[Sarcoidosis; a study of a case diagnosed by biopsy with a later necroptic examination & critical analysis of the mechanisms determining mortality in this process].
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Biopsy↗
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Results for “Mortality Determinants”
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.
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[Non-valvular atrial fibrillation and completed stroke: factors determining mortality, recurrence and prognosis after a first event in the Mexican population].
AIMS: Non-valvular atrial fibrillation (NVAF) accounts for 25% of completed strokes (CS) of a cardioembolic origin in patients over 60 years old. Our aim was to define the predictors of a good and poor prognosis after a CS secondary to an NVAF in our milieu. PATIENTS AND METHODS: We evaluated the risk factors (RF) and severity of CS in relation to death, functionality and recurrence at 5 years. 81 patients between the ages of 49 and 88 were followed up consecutively for 1 to 90 months; 38 (46.9%) of them were males. Multivariate analysis was performed with the following independent variables: age, gender, smoking, hypertension, heart disease, diabetes mellitus and characteristics of the stroke. The severity of the CS was assessed by means of the modified Rankin scale, which was dichotomised into a good prognosis (0-2) and a poor prognosis (> or = 3), both basal and at the end of the clinical control. We also evaluated the secondary preventive treatment used and its relation with recurrence, prognosis, death and complications. RESULTS: No RF was linked to a poor prognosis or recurrence; 88% had a poor prognosis. Antiplatelet drugs were used in 42% of cases and 39% received anticoagulants. A good final progression was observed in 9.5% of the patients treated with antiplatelet drugs versus 35% of those receiving anticoagulation therapy (p = 0.004). Severity of the CS on admission was worse in the aspirin group, with no differences in recurrence and mortality. A better prognosis was observed in patients from urban areas. CONCLUSIONS: Use of antiplatelet drugs, living in a rural area and a Rankin score of > or = 3 on admission are factors suggesting a poor prognosis in the clinical control at 5 years.
Aged↗
Critical factors in determining mortality from abdominal aortic trauma.
Aortic injuries remain highly lethal. Major factors contributing to death in these patients appear to be free peritoneal hemorrhage and associated abdominal vascular trauma. These conditions often manifest as profound shock upon hospital presentation and portend a grim prognosis. Potential means to improve survival include: 1, vigorous resuscitation and prompt operative intervention in patients with penetrating abdominal trauma presenting in a state of shock; 2, careful search and control of associated vascular injuries prior to definitive aortic repair, and 3, constant vigilance to coagulation function, core temperature and acid-base status.
Abdomen↗
A mortality determinant in nonuniform exposures of the mammal.
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Animals↗
[Factors determining mortality in elderly patients with femoral fractures at the hip].
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Age Factors↗
How similar are the determinants of mortality and fertility?
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Age Factors↗
[Determinants of mortality].
"In this article determinants of mortality [in the Netherlands] are studied.... The main results are the following: For all ages women have lower mortality risks than men.... Married people live longer than those who are not. However, the cause is not certain.... In large cities mortality rates are higher than in small towns (especially due to diseases of the lungs and to narcotics, alcohol and violent causes of death). People with a high socio-economic status have lower mortality risks than those with a low status." (SUMMARY IN ENG)
Alcohol Drinking↗
[Causes and determinants of mortality under 2 years of age in subSaharan Africa: application of concurrent risk models].
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Africa↗
Determinants of mortality among Cameroonian children: are the effects of breastfeeding and pace of childbearing artifacts?
"We analyse a rich data source, the Yaounde round of surveys [conducted] by IFORD (Institut de Formation et de Recherche Demographiques) during the late seventies and early eighties in several African urban centers. We argue that despite important limitations, these surveys are potentially very useful as a source of verification of hypotheses that have been heretofore improperly tested with retrospective surveys. Using the Yaounde round we obtain fine-tuned estimates of the effects of lactation and timing of following conception on infant and child mortality. We are able to identify the role played by birthweight, types of breastfeeding, and antecedent illnesses and thus control for important variables that are not normally recorded in conventional demographic surveys. We show that potential biases associated with losses to follow-up and selection processes are of little significance." (SUMMARY IN ITA AND FRE)
Africa↗
Systematic review of determinants of mortality in high frequency oscillatory ventilation in acute respiratory distress syndrome.
