ADJUDICATION PILOT STUDY OF CAUSE OF DEATH IN THE LONG LIFE FAMILY STUDY

Abstract Background: Death certificate inaccuracy increases at older ages. The Long Life Family Study (LLFS) utilizes a physician adjudication committee to review the death certificate, medical records and a family narrative about cause of death. We report here the adjudication process and the prevalent underlying causes of death for a subsample of those who have died so far. Methods: We first describe the adjudication process. There were ~1,250 deaths in LLFS. We report underlying causes of death for a subset of proband generation subjects enrolled and evaluated by two LLFS study centers. Results: As of May 2019, we have adjudicated 190 deaths (98 male, 92 female) . Mean age 95 years (range 81-105 years). Top 5 causes of death for men: cancer (13%), coronary heart disease (CHD, 13%), dementia (13%), "other" (11%) and "unknown" (9%) and for women: dementia (21%), valvular heart disease (14%), coronary heart disease (12%), unknown (12%) and other (9%). Rate of death due to dementia was greater in women compared to men (CHI2 =7.33, p=0.006). Conclusions: In this pilot study, a significantly greater proportion of women died due to dementia compared to men. At least some portion of this difference may be due to the observation that women are known to survive chronic aging-related diseases more than men and thus have a greater opportunity to die from dementia at advanced ages. An additional cause to consider includes clinicians’ gender bias in ascribing diagnoses in the medical records that were relied upon as part of the adjudication process.

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Decline of coronary heart disease mortality is strongly effected by changing patterns of underlying causes of death: an analysis of mortality data from 27 countries of the WHO European region 2000 and 2013

European Journal of Epidemiology ◽

10.1007/s10654-020-00699-0 ◽

2020 ◽

Author(s):

Susanne Stolpe ◽

Bernd Kowall ◽

Andreas Stang

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cause Of Death ◽

Western Europe ◽

Causes Of Death ◽

Total Mortality ◽

Coronary Heart Disease Mortality ◽

Mortality Rates ◽

Mortality Data ◽

Underlying Causes

AbstractMortality rates for coronary heart disease (CHD) experience a longstanding decline, attributed to progress in prevention, diagnostics and therapy. However, CHD mortality rates vary between countries. To estimate whether national patterns of causes of death impact CHD mortality, data from the WHO “European detailed mortality database” for 2000 and 2013 for populations aged ≥ 80 years was analyzed. We extracted mortality rates for total mortality, cardiovascular diseases, neoplasms, dementia and ill-defined causes. We calculated proportions of selected causes of death among all deaths, and proportions of selected cardiovascular causes among cardiovascular deaths. CHD mortality rates were recalculated after re-coding ill-defined causes of death. Association between CHD mortality rates and proportions of CHD deaths was estimated by population-weighted linear regression. National patterns of causes of death were divers. In 2000, CHD was assigned as cause of death in 13–53% of all cardiovascular deaths. Until 2013, this proportion changed between − 65% (Czech Republic) and + 57% (Georgia). Dementia was increasingly assigned as underlying cause of death in Western Europe, but rarely in eastern European countries. Ill-defined causes accounted for between < 1% and 53% of all cardiovascular deaths. CHD mortality rates were closely linked to a countries’ proportion of cardiovascular deaths assigned to CHD (R2 = 0.95 for 2000 and 0.99 for 2013). We show that CHD mortality is considerably influenced by national particularities in certifying death. Changes in CHD mortality rates reflect changes in certifying competing underlying causes of death. This must be accounted for when discussing reasons for the CHD mortality decline.

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Time series of diabetes attributable mortality from 2008 to 2017

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01549-w ◽

2021 ◽

Author(s):

U. Fedeli ◽

E. Schievano ◽

S. Masotto ◽

E. Bonora ◽

G. Zoppini

Keyword(s):

Cause Of Death ◽

Causes Of Death ◽

Death Certificate ◽

Attributable Mortality ◽

Joinpoint Regression ◽

Annual Percent Change ◽

Percent Change ◽

Underlying Causes ◽

Underlying Cause Of Death ◽

Circulatory Diseases

Abstract Purpose Diabetes is a growing health problem. The aim of this study was to capture time trends in mortality associated with diabetes. Methods The mortality database of the Veneto region (Italy) includes both the underlying causes of death, and all the diseases mentioned in the death certificate. The annual percent change (APC) in age-standardized rates from 2008 to 2017 was computed by the Joinpoint Regression Program. Results Overall 453,972 deaths (56,074 with mention of diabetes) were observed among subjects aged ≥ 40 years. Mortality rates declined for diabetes as the underlying cause of death and from diabetes-related circulatory diseases. The latter declined especially in females − 4.4 (CI 95% − 5.3/− 3.4), while in males the APC was − 2.8 (CI 95% − 4.0/− 1.6). Conclusion We observed a significant reduction in mortality during the period 2008–2017 in diabetes either as underlying cause of death or when all mentions of diabetes in the death certificate were considered.

