Alcohol-related mortality by ethnic origin of natives: a prospective cohort study based on multigenerational population register data from Finland and Sweden

ObjectivesThe aim was to assess alcohol-related mortality of persons with mixed and uniform ethnic origins in two national contexts.SettingData were from the multigenerational population registers of the total population of Finland and Sweden observed from 1971 to 2017. Study persons were men and women of ethnic Finnish and Swedish background, born in their country of residence.ParticipantsPersons were born between 1953 and 1999. In Finland, ethnic origin was assessed through own, mother’s and father’s Finnish or Swedish ethnolinguistic affiliation. Data on Sweden included persons born in Sweden, with mother and father born in Sweden or Finland. A total of 2 997 867 and 4 148 794 persons were included in the Finnish and Swedish data, respectively. The total number of alcohol-related deaths by main cause was 13 204 and 3336. Cox regressions were used to examine associations.Outcome measuresFor the period 1971–2017, we studied alcohol as the main cause of death. For the period 1996–2017, we observed if alcohol was the main or contributing cause of death. Parallel analyses were performed for all-cause mortality.ResultsFor men in Finland, the hazard rate of alcohol-related mortality of Swedish speakers with uniform Swedish background was 0.44 (95% CI: 0.38 to 0.52) that of Finnish speakers with uniform Finnish background. The corresponding hazard rate for women was 0.40 (95% CI: 0.28 to 0.55). In Sweden, the hazard rate of men with both parents born in Sweden was 0.40 (95% CI: 0.32 to 0.49) that of men with both parents born in Finland. The corresponding hazard rate for women was 0.50 (95% CI: 0.31 to 0.79). In both countries, persons with mixed background had an alcohol-related mortality rate between that of persons with uniform Finnish and Swedish background.ConclusionThe consistent pattern across countries necessitates increased policy attention towards offspring disadvantaged via parental ethnicity to minimise harmful consequences of alcohol consumption across and within ethnic groups.

Download Full-text

Underweight and mortality

Public Health Nutrition ◽

10.1017/s136898001500302x ◽

2015 ◽

Vol 19 (10) ◽

pp. 1751-1756 ◽

Cited By ~ 9

Author(s):

Joo Young Lee ◽

Hyeon Chang Kim ◽

Changsoo Kim ◽

Keeho Park ◽

Song Vogue Ahn ◽

...

Keyword(s):

Cohort Study ◽

Normal Weight ◽

Reverse Causation ◽

Men And Women ◽

Hazard Ratios ◽

All Cause Mortality ◽

Per Se ◽

Never Smokers ◽

Smoking And Health

AbstractObjectiveAccording to most prospective studies, being underweight (BMI<18·5 kg/m2) is associated with significantly higher mortality than being of normal weight, especially among smokers. We aimed to explore in a generally lean population whether being underweight is significantly associated with increased all-cause mortality.DesignProspective cohort study.SettingKorea Medical Insurance Corporation study with 14 years of follow-up.SubjectsAfter excluding deaths within the first 5 years of follow-up (1993–1997) to minimize reverse causation and excluding participants without information about smoking and health status, 94 133 men and 48 496 women aged 35–59 years in 1990 were included.ResultsWe documented 5411 (5·7 %) deaths in men and 762 (1·6 %) in women. Among never smokers, hazard ratios (HR) for underweight individuals were not significantly higher than those for normal-weight individuals (BMI=18·5–22·9 kg/m2): HR=0·87 (95 % CI 0·41, 1·84, P=0·72) for underweight men and HR=1·12 (95 % CI 0·76, 1·65, P=0·58) for underweight women. Among ex-smokers, HR=0·86 (95 % CI 0·38, 1·93, P=0·72) for underweight men and HR=3·77 (95 % CI 0·42, 32·29, P=0·24) for underweight women. Among current smokers, HR=1·60 (95 % CI 1·28, 2·01, P<0·001) for underweight men and HR=2·07 (95 % CI 0·43, 9·94, P=0·36) for underweight women.ConclusionsThe present study does not support that being underweight per se is associated with increased all-cause mortality in Korean men and women.