INTRODUCTION: Mechanical ventilation has been shown to cause lung injury and to have a significant impact on mortality in acute respiratory distress syndrome. Theoretically, high frequency oscillatory ventilation seems an ideal lung protective ventilation mode. This review evaluates determinants of mortality during use of high frequency oscillatory ventilation. METHODS: PubMed was searched for literature reporting randomized trials and cohort studies of high frequency ventilation in adult patients with acute respiratory distress syndrome. Data on mortality and determinants were extracted for patients treated with high frequency oscillatory ventilation. Linear regression analyses were conducted to produce graphical representations of adjusted effects of determinants of mortality. RESULTS: Cohorts of patients treated with high frequency oscillatory ventilation from two randomized trials and seven observational studies were included. Data from cohorts comparing survivors with non-survivors showed differences in age (42.3 versus 51.2 years), prior time on conventional mechanical ventilation (4.0 versus 6.2 days), APACHE II score (22.4 versus 26.1), pH (7.33 versus 7.26) and oxygenation index (26 versus 34). Each extra day on conventional ventilation was associated with a 20% higher mortality adjusted for age and APACHE II score (relative risk (RR) 1.20, 95% confidence interval (CI) 1.15-1.25). However, this association was confounded by differences in pH (pH adjusted RR 1.03, 95% CI 0.73-1.46). Oxygenation index seemed to have an independent effect on mortality (RR 1.10, 95% CI 0.95-1.28). CONCLUSION: Prolonged ventilation on conventional mechanical ventilation prior to high frequency oscillatory ventilation was not related to mortality. Oxygenation index was a determinant of mortality independent of other disease severity markers.
Cohort Studies↗
The effect of late-onset ventilator-associated pneumonia in determining patient mortality.
STUDY OBJECTIVE: To determine whether the development of late-onset ventilator-associated pneumonia (VAP) is associated with an increased risk of hospital mortality. DESIGN: Prospective cohort study. SETTING: ICUs of two university-affiliated teaching hospitals. PATIENTS: Three hundred fourteen patients admitted to an ICU who required mechanical ventilation for greater than 5 days. INTERVENTIONS: Prospective patient surveillance and data collection. MEASUREMENTS: The primary outcome measures were the development of late-onset VAP (ie, occurring > 96 h after intubation) and hospital mortality. RESULTS: Late-onset VAP was observed in 87 patients (27.7%). Thirty-four (39.1%) patients with late-onset VAP died during hospitalization compared with 85 patients (37.4%) without late-onset VAP (relative risk, 1.04; 95% confidence interval [CI], 0.76 to 1.43). Twenty patients (6.4%) developed late-onset VAP due to a "high-risk" pathogen (ie, Pseudomonas aeruginosa, Acinetobacter sp, Xanthomonas maltophilia) with an associated mortality rate of 65%. Stepwise logistic regression analysis identified five variables as independent risk factors for hospital mortality (p < 0.05): an organ system failure index of 3 or greater (adjusted odds ratio [AOR], 3.4; 95% CI, 2.0 to 5.8; p < 0.001), having a nonsurgical diagnosis (AOR, 2.1; 95% CI, 1.3 to 3.6; p = 0.002), a premorbid lifestyle score of 2 or greater (AOR, 1.8; 95% CI, 1.1 to 2.9; p = 0.015), acquiring late-onset VAP due to a "high-risk" pathogen (AOR, 3.4; 95% CI, 1.2 to 10.0; p = 0.025), and having received antacids or histamine type-2 receptor antagonists (AOR, 1.7; 95% CI, 1.0 to 2.9; p = 0.034). Additionally, we found the occurrence of late-onset VAP due to high-risk pathogens to be the most important predictor of hospital mortality among patients developing VAP (AOR, 5.4; 95% CI, 2.8 to 10.3; p = 0.009). CONCLUSIONS: Nosocomial pneumonia due to certain high-risk microorganisms is an independent risk factor for hospital mortality among patients requiring prolonged mechanical ventilation. We suggest that future investigations of late-onset VAP stratify patient outcomes according to the distribution of high-risk pathogens when reporting their results.
