Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Excess 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 487 records · Page 27Linked to original sources
PubMed1997

[Mortality among workers in the pulp-paper industry. A successive follow up of the cohort].

After five successive years of observation the authors present a verified evaluation of the delayed health effects in the pulp and paper industry workers (with particular regard to mortality from malignant neoplasms). The cohort studied consisted of 10,460 workers employed for at least 12 months between 1967 and 1990 in the plants manufacturing sulfate pulp, paper, board and paper products. Subjects were assigned to three subcohorts according to the work areas: 1. pulp mill workers; 2. paper mill workers (paper and board as well as their products); 3. other workers. The workers were enrolled in the subcohort if they were employed for at least one year in one of these departments. One subject could be included in more than one subcohort. The vital status of the cohort was determined through a variety of sources over an observation period of 28 yrs (1967-95). Mortality data were analysed in terms of cause-specific standardized mortality ratios (SMRs) with expected deaths count based on the national mortality rates in Poland. The results of a twenty three-year cohort observation, published earlier, showed the lowered overall mortality (explained by a "healthy worker effect") and the excess of deaths from malignant neoplasms for some sites (peritoneum, prostate, brain). Due to a small number of deaths recorded, kind of exposure and its duration, were left out of the analysis. The results presented in this paper, obtained after five successive years of the male cohort observation, showed an excess of deaths from cancers of the respiratory tract and peritoneum. In the female cohort an excess of brain cancers was found. Only an excessive mortality from malignant neoplasms of the respiratory system was coherent with the exposure to higher concentrations of wood, paper and board dust. An excess mortality from diseases of the circulatory system was found in both males and females employed in paper production.

Adult↗
PubMed1998

Long-term survival of people with unprovoked seizures: a population-based study.

PURPOSE: Few population-based studies of long-term survival in people with seizures or epilepsy have been made. METHODS: Between January 1, 1960 and December 31, 1964, we identified 224 incidence cases of unprovoked seizures in Iceland and determined survivorship status and date of death for the cases as of January 1, 1996. We compared survivorship with that expected based on data from age-/sex-specific life tables from the country for 1961-1990 and calculated the standardized mortality ratio (SMR). RESULTS: By 30 years after diagnosis, there were 45 deaths among patients with unprovoked seizures as compared with an expected 28 deaths [standardized mortality ratio (SMR) 1.6; 95% confidence interval (CI) 1.2-2.2]. Patients with unprovoked seizures of unknown etiology did not have a significant increase in mortality overall (SMR 1.3, 95% CI 0.8-1.9) or in any time interval. For patients with remote symptomatic unprovoked seizures, mortality was increased (SMR 2.3, 95% CI 1.4-3.5). This increase was attributable to excess mortality for the first 15 years after diagnosis (SMR 4.1, 95% CI 2.4-6.6), and SMR was not different after that time. CONCLUSIONS: Survivorship was decreased for the population of patients with unprovoked seizures. The increased mortality was primarily due to excess mortality in patients with remote symptomatic seizures, occurring in the first 15 years after diagnosis. Overall mortality for idiopathic unprovoked seizures was not significantly increased.

Adult↗
PubMed2000

Mortality among persons with a history as psychiatric inpatients with functional psychosis.

BACKGROUND: An important aim in all psychiatric care should be a reduction of overall mortality. Information on mortality patterns in different types of psychiatric populations is vital for a successful design of treatment strategies and preventive programmes. The present study aims to describe mortality among persons with a history as psychiatric inpatients with functional psychosis. METHODS: All psychiatric inpatients, 17,878 men and 23,256 women, registered in the Swedish National Hospital Discharge Registry between 1978 and 1982 with a functional psychosis (ICD-8 = 295-299) as principal diagnosis were followed for mortality during the time period 1983-85. Life tables were constructed and death rates for various types of causes of death were calculated. RESULTS: Compared to the general population, the excess mortality in the study group caused a reduction in life expectancy of 22.1-27.9% (95% CI) among the men and 15.0-21.7% among the women. In the age group 2049 years, 62% of the excess mortality was caused by suicide. In the age group 50-89 years, only 8% of the excess was suicide, while 52% was caused by cardiovascular disorders. CONCLUSIONS: Reduction in mortality rates requires different strategies in different age groups. Even if the suicide rate were reduced to zero, it would only have a marginal influence on the highly elevated mortality among patients in upper middle age and among the elderly. Among the younger patients (<35 years), on the other hand, practically all excess mortality was caused by suicide and accidents.

