scholarly journals P099: Extending the trimodal distribution of death; trauma patients die at increased rates after discharge. Linking trauma registry data to vital statistics and hospital datasets identifies opportunities to save life

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S100-S100
Author(s):  
J. French ◽  
C. Somayaji ◽  
D. Dutton ◽  
S. Benjamin ◽  
P. Atkinson
Keyword(s):  
Mortality Rate ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Trauma Registry ◽  
Vital Statistics ◽  
Trauma Patients ◽  
Age Group ◽  
Post Discharge ◽  
One Year

Introduction: The New Brunswick Trauma Registry is a database of injury admissions from eight hospitals throughout the province. Data tracks individuals in-hospital. By linking this information with vital statistics, we are able to observe outcomes post-discharge and can model health outcomes for participants. We want to know how outcomes for trauma patients compare with the general population post discharge. Methods: Using data from 2014-15, we followed over 2100 trauma registry observations for one year and tracked mortality rate per 1,000 people by age-group. We also compared the outcomes of this group to all Discharge Abstract Database (DAD) entries in the province (circa. 7500 total). We tracked mortality in-hospital, at six months, and one year after discharge. We truncated age into groups aged 40-64, 65-84, and 85 or older. Results: In-hospital mortality among those in the trauma registry is approximately 20 per 1,000 people for those age 40-64, 50 per 1,000 people for those aged 65-84, and 150 per 1,000 people aged 85 or older. For the oldest age group this is in line with the expected population mortality rate, for the younger two groups these estimates are approximately 2-4 times higher than expected mortality. The mortality at six-month follow-up for both of the younger groups remains higher than expected. At one-year follow-up, the mortality for the 65-84 age group returns to the expected population baseline, but is higher for those age 40-64. Causes of death for those who die in hospital are injury for nearly 50% of observations. After discharge, neoplasms and heart disease are the most common causes of death. Trends from the DAD are similar, with lower mortality overall. Of note, cardiac causes of death account for nearly as many deaths in the 6 months after the injury in the 40 -64 age group as the injury itself. Conclusion: Mortality rates remain high upon discharge for up to a year later for some age groups. Causes of death are not injury-related. Some evidence suggests that the injury could have been related to the eventual cause of death (e.g., dementia), but questions remain about the possibility for trauma-mitigating care increasing the risk of mortality from comorbidities. For example, cardiac death, which is largely preventable, is a significant cause of death in the 40-64 age group after discharge. Including an assessment of Framingham risk factors as part of the patients rehabilitation prescription may reduce mortality.

scholarly journals Mortality in Emergency Services in a University Teaching Hospital: A Retrospective Study

2019 ◽  
Vol 41 (2) ◽  
pp. 17-20
Author(s):  
Tirtha Man Shrestha ◽  
Ramesh P Aacharya ◽  
Ram P Neupane ◽  
Bigyan Prajapati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Septic Shock ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Emergency Services ◽  
University Teaching ◽  
Chronic Obstructive ◽  
Age Group ◽  
Obstructive Pulmonary Disease

Introduction: Emergency services are the gateway between the community and hospital that provides 24-hour access for most needy patients in critical and emergency conditions. Mortality rate varies in emergency department across the world and even in different emergency units of the same hospital. This retrospective study was done in adult emergency services of a tertiary hospital to determine mortality rate and analyze causes of death. Methods: A retrospective observational study of mortality cases to analyze mortality rate and causes of death of patients for a period of 6 months between October 2017 to March 2018 was carried out in the adult emergency services of Tribhuvan University Teaching Hospital, Kathmandu. Data required were collected from copies of death certificates. Results: During the study period, a total of 128 patients died in emergency, accounting 0.5% of total patient. Male deaths (52.3%) were slightly higher compared to female deaths (47.7%). Age group 66-75 years had the highest (24.2%) of total mortalities in the emergency. The most common immediate cause of death was sepsis/septic shock (21.9%) followed by cardiopulmonary arrest, aspiration, respiratory failure, other causes of shock and poisoning. The commonest antecedent cause of death was attributed to respiratory causes. Similarly, the most common contributory cause of death was chronic obstructive pulmonary disease. Conclusion: Older age group is prone to the mortality risk. Sepsis/septic shock was the most common immediate cause of death. Pneumonia was the most common antecedent causes of death. Chronic obstructive pulmonary disease was the commonest contributory cause.

