected. RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001). CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

Cause of Death↗
PubMed2000

Standardized mortality ratio and life expectancy: a comparative study of Chinese mortality.

BACKGROUND: Various models have been proposed for rapid conversion of the standardized mortality ratio (SMR) to life expectancy using data from developed countries. METHODS: We compared two methods for converting the SMR to life expectancy using mortality data from the largest developing country, China. RESULTS: The first model, using the Gompertz function, does not provide a good fit to the life expectancy and SMR of China. The regression lines derived from the second, a log-linear model using parameters estimated from the US white population are not a good fit to Chinese males and older females. However, if the parameters in the log-linear model are estimated using Chinese mortality data, the resultant regression lines fit the data reasonably well. CONCLUSION: The relationship between life expectancy and SMR based on mortality data from developed countries may not be valid for developing countries. Based on our empirical study, separate estimates of the coefficients of the model are required for developing countries.

Adult↗
PubMed1997

Examination of "early mortality exclusion" as an approach to control for confounding by occult disease in epidemiologic studies of mortality risk factors.

Methods for the estimation of the effects of chronic disease risk factors on mortality continue to be an area that generates confusion and controversy. In response to the frequently observed U- or J-shaped relations between risk factors and mortality, some authors suggest that subjects dying during the first k years of follow-up (where k is some positive number less than the total length of follow-up) be excluded from statistical analyses. By excluded, the authors mean completely removed from the data set. The rationale is that persons dying during the first k years are likely to have a preexisting occult disease that confounds the relation between the risk factor under study and mortality. Excluding persons dying during the first k years of follow-up purportedly reduces this confounding. However, the authors are aware of no demonstration that this procedure effectively accomplishes its goal. They show that excluding subjects who die during the first k years of follow-up does not necessarily lead to a reduction in bias in the estimated effect of a risk factor on mortality when this relation is confounded by the presence of occult disease. Moreover, it is possible for such exclusion to exacerbate the confounding due to preexisting disease. Thus, excluding subjects dying during the first k years of follow-up is not necessarily an effective strategy for dealing with confounding due to occult disease. Investigators are encouraged to pursue alternative methods.

Confounding Factors, Epidemiologic↗
PubMed1987

Inbreeding and prereproductive mortality in the Old Order Amish. II. Genealogic epidemiology of prereproductive mortality.

The effects of offspring and parental inbreeding on prereproductive mortality (death before age 20 years) in the historical population of the Lancaster County, Pennsylvania, Old Order Amish were investigated using the Amish genealogic registry, which contains information on 42,465 births dating to the time of the pioneer migrants in the 1700s. Inbreeding coefficients for offspring and parents were computed using the path method of tracing common ancestors in the multigenerational pedigrees. In this population, prereproductive mortality declined from about 15% in the late 1800s to about 5% after 1930. Offspring inbreeding was found to be an independent predictor of prereproductive mortality after multivariate adjustment for demographic risk factors for mortality. Moreover, the higher the coefficient, the higher the relative risk of prereproductive death, and the higher the risk of multiple deaths in the same sibship. There was no evidence of declining inbreeding effects over 10 generations of continuous inbreeding, nor of any significant parental inbreeding effects. Because of the high levels of inbreeding, it could be shown that inbreeding accounts for about 40% of all prereproductive deaths in the present population. Genetic load analysis showed an average of about 1.7 lethal equivalents and a mostly mutational load.

Adult↗
PubMed2007

Mortality in Emergency Department Sepsis (MEDS) score predicts 1-year mortality.

OBJECTIVE: To assess the predictive performance for 1-yr mortality of the previously derived and validated Mortality in Emergency Department Sepsis (MEDS) score. DESIGN: Prospective cohort study. PATIENTS: Consecutive adult (aged > or =18 yrs) emergency department patients presenting to an urban, tertiary care, university hospital were eligible if they had a clinically suspected infection as indicated by the decision to obtain a blood culture. The enrollment period was between February 1, 2000, and February 1, 2001. Of 3,926 eligible patient visits, 3,762 (96%) were enrolled and 3,102 unique first visits were analyzed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 667 patients (21.5%) died within 1 yr. The unadjusted 1-yr mortality rates for the MEDS risk groups were: very low risk, 7%; low risk, 20%; moderate risk, 37%; high risk, 64%; very high risk, 80%. Using a Cox proportional hazard model that controlled for age, sex, and Charlson co-morbidity index, the 1-yr hazard ratios compared with the baseline very low-risk group were: low risk, 2.2 (1.7-2.9); moderate risk, 3.5 (2.7-4.6); high risk, 6.7 (4.9-9.3); and very high risk, 10.5 (7.2-15.4). The groups were significantly different (p < .0001). CONCLUSIONS: Although the score was initially derived for 28-day in-hospital mortality, our results indicate that the MEDS score also predicts patient survival at 1 yr after index hospital visit with suspected infection. The score needs external validation before widespread use.