APACHE↗
Determinants of mortality among children in the urban slums of Dhaka city, Bangladesh.
The growing slum population in the developing world is an increasing challenge for local health authorities. Little is known of the patterns of disease occurrence including treatment types offered in this population. The paper describes reported child mortality and its determinants, including the main diseases affecting children and treatments, in the slum population of Dhaka city, Bangladesh. 1500 households in three slum communities were included in a cross-sectional survey. Reported death rates in the households per 1000 children (0-107 months) within the last year from the interview were 20.5 for boys and 27.0 for girls. More girls than boys died in infancy (age < 12 months). The most frequent reported causes of deaths were tetanus in infancy and diarrhoea among children aged < or = 12 months. Vaccination coverage (DPT, polio, measles and BCG) was 73% for children < 3 years of age. The results showed that gender difference in mortality may have been influenced by the patterns of treatment received during sickness and the choice of treatment was determined by the financial ability of the households. Household income, children's vaccinations, TT immunization of mothers and personal cleanliness appeared to be significantly associated with child mortality. Despite the relatively high vaccination coverage for this population, child mortality remained alarmingly high, indicating that socioeconomic and environmental conditions must be improved to substantially reduce morbidity and mortality in this population.
Accidents↗
Cognitive functioning and health as determinants of mortality in an older population.
The authors studied whether the ability of cognitive functioning to predict mortality is pervasive or specific, and they considered the role of health in the cognition-mortality association. Data were taken from a sample of 2,380 persons aged 55-85 years who took part in the Netherlands' Longitudinal Aging Study Amsterdam in 1992-1993. Five cognitive measures were distinguished: general cognitive functioning, information processing speed, fluid intelligence, learning, and proportion retained. Mortality data were obtained during an average follow-up period of 1,215 days. Cox proportional hazards regression models revealed that all cognitive functions predicted mortality independent of age, sex, education, and depressive symptoms. When health (self-rated health, medication use, physical performance, functional limitations, lung function, specific chronic diseases) was also taken into account, information processing speed, fluid intelligence, and proportion retained remained independent predictors of mortality, whereas the ability of general cognitive functioning and learning to determine mortality was lost. The authors concluded that the ability of cognitive functioning to predict mortality is pervasive to all cognitive functions that were included in the study when age, sex, education, and depressive symptoms are considered and is more specific to some functions when also controlling for health.
Activities of Daily Living↗
Proximate determinants of child mortality in Liberia.
The study looks at the effects of maternal sociodemographic characteristics and the quality of the environment on child survival through two intervening variables, breast-feeding and prenatal care. A linear structural equation modelling approach was used to examine infant and child survival based on a weighted sample of 5180 Liberian children aged 0-5 years. The findings confirm previous studies, but also reveal complex relationships of the role of education, maternal age and breast-feeding in enhancing child survival.
Breast Feeding↗
Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh.
Longitudinal data collected from the Demographic Surveillance System (DSS) in Matlab, a rural area in Bangladesh, are used for determining trends in and determinants of mortality of the elderly population (60 yr and over) in 1974-1996. The old-age mortality rate is high in Matlab, 1.2 times that of Sri Lankan and 1.5 times that of the Swedish elderly population in a comparable period. Mortality among the elderly population declined in 1974 1982, but much less so in 1982-1996. Proportional hazards models were used for examining determinants of mortality in a sample of about 10,000 elderly persons. This multivariate analysis used information on several social and economic variables derived from the 1982 census and mortality data of this population which was followed prospectively in 1982-1992. Marital status was the single most important determinant: widows and widowers had 1.5 to 2 times higher risk of death compared to couples where both husbands and wives were alive. Social support in old age by children also plays a role, especially for women: women living with at least one son or daughter had 18% lower mortality than women living in a household without sons or daughters. Socioeconomic factors are also important. Those who had at least some education or were relatively affluent had lower mortality than those with no education or who were less affluent.
Aged↗
Reoperations for valve surgery: perioperative mortality and determinants of risk for 1,000 patients, 1958-1984.
