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PubMed1995

[Long-term results in valve replacement with Björk-Shiley prosthesis. Analysis of life expectancy by relative survival rate].

Using the U.S. STS guidelines, I analyzed the results of 389 patients who underwent Björk-Shiley valve (BS valve) replacement at Nippon Medical School over the past 15 years. In addition, I calculated their relative survival rates using the Japanese Abridged Life Table and objectively determined the treatment effects by taking into account the patients' postoperative life expectancy. There were 201 male and 188 female patients, whose mean age at the time of surgery was 52 +/- 12 years. Of these, 151 patients underwent aortic valve replacement (AVR); 185 had mitral valve replacement (MVR); and 53, aortic and mitral valve replacement (DVR). Convexo-Concave models (CC models) were used in 94 patients, and Monosrut models (MS models) in 295. Their cumulative follow-up was 2006 patient-years and their average observation period was 5.2 +/- 3.6 years (complete follow-up in 98% of cases). A total of 32 patients suffered an early death, while 36 suffered a late death. At 10 years after surgery, the actual survival rates were 80.3% for patients who underwent AVR; 81.9% for MVR; and 70.7% for DVR, indicating no significant differences among the three groups (NS). Meanwhile, the relative survival rates at 10 years after surgery were 88.6% for patients who underwent AVR; 88.2% for MVR; and 75.4% for DVR, indicating that AVR was superior to DVR (p < 0.001), with MVR rated between the two. No significant differences were seen among the three groups with respect to the occurrence rate of valve-related complications. The most frequent complications' thromboembolism occurred at a rate of 2.29%/patient-years overall. Strut fractures occurred in two patients using the CC models (0.25%/patient-years), but there were no strut fractures among those using the MS models. While the effect of atrial fibrillation on the subjects' life prognoses was unclear (NS), patients often developed complications related to artificial valves (p < 0.025), and their life prognoses were inferior to those of patients with sinus rhythm. Survivors reported marked improvements in their quality of life, and their late survival rates were satisfactory. However, their life expectancy was inferior to that of the normal population.

Female↗
PubMed2005

Review of sources and methods to monitor healthy life expectancy.

This article presents the rationale for proposed changes in the methods used to calculate Healthy Life Expectancy (HLE). HLE is currently calculated for Great Britain and England based on data from the General Household Survey (GHS). The proposed revisions have been prompted by three sets of changes reflecting improvements to sources and methods. Changes in GHS methodology and survey coverage which affect estimates of the rates of ill-health in the noninstitutional population. Availability of data from the 2001 Census to update estimates of the ill-health rates and the size of the institutional population. Inclusion of data from the Continuous Household Survey of Northern Ireland (CHS-NI) to produce a HLE estimate for the UK.

Adolescent↗
PubMed2002

Disability-free life expectancy by health region.

OBJECTIVES: This article presents a profile of variations in disability-free life expectancy (DFLE) by health region. DATA SOURCES: Mortality data for 1995 through 1997 are from the Canadian Vital Statistics Database. Estimates of disability (major activity limitations) and sociodemographic characteristics are based on data from the 1996 Census. Supplementary information was provided by the Demography and Geography divisions at Statistics Canada. ANALYTICAL TECHNIQUES: DFLE was calculated using a modified version of Sullivan's method. Linear regression using 4 factors representing socio-demographic profiles was used to explain the variation of DFLE by health region. These 4 synthetic variables were determined using principal component analysis. MAIN RESULTS: In 1996, DFLE for both sexes was estimated to be 68.6 years. Estimates by health region varied considerably. Socio-economic status explains a high proportion of the variation of DFLE by health region.

Aged↗
PubMed1997

Influence of selegiline and lipoic acid on the life expectancy of immunosuppressed mice.