Adult↗
PubMed1995

Rural and urban differences in mortality among Americans 55 years and older: analysis of the National Longitudinal Mortality Study.

Previous research on rural and urban differences in risk of mortality has been inconclusive. This article used data from the National Longitudinal Mortality Study to establish whether all-cause mortality risk among persons 55 years and older varies by degree of urbanization, controlling for the potential sociodemographic confounders of age, gender, race/ethnicity, education, income, and marital status. Using the Cox Proportional Hazards Regression Procedure, the authors found that persons living in the most rural locales and those living in rural communities in standard metropolitan statistical areas (SMSAs) have the lowest risk of mortality, while those living in SMSA central cities had the highest risk of dying during the study period. The protective effect of rural residence declines in older age cohorts.

Age Factors↗
PubMed2006

[Quality of socioeconomic and demographic data in relation to infant mortality in the Brazilian Mortality Information System (1996/2001)].

This study aimed to evaluate the quality of socioeconomic and demographic data in the Brazilian Mortality Information System (SIM), in relation to infant mortality. The article assesses the system's potential for monitoring inequalities in infant mortality in various States in the country. Accessibility, timeliness, methodological clarity, incompleteness, and consistency were explored as quality indicators. Selected variables were: race, birth weight, gestational age, medical care, parity, and maternal schooling, age, and occupation. The study also reviewed the system's working documentation and the scientific literature on infant mortality. Proportions of data incompleteness were calculated by region and State, identifying factors that might influence (in)completeness using logistic regression. Despite the database's accessibility and the relevance of most of its variables, the system has serious quality problems: confusing instructions in the information manual concerning missing data, misclassification of maternal occupation, lack of data on the informant's race/ethnicity, and high proportions of incomplete information. The system does not appear to be a reliable source for monitoring, evaluating, and planning measures to minimize infant health inequalities.

Brazil↗
PubMed2006

Is mortality from heart failure increasing in Australia? An analysis of official data on mortality for 1997-2003.

OBJECTIVE: To assess whether trends in mortality from heart failure (HF) in Australia are due to a change in awareness of the condition or real changes in its epidemiology. METHODS: We carried out a retrospective analysis of official data on national mortality data between 1997 and 2003. A death was attributed to HF if the death certificate mentioned HF as either the underlying cause of death (UCD) or among the contributory factors. FINDINGS: From a total of 907 242 deaths, heart failure was coded as the UCD for 29 341 (3.2%) and was mentioned anywhere on the death certificate in 135 268 (14.9%). Between 1997 and 2003, there were decreases in the absolute numbers of deaths and in the age-specific and age-standardized mortality rates for HF either as UCD or mentioned anywhere for both sexes. HF was mentioned for 24.6% and 17.8% of deaths attributed to ischaemic heart disease and circulatory disease, respectively, and these proportions remained unchanged over the period of study. In addition, HF as UCD accounted for 8.3% of deaths attributed to circulatory disease and this did not change materially from 1997 to 2003. CONCLUSION: The decline in mortality from HF measured as either number of deaths or rate probably reflects a real change in the epidemiology of HF. Population-based studies are required to determine accurately the contributions of changes in incidence, survival and demographic factors to the evolving epidemiology of HF.

Aged↗
PubMedDate not supplied

Validity of the updated pediatric risk of mortality score (PRISM III) in predicting the probability of mortality in a pediatric intensive care unit.

This study assessed the validity of the PRISM III scoring system in accurately predicting the probability of mortality in a pediatric intensive care unit (PICU) in Taiwan. We collected data from consecutive patients admitted to our PICU during a one-year period from November 1999 through October 2000. Our PICU had 412 admissions including 385 patients (202 boys and 183 girls) with an average age of 53.9 +/- 58.2 months (range: 1 month to 18 years). The most common reason for admission was respiratory failure (26.2%). Almost 60% of the patients had at least one underlying chronic disease. The average duration of stay was 4.52 +/- 8.43 days (range 1 day to 81 days). The average PRISM III score was 5.06 +/- 6.95 (range 0-44). The overall mortality rate in the PICU was 8.17%. The mortality rate was not significantly different from the predicted rate (7.56%) (p=0.65). The efficiency of care was 32.5% and the standardized PICU length of stay ratio (SLOSR) was 1.33. The SLOSR ratio was significantly higher than the predicted rate (p value < 0.001). The PRISM III score was validfor assessing mortality risk of PICU patients in this hospital in Taiwan. However, the SLOSR ratio obtained in this study was higher than predicted. Differences in the patterns of practicing medicine may play an important role in observed PICU length of stay. Special caution is needed in adopting a severity of illness scoring system to assess performance of care, particularly in contexts different from the ones in which the instrument was originally developed. Further study including more pediatric intensive care units and other regions would enable greater generalization of the validity of this instrument.

