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At least 109 records · Page 6Linked to original sources

Mortality and causes of death in idiopathic Parkinson's disease: results from the Aberdeen whole population study.

Two hundred and forty-nine patients with Parkinson's disease previously examined by Mutch et al 1,2 were followed up three and a half years after the original study. Cognitive impairment, age, some postural signs and symptoms of Parkinson's disease and high scores on the Hoehn and Yahr scale predicted premature death. Patients were more likely to die from respiratory infections than controls. Respiratory diseases as cause of death recorded on the death certificate were not related to kyphosis, posture scores or Hoehn and Yahr scores before death. The hypothesis is advanced that death of respiratory causes might be associated with signs of general autonomic dysregulation.

Aged↗

Perinatal circumstances and risk of offspring suicide. Birth cohort study.

BACKGROUND: A higher risk of suicide has been associated with low birth weight in one study, but not yet replicated. Higher birth order has been associated with self-harm, but not with suicide. AIMS: To examine the relationship between perinatal circumstances and subsequent young adult suicide in Scotland. METHOD: Using linked data from the Scottish Morbidity Record and Scottish death records, a birth cohort of 1061830 people was followed-up for a mean of 25.1 years. Data were analysed using Cox regression. RESULTS: Higher maternal parity, younger maternal age (<25 years), non-professional parental occupations and low birth weight (<2500 g) were independently associated with higher suicide risk of offspring as young adults. There was no independent association with gestational age. CONCLUSIONS: Our findings provide support for the influence of maternal circumstance and foetal experience on subsequent mental health.

Adolescent↗

[Underlying cause of death from external causes: validation of official data in Recife, Pernambuco, Brazil].

OBJECTIVE: To validate the underlying cause of death recorded on the death certificates for individuals under 20 years of age who died from external causes in 1995 in Recife, Pernambuco, Brazil. METHODS: We divided the study into two stages, coding and validation. In both stages we compared the official data concerning causes of death to the data we obtained during our study. We grouped the death certificates into 5 broad categories according to the cause of death; we later subdivided them into 14 categories. We also individually compared the death certificates applying the four-digit system of the International Classification of Diseases, Ninth Revision (ICD-9). We assessed the agreement between the official data and our data in terms of sensitivity and the kappa coefficient. We took as the standard the categorization of the cause of death that we had made during our investigation. RESULTS: In the coding stage, considering all the external causes of death, the overall agreement between the official data and our study data was 94% for the 5 categories, 92% for the 14 categories, and 81% for the four-digit ICD-9 system. In the validation stage the overall agreement was 94% for the 5 categories, 91% for the 14 categories, and 73% for the four-digit ICD-9 system. CONCLUSIONS: Our results suggest that for the death certificates to be reliable, the Institute of Legal Medicine must fill them out following recommended standards. In addition, hospitals and police departments must use greater care in completing the transfer slips that accompany the bodies that are sent to the Institute. More accurate data need to be generated and disseminated for a society to better understand its patterns of violence.

Adolescent↗

Misclassification of infant deaths--Alaska, 1990-1991.

In June 1991, the Alaska Section of Vital Statistics reported that nine deaths of Alaskan Native infants occurred in seven villages in southwestern Alaska from January 1990 through June 1991. In comparison, seven Alaskan Native infant deaths occurred in these villages during 1986-1989. Two of the deaths during 1990-1991 had been attributed to acute viral myocarditis (International Classification of Diseases, Ninth Revision [ICD-9], code 422.9) and three to viral or unspecified pneumonitis (ICD-9 codes 480.9 and 486), while from 1985 through 1989, one infant death in these villages had been attributed to either of these causes. An examination of the clinical histories of these nine infants by the Alaska Division of Public Health (ADPH) suggested some of the diagnoses might be inaccurate. This report summarizes an investigation by the ADPH to assess the accuracy of the immediate cause of death recorded on the death certificates for the nine infants.

Alaska↗

Enhanced maternal mortality surveillance--North Carolina, 1988 and 1989.

Despite dramatic declines in maternal mortality in North Carolina since the late 1940s, public health officials have continued to characterize the magnitude of and risk factors for maternal death in that state (1,2). In 1989 and 1990, the State Center for Health and Environmental Statistics enhanced its surveillance for maternal mortality by computer-matching birth and fetal-death records with the death certificates of females who had died in 1988 and 1989. This report summarizes the findings of this enhanced surveillance for 1988 and 1989.

Adolescent↗

The accuracy of liver cancer as the underlying cause of death on death certificates.

