Multiple Sclerosis Mortality Rates in Canada, 1975-2009

ABSTRACTBackground: This study examined mortality due to multiple sclerosis (MS) in Canada, 1975-2009 to determine whether there has been a change in age at death relative to the general population and decrease in MS mortality rates. Methods: Mortality rates/100,000 population for MS and all causes were calculated using data derived from Statistics Canada, age-standardized to the 2006 population. Results: The average annual Canadian MS mortality rate, 1975-2009 was 1.23/100,000. Five-year rates for 1975-79, 1980-84, 1985-89, 1990-94, 1995-99, 2000-04, 2005-09 were: 1.16, 0.94, 1.01, 1.16, 1.30, 1.43, 1.33. Trend analysis showed mortality rates over the entire 35 years were stable (average annual percent change of less than one percent). The average annual 1975-2009 rates for females and males were 1.45 and 0.99. Five-year female rates were always higher than males. Regardless of gender, there was a decrease in MS mortality rates in the 0-39 age group and increases in the 60-69, 70-79, and 80+ groups over time. In contrast, there were decreases in all-cause mortality rates across each age group. The highest MS mortality rates for 1975-2009 were consistently in the 50-59 and 60-69 groups for both genders, while the highest all-cause mortality rates were in the 80+ group. Conclusions: Changes in the age distribution of MS mortality rates indicate a shift to later age at death, possibly due to improved health care. However MS patients remain disadvantaged relative to the general population and changes in age at death are not reflected in decreased mortality rates.

Download Full-text

Effect of healthcare fragmentation on breast, stomach, and colorectal cancer mortality in Colombia: A measurement estimated through administrative databases.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18808 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18808-e18808

Author(s):

Nicolás Rozo Agudelo ◽

Laura Estefania Saldaña Espinel ◽

Andres Felipe Patiño Benavidez ◽

Oscar Andres Gamboa Garay ◽

Giancarlo Buitrago

Keyword(s):

Colorectal Cancer ◽

Survival Time ◽

Cancer Mortality ◽

Age Distribution ◽

Mortality Rates ◽

Administrative Databases ◽

Primary Tumor Site ◽

All Cause Mortality ◽

Incident Cases ◽

Colorectal Cancer Mortality

e18808 Background: Fragmentation in healthcare leads to adverse outcomes in cancer patients. Currently there is no fragmentation measurement that has been acknowledged to reliably assess healthcare fragmentation across different health systems. We aimed to measure cancer healthcare fragmentation through administrative databases in Colombia and to calculate its effect on breast, stomach and colorectal cancer mortality. Methods: We conducted a cohort study based on health administrative databases from 2013 to 2017. We combined data from two Colombian national health databases (Capitation Payment Unit database and Vital Statistics from DANE). We developed an algorithm based on ICD-10 codes and oncological procedures to select incident cases of breast, stomach and colorectal cancer. To measure healthcare fragmentation, we identified the number of providers between the dates of the first and last registered services. For patients who died during observation we adjusted the number of providers for survival time in days, otherwise survival time was set to 31 december, 2017. We categorized fragmentation in quartiles and evaluated its effect on mortality rate by Kaplan Meier estimates. Results: We identified three cohorts of patients based on primary tumor site. Age distribution was similar in stomach and colorectal cancer. Fragmentation measured as a continuous variable has a non-parametric distribution in all cohorts. The median of follow-up time ranged between 2.4 to 4.4 years. All-cause mortality rates were highest in stomach cancer, lowest in breast cancer. When measured as quartiles, fragmentation has a consistent dose-response effect increasing all-cause mortality rates. Conclusions: Healthcare fragmentation can be measured through algorithms applied to administrative databases in Colombia. Fragmentation is a predictor for all-cause mortality across different oncologic populations. This measurement based on real-world national administrative data could be used as an indicator of high-quality oncological healthcare for the Colombian healthcare system.[Table: see text]

Download Full-text

Mortality from Alzheimer's disease in Brazil, 2000-2009

Cadernos de Saúde Pública ◽

10.1590/0102-311x00144713 ◽

2015 ◽

Vol 31 (4) ◽

pp. 850-860 ◽

Cited By ~ 6

Author(s):

