Causes of death among patients with multiple sclerosis

2010 ◽  
Vol 16 (12) ◽  
pp. 1437-1442 ◽  
Author(s):  
Marja-Liisa Sumelahti ◽  
Matti Hakama ◽  
Irina Elovaara ◽  
Eero Pukkala
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Confidence Interval ◽  
Mortality Risk ◽  
Causes Of Death ◽  
High Mortality Risk ◽  
Disease Mortality ◽  
Underlying Causes ◽  
Standardized Mortality Ratios

Background: Several studies show a high mortality risk among patients with multiple sclerosis (MS). Objectives: In this study, mortality and underlying causes of death were analysed among patients with MS diagnosed between 1964—1993 in Finland ( n = 1595). Methods: Standardized mortality ratios (SMRs) were calculated for both genders. The follow-up was based on linkage to the national computerized Cause-of-Death Register of Statistics Finland. Results: Altogether, 464 deaths were recorded by the end of 2006. The SMR as compared with the general population among females was 3.4 (95% confidence interval 3.0—3.9) and among males 2.2 (1.9—2.6). In total, 270 patients (58%) died from MS; only one of these deaths occurred during the first 2 years after the MS diagnosis. Mortality was also increased for other natural causes of death ( n = 160) in patients followed for more than 10 years (SMR 1.4, 1.2—1.7), with a significant increase in deaths from influenza (29, 6.0—85), pneumonia (4.7, 2.5—8.0) and gastrointestinal causes (4.4, 2.3—7.7). The SMR for violent causes was 1.2 (0.7—1.9) and for alcohol-related deaths 0.2 (0.02—0.7). The SMR for suicides was 1.7 (0.9—2.7). Conclusions: The MS population has an increased disease mortality, while the increase in the risk of accidents and suicides is not significantly increased among patients with MS in Finland.

scholarly journals Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study

2021 ◽  
Author(s):  
Natalie Glaser ◽  
Michael Persson ◽  
Anders Franco‐Cereceda ◽  
Ulrik Sartipy
Keyword(s):  
Aortic Valve ◽  
General Population ◽  
Life Expectancy ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Causes Of Death ◽  
Study Cohort ◽  
Surgical Aortic Valve Replacement ◽  
Standardized Mortality Ratios

Background Prior studies showed that life expectancy in patients who underwent surgical aortic valve replacement (AVR) was lower than in the general population. Explanations for this shorter life expectancy are unknown. The aim of this nationwide, observational cohort study was to investigate the cause‐specific death following surgical AVR. Methods and Results We included 33 018 patients who underwent primary surgical AVR in Sweden between 1997 and 2018, with or without coronary artery bypass grafting. The SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) register and other national health‐data registers were used to obtain and characterize the study cohort and to identify causes of death, categorized as cardiovascular mortality, cancer mortality, or other causes of death. The relative risks for cause‐specific mortality in patients who underwent AVR compared with the general population are presented as standardized mortality ratios. During a mean follow‐up period of 7.3 years (maximum 22.0 years), 14 237 (43%) patients died. The cumulative incidence of death from cardiovascular, cancer‐related, or other causes was 23.5%, 8.3%, and 11.6%, respectively, at 10 years, and 42.8%, 12.8%, and 23.8%, respectively, at 20 years. Standardized mortality ratios for cardiovascular, cancer‐related, and other causes of death were 1.79 (95% CI, 1.75–1.83), 1.00 (95% CI, 0.97–1.04), and 1.08 (95% CI, 1.05–1.12), respectively. Conclusions We found that life expectancy following AVR was lower than in the general population. Lower survival after AVR was explained by an increased relative risk of cardiovascular death. Future studies should focus on the role of earlier surgery in patients with asymptomatic aortic stenosis and on optimizing treatment and follow‐up after AVR. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02276950.

scholarly journals A population-based study of cardiovascular disease mortality risk in US cancer patients

