[AMP death rate for specific causes of death. (preliminary report)].
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Age Factors↗
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The death rate of Ostertagia circumcincta and Trichostrongylus colubriformis in lactating ewes: implications for anthelmintic resistance.
Lactating adult Romney ewes were infected, 4 weeks post-lambing, with benzimidazole (bz) resistant strains of Ostertagia circumcincta and Trichostrongylus colubriformis. Commencing 4 weeks after the initial infection the ewes were subjected to challenge 3 times weekly with 5000 L3 of bz-susceptible strains of both parasite species. At weekly intervals over the following 6 weeks, groups of ewes were drenched with a bz anthelmintic (oxfendazole) to remove bz-susceptible parasites and slaughtered to determine adult worm burdens of the bz-resistant parasites. The O. circumcincta infection declined exponentially with a mean daily death rate of 10.6% day-1 and no worms were recovered after 4 weeks or more of challenge. The T. colubriformis infection did not decline significantly over the 6 weeks of continuous challenge, indicating that the death rate could not be distinguished from zero. The upper 95% confidence limit for the death rate of T. colubriformis was 4.9%. The implications of these death rates on selection for drug resistance following ewe drenching during the post-partum period are discussed with selection pressure likely to be greater for T. colubriformis than for O. circumcincta.
Animals↗
[Postoperative recurrence and death rates of poorly differentiated carcinoma of the thyroid].
Postoperative recurrence and death rates of 54 cases of poorly differentiated thyroid carcinoma were analyzed. The rates of recurrence of 18 widely resected cases during 1979 and 1981 and 36 patients undergoing conventional surgery during 1965 and 1978 were 22.2% and 50%, respectively. The difference between the figures was statistically significant (p less than 0.05). The death rates of the two groups were 5.6% and 41.7%, respectively. These results indicate that wide resection is appropriate in the surgical treatment of the thyroid.
Carcinoma↗
The association of advanced life support training and decreased per capita trauma death rates: an analysis of 12,417 trauma deaths.
This study identified a number of significant predictors of per capita county trauma mortality rates: rurality, percentage nonwhite population, percentage unemployment, and Advanced Life Support (ALS) versus Basic Life Support (BLS) status. Of these, ALS versus BLS status is not only the most significant independent predictor, it is the only predictor readily amenable to change. The aspects of ALS clearly associated with decreased trauma death rates should be identified and, if possible, undergo widespread implementation.
Adult↗
Thirty-day postoperative death rate at an academic medical center.
OBJECTIVE: To improve understanding of perioperative deaths at an academic medical center. SUMMARY BACKGROUND DATA: Because published data have typically focused on specific patient populations, diagnoses, or procedures, there are few data regarding surgical deaths and complications in institutional or regional studies. Specifically, surgical adverse events and errors are generally not studied comprehensively. This limits the overall understanding of complications and deaths. METHODS: Data from all operations performed in the main operating suite of the University of Virginia Health Sciences Center from January 1 to June 30, 1999, were compared with state death records to gain a dataset of patients dying within 30 days of surgery. All clinical records from patients who died were screened for adverse events and subsequently reviewed by three surgeons who identified adverse events and errors and performed comparisons with survivors. RESULTS: One hundred nineteen deaths followed 7,379 operations performed on 6,296 patients, yielding a patient death rate of 1.9%. Patients dying within 30 days of surgery were older and had higher American Society of Anesthesiologists scores. Of 119 deaths, 86 (72.3%) were attributable to the patient's primary disease. Twenty-three patient deaths (19.3% of all deaths, 0.37% of all patients) could not be attributed to the patient's primary disease and thus were suspicious for an adverse event (AE) as the cause of the death. Of the 23 deaths suspicious for AE, 15 (12.6% of all deaths, and 65.2% of AE deaths) followed an error in care and thus were classified as potentially preventable, affecting 0.24% of the study population. CONCLUSIONS: Overall, the 30-day postoperative death rate was low in the total surgical population at an academic medical center. Errors and AEs were associated with 12.6% and 19.3% of deaths, respectively. Retrospective review inadequately characterized the nature of AEs and failed to determine causality. Prospective audits of outcomes will enhance our understanding of surgical AEs.
Academic Medical Centers↗
Rethinking the Hispanic paradox: death rates and life expectancy for US non-Hispanic White and Hispanic populations.
