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PubMedDate not supplied

International death rates compared.

Since 1950 substantial progress has been made in reducing mortality in the United States. The decline in age-adjusted death rates was especially notable among women and among nonwhite persons. In particular, women of all other races recorded a precipitous reduction in death rates. Notwithstanding, age-adjusted death rates in the United States are still higher than those in other countries with traditionally low mortality. Moreover, very little progress has been achieved in the past decade in narrowing the international mortality gap. Currently, the United States ranks eleventh out of 15 countries under review. Men and women in Japan have the best mortality record.

Age Factors↗
PubMed2001

[Effect of thrombopoietin II on exsanguine thrombocytopenia mouse death rate].

OBJECTIVE: To study the effect of thrombopoietin II (TPO II) on the exsanguine thrombocytopenia mouse death rate. METHODS: After the normal peripheral platelet counts were done on the samples obtained from the tail vein of purebred Babl/c mice before experiment, the purified ligand I of TPO II, artificial compound ligand II of TPO II and rhTPO were injected intraperitoneally once a day for 7 days. On d 7 and d 14, platelet counts were performed on 0.5 ml samples obtained from the supra-orbital vein, with the condition of the mouse death monitored daily. RESULTS: On d 7, ligand I of TPO II group platelet counts were higher than that of the negative control group (P < 0.05), while not being significantly different from that of rhTPO group (P > 0.05). On d 14, the platelet counts of two TPO II groups increased significantly as compared with the negative control group (P < 0.01), showing no significant difference from that of rhTPO group (P > 0.05). Moreover, the platelet counts of mice in two TPO II groups and the positive group had shown an increasing tendency in the days following experiment. In addition, mouse death occurred in all groups of mice following their phlebotomy from the supraorbital vein on d 7. But the death rate of negative control group was evidently higher than that of any other groups (P < 0.05). CONCLUSION: TPO II's biological activity obviously increases platelet production, thereby reducing the exsanguine thrombopenia mouse death rate.

Animals↗
PubMed1996

Death rates among patients hospitalized with community-acquired pneumonia: a reexamination with data from three states.

OBJECTIVES: Death rates for community-acquired pneumonia based on relatively small-scale, published studies tend to exceed 15% to 20%. This study reexamined these estimates by using very large, population-based databases. METHODS: Death rates from 1993 associated with community-acquired pneumonia were reexamined with hospital discharge data from all of Washington, Illinois, and Florida. RESULTS: These death rates were substantially lower (7.0%, 8.1%, and 9.7%, respectively) than what appears in the literature. Significant risk factors for dying were being 65 years of age or older (odds ratio [OR] = 2.9), being positive for human immunodeficiency virus (OR = 2.9), and having a high severity of illness (OR = 7.1). CONCLUSION: Sampling bias associated with selection for hospital admissions explain the discrepancy between previous and this study's results.

AIDS-Related Opportunistic Infections↗
PubMed2002

Thrombocytosis is associated with a significant increase in the cancer specific death rate after radical nephrectomy.

PURPOSE: We have previously reported that patients with advanced renal cell carcinoma and a normal platelet count of 400,000/mm. have a 64% increase in life expectancy compared with those with thrombocytosis. We determined whether thrombocytosis was predictive of death from renal cell carcinoma after radical nephrectomy was performed with curative intent for early stage disease. MATERIALS AND METHODS: We reviewed the records of 204 patients with renal cell carcinoma who underwent radical nephrectomy with curative intent between June 1993 and January 2000 at Emory University Hospital. Survival, pathological grade and stage were recorded from the Emory Winship Cancer Institute tumor registry. Platelet counts were recorded and any patient with at least 1 platelet count of greater than 400,000/mm. was classified with thrombocytosis. Those with a platelet count of 400,000/mm. were classified with a normal platelet count. RESULTS: There were 26 patients with thrombocytosis and 178 patients with persistently normal platelet counts. The overall and cancer specific death rate in the 26 patients with thrombocytosis was 50% and 42%, respectively. The overall mean time between nephrectomy and death was 12.1 months in this group. The overall and cancer specific death rate in the 178 patients with a normal platelet count was 15.2% and 7.3%, respectively. Mean time to death was 22.6 months in this group. Differences in the overall and cancer specific death rates were highly statistically significant as well as clinically significant. These differences remained significant after controlling for grade, stage and histological type of cancer. CONCLUSIONS: This study documents the association of thrombocytosis with decreased survival in patients with renal cell carcinoma. In those who undergo nephrectomy for early stage renal cell carcinoma with a perioperative platelet count of greater than 400,000/mm. the cancer specific death rate from renal cell carcinoma is greater than 5 times the rate in patients with a persistently normal platelet counts after radical nephrectomy. The platelet count appears to be a new and powerful independent prognosticator in patients with renal cell carcinoma who undergo radical nephrectomy for presumed localized disease.

