scholarly journals 531Investigating systemic autoimmune diseases as a group of causes of death: mortality burden and comorbidities

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Marianna Mitratza ◽  
Bart Klijs ◽  
A Elisabeth Hak ◽  
Jan WPF Kardaun ◽  
Anton E Kunst

Abstract Background Systemic autoimmune diseases (SAIDs) have chronic trajectories and share characteristics of self-directed inflammation and aspects of clinical expression. Nonetheless, burden-of-disease studies rarely investigate them as a distinct category. This study aims to assess the mortality rate of SAIDs as a group and to evaluate co-occurring causes of death. Methods We used death certificate data in the Netherlands, 2013-2017, (N = 711,247) and constructed a SAIDs list (4-position ICD-10). The mortality rate of SAIDs as underlying Cause of Death (CoD), non-underlying CoD, and any-mention CoD was calculated. We estimated age-sex-standardized observed/expected ratios to assess comorbidities in deaths with SAID relative to the general deceased population. Results We observed 3,335 deaths with SAID on their death certificate (0.47% of all deaths). The mortality rate of SAID was 14.6 per million population as underlying CoD, 28.0 as non-underlying CoD, and 39.7 as any-mention CoD. The mortality rate was higher for females and increased exponentially with age. SAID-related deaths were positively associated with all comorbidities except for solid neoplasms and mental conditions. Particularly strong was the association with musculoskeletal (O/E=3.38,95% CI[2.98,3.82]), other genitourinary (O/E=2.73,95% CI[2.18,3.38]), blood (O/E=2.02,95% CI[1.70,2.39]), skin and subcutaneous tissue (O/E=1.95,95% CI[1.54,2.45]), and infectious diseases (O/E=1.85,95% CI[1.70,2.01]), as well as influenza (O/E=2.71,95% CI[1.74,4.03]). Conclusions Systemic autoimmune diseases constitute a rare group of causes of death, but contribute to mortality through multiple comorbidities. Classification systems could be adapted to better encompass these diseases as a category. Key messages Reclassification of readily available data provides useful estimates for the mortality burden of systemic autoimmune diseases in the population.

Rheumatology ◽  
2020 ◽  
Author(s):  
Marianna Mitratza ◽  
Bart Klijs ◽  
A Elisabeth Hak ◽  
Jan W P F Kardaun ◽  
Anton E Kunst

Abstract Objectives Systemic autoimmune diseases (SAIDs) have chronic trajectories and share characteristics of self-directed inflammation, as well as aspects of clinical expression. Nonetheless, burden-of-disease studies rarely investigate them as a distinct category. This study aims to assess the mortality rate of SAIDs as a group and to evaluate co-occurring causes of death. Methods We used death certificate data in the Netherlands, 2013–2017 (N = 711 247), and constructed a SAIDs list at the fourth-position ICD-10 level. The mortality rate of SAIDs as underlying cause of death (CoD), non-underlying CoD, and any-mention CoD was calculated. We estimated age-sex-standardized observed/expected (O/E) ratios to assess comorbidities in deaths with SAID relative to the general deceased population. Results We observed 3335 deaths with SAID on their death certificate (0.47% of all deaths). The mortality rate of SAID was 14.6 per million population as underlying CoD, 28.0 as non-underlying CoD, and 39.7 as any-mention CoD. The mortality rate was higher for females and increased exponentially with age. SAID-related deaths were positively associated with all comorbidities except for solid neoplasms and mental conditions. Particularly strong was the association with diseases of the musculoskeletal system (O/E = 3.38; 95% CI: 2.98, 3.82), other diseases of the genitourinary system (O/E = 2.73; 95% CI: 2.18, 3.38), influenza (O/E = 2.71; 95% CI: 1.74, 4.03), blood diseases (O/E = 2.02; 95% CI: 1.70, 2.39), skin and subcutaneous tissue diseases (O/E = 1.95; 95% CI: 1.54, 2.45), and infectious diseases (O/E = 1.85; 95% CI: 1.70, 2.01). Conclusion Systemic autoimmune diseases constitute a rare group of causes of death, but contribute to mortality through multiple comorbidities. Classification systems could be adapted to better encompass these diseases as a category.