OBJECTIVES: We examined the "Hispanic paradox," whereby persons of Hispanic origin seemed to experience lower mortality than the non-Hispanic White population. This paradox coincided with a change from the classification of deaths and population by Spanish surname to the use of Hispanic-origin questions in the census and vital statistics. METHODS: To estimate US Hispanic and non-Hispanic White mortality, we applied a familiar relation between death rates for population subgroups to Hispanic and non-Hispanic White population death rates. We calculated age-specific death rates for the Hispanic population and the non-Hispanic White population and computed life tables for each. Result. For Texas between 1980 (surname) and 1990 (origin), the change in Hispanic deaths in persons aged 65 years or older was only half as great as the change in population size, implying a relative omission of 15% to 20% of deaths. By a different approach, the life tables for the US Hispanic and non-Hispanic White populations pointed to a similar omission. CONCLUSIONS: There is no "Hispanic paradox." The Hispanic paradox described in past research derives from inconsistencies in counts of Hispanic-origin deaths and populations.
Age Factors↗
Death rates from ischemic heart disease in women with a history of hypertension in pregnancy.
BACKGROUND: Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population-based study with a long follow-up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated. METHODS: All 7543 case records at the main maternity hospital in Iceland during 1931-1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups. RESULTS: Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR = 1.20; 95% CI 1.01-1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05-2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11-6.12) and those with preeclampsia (RR = 1.90; 95% CI 1.02-3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19-3.55; p = 0.01). CONCLUSION: There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the general population.
Adult↗
Risk-adjusted in-hospital death rates for peer hospitals in rural and urban regions.
The purpose of this research project was to compare inpatient mortality rates for rural hospitals with mortality rates of urban hospitals of given sizes and ranges of service. Statistical adjustments for risk were made in the probability of death during hospitalization for 43,000 patients across 166 hospitals by age, gender, principal diagnosis, principal surgical procedure, characteristics of the secondary diagnoses, and whether or not cancer was a secondary diagnosis. Eighty-three small hospitals that had a relatively unspecialized range of services constituted the study group. Patient characteristics of this study group were moderately representative of the national population. A standardized score was calculated for each hospital using a formula based on the actual hospital death rate and the death rate expected for a given hospital with patients of the same demographic and medical characteristics. Patients admitted to hospitals in nonmetropolitan areas had a mortality rate of 0.41 percent compared with a mortality rate of 0.66 percent in peer hospitals in metropolitan areas. After mortality rates were risk-adjusted and converted to z scores, nonmetropolitan areas had an average z of +0.16, and metropolitan areas had an average z of -0.25, where positive z scores reflect a lower-than-average adjusted mortality rate. The metropolitan-nonmetropolitan (urban-rural) difference was not statistically significant, but it is meaningful in that rural hospitals tended to have a lower adjusted mortality rate than urban hospitals of the same size and type, indicating that rural hospitals had the same or lower adjusted mortality rates. The possibility of urban hospitals having riskier patients was minimized but could not be definitively ruled out. Taken together with other studies, the data are consistent with the view that small rural hospitals generally make appropriate transfer decisions for severely ill patients and provide quality care for retained patients.
Adolescent↗
Hospital admissions and death rates from asthma in Kuwait during pre- and post-Gulf War periods.
BACKGROUND: The aim of the present study is to compare hospital admissions and death rates from asthma between pre (1987 to 1989)- and post (1992 to 1994)-Gulf War periods. METHODS: Data on annual hospital admissions by nationality and age, per International Statistical Classification of Diseases 493, were collected from the Health Statistics Department, Ministry of Health, Kuwait, and were analyzed with population data from the Annual Statistical Reports, Ministry of Planning, Kuwait. RESULTS: A total of 12,113 patients with asthma were admitted to various hospitals in Kuwait during the pre-Gulf War period compared with 9,771 patients during the post-Gulf War period. The average annual admissions rates per 100,000, people were 205 and 217, respectively, for the pre- and postwar periods. Total number of admissions showed an increase among Kuwaiti nationals during the study period. There were 95 deaths during the prewar period compared with 72 deaths during the postwar period. The mean annual death rates per 100,000 people were 1.60 and 1.59 respectively, for the pre- and post-Gulf War periods. CONCLUSIONS: This study did not show any statistically significant differences in either hospital admissions for or death rates attributable to asthma in the pre- and post-Gulf War periods in Kuwait. However, the number of hospital admissions in young adult Kuwaiti nationals increased. This study suggests hospital admissions and deaths from asthma did not increase after the invasion of Kuwait.