Jane Blanco Teixeira ◽

Paulo Roberto Borges de Souza Junior ◽

Joelma Higa ◽

Mariza Miranda Theme Filha

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

The Elderly ◽

Mortality Rates ◽

Age Group ◽

Mortality Trend ◽

Elderly Men ◽

Exponential Regression ◽

All Cause Mortality ◽

Regression Adjustment

Alzheimer's disease is the most prevalent type of dementia in the elderly worldwide. To evaluate the mortality trend from Alzheimer's disease in Brazil, a descriptive study was conducted with the Mortality Information System of the Brazilian Ministry of Health (2000-2009). Age and sex-standardized mortality rates were calculated in Brazil's state capitals, showing the percentage variation by exponential regression adjustment. The state capitals as a whole showed an annual growth in mortality rates in the 60 to 79 year age bracket of 8.4% in women and 7.7% in men. In the 80 and older age group, the increase was 15.5% in women and 14% in men. Meanwhile, the all-cause mortality rate declined in both elderly men and women. The increase in mortality from Alzheimer's disease occurred in the context of chronic diseases as a proxy for increasing prevalence of the disease in the population. The authors suggest healthcare strategies for individuals with chronic non-communicable diseases

Download Full-text

Association between firearms and mortality in Brazil, 1990 to 2017: a global burden of disease Brazil study

Population Health Metrics ◽

10.1186/s12963-020-00222-3 ◽

2020 ◽

Vol 18 (S1) ◽

Author(s):

Deborah Carvalho Malta ◽

Adauto Martins Soares Filho ◽

Isabella Vitral Pinto ◽

Maria Cecília de Souza Minayo ◽

Cheila Marina Lima ◽

...

Keyword(s):

Physical Violence ◽

Composite Index ◽

The Elderly ◽

Mortality Rates ◽

Global Burden ◽

Age Group ◽

Collection Rate ◽

Explanatory Variables ◽

Using Data ◽

Global Burden Of Diseases

Abstract Background Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017. Methods We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables. Results Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20–24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = −0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = −0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = −0.269, p = 0.005). Conclusions There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.

Download Full-text

Current and Future Burden of Prostate Cancer in Songkhla, Thailand: Analysis of Incidence and Mortality Trends From 1990 to 2030

Journal of Global Oncology ◽

10.1200/jgo.17.00128 ◽

2018 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Christian S. Alvarez ◽

Shama Virani ◽

Rafael Meza ◽

Laura S. Rozek ◽

Hutcha Sriplung ◽

...

Keyword(s):

Prostate Cancer ◽

Birth Cohort ◽

Developed Countries ◽

Mortality Rates ◽

Incidence Rates ◽

Mortality Trends ◽

Annual Percent Change ◽

Public Health Burden ◽

Incidence And Mortality ◽

Using Data

Purpose Prostate cancer is the second most common malignancy among men worldwide, and it poses a significant public health burden that has traditionally been limited mostly to developed countries. However, the burden of the disease is expected to increase, affecting developing countries, including Thailand. We undertook an analysis to investigate current and future trends of prostate cancer in the province of Songkhla, Thailand, using data from the Songkhla Cancer Registry from 1990 to 2013. Methods Joinpoint regression analysis was used to examine trends in age-adjusted incidence and mortality rates of prostate cancer and provide estimated annual percent change (EAPC) with 95% CIs. Age-period-cohort (APC) models were used to assess the effect of age, calendar year, and birth cohort on incidence and mortality rates. Three different methods (Joinpoint, Nordpred, and APC) were used to project trends from 2013 to 2030. Results Eight hundred fifty-five cases of prostate cancer were diagnosed from 1990 to 2013 in Songkhla, Thailand. The incidence rates of prostate cancer significantly increased since 1990 at an EAPC of 4.8% (95% CI, 3.6% to 5.9%). Similarly, mortality rates increased at an EAPC of 5.3% (95% CI, 3.4% to 7.2%). The APC models suggest that birth cohort is the most important factor driving the increased incidence and mortality rates of prostate cancer. Future incidence and mortality of prostate cancer are projected to continue to increase, doubling the rates observed in 2013 by 2030. Conclusion It is critical to allocate resources to provide care for the men who will be affected by this increase in prostate cancer incidence in Songkhla, Thailand, and to design context-appropriate interventions to prevent its increasing burden.