Download Full-text

Prehemodialysis arteriovenous access creation is associated with better cardiovascular outcomes in patients receiving hemodialysis: a population-based cohort study

PeerJ ◽

10.7717/peerj.6680 ◽

2019 ◽

Vol 7 ◽

pp. e6680

Author(s):

Cheng-Chieh Yen ◽

Mei-Yin Liu ◽

Po-Wei Chen ◽

Peir-Haur Hung ◽

Tse-Hsuan Su ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Sensitivity Analyses ◽

Major Adverse Cardiovascular Events ◽

First Year ◽

Research Database ◽

All Cause Mortality ◽

Arteriovenous Access ◽

Stage Renal Disease ◽

Related Mortality

Background Cardiovascular (CV) disease contributes to nearly half of the mortalities in patients with end-stage renal disease. Patients who received prehemodialysis arteriovenous access (pre-HD AVA) creation had divergent CV outcomes. Methods We conducted a population-based cohort study by recruiting incident patients receiving HD from 2001 to 2012 from the Taiwan National Health Insurance Research Database. Patients’ characteristics, comorbidities, and medicines were analyzed. The primary outcome of interest was major adverse cardiovascular events (MACEs), defined as hospitalization due to acute myocardial infarction, stroke, or congestive heart failure (CHF) occurring within the first year of HD. Secondary outcomes included MACE-related mortality and all-cause mortality in the same follow-up period. Results The patients in the pre-HD AVA group were younger, had a lower burden of underlying diseases, were more likely to use erythropoiesis-stimulating agents but less likely to use renin–angiotensin–aldosterone system blockers. The patients with pre-HD AVA creation had a marginally lower rate of MACEs but a significant 35% lower rate of CHF hospitalization than those without creation (adjusted hazard ratio (HR) 0.65, 95% confidence interval (CI) [0.48–0.88]). In addition, the pre-HD AVA group exhibited an insignificantly lower rate of MACE-related mortality but a significantly 52% lower rate of all-cause mortality than the non-pre-HD AVA group (adjusted HR 0.48, 95% CI [0.39–0.59]). Sensitivity analyses obtained consistent results. Conclusions Pre-HD AVA creation is associated with a lower rate of CHF hospitalization and overall death in the first year of dialysis.

Download Full-text

Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-028880 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028880

Author(s):

HeeKyoung Choi ◽

Hyo Suk Nam ◽

Euna Han

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Ischaemic Stroke ◽

Mortality Risk ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Normal Weight ◽

All Cause Mortality ◽

Related Mortality

ObjectivesAlthough obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea.DesignRetrospective cohort study.SettingA tertiary-hospital-based stroke registry linked to the death records.Participants3599 patients admitted for ischaemic stroke from January 2007 to June 2013.Outcome measuresThe HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above).ResultsFor stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83).ConclusionsObesity is more likely to reduce mortality risk than normal weight, especially in elderly patients.

Download Full-text

Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study

BMJ ◽

10.1136/bmj.c3966 ◽

2010 ◽

Vol 341 (aug24 1) ◽

pp. c3966-c3966 ◽

Cited By ~ 74

Author(s):

L. S. Gudmundsson ◽

A. I. Scher ◽

T. Aspelund ◽

J. H. Eliasson ◽

M. Johannsson ◽

...

Keyword(s):

Cohort Study ◽

Migraine With Aura ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Men And Women ◽

All Cause Mortality

Download Full-text

COVID19-related and all-cause mortality among middle-aged and older adults across the first epidemic wave of SARS-COV-2 infection in the region of Tarragona, Spain: results from the COVID19 TARRACO Cohort Study, March-June 2020

10.1101/2021.02.02.21251028 ◽

2021 ◽

Author(s):

Angel Vila-Corcoles ◽

Eva Satue-Gracia ◽

Angel Vila-Rovira ◽

Cinta de Diego-Cabanes ◽

Maria Jose Forcadell-Peris ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Nursing Home ◽