Adolescent↗
The diet and all-causes death rate in the Seven Countries Study.
Among 12 763 men aged 0-59, 1512 died in ten years, 413 from coronary heart disease. The 16 cohorts differed in all-causes as well as in coronary death rate. Those differences were not related to cohort differences in age, relative weight, activity, smoking habits, or percentage calories from total proteins or fats in the diet but were related to differences in blood-pressure, serum cholesterol, and percentage calories from saturated fatty acids. The correlation with saturates was r = 0.47 for all-causes, 4 = 0.84 for coronary death rate. The all-causes death variables were controlled in multiple regression. Inclusion of percentage calories from saturates, mono-enes, and polyunsaturates in multiple regression gave multiple R = 0.71 for all-cause deaths but not better discrimination for coronary deaths. Non-coronary death rate was not significantly related to the diet. Both mean blood-pressure and serum cholesterol were correlated with saturates is explained by inter-correlation of blood-pressure with saturates is explained by inter-correlation between blood-pressure and cholesterol. The findings do not prove that saturates in the diet cause increased mortality but are consistent with the hypothesis that risk of early death is increased by diet saturates in populations in which coronary disease is a major death cause. There is no support for the suggestion that the advantage for coronary disease of a diet restricted in saturated fats may be offset by increased non-coronary mortality.
Adult↗
Metastatic melanoma death rates by anatomic site after proton beam irradiation for uveal melanoma.
BACKGROUND: Ciliary body location is an established prognostic factor for metastasis-related death from uveal melanoma. We evaluated alternative approaches for classifying this covariate when constructing predictive models of patient survival. METHODS AND DESIGN: The analyses were based on a consecutive series of 1848 primary choroidal and/or ciliary body melanoma patients treated with proton beam irradiation (70 cobalt gray equivalent in 5 fractions) at the Harvard Cyclotron Laboratory, Boston, Mass, between July 1975 and December 1995. For each patient, the anatomic site of the tumor was classified according to an estimate of the proportion of the tumor base lying anterior to the ora serrata. Using proportional hazards regression, we estimated relative risk ratios and death rates from melanoma metastasis according to the extent of ciliary body involvement. All estimates were adjusted for other established prognostic factors. RESULTS: Patients were followed up through April 30, 1998; none were lost to follow-up. Of 1848 patients analyzed, 378 died of melanoma metastasis. The median follow-up period among survivors was 9.5 years. Ciliary body origin (>50% of tumor base anterior to the ora serrata) was positively associated with tumor pigmentation (P<.001), tumor height (P<.001), and extrascleral extension of the tumor (P<.001). Compared with tumors involving only the choroid, melanoma-associated death rates increased with the proportion of the tumor base lying within the ciliary body (P =. 006); the multivariate-adjusted relative risk ratio for greater than 75% involvement was 2.30 (95% confidence interval [CI], 1.26-4.23). The covariate-adjusted 5-year death rates for ciliary body origin and choroidal origin were 15.9% (95% CI, 11.3%-21.2%) and 9.8% (95% CI, 8.3%-11.7%), respectively. CONCLUSION: Patients with melanomas of presumed ciliary body origin seem to be subject to a higher risk of death resulting from melanoma metastasis. Arch Ophthalmol. 2000;118:1066-1070
Boston↗
Long-term Death Rates, West Nile virus epidemic, Israel, 2000.
We studied the 2-year death rate of 246 adults discharged from hospital after experiencing acute West Nile Virus infection in Israel during 2000. The age- and sex-adjusted death rates were significantly higher than in the general population. This excess was greater for men. Significant adverse prognostic factors were age, male sex, diabetes mellitus, and dementia.
Aged↗
[Estimation of mortality from census survival rates and consequent estimates of birth and death rates: 1975-1980 in Korea case].
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Aged↗
Indirect estimates of lung cancer death rates in Italy not attributable to active smoking.
We used a model, originally applied in the context of occupational cohort studies to evaluate confounding from smoking, to estimate lung cancer death rates in the Italian population not attributable to active smoking (background rates). Relevant parameters were the percentages of current and former smokers in the population, as derived from national interview surveys, and rate ratios for lung cancer and smoking. We studied differences over time (1956-1958 to 1987-1989) and place (urban/rural) in the background lung cancer death rates while allowing for changes in the average daily amount of tobacco consumption and in duration of smoking. We applied two functions proposed by Whittemore to obtain rate ratios for smokers: one assumes a linear relation between cumulative number of cigarettes smoked and lung cancer death rates; the other is closer to the multistage carcinogenesis theory. All our calculations indicate that the estimated background rates increased in Italy from the period 1956-1958 to the period 1987-1989; the increase was stronger in males than in females. In 1980-1982, higher background rates were observed in heavily urbanized areas than in rural areas. The results did not change when we considered cohort effects in smoking prevalence and when the key parameters were perturbed in a sensitivity analysis. It appears that factors other than smoking play an important role in causing lung cancer in Italy.
