Trends in mortality from external causes in the Republic of Seychelles between 1989 and 2018

AbstractData on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.

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Changes in Mortality Related to Traumatic Brain Injuries in the Seychelles from 1989 to 2018

Frontiers in Neurology ◽

10.3389/fneur.2021.720434 ◽

2021 ◽

Vol 12 ◽

Author(s):

Anne Abio ◽

Pascal Bovet ◽

Bernard Valentin ◽

Till Bärnighausen ◽

Masood Ali Shaikh ◽

...

Keyword(s):

Brain Injuries ◽

Road Traffic ◽

Age Distribution ◽

Mortality Rates ◽

Traumatic Brain Injuries ◽

Vital Statistics ◽

World Health ◽

African Region ◽

The Republic ◽

Related Mortality

Introduction: Traumatic Brain Injuries (TBIs) are a significant source of disability and mortality, which disproportionately affect low- and middle-income countries. The Republic of Seychelles is a country in the African region that has experienced rapid socio-economic development and one in which all deaths and the age distribution of the population have been enumerated for the past few decades. The aim of this study was to investigate TBI-related mortality changes in the Republic of Seychelles during 1989–2018.Methods: All TBI-related deaths were ascertained using the national Civil Registration and Vital Statistics System. Age- and sex-standardised mortality rates (per 100,000 person-years) were standardised to the age distribution of the World Health Organisation standard population.Results: The 30-year age-standardised TBI-related mortality rates were 22.6 (95% CI 19.9, 25.2) in males and 4.0 (95% CI 2.9, 5.1) in females. Road traffic collisions were the leading contributor to TBI-related mortality [10.0 (95% CI 8.2, 11.8) in males and 2.7 (95% CI 1.8, 3.6) in females, P > 0.05]. TBI-related mortality was most frequent at age 20–39 years in males (8.0) and at age 0–19 in females (1.4). Comparing 2004–2018 vs. 1989–2003, the age-standardised mortality rates changed in males/females by −20%/−11% (all cause mortality), −24%/+39.4% (TBIs) and +1%/+34.8% (road traffic injury-related TBI).Conclusion: TBI-related mortality rates were much higher in males but decreased over time. Road traffic collisions were the single greatest contributor to TBI mortality, emphasising the importance of road safety measures.

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Risk of Neonatal and Infant Mortality in Twins and Singletons by Gestational Age

American Journal of Perinatology ◽

10.1055/s-0038-1675218 ◽

2018 ◽

Vol 36 (08) ◽

pp. 798-805 ◽

Cited By ~ 1

Author(s):

Han-Yang Chen ◽

Suneet P. Chauhan

Keyword(s):

Infant Mortality ◽

Gestational Age ◽

Regression Models ◽

Causes Of Death ◽

Error Variance ◽

Mortality Rates ◽

Vital Statistics ◽

Adjusted Risk ◽

Live Births ◽

Risk Ratios

Objective To compare neonatal and infant mortality rates stratified by gestational age (GA) between singletons and twins and examine the three leading causes of death among them. Study Design This was a retrospective cohort study using the U.S. vital statistics datasets. The study was restricted to nonanomalous live births at 24 to 40 weeks delivered in 2005 to 2014. We used multivariable Poisson regression models with robust error variance to examine the association between birth plurality (singleton vs. twin) and mortality outcomes within each GA, while adjusting for confounders. The results were presented as adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results Of 26,292,747 live births, 96.6% were singletons and 3.4% were twins. At 29 to 36 weeks of GA, compared with singletons, twins had a lower risk of neonatal mortality (aRR: 0.37–0.78) and infant mortality (aRR: 0.54–0.86). When examined by GA, the three leading causes of neonatal and infant mortality varied between singletons and twins. Conclusion When stratified by GA, the risk of neonatal and infant mortality was lower at 29 to 36 weeks in twins than in singletons, though the cause of death varied.