Ten groups of 14 immunosuppressed NMRI-mice (nu/nu) were raised and kept under germ-reduced conditions. The control animals were fed a germ-reduced diet, nine other groups received the same diet with selegiline (CAS 14611-51-9, Deprenyl) or lipoic acid (thioctic acid, CAS 62-46-4) admixed at various amounts. The 50% survival rate, the total life span of each group and the areas under the curves were determined to evaluate life expectancy as compared to the controls. The racemate of lipoic acid at high dosage (350 mg/kg body weight) reduced the life span significantly. The S(-)-enantiomer of lipoic acid (75 mg/kg body weight) increased the 50% survival rate, whereas the physiologic R(+)-enantiomer (9 mg/kg body weight) expanded the total life span of its group. Alteration of only one out of three parameters was not considered significant. All other groups except for one did not differ from controls: only animals which obtained 75 micrograms selegiline per kg of body weight and per day exerted increased life expectancies by all three parameters. This group exhibited also in statistical evaluation a significantly (p < 0.05) prolongated survival time up to about 200% as compared to the control animals.

Animals↗
PubMed2006

Two methods for predicting limited life expectancy in nursing homes.

PURPOSE: To compare two methods of identifying nursing home residents with a life expectancy of 6 months or less. DESIGN: Secondary analysis of Minimum Data Set (MDS) assessment data from 111 U.S. nursing homes was used in two approaches to compare the prognostic value of each approach. MDS assessment data were collected during 2003 and 2004, and secondary analyses were completed during 2004 and 2005. METHODS: A bivariate analysis was used to identify variables associated with death within 6 months and a summative index was produced. Second, logistic regression was performed to develop a formula for calculating a Probability of Death score. FINDINGS: Both methods were reasonably sensitive in identifying dying residents. In the total sample of 21,852 residents, 17.5% died within 6 months. When the bivariate analysis and summative index were used, 51.1% of residents who had a score of 4 or higher died within 6 months, and residents who scored 10 or higher had an 80% mortality rate. With use of the logistic regression and Probability of Death scores, 52% of residents who had scores of 0.4 or higher died within 6 months, and residents who scored 0.9 or higher had an 80% mortality rate. CONCLUSIONS: MDS assessment data, collected in all U.S. nursing homes, can be useful to increase the specificity of identifying terminal residents. These statistical methods have high and similar prognostic values, but the summative index is easier to understand. It also is more user-friendly and could be incorporated into the nursing home assessment process with minimal additional training, and with no additional hardware or changes in software programming.

Aged↗
PubMed2006

[Women's empowerment and life expectancy at birth in Mexico].

OBJECTIVES: To assess the effect of women's empowerment (WE) on life expectancy at birth (LEB) in the federative states of Mexico and to compare the results of measuring WE with various compound indicators that reflect, to a greater or lesser degree, an individual or population focus. METHODS: This was an ecological study conducted in Mexico's 32 federative states. We estimated the correlations between overall and sex-specific LEB on the one hand, and a measure of gender empowerment (MGE), the index of women's ability to make decisions within the household (WADH), the index of women's autonomy (IWA), income inequality, certain aspects of the physical environment, the proportion of the population who spoke an indigenous language, and the net migratory rate on the other. By using robust regressions, we studied the effect on LEB of MGE, IWA, and WADH, after mutually adjusting for other independent variables. RESULTS: A very strong inverse correlation (-0.93) was found between overall LEB and factors of the physical environment linked to population vulnerability and biodiversity. Significant direct and inverse correlations were also found between LEB on the one hand and WADH, IWA, net migratory rate, the percentage of the population that spoke an indigenous language, and the Gini coefficient on the other. Multiple robust regressions showed inverse associations between MGE and LEB in women (beta: -1.44; 95% confidence interval [95% CI]: -2.71 to -0.17). WAI was positively associated with LEB in men (beta: 0.88; 95% CI: 0.01 to 1.75) and women (beta: 0.66; 95% CI: 0.03 to 1.30). CONCLUSION: The use of MGE as a surrogate for WE failed to reveal a positive effect of WE on LEB in Mexico. It is necessary to review the components that make up MGE and the relevance of using such a measure in different contexts. WAI showed a greater association with LEB and its effect was greater among men. This indicator made it possible to measure WE in Mexico and its use is recommended, as long as there are no other indicators available for capturing more effectively all the components that affect WE.

Female↗
PubMed2004

Life expectancy following psychogeriatric reactivation. Identification of prognostic characteristics of survival assessed on admission.