Mortality rate and causes of death in women with self-reported musculoskeletal pain: Results from a 17-year follow-up study

2013 ◽  
Vol 4 (2) ◽  
pp. 86-92 ◽  
Author(s):  
Anne K. Nitter ◽  
Karin Ø. Forseth
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Mortality Rate ◽  
Musculoskeletal Pain ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Sleep Problems ◽  
Whole Body ◽  
Risk Of Death

AabstractIntroductionChronic musculoskeletal pain represents a significant health problem among adults in Norway. The prevalence of chronic pain is reported to be 35-53% in cross sectional studies of both genders. For many years, it has been a common opinion among medical doctors that chronic pain may indeed reduce a person’s quality of life, but not affect life expectancy. However, over the previous two decades, reports about mortality and cause of death in individuals with chronic pain have been published. So far, several studies conclude that there is an increased mortality in patients with chronic pain, but it is not clear what causes this. Increased occurrences of cardio-vascular death or cancer death have been reported in some studies, but not verified in other studies.Aims of the studyThe aims of this study were to estimate the mortality rate in females with different extent of pain, to identify potential risk factors for death and to investigate if the causes of death differ according to prior reported pain.MethodsThis is a prospective population-based study of all women between 20 and 50 years registered in Arendal, Norway, in 1989 (N = 2498 individuals). At follow-up in 2007, 2261 living females were retraced, 89 had died.All subjects received a questionnaire containing questions about chronic pain (pain ≥ 3 months duration in muscles, joints, back or the whole body) as well as 13 sub-questions about pain-modulating factors, non-specific health complaints and sleep problems, by mail in 1990, 1995 and 2007. Only subjects who answered the questionnaire in 1990 were included in the analyses. Of the deceased, 71 had answered the questionnaire in 1990.A multivariate model for cox regression analysis was used in order to clarify if chronic pain, sleep problems, feeling anxious, frightened or nervous and number of unspecific health were risk factors for death.The causes of death of 87 of the deceased individuals were obtained by linking the ID-number with the Norwegian Cause of Death Registry.ResultsThe ratio of deceased responders was 2% (14/870) among those with no pain versus 5% (57/1168) among those with chronic pain at baseline. When separating into chronic regional pain and chronic widespread pain, the mortality rate was respectively 4% and 8% in the different groups. Age adjusted hazard ratio for mortality rate in individuals with initially chronic pain was [HR 2.5 (CI 1.4–4.5)] compared to pain free individuals. In the multivariate analysis, having chronic pain [HR 2.1 (1.1–4.2)] and feeling anxious, frightened or nervous [HR 3.2 (1.8–5.6)] were associated with increased risk of death. There was no difference in death from cardiovascular disease or malignancies between the groups of pain free individuals vs. the group of individuals with chronic pain.ConclusionThe mortality rate was significantly higher for individuals with chronic pain compared to pain free individuals, adjusted for age. In addition, feeling anxious, frightened or nervous were risk factors for death. There was an increase in all-cause mortality.

Causes of Death in Schizophrenia and Manic-Depression

1980 ◽  
Vol 136 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Ming T. Tsuang ◽  
Robert F. Woolson ◽  
Jerome A. Fleming
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Statistical Significance ◽  
Circulatory System ◽  
Vital Statistics ◽  
Significant Excess ◽  
Expected Number ◽  
Time Period ◽  
Depressive Patients

SummaryCauses of death were studied in a cohort of 200 schizophrenic, 100 manic, and 225 depressive patients who were followed in a historical prospective study. These patients were admitted between 1934 and 1944 and were studied 30 to 40 years later. Five cause of death categories were considered in this analysis: (1) unnatural deaths, (2) neoplasms, (3) diseases of the circulatory system, (4) infective and parasitic diseases, and (5) other causes. For each cause of death, the expected number of deaths was calculated from vital statistics for the State of Iowa for the time period of follow-up. Observed numbers of deaths were contrasted with expected numbers of deaths to assess statistical significance for each diagnostic group. There was a significant excess of unnatural deaths in all diagnostic groups in both sexes, with the exception of female manics. This group, however, did show a significant excess of circulatory system deaths. Both male and female schizophrenics showed a substantial excess of infective disorder deaths.

Good survival rates in systemic lupus erythematosus in southern Sweden, while the mortality rate remains increased compared with the population

Lupus ◽  
2019 ◽  
Vol 28 (12) ◽  
pp. 1488-1494
Author(s):  
R F Ingvarsson ◽  
A J Landgren ◽  
A A Bengtsson ◽  
A Jönsen
Keyword(s):  
Mortality Rate ◽  
Cause Of Death ◽  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Standardized Mortality Ratio ◽  
Southern Sweden ◽  
Mortality Ratio ◽  
Over Time ◽  
Observation Period