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Validity of death certificates for coding coronary heart disease as the cause of death in Bahrain

Eastern Mediterranean Health Journal ◽

10.26719/2000.6.4.661 ◽

2000 ◽

Vol 6 (4) ◽

pp. 661-669

Author(s):

R. Al Mahroos

Keyword(s):

Public Health ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cause Of Death ◽

Death Certificate ◽

Death Certificates ◽

Hospital Records ◽

Mortality Statistics ◽

National Mortality ◽

Underlying Cause Of Death

This study aimed to examine the accuracy of death certificates for coding coronary heart disease [CHD] as the underlying cause of death in Bahrain. Of the 1714 deaths occurring in Bahrain in 1993, 371 were classified as resulting from CHD. In this study the hospital diagnosis of 109 deaths [52 as CHD and 57 as other causes]were reviewed and re-diagnosed using hospital records. The coding of 459 death certificates [151 as CHD and 308 as other causes]by the Directorate of Public Health was similarly reviewed. The sensitivity and specificity of the hospital diagnosis were 76% and 72% respectively and those of the Directorate of Public Health were 85% and 89% respectively. National mortality statistics in Bahrain, which are based on death certificate data, may overestimate the frequency of CHD. Therefore, it is important that measures are taken to improve the accuracy of certification

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Why are epilepsy mortality rates rising in the United States? A population-based multiple cause-of-death study

BMJ Open ◽

10.1136/bmjopen-2019-035767 ◽

2020 ◽

Vol 10 (8) ◽

pp. e035767

Author(s):

Christopher M DeGiorgio ◽

Ashley Curtis ◽

Armen Carapetian ◽

Dominic Hovsepian ◽

Anusha Krishnadasan ◽

...

Keyword(s):

Heart Disease ◽

Vascular Dementia ◽

Ischaemic Heart Disease ◽

Cause Of Death ◽

Causes Of Death ◽

Mortality Rates ◽

Population Based ◽

All Cause Mortality ◽

The Usa ◽

Underlying Causes

IntroductionEpilepsy mortality rates are rising. It is unknown whether rates are rising due to an increase in epilepsy prevalence, changes in epilepsy causes of death, increase in the lethality or epilepsy or failures of treatment. To address these questions, we compare epilepsy mortality rates in the USA with all-cause and all-neurological mortality for the years 1999 to 2017.ObjectivesTo determine changes in US epilepsy mortality rates versus all-cause mortality, and to evaluate changes in the leading causes of death in people with epilepsy.DesignRetrospective population-based multiple cause-of-death study.Primary outcomeChange in age-adjusted epilepsy mortality rates compared with mortality rates for all-cause and all-neurological mortality.Secondary outcomeChanges in the leading causes of death in epilepsy.ResultsFrom 1999 to 2017, epilepsy mortality rates in the USA increased 98.8%, from 5.83 per million in 1999 to 11.59 per million (95% CI 88.2%–110.0%), while all-cause mortality declined 16.4% from 8756.34 per million to 7319.17 per million (95% CI 16.3% to 16.6%). For the same period, all-neurological mortality increased 80.8% from 309.21 to 558.97 per million (95% CI 79.4%–82.1%). The proportion of people with epilepsy who died due to neoplasms, vascular dementia and Alzheimer’s increased by 52.3%, 210.1% and 216.8%, respectively. During the same period, the proportion who died due to epilepsy declined 27.1%, while ischaemic heart disease as a cause of death fell 42.6% (p<0.001).ConclusionsEpilepsy mortality rates in the USA increased significantly from 1999 to 2017. Likely causes include increases in all-neurological mortality, increased epilepsy prevalence and changes in the underlying causes of death in epilepsy, led by increases in vascular dementia and Alzheimer’s. An important finding is that ischaemic heart disease and epilepsy itself are declining as underlying causes of death in people with epilepsy.

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A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

BMC Research Notes ◽

10.1186/s13104-021-05508-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Yasunari Yamashita ◽

Rina Kitajima ◽

Kiyoshi Matsubara ◽

Gaku Inoue ◽

Hajime Matsubara

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Medical Records ◽

Low Frequency ◽

University Hospital ◽

Diabetes Treatment ◽

C Statistic ◽

Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

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