Aged↗
PubMed1980

Estimating the approximate size of the illegal alien population in the United States by the comparative trend analysis of age-specific death rates.

This paper presents the results of an attempt to determine, through the use of demographic analysis, the approximate magnitude of the resident illegal alien population in the United States. The method described is the comparative analysis of trends in age-specific death rates in the United States and selected States, 1950 to 1975. The procedure depends on two assumptions: (a) that few or no illegal aliens are included in decennial census counts or current population estimates; and (b) that the reported statistics on deaths include deaths to all or nearly all illegal aliens. If the illegal alien population has increased by several million since 1970, then death rates in geographic areas where illegal aliens are most concentrated should show substantial excesses over the rates for the remainder of the country. A roughly similar downward trend in the death rates of all age groups since 1970 in all areas of the United States is apparent and hence does not support the view that many millions of illegal residents (perhaps over 6 million) are living here. However, the finding of a persistent deviation in the death rate trend for 10 selected States since 1960 for whites males, ages 20 to 44, and for no other group, suggests that the deaths of illegal aliens are being recorded in our vital statistics system. A range of estimates of the illegal alien population based on this analysis is presented and compared with the results of other studies.

Adolescent↗
PubMed2006

Impact of socio-economic deprivation on death rates after surgery for upper gastrointestinal tract cancer.

We hypothesised that socio-economic deprivation in England may be a prognostic factor for death after oesophagectomy or gastrectomy for cancer of the upper gastrointestinal tract. We analysed statistical data from hospital records linked to death records for patients who underwent operations for oesophageal and gastric cancer in England from April 1998 to March 2002. The patients were stratified into quintiles according to the index of multiple deprivation (IMD) (2000) for their place (ward) of residence. Age and sex standardised death rates at 30 and 90 days for each deprivation quintile were calculated. Following oesophagectomy, death rates showed a significant association with IMD. They increased with increasing levels of deprivation: the odds ratio for death, comparing highest with lowest quintile for deprivation, was 1.37 (95% confidence interval 1.03-1.85) at 30 days and 1.30 (1.04-1.64) at 90 days. Following gastrectomy, the death rates showed smaller and nonsignificant associations with IMD with odds ratios of 1.16 (0.84-1.62) and 1.10 (0.86-1.41), respectively. There is a significant association between social deprivation and death after oesophagectomy, but less of an association, if any, after gastrectomy in current UK practice.

Digestive System Surgical Procedures↗
PubMed1999

Age-adjusted death rates: consequences of the Year 2000 standard.