2019 ◽  
Vol 40 (48) ◽  
pp. 3889-3897 ◽  
Author(s):  
Kathleen M Sturgeon ◽  
Lei Deng ◽  
Shirley M Bluethmann ◽  
Shouhao Zhou ◽  
Daniel M Trifiletti ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
General Population ◽  
Cancer Diagnosis ◽  
Mortality Risk ◽  
First Year ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality ◽  
Cvd Mortality

Abstract Aims This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. Methods and results The Surveillance, Epidemiology, and End Results program was used to compare the US general population to 3 234 256 US cancer survivors (1973–2012). Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic aneurysm/dissection). Analyses were adjusted by age, race, and sex. Among 28 cancer types, 1 228 328 patients (38.0%) died from cancer and 365 689 patients (11.3%) died from CVDs. Among CVDs, 76.3% of deaths were due to heart disease. In eight cancer sites, CVD mortality risk surpassed index-cancer mortality risk in at least one calendar year. Cardiovascular disease mortality risk was highest in survivors diagnosed at <35 years of age. Further, CVD mortality risk is highest (SMR 3.93, 95% confidence interval 3.89–3.97) within the first year after cancer diagnosis, and CVD mortality risk remains elevated throughout follow-up compared to the general population. Conclusion The majority of deaths from CVD occur in patients diagnosed with breast, prostate, or bladder cancer. We observed that from the point of cancer diagnosis forward into survivorship cancer patients (all sites) are at elevated risk of dying from CVDs compared to the general US population. In endometrial cancer, the first year after diagnosis poses a very high risk of dying from CVDs, supporting early involvement of cardiologists in such patients.

Outcome in biopsy-proven Lupus nephritis: Evaluation of biopsies from the Norwegian Kidney Biopsy Registry

Lupus ◽  
2017 ◽  
Vol 26 (8) ◽  
pp. 881-885 ◽  
Author(s):  
G E Norby ◽  
G Mjøen ◽  
R Bjørneklett ◽  
B E Vikse ◽  
H Holdaas ◽  
...  
Keyword(s):  
General Population ◽  
Lupus Nephritis ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Causes Of Death ◽  
Cox Regression ◽  
Population Sample ◽  
All Cause Mortality ◽  
Class Iv

Objective To evaluate long-term mortality and end-stage renal disease (ESRD) in a cohort of Norwegian patients with biopsy-proven lupus nephritis (LN). Methods Renal biopsies were obtained from 178 patients with LN from 1988 until 2007. Mortality rate and death causes were provided by Statistics Norway and ESRD data were provided by the Norwegian Renal Registry. Risk factors for all-cause mortality were evaluated by Cox regression. Standardized mortality ratio (SMR) was compared to observed deaths in a matched general population sample. Results Mean age was 37.6 (±14.4) years, and median time of follow-up was 8.5 years (0–26.2). Thirty-six patients (20.2%) died during follow-up. The SMR for all-cause mortality was 5.6 (Confidence interval [CI] 3.7–7.5). In an adjusted multivariate analysis proliferative glomerulonephritis (LN class IV) was independently associated with all-cause mortality; hazard ratio (HR) 2.6 (Confidence interval [CI] 1.2–5.7 p = 0.017). Main causes of death were infections (47.2%) and cardiovascular events 8 (22.2%). Thirty-six patients (20.2%) reached ESRD. Conclusions Biopsy-proven LN is associated with increased mortality compared to the general population. LN class IV is associated with all-cause mortality. Infections and cardiovascular events were the most common causes of death. Patients with LN have a high incidence of ESRD.

scholarly journals Causes of death among crack cocaine users

2006 ◽  
Vol 28 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Marcelo Ribeiro ◽  
John Dunn ◽  
Ricardo Sesso ◽  
Andréa Costa Dias ◽  
Ronaldo Laranjeira
Keyword(s):  
General Population ◽  
Mortality Risk ◽  
Causes Of Death ◽  
Crack Cocaine ◽  
Study Endpoint ◽  
Intravenous Drug Use ◽  
Common Causes ◽  
History Of ◽  
Cocaine Users