2019 ◽  
Vol 4 (4) ◽  
pp. p327
Author(s):  
Malcolm J. D’Souza ◽  
Riza C. Li ◽  
Derald E. Wentzien

Using commercially available but powerful big data analytics, this non-clinical obesity and underlying causes of death observational study, analyzed the very large US Centers for Disease Control and Prevention’s (CDC) State of Obesity records, the CDC WONDER data, and the US census records. Compared to the 1999-to-2017 US obesity rate increase of 29.8%, an uncontrolled increase in Delaware’s obesity rate (81.7%) was observed. During the same time period, CDC WONDER death certificate archives disclosed that there was a 60.53% surge in crude Delawarean mortality rate when obesity was listed as a single underlying cause of death. When any mention of obesity was documented on the death certificate, Delaware’s 1999-2017 crude mortality rate advanced by 75.69% and its age-adjusted rate rose by 53.18%. Likewise, except for one year, Delaware’s African American/Black population experienced higher crude mortality rate averages but however, between the years of 1997 and 2017, its Caucasian/White inhabitants had an enormous 87.34% death rate increase. With additional available CDC mortality data, Delaware males saw substantially larger age-adjusted death rate increases (79.87%) than their female counterparts (28.92%).Diabetes, circulatory system diseases, and neoplasms (cancer), are three common obesity comorbidities. For these three conditions, Delaware’s 1999-2017 mortality rate figures mimic the falling national patterns of mortality rate averages, when each disease is listed as the single underlying cause of death, including observations where there are disproportionate numbers of cases that affect the African American/Black race.


2008 ◽  
Vol 61 (9-10) ◽  
pp. 503-506
Author(s):  
Nevenka Roncevic ◽  
Aleksandra Stojadinovic

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.


Author(s):  
S. S. Aleksanin ◽  
E. V. Bobrinev ◽  
V. I. Evdokimov ◽  
A. A. Kondashov ◽  
N. A. Mukhina ◽  
...  

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. 


2021 ◽  
Author(s):  
Mahdiyeh Heydari ◽  
Khadijeh Yarifard ◽  
Maryam Tajvar

Abstract Background: Youth is undeniably the most important force and resource of any country, thus, identifying the leading causes of death among them to develop preventable interventions is essential. This study aimed to determine the trend of mortality rate and the leading cause of death, based on the ICD-10, among young people in Iran.Methods: The present study is a retrospective cohort and examines the trend of Iranian youth mortality, aged 15-24 years, between 1990 and 2017. The data source was the Global Burden of Disease (GBD) website. Linear Regression analysis was used to measure the slope of changes in mortality rates and causes of mortality during the period, where "time" was the independent variable and "mortality rate" and "causes of mortality" were dependent variables.Results: the death rate of young people declined by 54% during the period, equal to an average of 1.37 units per year. The most common cause of death has been injuries (70%), and then NCDs (25%) and finally communicable diseases (5%). However, death due to injuries (except SUD) and communicable diseases (except HIV) declined significantly by 0.94 and 0.09 units per year, respectively (P<0.001), while, death due to the NCDs had an increasing trend by 0.12 units per year over 28 years (P=0.006).Conclusion: Examining past trends in death rates and causes strengthens insights into the state and future trends in health and death-related indicators, which are crucial for policy-making, especially in developing countries with limited resources.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019407 ◽  
Author(s):  
Amy E Peden ◽  
Richard C Franklin ◽  
Alison J Mahony ◽  
Justin Scarr ◽  
Paul D Barnsley

ObjectivesFatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths.DesignAn analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007–2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society—Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD.SettingAustralia, 2007–2011.ParticipantsUnintentional fatal drowning cases.ResultsThe Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0–17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level.ConclusionDefining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.


Author(s):  
Stuart Jarvis ◽  
Lorna Fraser

ABSTRACTObjectivesTo compare methods of estimating prevalence of life limiting conditions (LLC) among children and young people (CYP) using (i) cause of death recorded on death certificates and (ii) diagnostic codes in routinely collected inpatient and birth records. ApproachCYP with a LLC were identified from NHS inpatient and birth records in Scotland from 1 April 2003 to 30 March 2014 using a LLC ICD-10 coding framework. The cohort was restricted to individuals who died in the study period. For each cohort member, the LLC coding framework was used to determine whether a diagnosis identified as a LLC was recorded as the underlying cause of death. For those without LLC as an underlying cause of death, the underlying cause was checked to determine whether it was related to LLC – either itself indicative of LLC when recorded on a death certificate or related to one or more of the LLCs identified in the individual’s inpatient and birth records. Finally, for those with underlying cause of death neither a LLC nor related to a LLC, the contributing causes of death were checked against the coding framework for LLC; where found, the individual was marked as having a LLC as a contributing cause of death. These analyses were undertaken for the whole cohort, per year, by age groups and by diagnostic categories. Results20436 CYP with a LLC were identified between 1 April 2009 and 31 March 2014, of which 2249 had died and had a death register record. Of these, 1291 (57%) had a LLC as underlying cause of death; 319 (14%) had an LLC-related underlying cause of death and 268 (12%) had LLC only among contributing causes of death. 371 (16%) had no indication of LLC in their death records. Recording of a LLC as underlying cause of death was lower (41%) amongst under 1 year olds and also varied widely by diagnostic group. ConclusionAround one in six of CYP identified using the coding framework as having a LLC (and almost one in five of under 1s) would not have been so identified using all causes of death in death records. More than a quarter (28%) would be missed if only underlying cause of death was used. This, combined with longer survival times, means use of death records has the potential to greatly underestimate prevalence of LLC in children and young people.


