scholarly journals PMS11 LONG-TERM MORTALITY RATES AFTER INCIDENT FRACTURES IN A POPULATION-BASED COHORT OF MEN AND WOMEN

2009 ◽  
Vol 12 (7) ◽  
pp. A435
Author(s):  
S Morin ◽  
M Azimaee ◽  
L Lix ◽  
C Metge ◽  
P Caetano ◽  
...  
2021 ◽  
Vol 9 ◽  
Author(s):  
Zhenkun Wang ◽  
Youzhen Hu ◽  
Fang Peng

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them.Methods: This population-based multiyear cross-sectional study of Chinese people aged 0–84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework.Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, −0.04 to 0.3%) per year for men and −0.71% (95% CI, −0.96 to −0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China.Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.


2007 ◽  
Vol 62 (3) ◽  
pp. 271-275 ◽  
Author(s):  
H. THEOBALD ◽  
P.E. WÄNDELL

2021 ◽  
Author(s):  
Milad Fahim ◽  
Lea M. Dijksman ◽  
Thijs A. Burghgraef ◽  
Paul B. van der Nat ◽  
Wouter J.M. Derksen ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tak Kyu Oh ◽  
Eun Sun Jang ◽  
In-Ae Song

AbstractWe aimed to investigate whether elevated liver enzymes in the adult population were associated with mortality due to infection. As a population-based cohort study, data from the National Health Insurance Service Health Screening Cohort were used. Adult individuals (aged ≥ 40 years) who underwent standardized medical examination between 2002 and 2003 were included, and infectious mortality was defined as mortality due to infection between 2004 and 2015. Aspartate transaminase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GTP), AST/ALT ratio, and dynamic AST/ALT ratio (dAAR) were included in multivariable Cox modeling. A total of 512,746 individuals were included in this study. Infectious mortality occurred in 2444 individuals (0.5%). In the multivariable model, moderate and severe elevation in AST was associated with 1.94-fold [hazard ratio (HR):1.94, 95% confidence interval (CI) 1.71–2.19; P < 0.001] and 3.93-fold (HR: 3.93, 95% CI 3.05–5.07; P < 0.001) higher infectious mortality respectively, compared with the normal AST group. Similar results were observed for moderate and severe elevation in ALT and mild, moderate, and severe elevation in γ-GTP. Additionally, a 1-point increase in the AST/ALT ratio and dAAR was associated with higher infection mortality. Elevated liver enzymes (AST, ALT, AST/ALT ratio, γ-GTP, and dAAR) were associated with increased infectious mortality.


2022 ◽  
Vol 104-B (1) ◽  
pp. 45-52
Author(s):  
Liam Zen Yapp ◽  
Nick D. Clement ◽  
Matthew Moran ◽  
Jon V. Clarke ◽  
A. Hamish R. W. Simpson ◽  
...  

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.


2012 ◽  
Vol 53 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Ellen L. Idler ◽  
David A. Boulifard ◽  
Richard J. Contrada

Marriage has long been linked to lower risk for adult mortality in population and clinical studies. In a regional sample of patients ( n = 569) undergoing cardiac surgery, we compared 5-year hazards of mortality for married persons with those of widowed, separated or divorced, and never married persons using data from medical records and psychosocial interviews. After adjusting for demographics and pre- and postsurgical health, unmarried persons had 1.90 times the hazard of mortality of married persons; the disaggregated widowed, never married, and divorced or separated groups had similar hazards, as did men and women. The adjusted hazard for immediate postsurgical mortality was 3.33; the adjusted hazard for long-term mortality was 1.71, and this was mediated by married persons’ lower smoking rates. The findings underscore the role of spouses (both male and female) in caregiving during health crises and the social control of health behaviors.


2016 ◽  
Vol 4 (1) ◽  
pp. 1-218 ◽  
Author(s):  
David Field ◽  
Elaine Boyle ◽  
Elizabeth Draper ◽  
Alun Evans ◽  
Samantha Johnson ◽  
...  

BackgroundOur aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity.ObjectiveTo undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates.DesignTwo interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies.SettingCohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester.Data sourcesFor stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies.Main outcome measuresDetailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies.ResultsThe deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs.ConclusionsHealth professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background.Future workFuture work could include studies to improve our understanding of how deprivation increases the risk of mortality and morbidity in early life and investigation of longer-term outcomes and interventions in at-risk LMPT infants to improve future attainment.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.


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