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PubMed2006

Lung cancer death rates in lifelong nonsmokers.

BACKGROUND: Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking. METHODS: We measured age-, sex-, and race-specific rates (per 100,000 person-years at risk) of death from lung cancer among more than 940,000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959-1972 (CPS-I) and 1982-2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided. RESULTS: The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100,000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70-84 years (P < .001). CONCLUSIONS: Contrary to clinical perception, the lung cancer death rate is not higher in female than in male never smokers and shows little evidence of having increased over time in the absence of smoking. Factors that affect the interpretation of lung cancer trends are discussed. Our novel finding that lung cancer mortality is higher among African American than white women never smokers should be confirmed in other studies.

Adult↗
PubMed1989

[Study of logistic curve fitting for primary liver cancer death rate in Chengdu].

Logistic curve was used for fitting primary liver cancer (PLC) age-specific death rate in Chengdu. The results showed that the age-specific death rate from 1981 to 1986 in Chengdu (population about 4,000,000) was satisfactorily fitted by logistic curve in male, female and total (P less than 0.01). The R2s were 0.9885, 0.9912 and 0.9974, respectively. Velocity analysis of death rate showed that the increasing peak was in the group of age 40-60 for male and 50-65 for female. Male's velocity and slope of death rate were higher and steeper than female's. These results are consistent with the feature of logistic curve and parameters obtained from logistic curve fitting in this study. The age-specific death rate by sex for every year from 1981 to 1986 was fitted very well (P less than 0.01). R2s for male and female were 0.9415 +/- 0.044 and 0.9056 +/- 0.048, respectively.

Age Factors↗
PubMed2005

[Impact of ageing and related factors on death rate of diabetes mellitus in Beijing].

OBJECTIVE: To analyze the ageing and related risk factors affecting the death rate of diabetes mellitus in Beijing, and make a correct assessment of risk factors in changing the death rate of diabetes mellitus. METHOD: The changes of death rate on diabetes mellitus in the past 10 years, from 1991 to 2000 were analyzed and calculated as to making clear what is the effects resulting from the ageing and the risk factors. RESULTS: The death rate of diabetes mellitus was increased to 117.55%, from 1991 to 2000, in which 53.28% were attributing to the ageing and 46.72% to the risk factors. CONCLUSION: The effects of ageing and risk factors on death rate of diabetes mellitus should be different and the ageing should be a factor more important than the other risk factors.

Adolescent↗
PubMed1999

Quality of death rates by race and Hispanic origin: a summary of current research, 1999.

OBJECTIVES: This report provides a summary of current knowledge and research on the quality and reliability of death rates by race and Hispanic origin in official mortality statistics of the United States produced by the National Center for Health Statistics (NCHS). It also provides a quantitative assessment of bias in death rates by race and Hispanic origin. It identifies areas for targeted research. METHODS: Death rates are based on information on deaths (numerators of the rates) from death certificates filed in the states and compiled into a national database by NCHS, and on population data (denominators) from the Census Bureau. Selected studies of race/Hispanic-origin misclassification and under coverage are summarized on deaths and population. Estimates are made of the separate and the joint bias on death rates by race and Hispanic origin from the two sources. Simplifying assumptions are made about the stability of the biases over time and among age groups. Original results are presented using an expanded and updated database from the National Longitudinal Mortality Study. RESULTS: While biases in the numerator and denominator tend to offset each other somewhat, death rates for all groups show net effects of race misclassification and under coverage. For the white population and the black population, published death rates are overstated in official publications by an estimated 1.0 percent and 5.0 percent, respectively, resulting principally from undercounts of these population groups in the census. Death rates for the other minority groups are understated in official publications approximately as follows: American Indians, 21 percent; Asian or Pacific Islanders, 11 percent; and Hispanics, 2 percent. These estimates do not take into account differential misreporting of age among the race/ethnic groups.

Adolescent↗
PubMed1973

Death rate linked to unplanned birth in poor countries.

Reducing infant and child death rates in those areas of the world that operate on an agrarian subsistence economy is an important step that leads to planned smaller families, but it is only 1 of several necessary steps, according to Dr. George Mettrop, consultant to the World Health Organization (WHO). Other important contributory steps toward family planning include better education in health and nutrition and improvement in the economic status of the rural world, he said, in a study prepared for World Population Year, 1974. During the past 20 years, he reported, worldwide research has indicated that high birthrates and high maternal age are associated with high rates of disease and death for mothers and infants in all social classes. A study of 2287 families in the state of Uttar Pradesh in India, for example, revealed that in families with 5 or more births, 51% of the children died, while the death rate for children in families with 3 or fewer births was 38%. In Egypt, another study indicated that "parents who lost an infant generally compensated by having more children." Dr. Mettrop was replying to a question frequently asked of WHO: by lowering death rates is not WHO partly responsible for world population growth? His answer, a strong negative, was that reduction in infant mortality and overall improvement in environment health lead couples to serious consideration of the practice of family planning.