OBJECTIVE: The study accompanied 131 crack-cocaine users over a 5-year period, and examined mortality patterns, as well as the causes of death among them. METHOD: All patients admitted to a detoxification unit in Sao Paulo between 1992 and 1994 were interviewed during two follow-up periods: 1995-1996 and 1998-1999. RESULTS: After 5 years, 124 patients were localized (95%). By the study endpoint (1999), 23 patients (17.6%) had died. Homicide was the most prevalent cause of death (n = 13). Almost one third of the deaths were due to the HIV infection, especially among those with a history of intravenous drug use. Less than 10% died from overdose. CONCLUSIONS: The study suggests that the mortality risk among crack cocaine users is greater than that seen in the general population, being homicide and AIDS the most common causes of death among such individuals.

scholarly journals Prevalence of radiologically isolated syndrome in a pediatric population-based cohort: A longitudinal description of a rare diagnosis

2021 ◽  
pp. 135245852198922
Author(s):  
CL de Mol ◽  
AL Bruijstens ◽  
PR Jansen ◽  
MHG Dremmen ◽  
YYM Wong ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Confidence Interval ◽  
Pediatric Population ◽  
Population Based ◽  
Radiologically Isolated Syndrome ◽  
Demyelinating Lesions ◽  
Rare Diagnosis

Background: Radiologically isolated syndrome (RIS) is typified by multiple sclerosis (MS)-like lesions on imaging, without clinical MS symptoms. The prevalence of pediatric RIS is largely unknown. Objective: The objective of the study is to provide an estimated RIS prevalence in a population-based cohort of children. Methods: We used data from the Generation R study to identify the childhood RIS prevalence. Results: In 5238 participants, only one RIS case was identified (prevalence: 0.02%; 95% confidence interval (CI): 0.00–0.11). During a 62-month follow-up, imaging examinations showed accrual of new focal demyelinating lesions; however, no clinical MS symptoms occurred. Conclusions: This study shows that the occurrence of RIS in children from the general population is rare.

scholarly journals Causes of Death in Hepatocellular Carcinoma Patients: A SEER-Based Study

2021 ◽  
Author(s):  
Peri Harish Kumar ◽  
Sai Sharan Dwarka ◽  
Talal Zahid ◽  
Habib Ur Rehman ◽  
Tajbinder Singh Bains ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
General Population ◽  
Mortality Risk ◽  
Causes Of Death ◽  
Heart Diseases ◽  
Tumor Stage ◽  
Study Data ◽  
Parasitic Diseases ◽  
Common Causes ◽  
Standardized Mortality Ratios

Abstract Objective: To identify cancer and non-cancer causes of death in hepatocellular carcinoma (HCC) patients over different time periods after diagnosis and to compare the mortality risk of each cause in HCC patients with the general population.Methods: In this retrospective cohort study, data of 67,637 HCC patients from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the association between different causes of death and the following variables: age, race, tumor stage at diagnosis, and treatment (surgery, chemotherapy, and radiotherapy); each according to the periods of < 1 year, 1–5 years, 5–10 years, and > 10 years following the diagnosis. Standardized mortality ratios (SMRs) and their 95% confidence intervals (CIs) were calculated for cancer and non-cancer deaths in each of the mentioned periods following diagnosis.Results: Data of 67,637 patients, of whom 50,571 patients died during the follow-up period, were analyzed. Most deaths were due to HCC itself (35,535, 70.3%), followed by other cancers (3,983, 7.9%). Common causes of non-cancer mortality included infectious and parasitic diseases including HIV (2,823 patients, SMR = 105.68, 95% CI: 101.82-109.65), chronic liver disease (2,719 patients, SMR = 76.56, 95% CI: 73.71,79.5), and heart diseases (1,265 patients, SMR = 2.26, 95% CI: 2.14–2.39), with higher mortality risk in HCC patients than in the general population.Conclusion: Cancers stand for most deaths in patients with HCC. Besides, infectious, and parasitic diseases including HIV represent the commonest non-cancer cause of mortality.

