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At least 19 recordsLinked to original sources
PubMed2000

Attack rate, mortality and case fatality for acute myocardial infarction in Sweden during 1987-95. Results from the national AMI register in Sweden.

OBJECTIVE: To assess trends in attack rate, mortality and case-fatality of acute myocardial infarction (AMI) in Sweden. SETTING: All 303 324 Swedes discharged from hospitals, or deceased, with a diagnosis of AMI between 1987 and 1995. DESIGN: Analysis based on the National AMI Register in Sweden. The National AMI Register was assembled by linking the records of the National Hospital Discharge Register and the National Cause of Death Register in Sweden. MAIN OUTCOME MEASURES: Age-standardized attack rate, mortality and case fatality rates for AMI. RESULTS: Between 1987 and 1995, the age-standardized attack rate of AMI declined by 11% for men and 10% for women, whilst mortality from AMI decreased by 14% for both sexes. The decrease was most pronounced for men below the age of 64, with a reduction of 22% in attack rate and nearly 30% in mortality. There was no change over time in the case fatality rates on the date of attack, including also deaths outside hospital, whilst case fatality within 28 days decreased from 49 to 45% amongst men, and 45 to 42% amongst women. This reduction persisted over 1 year of follow-up. CONCLUSIONS: The decrease in attack rate of AMI in Sweden may be attributed both to changes in risk factors amongst the population and to improved medical intervention. The decline in case fatality rates indicates that improved treatment of patients with AMI has contributed to the reduction in mortality. However, the high, and essentially unchanged, proportion of deaths outside hospital stresses the importance of disease prevention.

Adult↗
PubMed1997

Declining autopsy rate in Sweden: a study of causes and consequences in Malmö, Sweden.

OBJECTIVE: In Sweden there has been a continuous decrease in the autopsy rate during the last 15-20 years. The autopsy rate in the city of Malmö has declined from 81% in 1984 to 34% in 1993. The intention of this study was to improve our understanding of the causes of the decline, and to assess its consequences with regard to cause of death surveillance and case retrieval in epidemiological and clinical research. DESIGN: A retrospective study. SETTING: The University Hospital in Malmö, a city in southern Sweden with 230000 inhabitants. SUBJECTS: All deceased in 1984 (2900) and 1993 (3198). Cancer incidence 1984 and 1993. MAIN OUTCOME MEASURES: Changes in autopsy rate in relation to age, sex, place of death and cause of death 1984 and 1993. Changes in the distribution of underlying causes of death in cases submitted and not submitted for a post mortem 1984 and 1993. Changes in cancer incidence and the number of incidentally-detected new tumours 1984 and 1993. RESULTS: Patients who died in nursing homes were less often sent for a post mortem than were patients who died at the hospital. From 1984 to 1993 the percentage of people dying in nursing homes increased from 1 to 29%. Care of the elderly has been reorganized, and the number of terminally ill patients who die in nursing homes has increased during the last 20 years in Sweden. This shift in place of death seems to be the single major explanation of the declining autopsy rate in Malmö. The overall autopsy rate in 1993 remained, however, lower than it was in 1984 when a shift in place of death was taken into account. During the period of study there was a decline in the autopsy rate at all departments within the hospital. The distribution of underlying causes of death according to the death certificates was similar in 1984 and in 1993. However, in cases not submitted for autopsy in 1993 there were greater proportions dying from pulmonary and circulatory diseases, respectively, than there were in 1984. The lower autopsy rate in 1993 was for several cancer sites also associated with a reduced number of new cancer cases. The percentage of tumours incidentally detected at autopsy went down in men from 40 to 19% and in women from 39 to 17%. CONCLUSION: Patients submitted for autopsy represented, with regard to age, sex, cause and place of death, a selected group of all deceased. The declining autopsy rate was associated with a difference in the distribution of underlying cause of death and of the incidence of cancer. It is concluded that the changes in the autopsy rate have to be taken into account in studies dealing with time trends of causes of death and incidence of cancer.

Adult↗
PubMed2001

Use of complementary and alternative medicine remedies in Sweden. A population-based longitudinal study within the northern Sweden MONICA Project. Multinational Monitoring of Trends and Determinants of Cardiovascular Disease.