OBJECTIVES: To estimate life expectancy of psychogeriatric patients having participated in a reactivation program. To identify prognostic characteristics - on admission - for survival after discharge. DESIGN: A prospective, clinical-empirical observational study. SETTING: A Dutch psychiatric-skilled nursing home. PARTICIPANTS: Psychogeriatric patients (n = 75) suffering from very mild to moderate cognitive function disorders in conjunction with psychiatric function disorders. INTERVENTION: Interdisciplinary reactivation program. MEASUREMENTS: General, functional and diagnostic patient characteristics assessed on admission for the psychogeriatric reactivation program, and survival rate after discharge over a period of 7 years. RESULTS: The probability of survival for patients who were discharged from the psychogeriatric reactivation program to their own homes or to a residential home with restricted support ('independent' group, n = 53) was higher (1/HR = 3.2) than for patients who were discharged to a nursing home ('dependent' group, n = 22). The median survival period of the reference group (community-dwelling elderly people) was 95 months (95% confidence interval, CI: 74-116), that of the 'independent' group 35 months (95% CI: 25-45) and that of the 'dependent' group 13 months (95% CI: 3-22). For the reactivated patients (n = 75), gender was the only general characteristic of prognostic value for survival after discharge (the survival rate for women was higher; hazard ratio (HR) = 3.07; 95% CI: 1.61-5.85). Age was statistically insignificant. One functional characteristic, the Global Deterioration Scale, was of prognostic significance (HR = 1.58; 95% CI: 1.11-2.23). The diagnostic characteristics of prognostic significance were: psychiatric function disorders (paranoia; HR = 2.19; 95% CI: 1.11-4.28), somatic comorbidity (urogenital pathology; HR = 1.83; 95% CI: 1.13-2.94; cardiopulmonary pathology; HR = 1.56; 95% CI: 1.16-2.07) and adequacy of the caregiver system (HR = 0.59; 95% CI: 0.33-1.03). The specific diagnostic classifications of cognitive function disorders (DSM-IV) were not of prognostic significance. It was possible to account for 32% of the variance in survival after discharge. CONCLUSION: The survival rate of the 'independent' group of patients was obviously higher (1/HR = 3.2) than that of the 'dependent' group. There was no overlap in the 95% CI of the median survival period after discharge. The results suggest that with respect to survival the two groups of psychogeriatric patients who participated in the intensive reactivation program differed definitely. Additionally, patients belonging to the 'independent' group had a greater chance to benefit from a reactivation program. The program should pay special attention to the patient characteristics on admission, which demonstrated a significant negative correlation to survival. These patient characteristics belonged to five domains (i.e. gender, cognitive function disorders, psychiatric function disorders, somatic comorbidity and adequacy of the caregiver system) The five dimensions are of clinical interest for optimizing the selection of patients who may derive most benefit from a reactivation program. The development of a valid prognostic instrument is a prerequisite for optimal medical decision-making for such intensive intervention programs, as is the analysis of cost-effectiveness. In order to draw firm conclusions, it is recommended that a large-scale study with a randomized, parallel-group design will be performed. Our group has started such a research program in July 2001.

Aged↗
PubMed2000

Maintenance and the life expectancy of healthcare equipment in developing economies.

Measuring the economic viability of systematically maintaining physical assets (buildings, utilities, medical equipment) in healthcare is important in emerging economies with limited resources. This paper puts forward a way to estimate the benefit by comparing the input for maintenance with the savings achieved by extending the useful life of physical assets. For this purpose, life expectancies have been studied under conditions with and without systematic maintenance based on a planned and preventative approach for a selection of utilities and medical equipment. The result shows that the average prolongation of useful life for healthcare equipment in emerging economies is about two-fold. Specific figures on the life expectancy of 16 different items are presented. Finally, recommendations are given on how to employ the method locally.

Cost-Benefit Analysis↗
PubMed2006

Extrapolaholics anonymous: why demographers' rejections of a huge rise in cohort life expectancy in this century are overconfident.