Demography↗
PubMed1976

[Pulmonary artery pressure in the pathophysiology of lung-resections therapy. Part I: standard values, surgical lung diseases, postoperative death rate (author's transl)].

The early death rate after lung-resections is caused mainly by right heart failure. The level of pulmonary blood pressure plays a decisive role in this respect. In patients with surgical lung diseases the blood pressure is significantly higher in several parts of lung circulation than in healthy persons. The early death rate after operation was found to be increased in patients with a higher level of preoperative pulmonary artery pressure.

Blood Pressure↗
PubMed1998

Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study.

OBJECTIVE: To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses. DESIGN: Population based cohort study. SUBJECTS: 1 026 249 pregnancies without congenital malformations. SETTING: Sweden 1983-92. MAIN OUTCOME MEASURE: Late fetal death rate. RESULTS: Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women >=175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers. CONCLUSIONS: Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants-for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension.

Adolescent↗
PubMed2001

A 9-year, single-institution, retrospective review of death rate and prognostic factors in adult respiratory distress syndrome.

OBJECTIVE: To evaluate, at a single institution, the adult respiratory distress syndrome (ARDS) death rate in critically ill ventilated surgical/trauma patients and to identify the factors predicting death in these patients. SUMMARY BACKGROUND DATA: The prognostic features affecting mortality at the onset of ARDS have not been clearly defined. Defining rare characteristics would be valuable because it would allow for better stratification of patients in clinical trials and more appropriate utilization of constrained resources in ICU environments. METHODS: A retrospective analysis of 980 ventilated surgical and trauma intensive care unit patients from January 1990 to December 1998 was performed at Rhode Island Hospital. One hundred eleven adult intensive care unit patients with ARDS were identified using the criteria of Lung Injury Score more than 2.50 and the definition from the American-European Consensus Conference. Slightly more than half were trauma patients, 57% were men, and the median age was 59 years. The overall death rate was 52%. Patients were segregated by admission date to the intensive care unit (before or after January 1, 1995). Severity of illness was measured by the Revised Trauma Score for trauma patients and the Acute Physiology and Chronic Health Evaluation III for surgical patients. The Multiple Organ Dysfunction Score was determined on the day of onset of ARDS for all patients. Other recorded variables were age, sex, intensive care unit length of stay, length and mode of ventilation, presence or absence of tracheostomy, ventilation variables of peak and mean airway pressures, lung injury scores, elective versus emergency surgery, and presence or absence of pneumonia. RESULTS: There was a significant decrease in the ARDS death rate from the period 1990 to 1994 to the period 1995 to 1998. The major reason for the decline was a reduction in the posttraumatic ARDS death rate. Lung-protective ventilation strategies were used more frequently in the second period than in the first, and the death rate was significantly decreased in trauma patients in the second period when lung-protective ventilation modes were used. Predictors of death at the onset of ARDS were advanced age, Multiple Organ Dysfunction Score of 8 or more, and Lung Injury Score of 2.76 or more. CONCLUSION: In this single-institution series, the death rate from ARDS declined from 1990 to 1998, primarily in posttraumatic patients, and the decrease is related to the use of lung-protective ventilation strategies. Based on this patient population, the authors developed a statistical model to evaluate important prognostic indicators (advanced age, organ system and pulmonary dysfunction measurements) at the onset of ARDS.

Female↗
PubMed2003

Fragility versus excessive crash involvement as determinants of high death rates per vehicle-mile of travel among older drivers.

Using multiple national data systems, the roles of fragility (susceptibility to injury) versus excessive crash involvement in the increased fatality risk of older drivers per vehicle-mile of travel (VMT) were estimated. For each age and gender group, deaths per driver involved in a crash (a marker of fragility) and drivers involved in crashes per VMT (a marker of excessive crash involvement) were computed. Compared with drivers ages 30-59, those younger than 20 and those 75 or older both had much higher driver death rates per VMT. The highest death rates per mile driven, 13-fold increases, were observed among drivers age 80 or older, who also had the highest death rates per crash. Fragility began to increase at ages 60-64 and increased steadily with advancing age, accounting for about 60-95% of the excess death rates per VMT in older drivers, depending on age group and gender. Among older drivers, marked excesses in crash involvement did not begin until age 75, but explained no more than about 30-45% of the elevated risk in this group of drivers; excessive crashes explained less of the risk among drivers ages 60-74. In contrast, crash over-involvement was the major factor contributing to the high risk of death among drivers younger than 20, accounting for more than 95% of their elevated death rates per VMT. Although both fragility and crash over-involvement contributed to the excess death rates among older drivers per VMT, fragility appeared to be of over-riding importance. These findings suggest that measures to improve the protection of older vehicle occupants in crashes should be vigorously pursued.