Download Full-text

122. All-Cause Mortality Increased With Nontuberculous Mycobacterial Lung Disease in US Medicare

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy209.013 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S7-S7

Author(s):

Theodore Marras ◽

Quanwu Zhang ◽

Mehdi Mirsaeidi ◽

Christopher Vinnard ◽

Keith Hamilton ◽

...

Keyword(s):

Native American ◽

Lung Disease ◽

Mortality Rates ◽

Age Group ◽

Control Cohort ◽

Risk Of Mortality ◽

Nontuberculous Mycobacterial Lung Disease ◽

Increased Risk ◽

All Cause Mortality ◽

Research Grant

Abstract Background Nontuberculous Mycobacterial Lung Disease (NTMLD) is a chronic, debilitating, and progressive disease. This study evaluates all-cause mortality in patients with NTMLD in the US Medicare. Methods Patients (n = 43,394) were identified from the Medicare database (excluding Part C) based on physician claims for NTMLD on ≥2 separate occasions ≥30 days apart between 2007 and 2015. About 12% patients were <65 years and qualified for Medicare due to disability. A control cohort (n = 84,814) was randomly selected and matched to the NTMLD sample by age and sex. The NTMLD diagnosis date was assigned to the matched controls as an index date. Poisson and Cox regression were used to derive descriptive rates and adjusted risk of mortality accounting for baseline comorbidities of pulmonary, immune, cardiovascular, cancer, and other disorders. Results Mean age was 74 (±10) years and 68% were female in both NTMLD and control cohorts. Mean Charlson comorbidity index (CCI) was 2.9 (standard deviation ±2.6) in NTMLD vs. 1.3 (±1.9) in control cohort. In Medicare members ≥65 years, mean age was 76 (±7) years and 70% were female. Mean CCI was 2.8 (±2.5) in NTMLD cohort vs. 1.4 (±2.0) in control cohort. In Medicare members <65, mean age was 53 (±10) and 49% were female. Mean CCI was 3.8 (±3.3) in NTMLD vs. 1.1 (±1.9) in the control. Observed yearly mortality rates were 9.8% in NTMLD vs. 4.7% in control cohort (rate ratio [RR] = 2.1; 95% CI: 2.03–2.13). In ≥65 Medicare members, the observed rates were 9.7% in NTMLD vs. 5.0% in control cohort (RR = 2.0; 1.9–2.0). In Medicare members <65, the observed rates were 10.4% in NTMLD vs. 2.5% in control cohort (RR = 4.1; 3.8–4.5). Compared with the Asian race, observed mortality was higher in NTMLD patients of Native American (hazard ratio [HR] = 1.69, 1.30–2.19), Black (HR = 1.23; 1.08–1.39), Hispanic (HR = 1.27, 1.07–1.51), or White (HR = 1.18, 1.06–1.31) race (Figure 1). Mortality rates were elevated with NTMLD relative to controls in all age categories from ≥65 years (Figure 2). Adjusted mortality increased with NTMLD by 35% overall (HR = 1.35; 1.3–1.4), by 23% in age group ≥65 (HR = 1.23, 1.19–1.27), and almost doubled in age group <65 (HR = 1.97, 1.80–2.15). Conclusion Among US Medicare enrollees, NTMLD was associated with a 35% increased risk of mortality overall. Disclosures T. Marras, Insmed Incorporated: Investigator, Consulting fee and Research grant. Horizon Pharmaceuticals: Consultant, Consulting fee. Red Hill: Consultant, Consulting fee. AstraZeneca: CME, Speaker honorarium. Q. Zhang, Insmed Incorporated: Employee, Salary. G. Eagle, Insmed Incorporated: Employee, Salary. P. Wang, Insmed Incorporated: Employee, Salary. R. Zhang, Insmed Incorporated: Consultant, Consulting fee. E. Chou, Insmed Incorporated: Employee, Salary. K. L. Winthrop, Insmed Incorporated: Consultant and Scientific Advisor, Consulting fee and Research grant.