Objective To ascertain the mortality rate and causes of death in patients with systemic lupus erythematosus (SLE) within a defined region in southern Sweden during the time period 1981–2014 and determine whether these have changed over time. Methods In 1981, a prospective observation study of patients with SLE was initiated in southern Sweden. All incident SLE patients within a defined geographic area were identified using previously validated methods including diagnosis and immunology registers. Patients with a confirmed SLE diagnosis were then followed prospectively at the Department of Rheumatology in Lund. Clinical data was collected at regular visits. Patients were recruited from 1981 to 2006 and followed until 2014. The patient cohort was split into two groups based on the year of diagnosis to determine secular trends. Causes of death were retrieved from medical records and from the cause of death registry at The National Board of Health and Welfare in Sweden. Results In all, 175 patients were diagnosed with SLE during the study period. A total of 60 deaths occurred during a total of 3053 years of follow-up. In the first half of the study inclusion period 46 patients died, compared with 14 in the latter. The majority of patients (51.7%) died of cardiovascular disease. Infections caused 15% of the deaths and malignancy was the cause of death in 13.3% of patients. SLE was the main cause of death for 6.7% of the patients and a contributing factor for half of the patients. Standardized mortality ratio was increased in patients by a factor of 2.5 compared with the general population. Deaths occurred at an even rate throughout the whole observation period. No significant difference in standardized mortality ratio was observed between genders but was increased in older female patients. Furthermore, secular mortality trends were not identified. Conclusions In this long-term epidemiologic follow-up study of incident SLE, we report a substantially raised mortality rate amongst SLE patients compared with the general population. The mortality rates have not changed significantly during the observation period that spanned three decades. The main cause of death was cardiovascular disease and this finding was consistent over time.

scholarly journals Characterizing Fentanyl-Associated Mortality using the Literal Causes of Death

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Brandon Ramsey ◽  
Heather Rubino ◽  
Janet J. Hamilton ◽  
David Atrubin
Keyword(s):  
Cause Of Death ◽  
Surveillance System ◽  
Causes Of Death ◽  
Vital Statistics ◽  
Free Text ◽  
Age Group ◽  
Mortality Trends ◽  
Death Record ◽  
Record Data ◽  
Icd 10

ObjectiveTo characterize fentanyl-associated mortality in Florida using freetext queries of the literal causes of death listed on death certificates.IntroductionIn October 2015, the Centers for Disease Control and Prevention(CDC) released health advisory #384 to inform people about increasesin fentanyl fatalities. Florida’s statewide syndromic surveillancesystem, Electronic Surveillance System for the Early Notification ofCommunity-based Epidemics (ESSENCE-FL), captures electronicdeath record data in near real time which allows for the monitoringof mortality trends across the state. One limitation of using deathrecord data for fentanyl surveillance is the lack of a fentanyl-specificoverdose ICD-10 code; however, the literal cause of death fields(“literals”) provide a level of detail that is rich enough to capturementions of fentanyl use. The “literals” are a free text field on thedeath certificate, recorded by a physician at the time of death anddetail the factors that led to the death. ESSENCE-FL has the benefitof not only receiving death record data in near real-time, but alsoreceiving the literal cause of death fields. This work analyzes trendsin fentanyl-associated mortality in Florida over time by using theliteral cause of death fields within death records data obtained fromESSENCE-FL.MethodsThe “literals” elements of Florida Vital Statistics mortality datafrom 2010 through 2015 accessed via ESSENCE-FL were queriedfor the term ^fent^. No necessary negations or extra term inclusionswere deemed necessary after looking at the records pulled with ^fent^alone. Deaths were analyzed by various demographic and geographicvariables to characterize this population in order to assess whichgroups are most heavily burdened by fentanyl-associated mortality.Population estimates by county for 2015 were obtained from the U.S.Census Bureau to calculate mortality rates. Language processing in RStudio was used to determine which other substances were commonlyreported when fentanyl was listed on the death certificate, in order toassess polydrug use and its impact on increased mortality.ResultsCompared to the number of fentanyl-associated mortalities in 2010(82), fentanyl-associated mortality in 2015 (599) was 6.5 times higherafter controlling for the natural increase in total mortality between2010 and 2015. Almost three-fourths of the deaths in 2015 were male(73%), which is higher than the proportion of male deaths in 2010(55%). The age group with the largest burden of fentanyl-associatedmortality was the 30 – 39 age group, with almost one-third of thedeaths in 2015 coming from this age group (31%) compared to only10% in 2010, a roughly 200% increase. Fentanyl-associated mortalitywas almost exclusive to people that are Caucasian, with 94% of thefentanyl-associated mortalities in 2015 occurring among Caucasians.Multi-drug use was also identified for those with fentanyl-associatedmortality. Mentions of other drugs were present in at least 10% of thedeaths. Some of the other drugs mentioned in the “literals” includedheroin, cocaine, and alprazolam. There was county variation in thenumber of fentanyl morality deaths ranging from 21.19 deaths per100,000 to 0.29 deaths per 100,000 residents. Two counties with thehighest rates were located adjacent to one another.ConclusionsHaving death record data readily available within the statesyndromic surveillance system is beneficial for rapid analysisof mortality trends and the analytic methods used for syndromicsurveillance can be applied to mortality data. Free text querying ofthe “literals” in the vital statistics death records data allowed forsurveillance of fentanyl-associated mortality, similar to methods usedfor querying emergency department chief complaint data. Althoughunderlying ICD-10 codes can lack detail about certain causes ofdeath, the “literals” provide a clearer picture as to what caused thedeath. The “literals” also make it possible to look at potential drugcombinations that may have increased risk of mortality, which willbe explored more thoroughly. Further work will explore other datasources for fentanyl usage and mortality trends, as well as examinepotential risk factors and confounders.

