scholarly journals Razões de mortalidade frente ao efeito desigualdade em estudos de mortalidade associada a categorias ocupacionais e níveis sociais

1988 ◽  
Vol 22 (4) ◽  
pp. 335-340 ◽  
Author(s):  
Davi Rumel
Keyword(s):  
Risk Ratio ◽  
Standardized Mortality Ratio ◽  
Healthy Worker Effect ◽  
Proportional Mortality ◽  
Mortality Ratio

As razões de mortalidade: "Standardized Risk Ratio" (SRR), "Standardized Mortality Ratio" (SMR) e "Standardized Proportional Mortality Ratio" (SPMR) são apresentadas visando divulgar uma metodologia para o estudo da mortalidade associada a categorias ocupacionais e níveis sociais. Discute-se a influência do "Healthy Worker Effect" e do Efeito Desigualdade na escolha da população de referência e apresenta-se uma forma operacional de testar a significância estatística dessas razões.

scholarly journals Application of Standardized Proportional Mortality Ratio to the Assessment of Health Risk in Relatively Healthy Populations: Using a Study of Cancer Risk in Telecommunication Workers with Excess Exposure to Acid Mists as an Example

2021 ◽  
Vol 18 (18) ◽  
pp. 9870
Author(s):  
Ying-Fong Ker ◽  
Perng-Jy Tsai ◽  
How-Ran Guo
Keyword(s):  
Cancer Risk ◽  
Geometric Mean ◽  
Epidemiological Studies ◽  
Standardized Mortality Ratio ◽  
Acid Mist ◽  
Proportional Mortality ◽  
Mortality Ratio ◽  
Carcinogenic Effects ◽  
Study Population

When a study population is relatively healthy, such as an occupational population, epidemiological studies are likely to underestimate risk. We used a case study on the cancer risk of workers with exposure to acid mists, a well-documented carcinogen, to demonstrate that using proportional mortality ratios (PMRs) is more appropriate than mortality ratios in assessing risk in terms of mortality. The study included 10,229 employees of a telecommunication company who worked in buildings with battery rooms. In these buildings, the battery rooms had the highest levels of sulfuric acid in the air (geometric mean = 10.7 μg/m3). With the general population in Taiwan as a reference, a decreased standardized mortality ratio (0.42, p < 0.01) from all causes combined, between 1 January 1985 and 31 December 1996, was observed, indicating a healthy worker effect. When we reanalyzed the data using standardized PMR, elevated risks were observed for all cancers combined (1.46, p = 0.01) and cancers of the digestive organs and peritoneum (1.61, p = 0.02), especially stomach cancer (2.94, p = 0.01). The results showed that PMR can detect increases in mortality when a study population is generally healthier than the comparison population and call for further studies on the possible carcinogenic effects of low-level acid mist exposures on the stomach.

The Standardized Mortality Ratio and Life Expectancy

1992 ◽  
Vol 135 (7) ◽  
pp. 824-831 ◽  
Author(s):  
Shan P. Tsai ◽  
Robert J. Hardy ◽  
C. P. Wen
Keyword(s):  
Life Expectancy ◽  
Standardized Mortality Ratio ◽  
Mortality Ratio

scholarly journals Hospital Standardized Mortality Ratio: Consequences of Adjusting Hospital Mortality with Indirect Standardization

PLoS ONE ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. e59160 ◽  
Author(s):  
Maurice E. Pouw ◽  
Linda M. Peelen ◽  
Hester F. Lingsma ◽  
Daniel Pieter ◽  
Ewout Steyerberg ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Standardized Mortality Ratio ◽  
Mortality Ratio ◽  
Indirect Standardization

Identifying Emergency-Sensitive Conditions for the Calculation of an Emergency Care Inhospital Standardized Mortality Ratio

2014 ◽  
Vol 63 (4) ◽  
pp. 418-424.e2 ◽  
Author(s):  
Simon Berthelot ◽  
Eddy S. Lang ◽  
Hude Quan ◽  
Henry T. Stelfox ◽  
Patrick Archambault ◽  
...  
Keyword(s):  
Emergency Care ◽  
Standardized Mortality Ratio ◽  
Mortality Ratio ◽  
Sensitive Conditions