Studies of liver cancer mortality are subject to confusion attributable to the changes in categories by which liver cancer is identified in successive revisions of the International Classification of Diseases. To determine the effects of these changes, diagnoses of 2,388 cases of primary liver cancer in the years 1973-80 were compared to the underlying causes of death recorded on the death certificates, using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Results showed that only 53 percent of the deaths were attributed on death certificates to primary liver cancer. In a reverse comparison of 2,977 death certificates from the years 1973-85 with an underlying cause of death of primary liver cancer, 83 percent had been diagnosed as liver cancer. However, among the certificates that specified cancer of the liver, not specified as primary or secondary, as the cause of death, only 40 percent had been diagnosed originally as liver cancer. The mortality of liver cancer can be either underestimated or overestimated depending on which disease classification categories are used.

Cause of Death↗

Are causes of death predictable?

A random sample of death records of adult males from 1967 to 1970 was chosen from the South Australian Registry of Births, Deaths, and Marriages. The natural parents of these individuals were identified by cross-reference to birth certificates, and an extensive search was made of the death records for these parents. In this manner random families were selected for which, where possible, the cause of death and length of life of each family member were determined. From the information pertaining to the stated cause of death, each individual was assigned to one of five death categories.

Adult↗

The role of linked birth and infant death certificates in maternal and child health epidemiology in the United States.

Linked birth and infant death certificates allow measurement of birthweight-specific infant mortality. Jack Smith, MS, to whom this issue of the American Journal of Preventive Medicine is dedicated, played a key role in the National Infant Mortality Surveillance (NIMS) project. NIMS provided national data on birthweight-specific infant mortality for the 1980 birth cohort, updated data previously collected by the National Center for Health Statistics (NCHS) for the 1960 birth cohort, and supported NCHS's implementation of an annual linked file in 1983. NIMS illustrated themes in infant mortality that remain important: the role of low birthweight (LBW) as a contributor to infant mortality, the contribution of disparities in LBW and birthweight-specific mortality to black-white gaps in infant mortality, and the nation's greater success in reducing mortality among LBW infants than in preventing LBW. Linked birth and infant death records are used nationally and by states to study an array of maternal and infant health topics, from the quality of vital records to the impact of therapeutic and public health interventions. By supplementing birth and infant death records with linkages to program and hospital discharge data, epidemiologists and health service researchers are extending the utility of vital statistics data to monitor maternal and infant health.

Birth Certificates↗

A closer examination of neonatal mortality rates among the Texas Spanish surname population.

Considering the poor socioeconomic status of the Spanish surnamed population in Texas, the Spanish surname neonatal mortality rate seems surprisingly low. During five of the last 10 years, the neonatal mortality rate for Texas Spanish surnamed population was actually lower than for Anglos. It is often suggested that the low Spanish surname neonatal mortality rate is due in part to reporting problems peculiar to the Spanish surname population in Texas. Linked birth and neonatal death records of Texas residents are examined for evidence of underreporting or misreporting of Spanish surnamed neonatal deaths. It is found that discrepancies in coding race on the birth and death records cause a minor deflation of Spanish surname neonatal and infant mortality rates. Indirect evidence indicates that there may be a substantial amount of underreporting of Spanish surname neonatal deaths. This underreporting appears to be associated with the presence of a large number of Mexican nationals misidentified as Texas residents, and the greater reliance upon lay midwives by the Spanish surname population in Texas. Reasons proposed to explain a reluctance to report neonatal deaths include fear of contact with authorities, and fear that a reported death would diminish the value of the birth certificate.

Adult↗

Bronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children, 1979-1997.

A 1985 estimate that 4500 respiratory syncytial virus (RSV)-associated deaths occur annually among US children has not been updated using nationally representative data. Thus, 1979-1997 multiple cause-of-death records for children <5 years old listing bronchiolitis, pneumonia, or any respiratory tract disease were examined. Deaths among children associated with any respiratory disease declined from 4631 in 1979 to 2502 in 1997. During the 19-year study period, 1806 bronchiolitis-associated deaths occurred (annual mean, 95 deaths; range, 66-127 deaths). Of these deaths, 1435 (79%) occurred among infants <1 year old. Congenital heart disease, lung disease, or prematurity was listed in death records of 179 (9.9%), 99 (5.5%), and 76 (4.2%) children dying with bronchiolitis, respectively. By applying published proportions of children hospitalized for bronchiolitis or pneumonia who were RSV-infected to bronchiolitis and pneumonia deaths, it was estimated that < or =510 RSV-associated deaths occurred annually during the study period, fewer than previously estimated.

Bronchiolitis↗

Cause-specific mortality in under fives in the urban slums of Lucknow, north India.

We recorded the causes of death in the preceding 3 years in a slum population of 24,196 children less than 5 years of age in Lucknow, North India. Of 1469 deaths recorded, 298 were stillbirths. For each death, a 'verbal autopsy' was conducted by interviewing the parents to ascertain the cause of death. 71.8 per cent of deaths were at home; 94.5 per cent of hospital deaths had no death certificate. Excluding stillbirths, 69.9 per cent of deaths were in the first year of life. Leading causes of death in the neonatal period were prematurity (38.5 per cent) and tetanus (36.4 per cent). Beyond the neonatal period, the leading causes of death were pneumonia (23.4 per cent), diarrhoeal disease (20.9 per cent), and malnutrition and/or anaemia (11.4 per cent). The existent mortality-recording system was under-reporting at least one third of the deaths. We conclude that stillbirths and neonatal mortality can be reduced by improved antenatal and natal care. In the postnatal period, since most of the mortality is due either to infective diseases or malnutrition, interventions to improve the nutritional status of preschool children can reduce this.