Fatal accidents among Danes with multiple sclerosis

2006 ◽  
Vol 12 (3) ◽  
pp. 329-332 ◽  
Author(s):  
Henrik Brønnum-Hansen ◽  
Thomas Hansen ◽  
Nils Koch-Henriksen ◽  
Egon Stenager
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Traffic Accidents ◽  
Excess Risk ◽  
Road Accidents ◽  
Significant Excess ◽  
Fatal Accidents ◽  
Standardized Mortality Ratios ◽  
Significant Excess Risk

We compared the rate of fatal accidents among Danes with multiple sclerosis (MS) with that of the general population. The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry and covered all 10 174 persons in whom MS was diagnosed during the period 1953-1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the risk for death from accidents among persons with MS was 37% higher than that of the general population (SMR=1.37). We found no significant excess risk for fatal road accidents (SMR=0.80). The risk for falls was elevated (SMR=1.29) but not statistically significantly so. The risks were particularly high for deaths from burns (SMR=8.90) and suffocation (SMR=5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation.

scholarly journals Age-dependency in mortality of Finnish family caregivers: a nationwide register-based study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T M Mikkola ◽  
H Kautiainen ◽  
M Mänty ◽  
M B von Bonsdorff ◽  
T Kröger ◽  
...  
Keyword(s):  
General Population ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Causes Of Death ◽  
Lower Mortality ◽  
All Cause Mortality ◽  
The Difference ◽  
Caregiver Role ◽  
Selection Of

Abstract Purpose Mortality appears to be lower in family caregivers than in the general population. However, there is lack of knowledge whether the difference in mortality between family caregivers and the general population is dependent on age. The purpose of this study was to analyze all-cause mortality in relation to age in family caregivers and to study their cause-specific mortality using data from multiple Finnish national registers. Methods The data included all individuals, who received family caregiver's allowance in Finland in 2012 (n = 42 256, mean age 67 years, 71% women) and a control population matched for age, sex, and municipality of residence (n = 83 618). Information on dates and causes of death between 2012 and 2017 were obtained from the Finnish Causes of Death Register. Flexible parametric survival modeling and competing risk regression adjusted for socioeconomic status were used. Results The total follow-up time was 717 877 person-years. Family caregivers had lower all-cause mortality than the controls over the follow-up (8.1% vs. 11.6%) both among women (hazard ratio [HR]: 0.64, 95% CI: 0.61-0.68) and men (HR: 0.73, 95% CI: 0.70-0.77). Younger adult caregivers had equal or only slightly lower mortality than their controls, but after age 60, the difference increased markedly resulting in over 10% lower mortality in favor of the caregivers in the oldest age groups. Caregivers had lower mortality for all the causes of death studied, namely cardiovascular, cancer, neurological, external, respiratory, gastrointestinal and dementia than the controls. Of these, the lowest was the risk for dementia (subhazard ratio=0.29, 95%CI: 0.25-0.34). Conclusions Older family caregivers have lower mortality than the age-matched controls from the general population while younger caregivers have similar mortality to their peers. This age-dependent advantage in mortality is likely to reflect selection of healthier individuals into the family caregiver role. Key messages The difference in mortality between family caregivers and the age-matched general population varies considerably with age. Advantage in mortality observed in family caregiver studies is likely to reflect the selection of healthier individuals into the caregiver role, which underestimates the adverse effects of caregiving.