Adult↗
PubMed2003

Incidence and survival of Swedish patients with differentiated thyroid cancer.

Papillary (PTC) and follicular (FTC) thyroid cancers are rare disorders but are, nevertheless, among the most common cancers in individuals below 40 years of age. From the population-based Swedish Cancer Registry we identified 3,588 individuals with PTC and 1,966 with FTC during 1958-87. Histopathology was determined by examining the original histopathology reports. The relative survival ratio (RSR) was used as the measure of patient survival. Incidence of both PTC and FTC was higher among women, especially for PTC and particularly during the fertile part of female life. Incidence of PTC increased significantly over time, a trend that was not observed for FTC. Five-year relative survival appeared to be higher for patients diagnosed with PTC compared to FTC, although this difference was almost completely explained by the confounding effect of age. Patients with PTC experience lower mortality during the period 7-20 years after diagnosis. Excess mortality was lower among women, although the magnitude of the difference varied with age and histopathology. In contrast to our perceptions based on clinical practice, we observed no difference in excess mortality between patients diagnosed with PTC and FTC during the years immediately after diagnosis (where the majority of deaths occur). Our data suggest that there may exist a subgroup of thyroid tumors with superior prognosis diagnosed in women during the fertile part of female life. Sex hormones may play a role in the etiology of these tumors.

Adenocarcinoma, Follicular↗
PubMed1999

Hereditary haemorrhagic telangiectasia: a population-based study of prevalence and mortality in Danish patients.

INTRODUCTION: Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by telangiectatic lesions. The disease manifestations are variable and include epistaxis, gastrointestinal bleeding, pulmonary arteriovenous malformations and cerebral arteriovenous malformations. Early death due to these complications has been described. DESIGN: We report a study on the prevalence and mortality of HHT in a Danish population based on two cross-sectional surveys in combination with a long-term follow-up study. SETTINGS AND SUBJECTS: Prevalent cases of HHT as of 1 January 1974 in the County of Fyn, Denmark, were identified. In 1995-97 a follow-up study of mortality was performed of the initial patient sample, and a new point prevalence rate of HHT as of 1 January 1995 was calculated. All live patients and their families were invited to attend a detailed clinical examination. RESULTS: The prevalence of HHT in the County of Fyn was 13.8 per 100,000 on 1 January 1974 and 15.6 per 100,000 on 1 January 1995. In the HHT group as a whole, we found a slightly increased mortality; however, amongst the HHT patients younger than 60 years at inclusion the mortality of HHT patients was twice the expected. The excess mortality could be fully explained by severe HHT symptoms. CONCLUSION: This study suggests that HHT is more prevalent than previously believed. In young patients the disease is associated with an excess mortality which is fully attributable to HHT. Future research should aim at the identification of HHT patients at particular risk of developing severe complications.

Adolescent↗
PubMed2002

[Infections and other causes of mortality correlated with drug addiction].

Drug use and related injection practices determine an excess mortality in drug abusers compared to the general population adjusted for age and gender. HIV/AIDS and overdose are the most important causes of death among injecting drug users; however, excess mortality is also due to other causes, such as cirrhosis and endocarditis. Infections have a great impact on the health of injection drug users. Viral infections, such as HIV, HCV, and HBV, are the most important ones, but bacterial and fungal infections, and, to a lesser extent, protozoal infections, are also common. In depth knowledge of drug-related morbidity and mortality causes is important to improve clinical skills and to implement control activities.