Age Distribution↗

Possible underascertainment of variant Creutzfeldt-Jakob disease: a systematic study.

OBJECTIVES: To predict the size of the vCJD epidemic it is important to know whether the description of cases of vCJD in 1996 represent the first cases of a new disease entity or whether detection was due to increased surveillance of CJD in humans. Detection of earlier cases would suggest a shorter incubation period and might lead to predictions of epidemic size being revised. METHODS: All certified deaths (excluding external injury and poisoning) in residents of Wales aged 15-45, between 1985 and 1995, were reviewed to detect vCJD deaths that might have been overlooked. 12 091 deaths were reviewed. "Non-specific fatal disorders compatible with vCJD" were defined. Deaths recorded to diseases other than those defined were rejected from further analysis (8769). Remaining cases (3322) were subdivided. Group A comprised deaths recorded to suicide, transport accidents, and those that could not be ascertained (ICD9 rubrics E950-959, E800-848, and 7999), a total of 2698 cases. Group B comprised deaths due to neurological disease, psychiatric disease, or substance abuse (624). RESULTS: For group A, remaining brain material was identified (n=218, 8.1%) and examined by routine histology and immunocytochemistry for prion protein. No cases of vCJD were detected. For group B, review of remaining clinical information was undertaken. Of 624 cases, information was available on 447 (72%). Brain tissue was examined by routine histology and immunocytochemistry in 47 (7.5%) cases. Sufficient clinical and pathological information was available to exclude all these as potential cases of vCJD. CONCLUSION: Variant CJD is a new disease entity and not simply the result of better case ascertainment.

Adolescent↗

A proportionate mortality analysis of California agricultural workers, 1978-1979.

There are few published reports of epidemiologic studies of the risks of agricultural work. Members of this occupational group have been of special concern because of their exposure to pesticides, some of which are mutagens and animal carcinogens. A previous proportionate mortality study of California agricultural workers was based on deaths recorded among white males of this occupational group during 1959-1961. We have conducted a proportionate mortality analysis of all deaths recorded during 1978-1979 among California farm workers and farm owner/managers. In general, the findings of our study are consistent with those of the previous study. For farm workers, we found proportionate mortality ratios (PMRs) which were consistently elevated for all race and sex categories (in which there were 6 or more decedents) for deaths due to motor vehicle accidents, all respiratory disease, and all infective and parasitic diseases. The PMRs for the former three causes of death were also found to be elevated across several race and sex categories for farm owner/managers. We also found a significant and consistent deficit of deaths among farm workers and farm owner/managers due to arteriosclerotic heart disease. The proportionate cancer mortality ratios (PCMRs) for cancer of the stomach and cancer of other lymphatic tissue were elevated, although not necessarily statistically significantly, for several race and sex categories among farm workers and farm owner/managers. The PCMR for cancer of the cervix was statistically significant for white female farmworkers.

Accidents↗

Organised inpatient (stroke unit) care for stroke.

BACKGROUND: Specially organised stroke units can be a ward or team that exclusively manages stroke patients (a dedicated stroke unit) or a ward or team that provides a generic disability service (a mixed assessment or rehabilitation unit). OBJECTIVES: The objective of this review was to assess the effect of care in a stroke unit compared with conventional care of patients following a stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group trials register, reference lists of articles and contacted researchers in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing organised inpatient stroke unit care with conventional care. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed eligibility and trial quality. The principal reviewer conducted a structured interview with the coordinators of unpublished trials. MAIN RESULTS: Twenty trials were included. Stroke unit care showed a reduction in the odds of death recorded at final follow-up (median one year). The odds ratio was 0.83, 95% confidence interval 0.71 to 0.97. The odds of death or institutionalised care were lower (0.76, 95% confidence interval 0.65 to 0.90) as were death or dependency at final review (odds ratio 0.75, 95% confidence interval 0.65 to 0.87). Subgroup analyses showed that the observed benefits were independent of patient age, sex, stroke severity, and types of stroke unit organisation. There was no indication that organised stroke unit care resulted in increased hospital stay, although there was heterogeneity between the trials. REVIEWER'S CONCLUSIONS: Stroke patients who receive organised inpatient care in a stroke unit are more likely to be alive, independent, and living at home one year after the stroke. The apparent benefits are not restricted to any particular sub-group of patients or model of stroke unit care. No systematic increase was observed in the length of inpatient stay.

Hospital Units↗