Accidents, Traffic↗
PubMed1975

Reduction of prehospital, ambulance and community coronary death rates by the community-wide emergency cardiac care system.

Initiation of quick prehospital cardiopulmonary resuscitation and emergency cardiac care completed the total system needed to provide emergency and convalescent coronary care for a community. Subsequently, annual community rates for coronary death during ambulance transport fell by 62 per cent and for prehospital coronary death by 26 per cent in people under 70 years of age. In cardiac arrest due to acute myocardial infarction, prompt successful prehospital correction of ventricular fibrillation and asystole yielded long-term survival in two thirds of cases. This 66 per cent success rate of prehospital cardiopulmonary resuscitation and emergency cardiac care is identical to contemporary international experience. Precordial thump-version with the fist and precordial fist pacing appeared logical additions to prehospital cardiopulmonary resuscitation and emergency cardiac care technics. Community lives saved yearly were 15.2/100,000 people aged 30 to 69 years and 6.4/100,000 total population. Simultaneously, annual community rates for coronary death as a cause of death and coronary death per 1,000 people fell significantly by 15 and 17 per cent, respectively. Unquantifiable influences included prehospital relief of ischemic chest pain; prehospital correction of acute dysautonomia; prehospital abolition of otherwise prefatal dysrhythmias; similar treatment for acute myocardial infarction in the emergency department, in the inhospital mobile coronary care unit and in the progressive intermediate coronary convalescent unit; and general community education through the media of newspapers, radio and television. The present frequency of coronary death during ambulance transport, 9 to 22 per cent of prehospital coronary deaths in this and other surveys, suggests that the prehospital cardiopulmonary resuscitation and emergency cardiac care component needs improvement in many communities. By reducing prehospital and ambulance coronary death rates, prehospital cardiopulmonary resuscitation and emergency cardiac care for acute myocardial infarction constitutes an essential component of the total system approach to emergency coronary care. Since prehospital cardiopulmonary resuscitation and emergency cardiac care have cheaply and effectively expedited and abbreviated hospitalization for acute myocardial infarction, and lowered community death rates from coronary artery disease, its adoption throughout the United States and the western world seems justified.

Ambulances↗
PubMed1983

Population crowding and death rates due to heart disease.

Based upon the methodology of earlier research on death rates due to malignant neoplasms reported in this journal, this paper examines the relations between select social morphological factors of population size and density and rates of deaths due to heart disease. This study supports the findings of that earlier paper: populations having a stable morphological structure have a negative relation with death rates; populations experiencing a change in morphology, particularly an increase in the number of persons per housing unit, have a positive relation with mortality rates. An human ecological perspective is introduced to conceptualize the researches.

Age Factors↗
PubMed1988

Relationship between liver cirrhosis death rate and nutritional factors in 38 countries.

The relationship between liver cirrhosis death rates and certain nutritional factors was studied in 38 countries where mortality statistics were considered to be reliable. A partial correlation analysis showed that several food commodity consumption factors were independently and negatively (p less than 0.01) associated with liver cirrhosis death rates after adjustment for alcohol consumption. These factors were total calories, protein, fat, calcium, vitamin A and vitamin B2. The significant association of protein, vitamin A, vitamin B2 and calcium with the cirrhosis death rates is of importance since they were not intercorrelated with alcohol consumption. Further results showed that animal protein was more significantly related to cirrhosis death rates than vegetable protein. However, in view of certain limitations of this study, the findings do not necessarily reflect causal relationships but rather support the consideration by scientists that protein and vitamin deficiency may have certain effects on liver cirrhosis.

Alcohol Drinking↗
PubMed2000

The widening gap in death rates among income groups in the United States from 1967 to 1986.