PUBLIC HEALTH

PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 343-347
Author(s):  
George M. Wheatley ◽  
Stephen A. Richardson
Keyword(s):  
Public Health ◽  
United States ◽  
Cause Of Death ◽  
United States Public Health ◽  
The United States ◽  
Vital Statistics ◽  
West Germany ◽  
Medical Attention ◽  
Age Group ◽  
Number Of Children

IN ALL COUNTRIES for which there are vital statistics, accidents are a major cause of death and disability among children. In countries where the food supply is adequate and infectious diseases have been brought under control, accidents have become the leading cause of death in the age group 1 to 19 years. For example, in such countries as Australia, Canada, Sweden, West Germany, and the United States, more than one-third of all deaths in this age group are caused by accidents. The number of children who are injured by accidents fan exceeds the number who are killed. Although no accurate international figures are available, the Morbidity Survey conducted by the United States Public Health Service indicates that in the United States, for every child under 15 killed by accident, 1,100 children are injured severely enough to require medical attention or to be restricted in their activity for at least a day.

scholarly journals Causes of Mortality in Older People With Intellectual Disability: Results From the HA-ID Study

2018 ◽  
Vol 123 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Alyt Oppewal ◽  
Josje D. Schoufour ◽  
Hanne J.K. van der Maarl ◽  
Heleen M. Evenhuis ◽  
Thessa I.M. Hilgenkamp ◽  
...  
Keyword(s):  
Older Adults ◽  
Intellectual Disability ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Circulatory System ◽  
Bacterial Diseases ◽  
Specific Mortality ◽  
Causes Of Mortality ◽  
Insight Into

Abstract We aim to provide insight into the cause-specific mortality of older adults with intellectual disability (ID), with and without Down syndrome (DS), and compare this to the general population. Immediate and primary cause of death were collected through medical files of 1,050 older adults with ID, 5 years after the start of the Healthy Ageing and Intellectual Disabilities (HA-ID) study. During the follow-up period, 207 (19.7%) participants died, of whom 54 (26.1%) had DS. Respiratory failure was the most common immediate cause of death (43.4%), followed by dehydration/malnutrition (20.8%), and cardiovascular diseases (9.4%). In adults with DS, the most common cause was respiratory disease (73.3%), infectious and bacterial diseases (4.4%), and diseases of the digestive system (4.4%). Diseases of the respiratory system also formed the largest group of primary causes of death (32.1%; 80.4% was due to pneumonia), followed by neoplasms (17.6%), and diseases of the circulatory system (8.2%). In adults with DS, the main primary cause was also respiratory diseases (51.1%), followed by dementia (22.2%).

scholarly journals Out Come of Threatened Abortion in a Series of 100 Cases in RMCH

1970 ◽  
Vol 18 (2) ◽  
pp. 76-79
Author(s):  
M Khanam ◽  
Nahid Yusuf ◽  
Fatema Ashraf
Keyword(s):  
Economic Condition ◽  
Preterm Labour ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Placenta Praevia ◽  
Age Group ◽  
Missed Abortion ◽  
Threatened Abortion ◽  
One Year

Threatened abortion is a clinical entity where the process of abortion has started but has not progressed to a state from which recovery is impossible1. The prognosis of threatened abortion is very unpredictable whatever method of treatment is employed either in hospital or at home. 100 cases of threatened abortion were studied in RMCH. Over one year of study it was found that abortion cases constituted about 34% of all gyneacological admission. Among them 12% of all abortion related admitted cases had threatened abortion. From the results it was evident that most of the cases were between 20-30 yrs. Age group (58%), 71% were multigravida, 80% were illiterate & low socio economic condition uneventfully & discharged by giving conservative management. In the rest abortion pregnancy was terminated either by inevitable abortion or missed abortion. Follow up data showed that among 46 cases of threatened abortion who readmitted in hospital, 26 cases had normal pregnancy out come, 2 cases developed IUD, 4 cases developed preterm labour, 12 cases had placenta praevia, 2 cases had IUGR & 2 cases had aboruptio placenta. So the conclusion of the study was first trimester vaginal bleeding is an independent risk factor for adverse obstetric out come that is directly proportional to the amount of bleeding.   doi: 10.3329/taj.v18i2.3170 TAJ 2005; 18(2): 76-79

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

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