PURPOSE: For nearly 60 years, official U.S. mortality statistics have been age-adjusted using the age distribution from the U.S. population for the year 1940. A new population standard, the projected Year 2000 U.S. standard, has been approved for use by the Department of Health and Human Services (DHHS). It will be implemented for official U.S. Government statistics published for deaths occurring in 1999. The new standard reflects the older age distribution of the population; 6.8% of the population was age 65 years or more in 1940, as compared to 12.6% projected for 2000. METHODS: This paper investigates the consequences of the new age distribution standard by comparing death rates by time, place, and population characteristics, adjusted to both the 1940 and projected 2000 population standards. RESULTS: The new standard changes the level of the age-adjusted death rate for total mortality and for many causes of death, as compared to the 1940 standard. For example, the 1995 death rate for diseases of the heart is 138 per 100,000 population when adjusted using the 1940 standard, but is 296 per 100,000 using the Year 2000 standard. The new standard may change the comparison of age-adjusted rates if there are substantial differences in the age-specific rates. For example, the ratio of age-adjusted death rates for ischemic heart disease in black relative to white males is 1.07 using the 1940 standard, but is 0.96 using the Year 2000 standard. CONCLUSIONS: The new Year 2000 age standard has the potential to change both levels and comparisons of age-adjusted rates. Age-adjustment is an averaging process, and consequently, has the potential to view the data effectively as a whole while possibly obscuring important age-specific details.

Adolescent↗
PubMed1995

Rising death rate from non-malignant disease of the oesophagus (NMOD) in England and Wales.

Between 1968 and 1991, the number of deaths from non-malignant oesophageal disease (NMOD) (International Classification of Diseases code 530), recorded by the Office of Population Censuses and Surveys (OPCS) in England and Wales, trebled in women, from 118 to 340 (5 to 13 per million) and doubled in men, from 131 to 251 (5.5 to 10 per million). Calculation of age specific death rates, shows the increase to result from a rise in mortality in those over 75 years and age standardised mortality confirms a rise in overall frequency from 2.9 to 7.0 deaths per million men and 5.2 to 13.1 per million women. Between 1974 and 1988 when specific diagnoses were coded, deaths from oesophageal ulcer rose from 1.5 to 2.5 per million. In men, the death rate from oesophageal stricture increased from 2.5 to 3 per million and in women from 3.5 to 6 per million. Mortality from oesophageal perforation did not change (1 per million). Some of these changes reflect the increasing age of the population in general, but further explanations are required. Review of 84 sets of case notes from a total of 281 inpatients whose coded diagnoses had included NMOD and who had died suggested that in 28 (33%) death was actually due to NMOD, and in seven of these endoscopic intervention was responsible. The certified underlying cause of death was compared with that suggested from case note review in 62 cases; death from NMOD was substantially underestimated. This study concludes that a rising death rate attributed to NMOD is underestimated on death certificates and that endoscopic intervention explains only a few of the cases.

Aged↗
PubMed1985

Analysis of death rates in the population aged 60 years and over of Greater Glasgow by postcode sector of residence.

Using computer tapes of death registrations for the period 1980-2, and paper copy of population data for the 1981 census, death rates were calculated for the population resident in each of the 112 postcode sectors that make up the area served by the Greater Glasgow Health Board. Rates were calculated for both sexes in combination for each of the age groups 60-64, 65-69, 70-74, 75-79, 80-84, and 85 years and over. The difference in the mean death rate for the 22 postcodes in the quintile with the highest rates and the 22 postcodes in the quintile with the lowest rates was just over twofold in the 60-64 age group, just under twofold in the 65-84 age groups, but only 1.2-fold in the age group 85 years and over. There was marked consistency between the various age groups in the mortality rating for the postcode sectors, the postcode sectors with the highest death rates being located entirely in the more disadvantaged areas of the city and suburbs. The geographical mortality pattern for the older population was very similar to that (standardised for age and sex) in the 15-59 year age group.

Aged↗
PubMed2002

Death rate variation in US subpopulations.

OBJECTIVE: To account for variations in death rates in population subgroups of the USA. METHODS: Factors associated with age-adjusted death rates in 366 metropolitan and non- metropolitan areas of the United States were examined for 1990-92. The rates ranged from 690 to 1108 per 100 000 population (mean = 885 +/- 78 per 100 000). FINDINGS: Least squares regression analysis explained 71% of this variance. Factors with the strongest independent positive association were ethnicity (African-American), less than a high school education, high Medicare expenditures, and location in western or southern regions. Factors with the strongest independent negative associations were employment in agriculture and forestry, ethnicity (Hispanic) and per capita income. CONCLUSION: Additional research at the individual level is needed to determine if these associations are causal, since some of the factors with the strongest associations, such as education, have long latency periods.