Adult↗
[Some features of the death rate among the population of the Ukraine territory steppes in the Bronze Age (based on archeological data)].
"The Bronze Age in the territory of the Ukraine has been studied as to peculiarities of the population death-rate in steppe areas. The first successes in the economy of production led first of all to prolongation of...life, while a high level of the early death-rate among women was a result of the generative death-rate and treatment of women under patriarchy." (SUMMARY IN ENG)
Cause of Death↗
Pharmacist-provided anticoagulation management in United States hospitals: death rates, length of stay, Medicare charges, bleeding complications, and transfusions.
We explored the associations between pharmacist-provided anticoagulation management in hospitalized Medicare patients and several major heath care outcomes: death rate, length of stay, Medicare charges, bleeding complications, and transfusions. Using the 1995 National Clinical Pharmacy Services database and the 1995 Medicare database for hospitals, data were retrieved for 717,396 Medicare patients treated in 955 hospitals for conditions requiring anticoagulant therapy. In hospitals without pharmacist-provided heparin management, death rates were 11.41% higher (chi2 (1) = 122.84, p<0.0001), length of stay was 10.05% higher (Mann-Whitney U test = 40039529342, p<0.0001), Medicare charges were 6.60% higher (U = 41004749266, p<0.0001), bleeding complications were 3.1% higher (chi2 (1) = 10.996, p=0.0009) and the transfusion rate for bleeding complications was 5.47% higher (chi2 (1) = 11.24, p=0.0008) than in hospitals with pharmacist-provided heparin management. In hospitals without pharmacist-provided warfarin management, death rates were 6.20% higher (chi2 (1) = 19.20, p<0.0001), length of stay was 5.86% higher (U = 25730993838, p<0.0001), Medicare charges were 2.16% higher (U = 259955112970, p<0.0001), bleeding complications were 8.09% higher (chi2 (1) = 49.259, p<0.0001), and the transfusion rate for bleeding complications was 22.49% higher (chi2 (1) = 78.68, p<0.0001). Study hospitals without pharmacist-provided heparin management had 4664 more deaths, 494,855 more patient-days, 145 more patients with bleeding complications, and $651,274,844 more in patient charges; 9784 more units of whole blood were used in patients requiring transfusions for bleeding complications. Hospitals without pharmacist-provided warfarin management had 2786 more deaths, 316,589 more patient-days, 429 more patients with bleeding complications, and $234,275,490 more in patient charges; 8991 more units of whole blood were used in patients requiring transfusions for bleeding complications. The implications of these findings are significant for the health care system, especially considering that the study population represents 28.25% of hospitalized Medicare patients who should receive anticoagulants, and that total Medicare admissions represent 35.02% of total admissions to United States hospitals.
Anticoagulants↗
Changes in water hardness and cardiovascular death rates.
Ten years ago Crawford, Gardner and Morris reported that changes in cardiovascular death rates between 1951 and 1961 had been associated with changes in the hardness of water supplies. That study has been critically reviewed but after amendments to method and data its overall conclusion is upheld. New results based on changes that have taken place in water hardness and in cardiovascular death rates between 1961 and 1971 in the county boroughs of England and Wales indicate a significant trend for men, in the direction of decreasing cardiovascular mortality with increasing hardness, but no trend for women. The trend in male mortality appears to be specific to cardiovascular disease. The results are similar to those of the earlier study and support the hypothesis of a weak causal relationship between the hardness of drinking water and mortality from cardiovascular disease.
Aged↗
[Prehospital death rate in acute myocardial infarction].
The aim of the study was the analysis of prehospital death rate caused by AMI depending on sex, age and place of habitation in an agricultural-industrial region. Prehospital death rate resulting from AMI reached 34.6% (32.8% men and 39.3% women). 30.4% of patients died before obtaining medical help. The incidence of deaths increased with the more advanced age (until 70 was between 20-25% whilst, over 70 as high as 62-94%).
Adult↗