Author(s):  
V. P. Kolosov ◽  
L. G. Manakov ◽  
E. V. Polyanskaya ◽  
J. M. Perelman

Introduction. New viral respiratory infections in humans make it possible to speak of corona viruses as extremely dangerous human pathogens. They are characterized by a high mortality rate and pose a significant medical and social threat to society due to life-threatening complications of the disease. In this regard, it seems necessary to answer the questions about the dynamics of mortality of the population of the region for different classes of ICD-10 in the prepandemic and pandemic period, including various nosological forms of respiratory diseases. Aim. To assess the degree of influence of the pandemic of the new respiratory coronavirus infection COVID-19 on the mortality rate of the population for various classes of ICD-10, including the class “Diseases of the respiratory system” in the Far Eastern Federal District.Materials and methods. To implement the tasks of the study, a complex of analytical, epidemiological and statistical studies was carried out. Methods used: descriptive statistics, epidemiological analysis and monitoring; mathematical; structural and comparative analysis, methods of time series analysis and content analysis of publications on the problem. Epidemiological and statistical assessment of mortality was carried out on the basis of ICD-10 using the database of the Federal State Statistics Service for 1999-2020 in the territory of the Far Eastern Federal District. For the analysis and processing of statistical information, modern information systems and computer programs (MS Excel-2016) were used. Results. The pandemic of COVID-19 has had a significant impact on the level and structure of mortality across the entire spectrum of the main causes of death, and its magnitude (98.8 per 100,000, 2020), as a new cause of death, exceeds the whole the class of causes of death ICD-10 (J00-J99) by 33.3%, changing the pace and direction of demographic processes in Russia. At the same time, the dynamics of mortality due to respiratory diseases is unprecedented, the level of which in the Russian Federation in the first year of the COVID-19 pandemic increased by 38.8%, and in the Far Eastern Federal District – by 27.7% against the background of the previous long-term stable a downward trend in mortality rates. Especially high growth rates of mortality rates are observed in pneumonia, the level of which has increased by 3.5 times over the last decade, and among city residents – by 4.2 times (Amur Region). Features of the socio-economic and natural-climatic living conditions of the population of the region determine a significant differentiation of regions in terms of mortality rates, including due to respiratory diseases, the gradients of which among the subjects of the Far Eastern Federal District in the first year of the pandemic period (2020) amounted to 2.5 times with a minimum the level in the Republic of Sakha (Yakutia) (40.9 per 100,000 population) and the maximum – in the Jewish Autonomous Region (101.7 per 100,000 population), which indicates the ambiguous degree of influence of the new viral infection on the dynamics of mortality. At the same time, the variability in mortality rates due to respiratory diseases in the previous period (1999-2019) was even more pronounced, and among the subjects of the Far Eastern Federal District, during this period, higher mortality rates were also demonstrated, which are not even comparable to the current level of the pandemic period. These circumstances require a detailed study and a substantive analysis of the degree of influence of a COVID-19 on the mortality rate of the population using mechanisms and methods for its detection, record and registration. Conclusion. The pandemic of COVID19 had a significant impact on the level and structure of mortality across the entire spectrum of major causes of death, especially in the ICD-10 class “Respiratory diseases”, changing the pace and direction of demographic processes.


Author(s):  
U. Fedeli ◽  
E. Schievano ◽  
S. Masotto ◽  
E. Bonora ◽  
G. Zoppini

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.


2019 ◽  
Vol 4 (4) ◽  
pp. 53-55
Author(s):  
O. E. Yolkina

The article focuses on the problems of mortality rate and the ways of its reducing in the Moscow Region as well as correct coding of causes of death according to ICD-10.


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