Cox Regression ◽

Middle Aged ◽

Mortality Risks ◽

Increased Risk ◽

Epidemic Period ◽

All Cause Mortality ◽

Related Mortality

SUMMARYBackgroundDirect and indirect COVID19-related mortality is uncertain. This study investigated COVID19-related and all-cause deaths among middle-aged and older adults during the first wave of COVID19 epidemic period, assessing mortality risks by pre-existing socio-demographic and medical underlying conditions.MethodsPopulation-based cohort study involving 79,083 individuals ≥50 years-old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (age/sex, comorbidities and medications/vaccinations history) were established at study start (01/03/2020) and main outcomes were COVID19-related deaths (occurred in patients diagnosed with the disease) and all-cause deaths occurred among cohort members between 01/03/2020-30/06/2020. Mortality risks were assessed by Cox regression analyses.ResultsCohort members were followed for 1,356,358 persons-weeks, occurring 576 all-cause deaths (124 COVID19-related). All-cause mortality rate was 42.5 deaths per 100,000 persons-week, being 22.8 in healthy/unrelated-COVID19 subjects, 236.4 in COVID19-excluded/PCR-negative subjects, 493.7 in COVID19-compatible/PCR-unperformed subjects and 4009.1 in COVID19-confirmed patients. In multivariable analyses, increasing age, sex male, nursing-home residence, cancer, neurologic, cardiac or liver disease, receiving diuretics, systemic corticosteroids, proton-pump inhibitors and benzodiazepines were associated with increased risk of all-cause mortality; conversely, receiving renin-angiotensin inhibitors and statins were associated with reduced risk. Age/years, sex male and nursing-home residence were strong predictors for COVID19-related mortality, but none comorbidity appeared significantly associated with an increased risk.ConclusionApart from direct COVID19-related deaths (which represented almost 22% of all-cause mortality), theoretically COVID19-excluded patients (PCR-negative) suffered considerable greater all-cause mortality than healthy/unrelated-COVID19 subjects, which could explain, in part, the large excess deaths observed across the COVID19 pandemic.

Download Full-text

The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10020295 ◽

2021 ◽

Vol 10 (2) ◽

pp. 295

Author(s):

Bernard Surial ◽

Nicolas Bertholet ◽

Jean-Bernard Daeppen ◽

Katharine Darling ◽

Alexandra Calmy ◽

...

Keyword(s):

Cohort Study ◽

Liver Disease ◽

Binge Drinking ◽

Incidence Rate ◽

Hazardous Drinking ◽

Drinking Patterns ◽

All Cause Mortality ◽

The Impact ◽

Related Mortality

Whereas excessive alcohol consumption increases liver disease incidence and mortality, evidence on the risk associated with specific drinking patterns is emerging. We assessed the impact of binge drinking on mortality and liver disease in the Swiss HIV Cohort Study. All participants with follow-up between 2013 and 2020 were categorized into one of four drinking pattern groups: “abstinence”, “non-hazardous drinking”, “hazardous but not binge drinking” (Alcohol Use Disorder Identification Test Consumption [AUDIT-C] score ≥ 3 in women and ≥4 in men), and “binge drinking” (≥6 drinks/occasion more than monthly). We estimated adjusted incidence rate ratios (aIRR) for all-cause mortality, liver-related mortality and liver-related events using multivariable quasi-Poisson regression. Among 11,849 individuals (median follow-up 6.8 years), 470 died (incidence rate 7.1/1000 person-years, 95% confidence interval [CI] 6.5–7.8), 37 experienced a liver-related death (0.6/1000, 0.4–0.8), and 239 liver-related events occurred (3.7/1000, 3.2–4.2). Compared to individuals with non-hazardous drinking, those reporting binge drinking were more likely to die (all-cause mortality: aIRR 1.9, 95% CI 1.3–2.7; liver-related mortality: 3.6, 0.9–13.9) and to experience a liver-related event (3.8, 2.4–5.8). We observed no difference in outcomes between participants reporting non-hazardous and hazardous without binge drinking. These findings highlight the importance of assessing drinking patterns in clinical routine.

Download Full-text

Potential gains in reproductive-aged life expectancy if maternal mortality were eradicated from the Kintampo districts of Central Ghana

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2515-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Sulemana Watara Abubakari ◽

Ayaga Agula Bawah ◽

Ernest Obed Nettey ◽

Edward Anane Apraku ◽

Charles Zandoh ◽

...