scholarly journals POS0141 ACTIVE SCREENING FOR GOUT IDENTIFIES A LARGER CARDIOVASCULAR POPULATION AT HIGH MORTALITY RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 282.2-282
Author(s):  
S. Ruiz-Simón ◽  
I. Calabuig ◽  
M. Gomez-Garberi ◽  
M. Andrés
Keyword(s):  
High Mortality ◽  
Mortality Risk ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Field Studies ◽  
High Mortality Risk ◽  
Active Screening ◽  
Tertiary Centre ◽  
All Cause Mortality

Background:We have recently revealed by active screening that about a third of gout cases in the cardiovascular population is not registered in records [1], highlighting the value of field studies.Objectives:To assess whether gout screening in patients hospitalized for cardiovascular events may also help identify patients at higher risk of mortality after discharge.Methods:A retrospective cohort field study, carried out in 266 patients admitted for cardiovascular events in the Cardiology, Neurology and Vascular Surgery units of a tertiary centre in Spain. The presence of gout was established by records review and face-to-face interview, according to the 2015 ACR/EULAR criteria. The occurrence of mortality during follow-up and its causes were obtained from electronic medical records. The association between gout and subsequent mortality was tested using Cox regression models. Whether covariates affect the gout-associated mortality was also studied.Results:Of 266 patients recruited at baseline, 17 were excluded due to loss to follow-up (>6mo), leaving a final sample of 249 patients (93.6%). Thirty-six cases (14.5% of the sample) were classified as having gout: twenty-three (63.9%) had a previously registered diagnosis, while 13 (36.1%) had not and was established by the interview.After discharge, the mean follow-up was 19.9 months (SD ±8.6), with a mortality incidence of 21.6 deaths per 100 patient-years, 34.2% by cardiovascular causes.Gout significantly increased the risk of subsequent all-cause mortality, with a hazard ratio (HR) of 2.01 (95%CI 1.13 to 3.58). When the analysis was restricted to gout patients with registered diagnosis, the association remained significant (HR 2.89; 95%CI 1.54 to 5.41).The adjusted HR for all-cause mortality associated with gout was 1.86 (95% CI 1.01-3.40). Regarding the causes of death, both cardiovascular and non-cardiovascular were numerically increased.Secondary variables rising the mortality risk in those with gout were age (HR 1.07; 1.01 to 1.13) and coexistent renal disease (HR 4.70; 1.31 to 16.84), while gender, gout characteristics and traditional risk factors showed no impact.Conclusion:Gout was confirmed an independent predictor of subsequent all-cause mortality in patients admitted for cardiovascular events. Active screening for gout allowed identifying a larger population at high mortality risk, which may help tailor optimal management to minimize the cardiovascular impact.References:[1]Calabuig I, et al. Front Med (Lausanne). 2020 Sep 29;7:560.Disclosure of Interests:Silvia Ruiz-Simón: None declared, Irene Calabuig: None declared, Miguel Gomez-Garberi: None declared, Mariano Andrés Speakers bureau: Grunenthal, Menarini, Consultant of: Grunenthal, Grant/research support from: Grunenthal

scholarly journals Treatment experience of a patient with duodenal trauma

2020 ◽  
pp. 95-96
Author(s):  
A. K. Krekoten ◽  
A. A. Krekoten ◽  
V. N. Mutyl
Keyword(s):  
Small Intestine ◽  
High Mortality ◽  
Mortality Risk ◽  
Postoperative Period ◽  
Pancreatic Ducts ◽  
High Mortality Risk ◽  
Intraoperative Diagnosis ◽  
Short Loop ◽  
The Common

A case of combined duodenal trauma in the 11-year-old patient is described. Complications of pre-operative and intraoperative diagnosis as well as complicated postoperative period are emphasized to be a cause of high mortality risk in this pathology. The disconnection of proximal and distal parts of duodenum was performed; anastomoses were placed between the common bile and pancreatic ducts and small intestine, and gastroenteroanastomosis was performed on a short loop. Follow-up traced for 10 months: recovery.

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