Death rates in the United States have fallen since the 1960s, but improvements have not been shared equally by all groups. This study investigates the change in inequality in mortality by income level from 1967 to 1986. Comparable death rates are constructed for 1967 and 1986 using National Mortality Followback Surveys as numerators and National Health Interview Surveys as denominators. Direct age-adjusted death rates are calculated for income levels for the U.S. noninstitutionalized civilian population 35 to 64 years old. A summary measure of inequality in mortality adjusts for differences in the size and definition of income groups in the two years. In both 1967 and 1986, mortality decreased with each rise in income level. Measured in relative terms, this inverse relationship was greater in 1986 then in 1967 for men and women, blacks and whites. Between 1967 and 1986, death rates for those with maximal income declined between two and three times more rapidly than did rates for the middle and low income groups. The greatest increase in relative inequality was seen among white males.

Adult↗
PubMed1986

The diet and 15-year death rate in the seven countries study.

In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-59 years and "healthy" at entry, 2,288 died in 15 years. Death rates differed among cohorts. Differences in mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart disease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weight, fatness, and physical activity. The cohorts differed in average diets. Death rates were related positively to average percentage of dietary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smoking habits as independent variables accounted for 85% of variance in rates of deaths from all causes, 96% coronary heart disease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all differences in monounsaturates among cohorts. All-cause and coronary heart disease death rates were low in cohorts with olive oil as the main fat. Causal relationships are not claimed but consideration of characteristics of populations as well as of individuals within populations is urged in evaluating risks.

Adult↗
PubMed1993

How socioeconomic status affects birth and death rates in rural Kerala, India: results of a health study.

Data relating to birth and death were collected from throughout the state of Kerala, India, in a health survey conducted by the Kerala Sastra Sahitya Parishad, a voluntary organization. In this study, the authors analyze birth and death rates as calculated from the sample of 9,940 households (57,665 persons), with respect to other variables such as region, religion, and socioeconomic status. In order to study the effect of socioeconomic factors on birth and death rates, a socioeconomic status rating (SES rating) was developed, taking into account such factors as income, education, housing conditions, and land ownership. Socioeconomic status was found to have a definite influence on birth and death rates, with higher socioeconomic status resulting in lower birth and death rates. This effect was independent of such confounding variables as age structure of the population, religion, and region. The higher risk of mortality among the poorer households can partly be explained by the material deprivation: the higher birth rates could be the result of poorer educational attainments.

Adolescent↗
PubMed1979

Nonlogarithmic death rate calculations for Byssochlamys fulva and other microorganisms.

Survivor curves for heat-resistant ascospores of Byssochlamys fulva exposed to lethal heat were nonlogarithmic. At lower heating temperatures, the log survivor curves were characterized by a shoulder plus an accelerating death rate; with increased temperatures, the rate approached logarithmic death. The formula (log No -- log N)a = kt + C was adapted to linearize these data. No and N are the initial and surviving numbers of organisms at the time t. The death rate is given by k, and C is a constant for a set of data. The a value is derived from the least-squares slope of a plot of log (log No -- log N) against log time and is used to linearize the thermal death rate curves. This formula permitted calculations of parameters analogous to those for logarithmic death (D and z). Use of formula is illustrated for selected nonlinear microbial death rate curves from the literature.

Ascomycota↗
PubMed1996

Correlation of age-adjusted incidence and age-adjusted death rate in colorectal cancer among municipalities in Aomori Prefecture.

To clarify to what extent death rate reflects the incidence of colorectal cancer, we calculated the age-adjusted death rates for colorectal cancer among municipalities in Aomori Prefecture for the period between 1983 and 1987, and examined the correlation with the age-adjusted incidences of the disease during different 5-year periods. In males, the age-adjusted death rate of rectal or colon cancer most correlated with the age-adjusted incidence in the preceding period by three or two years, respectively; however in females, the age-adjusted death rate best reflected the age-adjusted incidence of the same period. In males, significant correlation was lost if the interval exceeded seven years in both rectal and colon carcinomas. In females, the correlation became insignificant after an interval of four and five years in rectal and colon cancers, respectively.

Adult↗
PubMed1992

Importance of the first day death rate in infant mortality.

The conventional partition of infant mortality into neonatal and postneonatal deaths, with the 28th day postpartum as the dividing line, has lost much of its epidemiological rationale in countries with low infant death rates. Infant deaths are concentrated increasingly at the start of the neonatal period: one out of three infant deaths in the United States occurs during the first 24 hours. Circumstances of early neonatal deaths differ considerably from those of later neonatal deaths. Failure to monitor separately early and late neonatal mortality can compromise the recognition of distinct epidemiological patterns. Racial disparities in the US tend to be larger for first day deaths than for any other infant deaths. Total US infant mortality declined rapidly in the 1950s and 1960s but first day deaths rose at a steady pace. Surveillance of infant mortality, whether on the national or the community level, should encompass first day, first month and first year death rates.

Ethnicity↗