Keyword(s):

Life Expectancy ◽

Maternal Mortality ◽

Cause Of Death ◽

Reproductive Age ◽

Middle Income ◽

All Cause Mortality ◽

Age Patterns ◽

Demographic Impact ◽

Reproductive Aged Women ◽

Related Mortality

Abstract Background Almost 99% of pregnancy or childbirth-related complications globally is estimated to occur in developing regions. Yet, little is known about the demographic impact of maternal causes of death (COD) in low-and middle-income countries. Assuming that critical interventions were implemented such that maternal mortality is eradicated as a major cause of death, how would it translate to improved longevity for reproductive-aged women in the Kintampo districts of Ghana? Methods The study used longitudinal health and demographic surveillance data from the Kintampo districts to assess the effect of hypothetically eradicating maternal COD on reproductive-aged life expectancy by applying multiple decrement and associated single decrement life table techniques. Results According to the results, on the average, women would have lived an additional 4.4 years in their reproductive age if maternal mortality were eradicated as a cause of death, rising from an average of 28.7 years lived during the 2005-2014 period to 33.1 years assuming that maternal mortality was eradicated. The age patterns of maternal-related mortality and all-cause mortality depict that the maternal-related mortality is different from the all-cause mortality for women of reproductive age. Conclusion This observation suggests that other COD are competing with maternal mortality among the WRA in the study area and during the study period.

Download Full-text

Associations of Socioeconomic Status and Physical Activity With Obesity Measures in Rural Chinese Adults

Frontiers in Public Health ◽

10.3389/fpubh.2020.594874 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mingming Pan ◽

Runqi Tu ◽

Jianjun Gu ◽

Ruiying Li ◽

Xiaotian Liu ◽

...

Keyword(s):

Physical Activity ◽

Clinical Trial ◽

Socioeconomic Status ◽

Cohort Study ◽

Regression Models ◽

Total Population ◽

Education Level ◽

Low Ses ◽

Men And Women ◽

Low Education

Background: Although independent association of socioeconomic status (SES) or physical activity (PA) with obesity has been well-documented in urban settings, their independent and joint associations on obesity measures are limited in rural regions.Methods: Almost 38,000 (n = 37,922) individuals were included from the Henan Rural Cohort Study. The International Physical Activity Questionnaire (IPAQ) was used to evaluate PA. Obesity was reflected by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). The independent and interactive effects of SES and PA on obesity were analyzed by logistic regression models and generalized linear regression models, respectively.Results: Compared with high education level, the OR (95%CI) of obesity defined by BMI with low education level was 1.466 (1.337, 1.608), 1.064 (0.924, 1.225), and 1.853 (1.625, 2.114) in total population, men and women, respectively. Besides, the OR (95%CI) of obesity defined by BMI associated with per capita monthly income were 1.089 (1.015, 1.170), 1.192 (1.055, 1.347), 1.038 (0.951, 1.133) in total population, men and women, respectively. Similar results had been observed in other obesity measures. Negative interactive association of low education level and PA on obesity measures were observed only in women (all P < 0.05).Conclusions: This study suggests that women are more susceptible to obesity concerning low SES and that adequate PA may be a potential target for mitigating the negative effect of low SES on obesity in women.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

Download Full-text

Sex hormone-binding globulin, androgens and mortality: the KORA-F4 cohort study

Endocrine Connections ◽

10.1530/ec-20-0080 ◽

2020 ◽

Vol 9 (4) ◽

pp. 326-336 ◽

Cited By ~ 1

Author(s):