Adult↗
PubMedDate not supplied

Trends in heart disease death rates in diabetic and nondiabetic Pima Indians.

BACKGROUND: Secular trends over 34 years (1965-1998) in overall and cause-specific mortality were examined in 4,623 Pima Indians >or=35 years old. METHODS: The underlying and contributing causes of the 1,363 deaths were determined from a review of all available clinical records; 540 of the deaths occurred in the 2,528 nondiabetic participants and 823 in the 2,095 participants who had diabetes during all or part of the study period. Age/sex-adjusted death rates were calculated across four 8.5-year time intervals. RESULTS: In the nondiabetic participants, the rate of death from natural causes declined gradually over time (20.4, 17.3, 17.3, and 16.0 deaths per 1,000 persons/year; P=.11); deaths from ischemic heart disease (IHD) were uncommon (n=22), and the rate did not change appreciably, remaining as the fifth leading natural cause of death. In the diabetic participants, the rate of death from natural causes was unchanged over time, but the rate of death from IHD (n=141) increased nearly twofold (3.3, 4.2, 6.4, and 6.4 deaths per 1,000 persons/year; P<.01), becoming the leading cause of death in the third and fourth time intervals. CONCLUSIONS: The rate of death from IHD remained stable in nondiabetic Pima Indians but increased among those with diabetes. This finding suggests that, in the absence of diabetes, the underlying susceptibility to IHD in this population has not changed.

Adult↗
PubMed1994

A population-based multivariate analysis of the association of county demographic and medical system factors with per capita pediatric trauma death rates in North Carolina.

OBJECTIVE: This study analyzed the association between demographic and medical system factors and the pediatric trauma death rate in North Carolina. SUMMARY BACKGROUND DATA: Trauma is the leading cause of death in children. Various medical system factors have been suggested to reduce pediatric morbidity and mortality rates, but the association with these rates has not been tested. METHODS: Data were obtained from the North Carolina medical examiner's database. The dependent variable was the county per capita pediatric trauma death rate. Twenty-one demographic and medical system measures were selected as independent variables. RESULTS: Nine hundred forty-one pediatric trauma deaths from 1986 to 1989 were included in our sample. Multivariate analysis identified the variables most highly associated with the dependent variables. The presence of advanced life support (ALS) training was the only medical system factor associated significantly with pediatric trauma death rates. Trauma centers, emergency (911) telephone access, and other medical resource variables had no significant association. CONCLUSIONS: The study confirms other reports showing that demographic factors have an important predictive association with the trauma death rate in children. Advanced life support was the only medical system resource associated significantly with pediatric trauma death rates. This study underlines the significance of pre-hospital care in the treatment of pediatric trauma.

Adolescent↗
PubMed1982

Geographical pattern of death rates from multiple sclerosis in France. An analysis of 4912 deaths.

4912 deaths related to multiple sclerosis have been identified in France during the period 1968-1977. The average annual death rate was equal to 0.96 per 100,000 population. Analysis showed a clear south to north increasing gradient. The study failed to find any geographic difference from data concerning 5173 amyotrophic lateral sclerosis (ALS) deaths which had been identified during the same interval. A noteworthy increase in the number of deaths related to ALS was observed over the study period.

Adult↗
PubMed1993

Factors associated with the decline in cirrhosis death rates among young adults in Allegheny County, Pennsylvania, 1973-1985.