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Premature Mortality in Canada

University of Toronto Journal of Public Health ◽

10.33137/utjph.v1i1.33812 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Catherine Liang ◽

Emmalin Buajitti ◽

Laura Rosella

Keyword(s):

Cause Of Death ◽

Descriptive Analysis ◽

Premature Mortality ◽

Mortality Rates ◽

Vital Statistics ◽

Income Quintile ◽

Mortality Trends ◽

Premature Deaths ◽

Central Canada ◽

Over Time

Introduction: Premature mortality (deaths before age 75) is a well-established metric of population health and health system performance. In Canada, underlying differences between provinces/territories present a need for stratified mortality trends. Methods: Using data from the Canadian Vital Statistics Database, a descriptive analysis of sex-specific adult premature deaths over 1992-2015 was conducted by province, census divisions (CD), socioeconomic status (SES), age, and underlying cause of death. Premature mortality rates were calculated as the number of deaths per 100,000 individuals aged 18 to 74, per 8-year era. SES was measured using the income quintile of the neighbourhood of residence. Absolute and relative inequalities were respectively summarized using slope and relative indices of inequality, produced via unadjusted linear regression of the mortality rate on income rank. Results: Premature mortality in Canada declined by 21% for males and 13% for females between 1992-1999 and 2008-2015. The greatest reductions were in Central Canada, while Newfoundland saw notable increases. CD-level improvements appeared mostly in the southern half of Canada. As of 2008-2015, Newfoundland, Nova Scotia, and Nunavut had the highest mortality rates. Low area-level income was associated with higher mortality. SES inequalities grew over time. Newfoundland’s between-quintile differences rose from 1292 to 2389 deaths per 100k males, or 1.33 to 2.12-fold, and 586 to 1586 per 100k females, or 1.24 to 1.74-fold. In 2008-2015, mortality rates of the bottom quintile in Manitoba and Saskatchewan were more than 2.5 times those of the top. Mortality increased with age, and varied regionally. Low mortality in Central Canada and BC, and high mortality in the Territories were consistent across eras and sexes. Cause of death distributions shifted with age and sex, with more external deaths in younger males. Conclusion: Improvements were seen in adult premature mortality rates over time, but were unequal across geographies. Evidence exists for growing socioeconomic disparities in mortality.

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The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies

BMC Public Health ◽

10.1186/s12889-021-11721-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mehran Shams ◽

Farnam Mohebi ◽

Kimiya Gohari ◽

Masoud Masinaei ◽

Bahram Mohajer ◽

...

Keyword(s):

Mortality Rate ◽

Road Traffic ◽

National Level ◽

Mortality Rates ◽

Road User ◽

Attributable Mortality ◽

Older Individuals ◽

Registration System ◽

Helmet Use ◽

Road Traffic Injuries

Abstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Methods Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Results Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Conclusions Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced.

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Characteristics of mortality in the Orenburg region population in 2011-2017

Science and Innovations in Medicine ◽

10.35693/2500-1388-2020-5-2-99-104 ◽

2020 ◽

Vol 5 (2) ◽

pp. 99-104

Author(s):

Evgenii L. Borschuk ◽

Dmitrii N. Begun ◽

Tatyana V. Begun

Keyword(s):