Florian Schederecker ◽

Alexander Cecil ◽

Cornelia Prehn ◽

Jana Nano ◽

Wolfgang Koenig ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

German Population ◽

Hormone Binding ◽

Men And Women ◽

Increased Risk ◽

All Cause Mortality ◽

Specific Mortality

Objective Sex hormone-binding globulin (SHBG) and androgens have been associated with mortality in women and men, but controversy still exists. Our objective was to investigate associations of SHBG and androgens with all-cause and cause-specific mortality in men and women. Design 1006 men and 709 peri- and postmenopausal women (age range: 45–82 years) from the German population-based KORA F4 cohort study were followed-up for a median of 8.7 years. Methods SHBG was measured with an immunoassay, total testosterone (TT) and dihydrotestosterone (DHT) with mass-spectrometry in serum samples and we calculated free testosterone (cFT). To assess associations between SHBG and androgen levels and mortality, we calculated hazard ratios (HRs) with 95% CIs using Cox proportional-hazards models. Results In the cohort, 128 men (12.7%) and 70 women (9.9%) died. In women, we observed positive associations of SHBG with all-cause (HR: 1.54, 95% CI: 1.16–2.04) and with other disease-related mortality (HR: 1.86, 95% CI: 1.08–3.20) and for DHT with all-cause mortality (HR: 1.32, 95% CI: 1.00–1.73). In men, we found a positive association of SHBG (HR: 1.24 95% CI: 1.00–1.54) and inverse associations of TT (HR: 0.87, 95% CI: 0.77–0.97) and cFT (HR: 0.84, 95% CI: 0.73–0.97) with all-cause mortality. No other associations were found for cause-specific mortality. Conclusions Higher SHBG levels were associated with increased risk of all-cause mortality in men and women. Lower TT and cFT levels in men and higher DHT levels in women were associated with increased risk of all-cause mortality. Future, well-powered population-based studies should further investigate cause-specific mortality risk.

Download Full-text

COVID19-related and all-cause mortality risk among middle-aged and older adults across the first epidemic wave of SARS-COV-2 infection: a population-based cohort study in Southern Catalonia, Spain, March–June 2020

BMC Public Health ◽

10.1186/s12889-021-11879-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Angel Vila-Corcoles ◽

Eva Satue-Gracia ◽

Angel Vila-Rovira ◽

Cinta de Diego-Cabanes ◽

Maria Jose Forcadell-Peris ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Nursing Home ◽

Population Based ◽

Considerable Proportion ◽

Middle Aged ◽

Mortality Risks ◽

Increased Risk ◽

All Cause Mortality ◽

Related Mortality

Abstract Background Direct and indirect COVID19-related mortality is uncertain. This study investigated all-cause and COVID19-related deaths among middle-aged and older adults during the first wave of COVID-19 pandemic period, assessing mortality risks by pre-existing socio-demographic and medical underlying conditions. Methods Population-based cohort study involving 79,083 individuals ≥50 years-old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (age/sex, comorbidities and medications/vaccinations history) were established at study start (01/03/2020) and main outcomes were COVID19-related deaths (those occurred among patients with laboratory-confirmed COVID19) and all-cause deaths occurred among cohort members between 01/03/2020–30/06/2020. Mortality risks were assessed by Cox regression analyses. Results Cohort members were followed for 1,356,358 persons-weeks, occurring 576 all-cause deaths (124 COVID19-related deaths). Of the 124 deceased patients with a laboratory-confirmed COVID19, 112 (90.3%) died by (due to) COVID-19, while 12 (9.7%) died with COVID-19 (but likely due to other concomitant causes). All-cause mortality rate among cohort members across study period was 42.5 deaths per 100,000 persons-week, being 22.8 among healthy/unrelated-COVID19 subjects, 236.4 in COVID19-excluded/PCR-negative subjects, 493.7 in COVID19-compatible/PCR-unperformed subjects and 4009.1 in COVID19-confirmed patients. Increasing age, sex male, nursing-home residence, cancer, neurologic, cardiac or liver disease, receiving diuretics, systemic corticosteroids, proton-pump inhibitors and benzodiazepines were associated with increased risk of all-cause mortality; conversely, receiving renin-angiotensin inhibitors and statins were associated with reduced risk. Age/years (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.06–1.10), sex male (HR: 1.82; 95% CI: 1.24–2.70), nursing-home residence (HR: 12.56; 95% CI: 8.07–19.54) and number of pre-existing comorbidities (HR: 1.14; 95% CI: 1.01–1.29) were significant predictors for COVID19-related mortality, but none specific comorbidity emerged significantly associated with an increased risk in multivariable analysis evaluating it. Conclusion COVID19-related deaths represented more than 20 % of all-cause mortality occurred among middle-aged and older adults during the first wave of the pandemic in the region. A considerable proportion (around 10 %) of these COVID19-related deaths could be attributed to other concomitant causes. Theoretically COVID19-excluded subjects (PCR-negative) suffered ten-times greater all-cause mortality than healthy/unrelated-COVID19 subjects, which points to the existence of considerable number of false negative results in earlier PCR testing and could explain part of the global excess all-cause mortality observed during the pandemic.

Download Full-text