From 1973 to 1985, the age-adjusted death rate from liver cirrhosis (International Classification of Diseases, Ninth Revision, code 571) dropped by 62.7% among adults aged 25-54 years in Allegheny County, Pennsylvania. The authors investigated factors associated with this decline by verifying causes of death on death certificates from medical records, coroner's reports, and autopsy reports. Although death rates from cirrhosis were slightly underestimated from death certificates, the underestimation did not alter the declining mortality trend. This decline in rates was significant after adjustment of the age, sex, and race effect using statistical modeling. No significant variability in the time trends was noted between sexes, races, and age groups. Neither did the trends in alcohol-related and "unspecified" cirrhosis differ. However, the trends varied significantly between the cirrhosis deaths certified by the coroner and by noncoroner physicians. From 1973-1975 to 1976-1978, the rate initially dropped by 51% among the coroner cases, whereas it dropped by only 9% among the noncoroner cases. By the period 1982-1985, the death rates of both coroner and noncoroner cases declined to approximately 50% of their 1973-1975 rates. These results suggest that the decline during the years 1973-1985 was real and that the trend was initiated by the pronounced decline during the early years in the coroner-certified cirrhosis deaths.

Adult↗
PubMed1989

[The death rate of the population in demo-logical interpretation].

"The present-day peculiarities...[of] population death-rate analysis are considered. It is substantiated that the population death-rate should be studied in two mutually complementary aspects: [a natural] historical process and a result of human activities. The demographic policy object is formulated as aimed at prolongation of the human life." (SUMMARY IN ENG)

Demography↗
PubMed1999

Explaining differences in English hospital death rates using routinely collected data.

OBJECTIVES: To ascertain hospital inpatient mortality in England and to determine which factors best explain variation in standardised hospital death ratios. DESIGN: Weighted linear regression analysis of routinely collected data over four years, with hospital standardised mortality ratios as the dependent variable. SETTING: England. SUBJECTS: Eight million discharges from NHS hospitals when the primary diagnosis was one of the diagnoses accounting for 80% of inpatient deaths. MAIN OUTCOME MEASURES: Hospital standardised mortality ratios and predictors of variations in these ratios. RESULTS: The four year crude death rates varied across hospitals from 3.4% to 13.6% (average for England 8.5%), and standardised hospital mortality ratios ranged from 53 to 137 (average for England 100). The percentage of cases that were emergency admissions (60% of total hospital admissions) was the best predictor of this variation in mortality, with the ratio of hospital doctors to beds and general practitioners to head of population the next best predictors. When analyses were restricted to emergency admissions (which covered 93% of all patient deaths analysed) number of doctors per bed was the best predictor. CONCLUSION: Analysis of hospital episode statistics reveals wide variation in standardised hospital mortality ratios in England. The percentage of total admissions classified as emergencies is the most powerful predictor of variation in mortality. The ratios of doctors to head of population served, both in hospital and in general practice, seem to be critical determinants of standardised hospital death rates; the higher these ratios, the lower the death rates in both cases.

Data Collection↗
PubMed2001

Towards an understanding of the high death rate among young people with diabetes in Ukraine.

AIMS: Published rates of deaths attributed to diabetes mellitus among those aged under 50 have risen substantially in several former Soviet republics since the late 1980s. The reasons for this increase, and the situation facing patients with diabetes in these countries are poorly understood. The aim of this study was to describe the circumstances leading up to the death of individuals dying under the age of 50 years with mention of diabetes on their death certificate. METHODS: Interviews with surviving relatives or neighbours, combining elements of verbal autopsy and confidential enquiry. For those who had lived in the city of Lviv a random sample was taken. For those in rural areas a purposive sample was used to ensure coverage of more and less remote areas. RESULTS: Key informants were identified and agreed to be interviewed for 64 individuals out of a possible 79 with insulin-treated diabetes identified from their death certificates. The main immediate causes of death were renal failure (69%), ischaemic heart disease (9%), ketoacidosis (6%) and hypoglycaemia (3%). Over a third of men, but no women, were reported to have been heavy drinkers. Informants described many difficulties in obtaining regular supplies of insulin and related supplies since 1990. Although insulin is officially available free of charge, most had retained supplies for use in an emergency. More than half had, at some time, purchased supplies. The large number of deaths from renal failure reflects the effective absence of renal replacement therapy for patients with diabetes. CONCLUSIONS: Individuals with diabetes in Ukraine face profound challenges involving access to necessary care. Their needs require significantly more attention from policy makers.

Adolescent↗