Cause of Death↗
PubMed1999

Mortality and causes of death in eating disorders in Denmark 1970-1993: a case register study.

OBJECTIVE: The aim of this study is to describe mortality rates and causes of death for patients with eating disorders. METHOD: By means of record-linkage, the study includes all patients admitted and diagnosed as suffering from an eating disorder according to the ICD-8 classification system during the period 1970-1993 at any Danish psychiatric (since 1970) or somatic department (since 1977). The study includes 2,763 cases, of which 237 are males. Maximum follow-up time is 23 years and mean follow-up time is 10.3 years. RESULTS: Crude mortality at follow-up is 8.4%. A significant excess mortality is demonstrated since the standardized mortality ratio (SMR) of the total patient population is 6.69 (CI 5.68-7.83) and the highest rate ratio (RR) of 14.92 (CI 9.66-22.03) relates to women aged 25-29. DISCUSSION: The study documents a significant excess mortality among eating-disordered patients.

Accidents↗
PubMed2003

Short and long term mortality associated with foodborne bacterial gastrointestinal infections: registry based study.

OBJECTIVES: To determine the excess mortality associated with infections with Salmonella, Campylobacter, Yersinia enterocolitica, and Shigella and to examine the effect of pre-existing illness. DESIGN: Registry based, matched cohort study. SETTING: Denmark. PARTICIPANTS: 48 857 people with gastrointestinal infections plus 487 138 controls from the general population. MAIN OUTCOME MEASURE: One year mortality among patients with gastrointestinal infections compared with controls after adjustment for comorbidity. RESULTS: 1071 (2.2%) people with gastrointestinal infections died within one year after infection compared with 3636 (0.7%) controls. The relative mortality within one year was 3.1 times higher in patients than in controls. The relative mortality within 30 days of infection was high in all four bacterial groups. Furthermore, there was excess mortality one to six months after infection with Yersinia enterocolitica (relative risk 2.53, 95% confidence interval 1.38 to 4.62) and from six months to one year after infection with Campylobacter (1.35, 1.02 to 1.80) and Salmonella (1.53, 1.31 to 1.79). CONCLUSIONS: Infections with all these bacteria were associated with an increased short term risk of death, even after pre-existing illnesses were taken into account. Salmonella, Campylobacter, and Yersinia enterocolitica infections were also associated with increased long term mortality.

Bacterial Infections↗
PubMed2001

[Mortality and causes of death in patients with eating disorders in Denmark, 1970-1993].

INTRODUCTION: The aim of this study was to describe standardised mortality rates and causes of death in patients with eating disorders, who were admitted to Danish psychiatric and somatic hospitals during the period, 1970 to 1993. METHODS: By means of record-linkage, the study covered all patients admitted for and diagnosed as suffering from an eating disorder, according to the ICD-8 classification system, at any Danish psychiatric (since 1970) or somatic department (since 1977) during the period 1970-1993. The study comprised 2763 patients 237 of whom were males. The maximum follow-up time was 23 years and the mean follow-up time 10.3 years. RESULTS: The crude mortality at follow-up was 8.4%. A significant excessive mortality was demonstrated, as the standardised mortality ratio (SMR) of the total patient population was 6.69 (CI 5.68-7.83) and the highest rate ratio (RR) of 14.92 (CI 9.66-22.03) related to women aged 25-29. CONCLUSION: With its 2763 patients, this is the largest study of a population with eating disorders ever published. The study documents a significant excessive mortality among such patients in all age groups.

Adolescent↗
PubMed1995

A proportional regression model for 20 year survival of colon cancer in Norway.

Twenty year survival of all Norwegians with colon cancer registered in a period of 10 years is estimated by both relative survival rates, and with a proportional regression model for the excess intensity. Male colon cancer patients have a significant positive excess mortality at least 20 years after diagnosis, while the excess mortality for females is about zero after 10 years. Stratified analyses for men indicate non-proportionality throughout the follow-up period, and when this information is included in the regression model, there are significant effects of age between 60 and 70 years and for pelvic cancer. The use of proportional regression models is also discussed when excess intensities are close to zero or negative.

