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PubMedDate not supplied

[Factors determining infant mortality in Spain].

We introduce an ecological research for Spain between the 1975 and 1979, trying to explain the variation of childhood mortality. The social-economical factor had an important weight, as the disposable familiar rent (R2 = 0.44) and the per capita rent, while the health factors had a least important influence. From this last group, the health resources utilization were the most important, as the consultation per habitant (partial regression coefficient -0.15 and -0.14 in 1977 and 1978 respectively) and the surgery activities. Every this reflect a country in change.

Ecology↗
PubMed1993

T-cryptantigen determination affects mortality in necrotizing enterocolitis.

Testing of infants suspected of having necrotizing enterocolitis for evidence of exposure of the Thomsen-Friedenreich cryptantigen (TCA) has been advocated, because patients with TCA exposure can have severe hemolytic reactions when undergoing transfusion with plasma containing blood products. We compared 62 patients who were managed with knowledge of TCA exposure status during a four year period with 66 patients who were not screened during a comparable four year period. Evidence of hemolysis after blood transfusion occurred significantly more frequently in patients who were not screened (42 versus 15 percent, p < 0.05) and there was significantly greater mortality (18.0 versus 4.5 percent, p < 0.05) in the group that was not screened. These findings suggest that screening for TCA exposure is not only of diagnostic and prognostic value in necrotizing enterocolitis, but is important for patient management and outcome.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1985

Factors influencing maternal survival in ruptured uterus.

Ruptured uterus continues to be a common obstetric hazard in under developed countries. The commonest cause is spontaneous rupture from obstructed labor in the multipara. There was not a single rupture in the primipara. Rupture following previous cesarean section scar is also common. The most effective way of management is to correct fluid and blood loss followed by laparotomy and subtotal hysterectomy. This method gave a lower mortality than either repair and sterilization or total hysterectomy. Adequate pre-operative resuscitation and time interval between rupture and operation also influences mortality rate. The experience of the surgeon is another vital factor in determining mortality rate.

Adolescent↗
PubMed2006

Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

OBJECTIVES: To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. METHODS: We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. RESULTS: Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. CONCLUSIONS: National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

Africa↗
PubMed1991

Parental education and child mortality in Burundi.

This paper examines the relationship between parental education and child mortality in Burundi using data collected in the 1987 Demographic and Health Survey. Proportional hazards models are estimated to examine this relationship, while holding constant other known child mortality determinants. Parental education proves to be a key factor in explaining differences in child mortality, the effect of maternal education being particularly strong compared to paternal education.

Birth Order↗
PubMed2007

Cancer mortality trends in the Umbria region of Italy 1978-2004: a joinpoint regression analysis.

BACKGROUND: The aim of the present paper was to analyse cancer mortality in the Umbria region, from 1978 to 2004. Mortality trends depend on a number of factors including exposures, health system interventions, and possibly artefact (e.g. classification change, variations of data completeness). Descriptive data on mortality only allow for generation of hypotheses to explain observed trends. Some clues on the respective role of possible mortality determinants may be found comparing mortality with incidence and survival data. METHODS: Mortality data for the periods 1978-1993 and 1994-2004 were supplied by the National Institute of Statistics (ISTAT) and the Regional Causes of Death Registry (ReNCaM) respectively. Sex and site-specific mortality time trends were analysed by the "joinpoint regression" method. RESULTS: For all sites combined, in both sexes, the standardised rate was first increasing before the end of the eighties and decreasing thereafter. Gastric cancer mortality showed a different trend by gender; that is the rate constantly decreased over the period among females while, for males, it was first increasing up to 1985 and decreasing thereafter. Liver cancer trend showed a pattern similar to gastric cancer. Large bowel cancer showed a gender specific trend, that is it was increasing among males and stable among females. Also lung cancer mortality varied by gender: it started to decline after 1989 among males but was steadily increasing over the study period among women. A decreasing trend for female breast cancer mortality began in 1994. Prostate cancer mortality trend is the only one showing two significant joinpoints: mortality decreased up to 1990, then it increased up to 1998 and, finally, was decreasing. CONCLUSION: Overall cancer mortality was decreasing in both sexes in Umbria and this favourable trend will probably continue and further improve since population screening against breast, cervix, and large bowel cancers were recently introduced. Besides gastric cancer, tobacco-related cancers and prostate cancer mainly contributed to mortality reduction in males, whereas breast cancer mainly contributed to declining mortality in females.

Breast Neoplasms↗
PubMed2002

[Care of critically-ill children in Asturias (Spain): characteristics and effectiveness].

OBJECTIVE: To describe the work performed in the Pediatric Intensive Care Unit of the Hospital Central de Asturias (Spain) in its first 5 years and to assess the effectiveness of the care provided. METHODS: A prospective study of the characteristics of critically-ill children admitted from 1996 to 2000 was performed. Effectiveness was defined as the ratio of observed to expected mortality, determined by pediatric risk of mortality (PRISM) score calculated 24 hours after admission. RESULTS: The median age of critically-ill children was 38 months and the mean length of stay was 6.8 days. Forty percent of the patients were transferred from other hospitals in Asturias and Leon. The most frequent causes of admission were respiratory, neurological and infectious diseases, and trauma. Overall mortality was 4.3 %. Over the years the severity of the patients increased with a consequent rise in mean length of stay, use of central venous access and mechanical ventilation. Forty-two percent of deaths were expected. The effectiveness of care was high among high-risk patients, among those with respiratory and metabolic diseases and in the postoperative period but was low among patients with hematologic and gastrointestinal diseases. Effectiveness increased over time. CONCLUSIONS: Studies analyzing pediatric intensive care units are useful for assessing and improving the effectiveness of care in these centers.