Mortality Rate ◽

Causes Of Death ◽

Age Groups ◽

Circulatory System ◽

Mortality Rates ◽

Female Population ◽

Orenburg Region ◽

The Third ◽

Circulatory System Diseases ◽

External Causes

Objectives - to study the mortality indicators, their dynamics and structure, in the population of the Orenburg region in the period of 2011-2017. Material and methods. The study was conducted using the data from the territorial authority of statistics in the Orenburg region in the period from 2011 to 2017. The analytical, demographic and statistical methods were implemented for the study of the demographic indicators. Results. Cities and municipal settlements of the Orenburg region with high mortality indicators were included in the second and fourth clusters during the cluster analysis. The first and third clusters included cities and municipal settlements with an average mortality. The most favorable position has the Orenburg area with the lowest mortality rate in the region in 2017 - 8.4%. The dynamics of mortality rates among the male and female population tends to decrease, more pronounced dynamics is in men. Though, the male population is characterized by higher mortality rates in all age groups. The leading position among the causes of death is taken by diseases of the circulatory system (46.3% of the total mortality). The second position is occupied by tumors (17.2%), the third - by external causes (8.4%). Mortality from circulatory system diseases and from external causes has reduced. The dynamics of mortality from tumors does not change significantly. The rank of leading causes of death is not identical in the clusters: in the third and fourth clusters, the other causes occupy the second place in the structure of mortality, while tumors occupy the third. Conclusion. In the Orenburg region, the mortality rate is higher than overage in the Russian Federation by 0.9 per 1000 people. The study revealed significant territorial differences in the mortality rates. In general, the mortality among men in all age groups is higher than the mortality of women. The mortality rate from diseases of the circulatory system plays the leading role in the structure of mortality, but has the tendency for decline. Until 2006, the mortality from external causes ranked the second place, now the second place is taken by death from tumors The mortality from external causes is decreasing; mortality from tumors does not change significantly. The obtained results could be used by local authorities in developing the program of public health protection and assessing its effectiveness.

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Mortality rate of adolescents in the Republic of Serbia

Medicinski pregled ◽

10.2298/mpns0810503r ◽

2008 ◽

Vol 61 (9-10) ◽

pp. 503-506

Author(s):

Nevenka Roncevic ◽

Aleksandra Stojadinovic

Keyword(s):

Mortality Rate ◽

Regional Differences ◽

Causes Of Death ◽

Health Indicators ◽

Vital Statistics ◽

Male Adolescents ◽

Icd 10 ◽

Causes Of Mortality ◽

The Republic ◽

External Causes

Introduction. Adolescents are the healthiest age group of the population but many studies show that period of adolescence is marked by significant morbidity and mortality. Health indicators of adolescent population have been getting worse during past decades. The aim of this study was to determine mortality rate of adolescents in the Republic of Serbia to determine most common causes of death in adolescence and to explore regional differences in adolescent mortality. Materials and methods: Documentation tables of vital statistics in the Republic of Serbia in 2004, and Documentation Tables of Census 2002 were used. The causes of mortality were classified according to ICD 10. Results and discussion. Specific morality rate in the Republic of Serbia is 32.08 on 100.000 adolescents. The leading causes of death in adolescence are injuries, malignancies and non specified causes, and there are significant regional differences, as well as gender and age differences. The mortality rate of male adolescents is about 2.4 times higher than the mortality rates in female adolescents. The mortality rate of older adolescents is significantly higher than mortality rate of younger adolescents. The mortality of adolescents is higher in Vojvodina than in Central Serbia. Precise data of external causes of death do not exist in vital statistics in our country. Conclusion. The mortality of adolescents is high, especially for older male adolescents (15 to 19 years of age) and majority of deaths among adolescents could be prevented. It is necessary to improve data of vital statistics to get better insight into causes of adolescent death.

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MEDICAL AND STATISTICAL INDICATORS OF MORTALITY IN EMPLOYEES OF RUSSIAN STATE FIRE SERVICE (1996–2015)

Medico-Biological and Socio-Psychological Problems of Safety in Emergency Situations ◽

10.25016/2541-7487-2018-0-4-05-26 ◽

2019 ◽

pp. 5-26 ◽

Cited By ~ 2

Author(s):

S. S. Aleksanin ◽

E. V. Bobrinev ◽

V. I. Evdokimov ◽

A. A. Kondashov ◽

N. A. Mukhina ◽

...