OBJECTIVES: Previous studies have shown a high prevalence of users of complementary and alternative medicine (CAM) remedies in Anglo-Saxon countries. We have explored the use of CAM remedies in Sweden, its distribution in different population groups and time trends during the years 1990-99. DESIGN AND SUBJECTS: Within the framework of the population-based northern Sweden Multinational Monitoring of Trends and Determinants of Cardiovascular Disease (MONICA) Project, randomly selected 25-74-year-old participants in risk factor surveys performed in 1990, 1994 and 1999 responded to questions about their use of CAM remedies. The participation rate was 72%. RESULTS: Amongst 5794 respondents in the 1999 survey, 30.5% reported that they had taken a CAM product (vitamins, minerals or biological CAM remedy) in the preceding 2 weeks. Vitamins/minerals only had been taken by 11.7% and other CAM remedies (dominated by fish oil, ginseng and Q10) with or without vitamins/minerals by 18.8%. Use of CAM remedies was more frequent in women than in men and more frequent in people with high than with low level of education. The prevalence was unrelated to a history of severe cardiovascular disease or diabetes but significantly more common in subjects with poor self-perceived health, particularly so in women. During 1990-99, the use of CAM remedies increased, more in women than in men. CONCLUSIONS: The prevalence of CAM remedy use (other than vitamins and minerals) is high in Sweden. It has been increasing during the 1990s. Its use is particularly common in women, well-educated people and in those with poor self-perceived health.

Adult↗
PubMed1999

Surveillance of antibiotic resistance in ICUs in southeastern Sweden. ICU Study Group of the South East of Sweden.

BACKGROUND: A study was designed to assess a computer-based program for continuous registration of antibiotic resistance, statistics concerning severity of illness, and consumption of antibacterial drugs. METHODS: The frequency of antibiotic resistance among bacteria in eight ICUs in southeastern Sweden was investigated yearly from 1995 through 1997. The antibiotic consumption in the ICUs was registered as defined daily doses (DDD) and compared to severity of illness (APACHE-II scores). RESULTS: There was a statistically significant increase in ampicillin resistance among Enterococcus spp. between 1996 and 1997, which was due to a shift from Enterococcus faecalis to Enterococcus faecium. A high prevalence of resistance among coagulase-negative staphylococci to oxacillin (approximately 70%), ciprofloxacin (approximately 50%), fucidic acid (approximately 50%) and netilmicin (approximately 30%) was seen in all ICUs during the whole study period. There was a statistically significant increase in ciprofloxacin resistance among Escherichia coli and Enterococcus spp. The resistance among Enterobacter spp. to cefotaxime decreased but this change was not statistically significant. Efforts were made to avoid betalactam antibiotics, except carbapenems, for treatment of infections caused by Enterobacter spp. and the consumption of cephalosporins decreased whereas the consumption of carbapenems increased. The total antibiotic consumption decreased by 2.5% during the study period. There was no correlation between APACHE II scores and antibiotic consumption. CONCLUSIONS: Each ICU within a hospital ought to have a program for "on-line" antibiotic resistance surveillance of drugs used in that unit so that changes in empirical treatment can be made when there is an increase in antibiotic-resistant isolates within that unit.

APACHE↗
PubMed1998

Secular trends in social patterning of cardiovascular risk factor levels in Sweden. The Northern Sweden MONICA Study 1986-1994. Multinational Monitoring of Trends and Determinants in Cardiovascular Disease.

OBJECTIVES: In the Northern Sweden MONICA Study, levels of cardiovascular risk factors were determined in 1986, 1990 and 1994. The aim of this study was to assess the trends in cardiovascular risk factors, and to analyse the relationship between levels of risk factors and level of education. DESIGN: Cardiovascular risk factors were determined in cross-sectional population studies of randomly selected 25-64 year old men and women in 1986, 1990 and 1994 (a total of 4742 individuals). RESULTS: Throughout the years 1986 to 1994, cardiovascular risk factor levels showed a marked social pattern, generally being more favourable among people with a university education. Serum cholesterol levels declined in all educational groups, but blood pressure declined significantly only in women with a university education. Body mass index increased, most markedly in men with university and in women with a secondary school education. Prevalence of cigarette smoking decreased significantly in young men. It increased markedly in low-educated women so that the social gaps in smoking widened substantially over time. The improved level of education in the population at large was calculated to explain only a little of the risk factor changes between 1986 and 1994. CONCLUSIONS: Trends in risk factor levels in different educational groups have been more diverging for women than for men. The most marked change in risk factor levels has been the decline in total serum cholesterol for both men and women in all educational groups.

Adult↗
PubMed1992

Cardiovascular mortality and morbidity in seven counties in Sweden in relation to water hardness and geological settings. The project: myocardial infarction in mid-Sweden.