Adolescent↗
PubMed1988

Panic disorder and mortality.

Evidence so far indicates two sources for excess mortality in panic disorder--suicide and cardiovascular morbidity. The risk for eventual suicide may rival that for primary depression, but the predictors and the necessary antecedents probably differ. The lapse between diagnosis and suicide may be larger for panic disorder, and complications such as secondary depression and substance abuse may be necessary. There are few well-established predictors for primary depression despite many relevant studies. The risk for suicide in panic disorder is barely recognized, and established predictors are accordingly remote. One study has demonstrated excess cardiovascular mortality among males with panic disorder, and another from the same center has provided weak support. Only one additional study has provided the necessary detail as to sex and cause, and those findings were quite supportive, although the subjects may have been mixed diagnostically. There are numerous feasible explanations for excess cardiovascular mortality in panic disorder and even some reason to believe that successful treatment might lessen it. To so advise patients would be not only premature at this point but unnecessary and countertherapeutic--unnecessary because these patients are motivated by discomfort to seek treatment and countertherapeutic because cardiovascular morbidity is what many of these patients pathologically fear. Rather, the findings suggest focus for future study. The initial findings of excess cardiovascular morbidity in males badly need replication, as do the more recent findings of Kahn et al. Likewise, animal models may reveal some of the pathophysiologic mechanisms at work. It is hoped that these efforts will converge in the not-too-distant future.

Anxiety Disorders↗
PubMed1990

Excess injury mortality among children in the United States: comparison of recent international statistics.

Using data from the National Center for Health Statistics and the World Health Organization, child injury death rates in the US were compared to those of Canada, England and Wales, France, Netherlands, and Norway. Except for the 1981 Canadian figure, overall US childhood injury mortality was greater than childhood injury mortality rates of all countries studied during each year from 1980 to 1986. Injury mortality steadily declined in most other countries, whereas the US rate appears to be increasing. Attention to specific causes reveals that much of the difference is explained by motor vehicle injuries and homicide, but in every childhood age group US death rates due to drowning, firearms, homicide, poisoning, and fire are among the highest. Excess US injury mortality is largely attributable to deaths among children younger than 5 and older than 14 years of age, the most vulnerable groups in all countries. Especially high rates among US minorities account for little of the observed differences; for many injuries, the mortality rate of US nonblacks is several times those reported by the comparison nations. Behavioral strategies are inadequate to deal with excess death rates of this magnitude. Limiting exposure through regulation of handguns, greater use of public transportation, and affordable and accessible day care are among the measures that should be implemented.

Adolescent↗
PubMed1996

Comparative assessment of pediatric intensive care in Moscow, the Russian Federation: a prospective, multicenter study.

OBJECTIVE: Comparative assessment of pediatric intensive care. DESIGN: Prospective multicenter study. SETTING: Four pediatric intensive care units in Moscow, the Russian Federation. PATIENTS: Consecutive unselected admissions (n = 583), < or = 14 yrs of age, in a 6-month period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Effectiveness was defined as the ratio of observed to predicted mortality, based on prediction by Pediatric Risk of Mortality (PRISM) severity of illness scoring. Efficiency (on the day of admission only) depended on either a mortality risk of > 1% or the administration of intensive care unit-dependent therapies. In all four hospitals, observed mortality rates were higher than expected, with a range of standardized mortality ratios between 1.10 and 1.83 (mean 1.32). The excess mortality was found in the low- and medium-risk strata (risk of mortality of < 1% to 15%). Admission efficiency ratings did not fluctuate greatly between institutions (mean 60.4%, range 55.7 to 65.9). CONCLUSIONS: We provided a quantitative description and assessment of pediatric intensive care in Moscow. Moderate efficiency may reflect a low threshold for ICU admission due to poor nurse/patient ratios on the wards. Effectiveness in the low- and medium-risk strata is below standard, as compared with a Western reference population. Excess mortality was concentrated in the low- and medium-risk strata, and can only partially be explained by the inclusion of co-morbidity. Future analysis should focus on specific treatment protocols, protocol adherence, and the determination of infectious and therapeutic complications.