Download Full-text

Evaluation of Strategies to Fight COVID-19: The French Paradigm

Journal of Clinical Medicine ◽

10.3390/jcm10132942 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2942

Author(s):

Audrey Giraud-Gatineau ◽

Philippe Gautret ◽

Philippe Colson ◽

Hervé Chaudet ◽

Didier Raoult

Keyword(s):

Surveillance System ◽

Excess Mortality ◽

Age Distribution ◽

European Countries ◽

Biological Assessment ◽

Epidemiological Surveillance ◽

Mortality Data ◽

Age Group ◽

All Cause Mortality ◽

Epidemiological Surveillance System

(1) Background: We collected COVID-19 mortality data and the age distribution of the deceased in France and other European countries, as well as specifically in the cities of Paris and Marseille, and compared them. (2) Methods: Data on mortality related to COVID-19 and the associated age distribution were collected from government institutions in various European countries. In France, data were obtained from INSEE and Santé Publique France. All-cause mortality was also examined in order to study potential excess mortality using EuroMOMO. The Marseille data came from the epidemiological surveillance system. (3) Results: France is one of the European countries most impacted by COVID-19. Its proportion of deaths in people under 60 years of age is higher (6.5%) than that of Italy (4.6%) or Spain (4.7%). Excess mortality (5% more deaths) was also observed. Ile-de-France and the Grand-Est are the two French regions with the highest mortality. The proportion of deaths in the under-60 age group was considerable in Ile-de-France (9.9% vs. 4.5% in the Southern region). There are significantly higher numbers of patients hospitalized, in intensive care and deceased in Paris than in Marseille. (4) Conclusions: No patient management, i.e., from screening to diagnosis, including biological assessment and clinical examination, likely explains the high mortality associated with COVID-19.

Download Full-text

Trends in winter excess mortality in Mexico 1991 - 2008

10.7287/peerj.preprints.1273v1 ◽

2015 ◽

Author(s):

Omar González-Santiago ◽

Evangelina Ramirez-Lara ◽

Sandra L. Gracia-Vásquez ◽

Isaias Balderas-Rentería

Keyword(s):

General Population ◽

Excess Mortality ◽

Age Groups ◽

Winter Season ◽

Age Group ◽

Old People ◽

Mediterranean Countries ◽

All Cause Mortality ◽

Main Factors ◽

Low Levels

Objective: Analyze the mortality by all causes in México during the Winter season. Methods: We extracted and tabulated data on monthly all-cause mortality in the general population from 1991 to 2008 from database INEGI. Coefficients of seasonal variation in mortality were calculated. Results: An increase of 15 % in mortality for general population during Winter was observed during the studied period. The more susceptible age groups were old people and children with an increase of winter deaths of 19 % and 11 % respectively. Months with low levels of mortality were April, October and September for children, adolescents and old people respectively. Conclusions: In Mexico winter months shown the highest levels of mortality. The increase in mortality is similar to some Mediterranean countries. More susceptible age groups correspond to child and old people. Months with low levels of mortality are different for each age group. In México it is necessary identify the main factors that contribute to low mortality among different months according age groups.

Download Full-text

Trends in winter excess mortality in Mexico 1991 - 2008

10.7287/peerj.preprints.1273 ◽

2015 ◽

Author(s):

Omar González-Santiago ◽

Evangelina Ramirez-Lara ◽

Sandra L. Gracia-Vásquez ◽

Isaias Balderas-Rentería

Keyword(s):

General Population ◽

Excess Mortality ◽

Age Groups ◽

Winter Season ◽

Age Group ◽

Old People ◽

Mediterranean Countries ◽

All Cause Mortality ◽

Main Factors ◽

Low Levels

Download Full-text

Changes in Excess Mortality from End Stage Renal Disease in the United States from 1995 to 2013

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.04330417 ◽

2017 ◽

Vol 13 (1) ◽

pp. 91-99 ◽

Cited By ~ 27

Author(s):

Bethany J. Foster ◽

Mark M. Mitsnefes ◽

Mourad Dahhou ◽

Xun Zhang ◽

Benjamin L. Laskin

Keyword(s):