Criticisms of demographers by other demographers have become frequent in scientific literature, generally consisting of accusations that trends observed in the recent past have been extrapolated unjustifiably into the future. Demographers, along with their colleagues in the actuarial profession, are in an invidious position in this regard, knowing full well that extrapolation is almost always only minimally justifiable, but knowing also that their readers, colleagues, and sources of funding tend to be much more interested in the future than in the past. It is unfortunate that, while actuaries typically resolve this dilemma by emphasizing the limitations of their methods and thereby lowering expectations that their predictions will be accurately fulfilled, demographers are more prone to respond combatively, attempting to reinforce the credibility of their extrapolations by recourse to data from areas in which their expertise is less tested, such as biology. This is valuable in that it raises the profile of the debate on the likely rate of scientific progress relevant to mortality rates, but it also runs the risk of lowering the technical quality of that debate, by telling policy makers and the public what they want to hear and thereby entrenching their expectations without recourse to the relevant biological facts. Extrapolations based on plausible sequences of scientific advances and the sociopolitical responses to them, summarized in this article, have led to the prediction of four-digit life expectancies of cohorts born in the 21st century and possibly even in the 20th. This prediction has attracted inevitable ridicule from prominent demographers, but being founded on science and sociology rather than on history it may be much more reliable than the extrapolations that those demographers presently prefer.

Cohort Studies↗
PubMed2004

Timing of brain-derived neurotrophic factor exposure affects life expectancy of new neurons.

The high vocal center (HVC) of adult male canaries, Serinus canaria, is necessary for the production of learned song. New neurons are added to HVC every day, where they replace older neurons that have died, but the length of their survival depends on the time of year when they are born. A great number of HVC neurons born in the fall, when adult canaries learn a new song, are still present 8 mo later, when this song is used during the breeding season. By contrast, most of the neurons born in HVC in the spring, when little song learning takes place, disappear much sooner. Here we show that infusion of brain-derived neurotrophic factor into HVC during days 14-20 after new HVC neurons are born in the spring confers on them a life expectancy comparable to that of fall-born neurons; this extension on life is not seen when infusion occurs 10 days earlier or later. We suggest that there is, in the adult HVC, a subset of neurons whose life expectancy is determined by brain-derived neurotrophic factor during a sensitive period soon after these neurons reach destination and start forming connections.

Animals↗
PubMed2006

"Life expectancy" of "ecstasy" tablets in Israel in the years 2001-2003.

3,4-Methylenedioxymethamphetamine (MDMA) tablets known as "ecstasy" became a very popular drug amongst Israeli youth in the last decade. The ecstasy tablets have a simple design impressed on them (logos) making it relatively easy to distinguish between various logos. The life expectancy of ecstasy tablet logos, defined as the period between the first seizure by the police of a certain logo until the last seizure of the same logo, was monitored during the years 2001-2003. During this time interval, 58 different tablet logos were seized. A total of 26 logos, defined as common logos with at least 10 independent seizures, were observed. At any given time interval during this period, 8-10 common logos were found with an average life expectancy of approximately 9 months. Five of the observed 26 common logos were defined as the most common logos that appeared in at least 200 independent seizures each. Plots of the number of seizures and number of tablets seized as a function of time are presented and discussed as well as explanations for the high turnover rate of any given logo.

Journal Article↗
PubMed1997

Life expectancy and social adaptation in individuals with Down syndrome with and without surgery for congenital heart disease.

Life expectancy and social adaptation in 373 children with Down syndrome with and without congenital heart disease (CHD) were assessed retrospectively. Survival at age 24 years was 92.2% for patients without CHD (n=200), and 74.6% for those with CHD (n=173). Survival for those who underwent operation for cardiovascular lesions (n=95) was 87.8%, and for those not operated on despite hemodynamically significant cardiovascular lesions (n=39), it was 41.4%. Cardiac functional capacity was better in the children without congenital heart disease and in the group operated on, where most patients also attained good social adaptation. We conclude that children with Down syndrome with congenital heart disease should undergo early cardiac evaluation and surgery if indicated.

Down Syndrome↗
PubMedDate not supplied

Long term effects of a 50 Hz electric field on the life-expectancy of mice.