Child↗
PubMed1991

Mortality among sulfide ore miners.

Lung cancer mortality was studied during 1965-1985 in Outokumpu township in North Karelia, where an old copper mine was located. Age-specific lung cancer death rates (1968-1985) were higher among the male population of Outokumpu than among the North Karelian male population of the same age excluding the Outokumpu district (p less than .01). Of all 106 persons who died from lung cancer during 1965-1985 in Outokumpu township, 47 were miners of the old mine, 39 of whom had worked there for at least three years and been heavily exposed to radon daughters and silica dust. The study cohort consisted of 597 miners first employed between 1954 and 1973 by a new copper mine and a zinc mine, and employed there for at least 3 years. The period of follow-up was 1954-1986. The number of person-years was 14,782. The total number of deaths was 102; the expected number was 72.8 based on the general male population and 97.8 based on the mortality of the male population of North Karelia. The excess mortality among miners was due mainly to ischemic heart disease (IHD); 44 were observed, the expected number was 22.1, based on the general male population, and the North Karelian expected number was 31.2 (p less than .05). Of the 44 miners who died from IHD, 20 were drillers or chargers exposed to nitroglycerin in dynamite charges, but also to several simultaneous stress factors including PAHs, noise, vibration, heavy work, accident risk, and working alone. Altogether 16 tumors were observed in the cohort. Ten of these were lung cancers, the expected number being 4.3. Miners who had died from lung cancer were 35-64 years old, and had entered mining work between 1954 and 1960. Five of the ten lung cancer cases came from the zinc mine (1.7 expected). Three of them were conductors of diesel-powered ore trains. The slight excess mortality from lung cancer could be explained by exposure to radon daughters and by the combined effect of silica dust and diesel exhaust gases in the zinc mine.

Adult↗
PubMed2004

Comparative analysis of patterns of survival by season of birth in rural Bangladeshi and Gambian populations.

BACKGROUND: Analysis of data from rural Gambia has previously shown that being born during the annual hungry season strongly influences susceptibility to mortality from infectious disease in young adulthood, possibly through an influence on immune function. In rural Bangladesh pregnancies are exposed to similar seasonality. The current paper uses data from a large demographic survey in the Matlab region of Bangladesh to retest the Gambian-derived hypothesis that early life exposures correlated with season of birth predict later patterns of mortality. METHODS: Since 1966, a continuous demographic surveillance system has been in operation in the rural Matlab region of Bangladesh. The current analysis is based on 172 228 births and 24 697 deaths between 1974 and 2000. Season of birth was defined as 'harvest' (January-June) and 'hungry' (July-December), based on monthly variations in rates of conception and neonatal mortality within the same dataset. RESULTS: Birth during the hungry season resulted in excess mortality during the first year of life. However, for adult mortality (deaths >15 years), there was no excess in individuals born during the annual hungry season: ratio of hazard July-December versus January-June = 1.12; 95% CI: 0.87, 1.45. CONCLUSIONS: The current study found no excess mortality in young adults born during the 'hungry' season in rural Bangladesh. This differing pattern in survival when compared with The Gambia may be a consequence of the greatly reduced incidence of young adult deaths in Bangladesh (0.1%) compared with The Gambia (3%). Under such conditions possible differences in immune function may not be detectable with early adult death as the outcome. However, it also remains possible that our Gambian observation could be a highly discrete phenomenon localized in either time or place, and as such, will not be replicated in other populations.

Adolescent↗
PubMed2001

Outcomes of primary and catheter-related bacteremia. A cohort and case-control study in critically ill patients.