An east-west regional gradient in cardiovascular mortality was found within seven counties in mid-Sweden during the years 1969-1983. The mortality differences were of considerable magnitude for ischaemic heart disease (IHD) as well as for stroke. In previous reports, in which the distribution of risk factors among middle-aged men was presented, the moderate variation among the communities could not explain the mortality variation. Water hardness has previously been reported to be inversely related to cardiovascular mortality in several countries. In this paper, water samples from all 76 communities in seven counties were analysed in relation to mortality rates from IHD and stroke for men and women. Water hardness (Ca+Mg and other minor constituents), and the sulphate and bicarbonate concentrations of the drinking water were inversely related to IHD as well as stroke mortality. The water factors were also inversely related to non-fatal IHD even when account was taken of the age variation and the traditional risk factors as measured by a postal questionnaire. Variation of the water factors accounted for 41% of the variation in IHD mortality rate and 14% of the variation in stroke mortality rate over the 76 communities.

Aged↗
PubMed1992

Mortality of all incident cases of diabetes mellitus in Sweden diagnosed 1983-1987 at age 15-34 years. Diabetes Incidence Study in Sweden (DISS) Group.

From 1983 all incident cases of diabetes in the age group 15-34 years in Sweden have been recorded prospectively. The aim of the present study was to assess the mortality pattern of cases reported for 1983-87 and followed until the end of 1987. Eighteen deaths were identified by linkage to the national death register. When comparing the mortality in the cohort with Swedish males and females in general, an excess mortality was found in all the groups studied. It is, however, less pronounced if the analysis is restricted to those with Type 1 diabetes (standardized mortality ratio (SMR) and 95% confidence interval = 2.1; 0.8, 4.6), Type 2 diabetes (SMR = 4.8; 1.3, 12.3) or Type 1 + Type 2 (SMR = 2.7; 1.3, 5.0). Eight (44%) of the deaths were in patients with secondary diabetes, a diagnosis that applied to less than 3% of the cohort. Alcohol abuse was prevalent in six cases and suspected in another two. Hypoglycaemia was established as a cause of death in only one case but could not be excluded in a further six. Only one death was associated with ketoacidosis. No valid support for an increased risk of the 'dead in bed' syndrome was found. We suggest that diabetes was decisively important for the death in two cases and less important in 10. In the remaining six cases the existing documentation precludes a proper judgement.

Adolescent↗
PubMed1992

A longitudinal study on anthropometric and clinical development of Indian children adopted in Sweden. II. Growth, morbidity and development during two years after arrival in Sweden.

One hundred and fourteen consecutively recruited children adopted from India (60% girls) to Sweden were studied during 2 years after arrival, with examinations monthly the first 6 months and thereafter every 3 months. Sixty-two percent were below 1 year of age at arrival. There was a mean increase from -2.2 standard deviation scores (SDS) height/age to -0.7 SDS during the two years, and a similar development for weight/age, with no significant difference between boys and girls. The weight/height remained at around -0.8 throughout the study period. Those who had lowest height/age at arrival had the most marked catch-up, but remained smaller throughout the 2 years. The psychomotor development was initially delayed in nearly 30% of the children, mainly among those stunted and/or with very low weight at arrival. After 2 years the rate was at a level similar to Swedish children. In a sub-sample, birth weight was found to be correlated to subsequent height and weight development. Hepatitis B, salmonella, giardia lamblia, trichuris trichiura, ascaris and hymenolepis nana were still found in a small percentage after 2 years. Other morbidity was at the same level as in Swedish children. Adopted children who are stunted and/or have a very low weight at arrival should be followed up with special care, and infectious diseases found at arrival should be kept in mind for differential diagnosis at subsequent disease episodes.

Adoption↗
PubMed1989

Vascular surgery in southern Sweden--the first year experience of a vascular registry. Vascular Registry in Southern Sweden (VRISS).

A vascular registry was set up in southern Sweden covering all peripheral vascular procedures performed in a population of almost 2 million. During the first year 1569 procedures were registered including 30-day follow-up, making a frequency of 84 per 100,000 inhabitants with a considerable variation between counties, from 42 to 146 procedures per 100,000 inhabitants. The operations were performed by 127 different surgeons, but only nine surgeons performed more than 50 operations each. These surgeons participated in 52.6% of all procedures. The frequency of re-operation differed from 4.0 to 17.9% between hospitals. One month postoperatively 70% of the patients had returned home while 13.2% were still in hospital. Median length of stay was 8 days. Overall mortality was 7.9%. The outcome at 30 days for various procedures was comparable with that of other recent reports from specialised centres.

Adolescent↗