The objective of our study was to determine the effect of an electric field (EF) on the life-span of mice. Male and female mice were paired and separated into two experimental groups: EF exposed and controls. The exposed mice were subjected to a 50 Hz, 10 kV/m electric field for 20 h/day. Offspring from both groups were identified as generation one and allowed to live for 18 months. Offspring from generation one were identified as generation two and allowed to die naturally. The age at which death occurred in both groups was recorded and post mortem examinations were performed. The obtained results were statistically analyzed by means of the chi-squared test. A statistically significant higher incidence of deaths before 18 months occurred in the first generation of the exposed group. The second generation of the exposed group showed a higher incidence of death at an earlier age. No increased incidence of malignant tumors nor any single specific cause of death was disclosed in the exposed animals. The results of this study indicate that continuous long-term exposure to a 10 kV/m electric field may shorten life-expectancy.

Animals↗
PubMedDate not supplied

Life expectancy estimation with breast cancer: bias of the declining exponential function and an alternative to its use.

BACKGROUND: Life expectancy gain (LEG) is an outcome measure commonly estimated with a declining exponential function in a Markov model. The accuracy of such estimates has not been objectively evaluated. PURPOSE: To compare LEGs from declining exponential function estimates with those calculated from population data, using published screening mammography studies as examples. METHOD: SEER-based population data are used to compare LEG calculation with declining exponential function estimation and empiric population data in a new model, the "nested" Markov. RESULTS: Analyses of the LEG of mammographic screening based on the declining exponential function significantly overestimate LEGs for younger women and underestimate them for older women. Because of offsetting errors, all-age analyses paradoxically appear accurate. CONCLUSION: Declining exponential function estimates of LEGs for chronic diseases with low mortality rates and long time horizons are liable to significant bias, especially with limited age cohorts.

Adult↗
PubMedDate not supplied

[Prognosis for life expectancy using the inductive learning method].

The aim of this paper was to find out the possibility of life expectancy achievement (LEA) prognosis in open population by using epidemiological data, to improve it and to determine the differences between regions. We were using inductive learning software tool, ASSISTANT Professional, based on modified Quinlan's inductive learning method. Data from an epidemiological study of oil/fat consuming influence on diabetes incidence in different regions in Croatia, 1887 examinees, have been used. In spite of limited number of attributes that were available, an improvement in prognosis of LEA has been made by selecting the proper attributes and by changing the limiting values of attributes (values that change the meaning of attributes). We reached the absolute accuracy of 75.54%. Even after further pruning of decision tree that lowered this value, Assistant showed 13% better result than those of random selected outcome. Differences between regions were also established that could not been explained with attributes that were used. Expanding the list of attributes and analysis of their influence in particular region can make further improvement in prognosis of LEA.

Croatia↗
PubMed2003

Life expectancy and cancer survival in the EUROCARE-3 cancer registry areas.

BACKGROUND: Mortality information is essential for estimating relative cancer survival (that excludes deaths from other causes). However, sufficiently detailed mortality data are not available for all areas covered by the cancer registries (CRs) participating in the EUROCARE-3 study. MATERIALS AND METHODS: Mathematical methods were used to construct complete local mortality data (life tables) for each year of age (0-99), for each year (1978-2000) and by sex, from the incomplete life tables provided by CRs, presenting the results as life expectancy at birth (LE). Socio-economic data were obtained from the United Nations (UN) and Organisation for Economic Co-operation and Development (OECD). RESULTS: The time and regional trends in LE provided by our estimates are closely similar to those published by the UN at the country level. According to UN data, LE (men plus women) varied from 70 years in Estonia to almost 79 years in Sweden in the period 1995-1999. LE increased markedly over the 20-year study period in most countries except Estonia and Denmark. LE correlated directly with GDP, national expenditure on health and relative survival for all cancers combined. We found that within-country LE variation was large in some countries (particularly the UK). Sweden, Iceland, Switzerland, and parts of Spain and Italy had high LE; eastern European countries had low LE. CONCLUSIONS: Detailed area-specific life tables are essential for reliable estimation of relative cancer survival and its comparison across populations, since LE varies markedly across Europe. Where not available, life tables can be constructed to the required level of detail using mathematical approaches.

Europe↗