Adolescent↗
PubMed2005

The impact of the 2003 heat wave on daily mortality in England and Wales and the use of rapid weekly mortality estimates.

This paper describes a retrospective analysis of the impact of the 2003 heat wave on mortality in England and Wales, and compares this with rapid estimates based on the Office for National Statistics routine weekly deaths reporting system. Daily mortality data for 4 to 13 August 2003, when temperatures were much hotter than normally seen in England, were compared with averages for the same period in years 1998 to 2002. The August 2003 heat wave was associated with a large short-term increase in mortality, particularly in London. Ozone and particulate matter concentrations were also elevated during the heat wave. Overall, there were 2139 (16%) excess deaths in England and Wales. Worst affected were people over the age of 75 years. The impact was greatest in the London region where deaths in those over the age of 75 increased by 59%. Estimated excess mortality was greater than for other recent heat waves in the United Kingdom. The estimated number of deaths registered each week is reported by the Office for National Statistics. The first clear indication of a substantial increase in deaths was published on 21 August 2003. This provided a quick first estimate of the number of deaths attributable to the heat wave and reflected the pattern of daily deaths in relation to the hottest days, but underestimated the excess when compared with the later analysis.

Aged↗
PubMed2005

Foetal mortality, infant mortality, and age of parents. An overview.

This review article examines the relationship between late foetal and infant mortality, and age of parents. The highest risks are observed at older maternal ages for foetal mortality and at both extremes of reproductive ages for infant mortality. For infant morbidity, the role of intermediate variables is discussed. Increasing paternal age seems to be related to higher foetal and neonatal mortality.

Female↗
PubMedDate not supplied

[The correlation of the indices of animal longevity and mortality in stationary populations with a constant rate of mortality].

Equations have been derived on the basis of general ratios of the numbers of different age groups of animals that allow to estimate the mortality coefficient in populations with stationary age structure and intensity of mortality that does not depend on age at their continuous and discontinuous replenishing by frequency of occurrence of individuals of the maximal age. The proposed method of estimation of mortality has been tested on models with different numbers of animals and age classes. The equation gives a non-biased estimate of mortality coefficient for populations with discontinuous replenishing with young individuals at very small sample sizes (less than 10 individuals).

Aging↗
PubMed1988

Characteristics of infant mortality in the RSA 1929-1983. Part I. Components of the white and coloured infant mortality rate.

Secular trends in white and coloured neonatal, post-neonatal and infant mortality rates are presented for the period 1929-1983. More detailed information is given for deaths in the first month of life. During this 54-year period the infant mortality rate for whites has declined from 64.2/1,000 to 13.5/1,000, whereas the rate for coloureds fell from 158.8 (1938) to 55.0/1,000. The greater part of the latter decline occurred after 1970. Since 1945 the neonatal mortality rate (NMR) for whites has exceeded the post-neonatal mortality rate (PNMR) but among coloureds the PNMR still exceeds the NMR.

Black or African American↗
PubMed1993

[Infant mortality and perinatal mortality in Poland in the eighties. II. Deaths by birthweight].

The dynamics of the changes in the level of the birthweight-specific infant mortality and perinatal mortality rates by age and cause during the eighties is presented. The strongest decline in the birthweight-specific infant and perinatal mortality rates is observed among the newborns weighing less than 2500 g. The level of the low birth weight (7.9% in 1989) and despite the decrease--the infant and perinatal mortality rates among the newborns weighing 1001-2500 g (100.5 and 109.4 respectively in 1989) and among the newborns weighing 601-1000 g (865.3 and 851.1 respectively in 1989) are high comparing to the developed countries.

Birth Weight↗
PubMed1997

Nativity, race, and mortality: favorable impact of birth outside the United States on mortality in New York City.

To determine the association of birthplace (US-born vs. foreign-born) with mortality among blacks and whites in New York City, we examined death records for 5 years from 1988 to 1992 and the 1990 census data. Mortality rates by race and birthplace were compared for all causes of death and for specific causes. Although overall death rates for blacks generally exceeded those for whites (1224.8 per 100,000 inhabitants vs. 721.4 for males and 593.7 vs. 393.1 for females), foreign-born blacks had death rates (664.6 for males and 350.2 for females) slightly lower than those for whites. The most striking variation among blacks was among those aged 25 to 64 years. US-born black males were three times as likely (1588.9 vs. 525.2) and US-born black females were more than 2.5 times as likely (673.5 vs. 263.4) to die as were foreign-born blacks. Among US-born blacks AIDS, homicide, and cancer for males and AIDS, heart disease, and cancer for females were the most important determinants of excess deaths, defined as the difference between observed deaths and expected deaths; these causes of death account for about half of the excess deaths for each sex. Among whites natives generally had higher death rates than migrants, but less prominently and consistently so than for blacks. Excess mortality of blacks is largely explained by higher death rates of US-born compared with foreign-born Americans.

Adolescent↗