One thousand consecutive cardiac reoperations for valve surgery in 897 patients were reviewed to determine in-hospital mortality and indicators of risk. Subgroups based on the number of previous cardiac procedures and the valve or valves replaced or repaired at reoperation (aortic valve, mitral valve, tricuspid valve, or multiple valves and mortality [deaths/number of procedures (% mortality)]) for those subgroups are as follows: (Table: see text) Predictors of increased risk for a first aortic valve reoperation were advanced age (p = .0002), endocarditis (p = .0018), female sex (p = .014), impaired left ventricular function (p = .039), and number of coronary vessels obstructed by 70% or more (p = .055). For a first mitral valve reoperation, the predictors were advanced age (p less than .0001), preoperative shock or cardiac arrest (p = .01), previous aortic or tricuspid valve operations (p = .02), type of mitral valve procedure (risk for repair of periprosthetic leak was greater than mitral valve replacement which was greater than mitral valve-conserving operation [p = .05]), and impaired left ventricular function (p = .059). For a first multiple valve reoperation, the predictors were diabetes (p = .04) and ascites (p = .02), whereas patients undergoing mitral valve replacement and tricuspid valve operations were at decreased risk (p = .01). Comparison of second reoperations with first reoperations indicates risk increases for multiple operations (p = .01) but not for aortic or mitral valve procedures. Rereplacement of a prosthesis (p = .007), coronary bypass grafting at reoperation (p = .006), and advanced age (p = .06) increased the risk for second reoperations. Age is the most consistent predictor of risk for patients undergoing valve reoperations.
Aortic Valve↗
Mortality and causes of death in schizophrenic patients in Denmark.
A cohort consisting of 6178 people that were psychiatric inpatients with a clinical schizophrenia diagnosis in 1957 were followed up from 1957 through 1986, and their cause-specific mortality was determined. Mortality from cardiovascular diseases, lung diseases, gastrointestinal and urogenital disorders, accidents and suicide was increased, whereas mortality from cerebrovascular disorders was reduced. In the male patients cancer mortality was reduced whereas cancer mortality in the female patients was increased. Mortality from a number of causes that theoretically could be associated with side effects from neuroleptics was increased. Mortality from some causes of death used as a measurement of the quality of medical care was found to be slightly increased. Further studies of the quality of the medical care provided to schizophrenic patients and of the association between neuroleptic medication and mortality are needed.
Adult↗
Effects of spray-dried animal plasma in calf milk replacer on health and growth of dairy calves.
Male Holstein calves (n = 120) purchased from local dairy farms were fed one of three calf milk replacers for 42 d. Experimental milk replacers were formulated to contain whey protein concentrate (WPC) as the primary protein source or WPC plus 5% spray-dried bovine plasma (SDBP) or spray-dried porcine plasma (SDPP). The SDPP was heated to remove heat-insoluble materials and provide products with similar IgG content. Calves were also fed commercial calf starter and water for ad libitum consumption. Intake, change in body weight (BW), feed efficiency, morbidity and mortality were determined. Mortality was 10, 3, and 2 in calves fed WPC, SDBP, and SDPP treatments, respectively. Morbidity, measured as the number of days that calves had diarrhea was reduced by 30% when SDBP or SDPP were fed. Calves had diarrhea for 6.9, 3.9, and 4.7 d during the 42-d study when fed commercial calf milk replacer containing WPC, SDBP, and SDPP, respectively. Fecal scores tended to be reduced and feed efficiency tended to be improved when SDBP or SDPP were fed. Mean intakes of total dry matter during the 42-d study were greater when calves were fed SDBP or SDPP and were 661, 710, and 684 g/d for calves fed WPC, SDBP, and SDPP, respectively. Mean BW gains from d0 to 42 were 231,261, and 218 g/d, respectively. Calves fed SDPP tended to have lower BW gain during the first 28 d of the study. However, difference in daily BW gain from d 1 to 28 was only 39 g/d. Inclusion of SDBP or SDPP in milk replacer reduced morbidity and mortality of milk-fed dairy calves.
Animal Nutritional Physiological Phenomena↗