INFECTIOUS diseases and vital statistics.
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Data for this article, as in previous reports, are drawn principally from the Monthly Vital Statistics Report, published by the National Center for Health Statistics. The international data come from the Demographic Yearbook and the quarterly Population and Vital Statistics Report, both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data. Except for mortality data by cause and age, which are based on a 10% sample, all the US data for 1983 are estimates by place of occurrence based upon a count of certificates received in state offices between two dates, one month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimates are very close to the subsequent final figures. There are, however, considerable variations in a few of the states, particularly in comparing data by place of occurrence with data by place of residence. State information should be interpreted cautiously.
Vital statistics were evaluated for artificial insemination sires leaving service during 1939 through 1974. Data consisted of 11,704 sires of six breeds. The major cause for leaving service was reproductive failure at a frequency of 32.5%; next ranked was undesirable characteristics of offspring with a frequency of 20.7%. Overall culling rate for low yields of daughters was 14.8%, but after 1965 this cause accounted for about 30%. Mean life span was 3.4 yr with small differences among years. Breed differences were detected for service life and causes for leaving service. Modifications of classic life table techniques are needed to reflect entry of sires into service at various ages and evaluation of vital statistics subsequent to 1974.
BACKGROUND: Very low birthweight (VLBW) rates, i.e. births of < 1500 g, have been long established as the major determinant of outcome for infants. Nevertheless, despite much medical, political and social effort, these rates have not declined during the past 40 years in the US Vital Statistics. To explore the causes of this disturbing finding, trends in low birthweight distribution at a community hospital and the Vital Statistics data were investigated. METHODS: The weights of livebirths and foetal deaths (27,944 births) at a community hospital during three 5-year periods, 1973-1987, were examined for trends in low birthweight (LBW) distribution, and they were contrasted with the US Vital Statistics. RESULTS: For white infants weighing 500-999 g the livebirth rates declined from 3.7 per 1000 births in period one to 1.1 per 1000 in period three (70.2%); for white infants 1000-1499 g, livebirths declined from 4.2 to 3.2 per 1000. Hospital white livebirths < 2500 g declined 18.7% from the first to the third period. Among black livebirths the LBW rate also declined from 126.4 per 1000 in period one to 85.4 per 1000 in the third period. Foetal deaths declined from 8.2 per 1000 births to 6.2 per 1000 in period three, a 24.4% decline. However, foetal deaths < 500 g increased 411%, from 3.6% of the total foetal deaths in period one to 18.4% in the third period. CONCLUSION: Increasing registration of births in the US may have hidden a marked improvement in the VLBW problem. More complete registration of births and changes in the perception of viability appear responsible for the artefact.
Data for this article, as in previous reports, are drawn principally from the Monthly Vital Statistics Report, published by the National Center for Health Statistics. The international data come from the Demographic Yearbook and the quarterly Population and Vital Statistics Report, both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data. Except for mortality data by cause and age, which are based on a 10% sample, all the United States data for 1979 are estimates by place of occurrence based upon a count of certificates received in state offices between two dates, one month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimate is very close to the subsequent final figures. There are, however, considerable variations in a few of the states, particularly in comparing data by place of occurrence with data by place of residence. State information should be interpreted cautiously.
As of January 31, 1996, 292 deaths among registered patients of Yusho were identified by three follow-up studies conducted in 1986, 1990, and 1996. In this study, we attempted to identify underlying causes of death by linkage of the registered data to the National Vital Statistics Data provided by the Management and Coordination Agency of Japan, which included 15 million deaths between 1978 and 1996. The two datasets were linked by matching for six variables; birth year/month/day, death year/month, and sex, along with a variable of death day or death place, or both. The matched cases were 203 among 235 deaths between 1978 and 1996 (matching rate was 86%). Among the 203 deaths, 58 underlying causes of death were newly identified, 146 causes of death were already grasped by the follow-up studies, and 31 deaths did not have matching pair in the National Vital Statistics data. Among the 146 deaths, 110 causes of death were concordant with each other, however, 35 causes of death were completely discord. The reason of the discordance and the unmatched deaths might be due to difference in information of the matching variables in the two datasets. In order to conduct an efficient follow-up study of Yusho patients, identification of underlying causes of death by linkage to the National Vital Statistics Date is evitable. For that, we need to substitute basic information in the Yusho database to those compatible to the National civil registration system.
PURPOSE: Where population-based studies of epilepsy mortality are impossible to conduct, other sources of data must be considered. We provide descriptive data on mortality and causes of death for epilepsy in Taiwan. METHODS: Two settings in Taiwan were used. First, we evaluated the mortality ratio for epilepsy, using the national vital statistics for 1996 with the total population of Taiwan as the denominator. Second, we evaluated mortality in a cohort of prevalent epilepsy cases from a University outpatient clinic. For both, proportionate mortality was calculated to determine the relative contributions of different causes of death in epilepsy. RESULTS: One hundred and sixty-two deaths were correctly coded under ICD code 345 from the 1975 detailed diagnostic listing during the 1-year period of 1996. Epilepsy was the diagnosis in 0.8 deaths/100,000 population. Over an 11-year period, there were 54 deaths (0.9%) among 1,224 prevalent epilepsy cases from a University clinic during 5,704 person-years of follow-up. The most common underlying cause of death was epilepsy-related death in 129 (79.6%) out of 162 deaths from the vital statistics data. There were 13 deaths unrelated to epilepsy (8.0%). Acute reactive seizure as the cause of death was found in 9 patients (5.6%). The leading cause of death in the epilepsy clinic was disease unrelated to epilepsy in 21 deaths (38.9%), epilepsy-related death in 12 patients (22.2%), and death related to the cause of epilepsy in 9 patients (16.7%). CONCLUSION: Data derived from vital statistics are inadequate to evaluate mortality in people with epilepsy.
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