Five-Year Outcomes After Implementing a Pain, Agitation, and Delirium Protocol in a Mixed Intensive Care Unit

2021 ◽  
pp. 088506662110634
Author(s):  
Jeffrey T. Fish ◽  
Jared T. Baxa ◽  
Ryan R. Draheim ◽  
Matthew J. Willenborg ◽  
Jared C. Mills ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Academic Medical Center ◽  
Admission Diagnosis ◽  
Surgical Intensive Care Unit ◽  
Standardized Mortality Ratio ◽  
Surgical Intensive Care ◽  
Mechanically Ventilated ◽  
Mortality Ratio ◽  
Apache Iv

Objective: Assess for continued improvements in patient outcomes after updating our institutional sedation and analgesia protocol to include recommendations from the 2013 Society of Critical Care Medicine (SCCM) Pain, Agitation, and Delirium (PAD) guidelines. Methods: Retrospective before-and-after study in a mixed medical/surgical intensive care unit (ICU) at an academic medical center. Mechanically ventilated adults admitted from September 1, 2011 through August 31, 2012 (pre-implementation) and October 1, 2012 through September 30, 2017 (post-implementation) were included. Measurements included number of mechanically ventilated patients, APACHE IV scores, age, type of patient (medical or surgical), admission diagnosis, ICU length of stay (LOS), hospital LOS, ventilator days, number of self-extubations, ICU mortality, ICU standardized mortality ratio, hospital mortality, hospital standardized mortality ratio, medication data including as needed (PRN) analgesic and sedative use, and analgesic and sedative infusions, and institutional savings. Results: Ventilator days (Pre-PAD = 4.0 vs. Year 5 post = 3.2, P < .0001), ICU LOS (Pre-PAD = 4.8 days vs. Year 5 post = 4.1 days, P = .0004) and hospital LOS (Pre-PAD = 14 days vs. Year 5 post = 12 days, P < .0001) decreased after protocol implementation. Hospital standardized mortality ratio (Pre-PAD = 0.69 vs. Year 5 post = 0.66) remained constant; while, APACHE IV scores (Pre-PAD = 77 vs. Year 5 post = 89, P < .0001) and number of intubated patients (Pre-PAD = 1146 vs. Year 5 post = 1468) increased over the study period. Using the decreased ICU and hospital LOS estimates, it is projected the institution saved $4.3 million over the 5 years since implementation. Conclusions: Implementation of an updated PAD protocol in a mixed medical/surgical ICU was associated with a significant decrease in ventilator time, ICU LOS, and hospital LOS without a change in the standardized mortality ratio over a five-year period. These favorable outcomes are associated with a significant cost savings for the institution.

scholarly journals The APACHE II measured on patients' discharge from the Intensive Care Unit in the prediction of mortality

2013 ◽  
Vol 21 (3) ◽  
pp. 811-819 ◽  
Author(s):  
Luciana Gonzaga dos Santos Cardoso ◽  
Paulo Antonio Chiavone
Keyword(s):  
Linear Regression Analysis ◽  
Prognostic Index ◽  
Apache Ii ◽  
Standardized Mortality Ratio ◽  
Good Discrimination ◽  
Risk Of Death ◽  
Prediction Of Mortality ◽  
Significant Area ◽  
Mortality Ratio ◽  
Good Calibration

OBJECTIVE: to analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE II), measured based on the data from the last 24 hours of hospitalization in ICU, for patients transferred to the wards. METHOD: an observational, prospective and quantitative study using the data from 355 patients admitted to the ICU between January and July 2010, who were transferred to the wards. RESULTS: the discriminatory power of the AII-OUT prognostic index showed a statistically significant area beneath the ROC curve. The mortality observed in the sample was slightly greater than that predicted by the AII-OUT, with a Standardized Mortality Ratio of 1.12. In the calibration curve the linear regression analysis showed the R2 value to be statistically significant. CONCLUSION: the AII-OUT could predict mortality after discharge from ICU, with the observed mortality being slightly greater than that predicted, which shows good discrimination and good calibration. This system was shown to be useful for stratifying the patients at greater risk of death after discharge from ICU. This fact deserves special attention from health professionals, particularly nurses, in managing human and technological resources for this group of patients.

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