Keyword(s):

Mortality Rate ◽

Causes Of Death ◽

Mortality Rates ◽

Fire Service ◽

The State ◽

Russian State ◽

Working Age ◽

Icd 10 ◽

External Causes ◽

Statistical Indicators

Relevance. Russia has high mortality rates in general and among the working-age population, with dominating effects of external causes.Intention– To study rates and structures of the medical-statistical indicators of mortality due to diseases and the effects of external causes in the employees of the State Fire Service of the EMERCOM of Russia over 20 years from 1996 to 2015.Methods.Annual population under study averaged (108.8 ± 6.2) thousand people, or about 80% of all the employees of the State Fire Service of Russia who had special military ranks. Operating staff comprised 53.4%, other employees – 46.6%. Mortality rates were calculated per 100 thousand employees of the State Fire Service of Russia. Data on the mortality of working-age men in Russia was obtained on the website of the Federal Statistics Service of Russia (Rosstat) [http://www.gks.ru/]. The unification of accounting and analysis of indicators was achieved using the International Statistical Classification of Diseases and Related Health Problems, the 10th revision (ICD-10). Results and Discussion. Mortality rate among employees of the State Fire Service of the EMERCOM of Russia in 1996–2015 was (116.9 ± 5.7) deaths per 100 thousand employees per year vs 11 times higher mortality rate among the working-age male population of Russia: (1063.9 ± 33.7) deaths per 100 thousand men (p < 0.001). The mean age of the deceased employees of the State Fire Service of Russia was (44.5 ± 0.3) years, with overall mean age (36.9 ± 1.6) years (p < 0.001). The leading causes of death among employees of the State Fire Service of Russia (from more to less significant) were injuries and other effects of external causes (ICD-10 chapter XIX), diseases of the circulatory system (chapter IX) and neoplasms (II), diseases of the digestive system (XI) and diseases of the respiratory system (X). Mortality rates from these causes per 100 thousand employees per year amounted to (63.3 ± 33.7), (32.6 ± 2.7), (7.1 ± 0.6), (5.3 ± 1.0) and (5.0 ± 0.9) deaths; in cause-of-death structure – 54.2, 27.9, 6.0, 4.5 and 4.3%, respectively. The mortality rate from suicide among working-age Russian men was 6.4 times higher than that of firefighters – (66.0 ± 4.1) and (10.3 ± 1.1) deaths per 100 thousand men, respectively. However, in the overall cause-of-death structure, this cause accounted for a larger share in employ ees of the Russian State Fire Service (6.2 vs 8.8%). Statistically significant difference (p < 0.05) was found when comparing occupational fatalities among the operating personnel of the State Fire Service of Russia and working population in Russia: (14.9 ±1.4) deaths per 100 thousand employees per year vs (11.6 ± 0.7) deaths per 100 thousand workers per year. Mortality rates of firefighters were calculated in the Federal districts and regions of Russia. For a number of causes of death in firefighters, there is a significant contribution of occupational factors, which require further research.Conclusion.There is a low alertness for identifying neoplasms and crisis conditions in firefighters. Focusing on the leading diseases, behavioral disorders, prevention of injuries, poisoning and other effects of external causes will improve health and reduce mortality of employees of the State Fire Service of Russia.Authors declare the absence of existing and potential conflicts of interest concerning the article publication.

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Mortality and potential years of life lost by road traffic injuries in Brazil, 2013

Revista de Saúde Pública ◽

10.1590/s1518-8787.2016050006465 ◽

2016 ◽

Vol 50 (0) ◽

Cited By ~ 2

Author(s):

Silvânia Suely Caribé de Araújo Andrade ◽

Maria Helena Prado de Mello-Jorge

Keyword(s):