We studied a cohort of 2201 patients hospitalized in 15 French intensive care units (ICUs) for > or = 48 h during a 4-mo period to assess the incidence and outcomes of primary and definite catheter-related bloodstream (CRB) or secondary nosocomial bloodstream infection (NBSI). Variables associated with ICU death and duration of stay were determined by logistic regression, and attributable mortality and length of stay (LOS) from a nested matched case-control (96 pairs) study, stratified on the source of bacteremia. Bacteremia occurred in 5% (95% CI 4.1-6%) of patients with > or = 48 h ICU stay. Primary, CRB, and secondary NBSI accounted for 29%, 26%, and 45% of the 111 episodes, respectively. NBSI was associated with a markedly increased risk of death (OR = 4.6; 95% CI 2.9-7.1) and an attributable mortality of 35% (95% CI, 28%-47%). In the case-control study, the excess mortality was 20% (p = 0.03) in patients with primary bacteremia and CRB, and 55% (p < 0.001) for secondary bacteremia; in patients with CRB only, the excess mortality was 11.5%. The median excess ICU LOS in survivors of NBSI was 9.5 d, and was similar, irrespective of its source. The risk of mortality associated with primary and catheter-related bacteremia appears much lower than that of secondary bacteremia, but is sizable, and the excess LOS incurred by the various categories of bacteremia is comparable. Differentiating catheter-related bacteremia from both primary and other secondary bacteremia appears warranted in studies conducted in critically ill patients.

Bacteremia↗
PubMedDate not supplied

Cardiovascular mortality--the hidden peril of heat waves.

OBJECTIVE: Define the mortality associated with extremely hot weather during the 04 July through 14 July, 1993 heat wave that struck the northeastern United States. METHODS: DESIGN--A rapid field assessment was used to compare mortality occurring during the heat wave to mortality occurring during a period in which there was no heat wave using copies of death certificates. The findings of the rapid field assessment were validated, and it was determined whether increases in mortality occurred in other metropolitan east-coast counties also affected by the heat wave, by reviewing computerized mortality files. SETTING--Information was collected on all deaths occurring in Baltimore City, Maryland; Baltimore County, Maryland; Essex County, New Jersey; Newcastle County, Delaware; and Philadelphia County, Pennsylvania; during these specified study periods: 08-18 June (comparison period) and 06-16 July (heat wave study period), 1993. MAIN OUTCOME MEASURES--Ratios for total mortality, cause-specific mortality, and variables such as age, sex, race, residence, and day and place of death, that were available from death certificates were calculated. RESULTS: From the rapid field assessment, the following were observed: a 26% increase in total mortality and a 98% increase in cardiovascular mortality associated with the heat wave in Philadelphia. Data from the computerized mortality files showed an increase in total mortality in four of five counties examined and an increase in cardiovascular mortality in all five counties. The risk for death for those dying from cardiovascular disease increased significantly for people older than 64 years, for both sexes, and all races. CONCLUSION: As initially indicated by the Philadelphia Medical Examiner, there was excess mortality associated with a heat wave in Philadelphia. All other nearby counties examined also experienced excess mortality associated with the heat wave, although this excess was not recognized by the local health officials. The true impact of a heat wave that causes excess preventable mortality must be appropriately and rapidly ascertained. Using a national standard to certify a death as heat-related will provide the needed information rapidly so that public health resources can be more effectively allocated and mobilized to prevent further heat-related illnesses and death.

Adolescent↗
PubMedDate not supplied

Cancer mortality in relation to asbestos in municipal water supplies.

The mortality experience of twenty-two municipalities in Quebec grouped by evidence of exposure to asbestos fibers in water supplies (known high, possible high, and probable low exposures) was evaluated. Excess mortality due to cancer of the stomach (males), pancreas (females), and lung (males) was observed in the two municipalities with known high exposures. The excesses among males have been due to occupational exposure to asbestos. The absence of excess mortality due to pancreatic cancer among males suggested that the excess among females was not due to waterborne asbestos. The study therefore did not reveal evidence of excess cancer mortality that could be attributed to exposure to asbestos in drinking water.

Adult↗