Catchment Area, Health↗
PubMedDate not supplied

[Mortality risk factors in critical surgical patients].

OBJECTIVE: To determine mortality risk factors for critically ill postoperative patients. PATIENTS: Two hundred eleven patients undergoing any type of surgery admitted to the intensive care unit (ICU) over a period of one year were enrolled. METHOD: We performed a cross-sectional study that was retrospective for pre- and intraoperative observations and prospective for ICU observations. A univariate analysis was performed and relative risk (95% CI) was calculated. Multivariate analysis was also performed and the adjusted odds ratio calculated (95% CI). The end point of measurement was death in the ICU. RESULTS: The independent risk factors for mortality were age 60 years (OR: 2.8; 95% CI 1.36-5.09), physical status ASA-V (OR: 9.66; 95% CI 5.62-14.31), intracranial surgery to treat severe head injury (OR: 5.33; 95% CI 3.08-9.47), hemorrhagic shock during surgery (OR: 5.20; 95% CI 4.16-8.29), arterial hypotension during surgery (OR: 4.0; 95% CI 2.78-11.65), APACHE III score upon admission to the ICU (OR: 9.29; 95% CI 3.62-21.38), multiple organ dysfunction syndrome (OR: 7.96; 95% CI 3.73-13.92), and cardiopulmonary arrest in the ICU (OR: 5.85; 95% CI 2.21-10.43). The APACHE III score demonstrated high sensitivity (87%) and positive predictive value (96%). CONCLUSIONS: Surgical patients in critical condition continue to account for a large number of admissions to and death in the ICU. The variables analyzed were sufficient to explain patient outcome, such that risk factors for mortality in surgical patients admitted to the ICU could be determined.

Adult↗
PubMed2000

Mortality rates and causes of death among emaciated cats.

OBJECTIVE: To determine mortality rates and causes of death for thin (i.e., lean or emaciated) cats and, if mortality rates were high, to determine factors associated with risk that cats would be thin. DESIGN: Cohort study. ANIMALS: 1,138 cats examined at 27 private veterinary practices in the northeastern United States. PROCEDURE: Body condition of the cats was scored (emaciated, lean, optimally lean, optimal, heavy, obese) between 1991 and 1992. Follow-up information on whether cats had developed any illnesses, whether cats had died, and, if cats had died, cause of death was obtained between 1994 and 1996. Mortality risk for emaciated cats was estimated, using cats in optimal condition as the reference group. RESULTS: Survival curves for emaciated cats were significantly lower than those for cats of other body conditions. Compared with cats in optimal condition, emaciated cats were 4.4 times as likely to die during the follow-up period. However, after adjusting for age and excluding cats that died within 1 year after body condition was scored, emaciated cats were no longer significantly more likely to die. Emaciated cats were more likely to die of an unknown cause than were cats of optimal condition. Risk factors for emaciated body condition included preexisting illness, age, and Siamese breed. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that emaciated cats had a significantly higher risk of death, compared with cats in optimal body condition. Serious illness and advancing age accounted for much, and perhaps all, of this increased risk of death.

Age Factors↗
PubMed1992

Coronary artery disease is the major determinant of excess mortality in patients with insulin-dependent diabetes mellitus and persistent proteinuria.

The goal of this review was to assess the magnitude of coronary artery disease (CAD) mortality and its determinants in insulin-dependent diabetes mellitus (IDDM) patients with persistent proteinuria. By reanalyzing data from two previously published studies of patients with nephropathy, it was found that these patients had extremely high CAD mortality rates in comparison with IDDM patients without proteinuria, but only after the age of 35 yr. In addition, the risk of CAD death was associated with high serum cholesterol levels but was unrelated to systemic blood pressure, smoking habits, and obesity. Further studies of the determinants of CAD in patients with IDDM and proteinuria are urgently needed. Except for efforts to lower serum cholesterol, it is not known whether any other measure can be undertaken to reduce the extremely high mortality due to CAD that afflicts IDDM patients with persistent proteinuria, in particular those patients whose renal failure might have been "successfully" postponed by antihypertensive therapy.

Adult↗
PubMed1987

Measurement of mortality from neonatal tetanus in Burma.

Surveys to determine mortality from neonatal tetanus were conducted in March and April 1985 in accessible areas of Burma, where pregnant women had been immunized with tetanus toxoid and, for comparison, also in areas where such immunization had not been given. Neonatal mortality rates were three times greater in areas where tetanus toxoid immunization had only recently or had not yet been introduced by the national expanded programme on immunization. Analysis of the data indicates that the impact on reduction of neonatal mortality from tetanus of three interventions (immunization of pregnant women with tetanus toxoid; delivery in hospital; or birth at home attended by a trained health worker) was greatest for immunization.

Health Surveys↗