Mortality Rate ◽

Traffic Safety ◽

Skin Color ◽

Road Traffic ◽

Age Groups ◽

Mortality Rates ◽

Years Of Life Lost ◽

Road Traffic Injuries ◽

Proportional Mortality ◽

The Impact

ABSTRACT OBJECTIVE To estimate the potential years of life lost by road traffic injuries three years after the beginning of the Decade of Action for Traffic Safety. METHODS We analyzed the data of the Sistema de Informações sobre Mortalidade (SIM – Mortality Information System) related to road traffic injuries, in 2013. We estimated the crude and standardized mortality rates for Brazil and geographic regions. We calculated, for the Country, the proportional mortality according to age groups, education level, race/skin color, and type or quality of the victim while user of the public highway. We estimated the potential years of life lost according to sex. RESULTS The mortality rate in 2013 was of 21.0 deaths per 100,000 inhabitants for the Country. The Midwest region presented the highest rate (29.9 deaths per 100,000 inhabitants). Most of the deaths by road traffic injuries took place with males (34.9 deaths per 100,000 males). More than half of the people who have died because of road traffic injuries were of black race/skin color, young adults (24.2%), individuals with low schooling (24.0%), and motorcyclists (28.5%). The mortality rate in the triennium 2011-2013 decreased 4.1%, but increased among motorcyclists. Across the Country, more than a million of potential years of life were lost, in 2013, because of road traffic injuries, especially in the age group of 20 to 29 years. CONCLUSIONS The impact of the high mortality rate is of over a million of potential years of life lost by road traffic injuries, especially among adults in productive age (early mortality), in only one year, representing extreme social cost arising from a cause of death that could be prevented. Despite the reduction of mortality by road traffic injuries from 2011 to 2013, the mortality rates increased among motorcyclists.

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Ischemic Stroke with Troponin Elevation: Patient Characteristics, Resource Utilization, and In-Hospital Outcomes

Cerebrovascular Diseases ◽

10.1159/000445526 ◽

2016 ◽

Vol 42 (3-4) ◽

pp. 213-223 ◽

Cited By ~ 5

Author(s):

Krishi Peddada ◽

Salvador Cruz-Flores ◽

Larry B. Goldstein ◽

Eliahu Feen ◽

Kevin F. Kennedy ◽

...

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Clinical Characteristics ◽

Causes Of Death ◽

Mortality Rates ◽

Hospital Death ◽

Stroke Patients ◽

Troponin Elevation ◽

Changes Over Time ◽

Over Time

Background: Among patients hospitalized for acute ischemic stroke, abnormal serum troponins are associated with higher risk of short-term mortality. However, most findings have been reported from European hospitals. Whether troponin elevation after stroke is independently associated with death among a more heterogeneous US population remains unclear. Furthermore, only a few studies have evaluated the association between the magnitude of troponin elevation and subsequent mortality, patterns of dynamic troponin changes over time, or whether troponin elevation is related to specific causes of death. Methods: Using data collected in the American Heart Association's ‘Get With The Guidelines' stroke registry between 2008 and 2012 at a tertiary care US hospital, we used logistic regression to evaluate the independent relationship between troponin elevation and mortality after adjusting for demographic and clinical characteristics. We then assessed whether the magnitude of troponin elevation was related to in-hospital mortality by calculating mortality rates according to tertiles of peak troponin levels. Dynamic troponin changes over time were evaluated as well. To better understand whether troponin elevation identified patients most likely to die due to a specific cause of death, investigators blinded from troponin values reviewed all in-hospital deaths, and the association between troponin elevation and mortality was evaluated among patients with cardiac, neurologic, or other causes of death. Results: Of 1,145 ischemic stroke patients, 199 (17%) had elevated troponin levels. Troponin-positive patients had more cardiovascular risk factors, more intensive medical therapy, and greater use of cardiac procedures. These individuals had higher in-hospital mortality rates than troponin-negative patients (27 vs. 8%, p < 0.001), and this association persisted after adjustment for 13 clinical and management variables (OR 4.28, 95% CI 2.40-7.63). Any troponin elevation was associated with higher mortality, even at very low peak troponin levels (mortality rates 24-29% across tertiles of troponin). Patients with persistently rising troponin levels had fewer anticoagulant and antiatherosclerotic therapies, with markedly worse outcomes. Furthermore, troponin-positive patients had higher rates of all categories of death: neurologic (17 vs. 7%), cardiac (5 vs. <1%), and other causes of death (5 vs. <1%; p < 0.001 for all comparisons). Conclusions: Ischemic stroke patients with abnormal troponin levels are at higher risk of in-hospital death, even after accounting for demographic and clinical characteristics, and any degree of troponin elevation identifies this higher level of risk. Troponins that continue to rise during the hospitalization identify stroke patients at markedly higher risk of mortality, and both neurologic and non-neurologically mediated mortality rates are higher when troponin is elevated.

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