United States ◽

General Population ◽

Excess Mortality ◽

The United States ◽

Mortality Rates ◽

Excess Risk ◽

Calendar Time ◽

Risk Of Death ◽

All Cause Mortality ◽

Functioning Kidney

Background and objectivesIndividuals with ESRD have a very high risk of death. Although mortality rates have decreased over time in ESRD, it is unknown if improvements merely reflect parallel increases in general population survival. We, therefore, examined changes in the excess risk of all-cause mortality—over and above the risk in the general population—among people treated for ESRD in the United States from 1995 to 2013. We hypothesized that the magnitude of change in the excess risk of death would differ by age and RRT modality.Design, setting, participants, & measurementsWe used time-dependent relative survival models including data from persons with incident ESRD as recorded in the US Renal Data System and age-, sex-, race-, and calendar year–specific general population mortality rates from the Centers for Disease Control and Prevention. We calculated relative excess risks (analogous to hazard ratios) to examine the association between advancing calendar time and the primary outcome of all-cause mortality.ResultsWe included 1,938,148 children and adults with incident ESRD from 1995 to 2013. Adjusted relative excess risk per 5-year increment in calendar time ranged from 0.73 (95% confidence interval, 0.69 to 0.77) for 0–14 year olds to 0.88 (95% confidence interval, 0.88 to 0.88) for ≥65 year olds, meaning that the excess risk of ESRD-related death decreased by 12%–27% over any 5-year interval between 1995 and 2013. Decreases in excess mortality over time were observed for all ages and both during treatment with dialysis and during time with a functioning kidney transplant (year by age and year by renal replacement modality interactions were both P<0.001), with the largest relative improvements observed for the youngest persons with a functioning kidney transplant. Absolute decreases in excess ESRD-related mortality were greatest for the oldest persons.ConclusionsThe excess risk of all-cause mortality among people with ESRD, over and above the risk in the general population, decreased significantly between 1995 and 2013 in the United States.

Download Full-text

Education inequalities in adult all-cause mortality: first national data for Australia using linked census and mortality data

International Journal of Epidemiology ◽

10.1093/ije/dyz191 ◽

2019 ◽

Vol 49 (2) ◽

pp. 511-518

Author(s):

Rosemary J Korda ◽

Nicholas Biddle ◽

John Lynch ◽

James Eynstone-Hinkins ◽

Kay Soga ◽

...

Keyword(s):

Negative Binomial ◽

Census Data ◽

International Comparisons ◽

Negative Binomial Regression ◽

Mortality Rates ◽

Mortality Data ◽

Age Group ◽

National Data ◽

Registration Data ◽

All Cause Mortality

Abstract Background National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods We used the Australian Bureau of Statistics Death Registrations to Census file, with data on deaths (2011–2012) linked probabilistically to census data (linkage rate 81%). To assess validity, we compared mortality rates by age group (25–44, 45–64, 65–84 years), sex and area-inequality measures to those based on complete death registration data. We used negative binomial regression to quantify inequalities in all-cause mortality in relation to five levels of education [‘Bachelor degree or higher’ (highest) to ‘no Year 12 and no post-secondary qualification’ (lowest)], separately by sex and age group, adjusting for single year of age and correcting for linkage bias and missing education data. Results Mortality rates and area-based inequality estimates were comparable to published national estimates. Men aged 25–84 years with the lowest education had age-adjusted mortality rates 2.20 [95% confidence interval (CI): 2.08‒2.33] times those of men with the highest education. Among women, the rate ratio was 1.64 (1.55‒1.74). Rate ratios were 3.87 (3.38‒4.44) in men and 2.57 (2.15‒3.07) in women aged 25–44 years, decreasing to 1.68 (1.60‒1.76) in men and 1.44 (1.36‒1.53) in women aged 65–84 years. Absolute education inequalities increased with age. One in three to four deaths (31%) was associated with less than Bachelor level education. Conclusions These linked national data enabled valid estimates of education inequality in mortality suitable for international comparisons. The magnitude of relative inequality is substantial and similar to that reported for other high-income countries.

Download Full-text