Mortality of Russian cosmonauts, 1960–2018

Introduction. From 1960 to 2018, 282 people were enrolled in cosmonaut groups in the USSR and Russia. Extreme special training and working conditions could lead to health disorders, which may be reflected in the causes and rates of mortality in the future. The goal of this work is to study the causes and rates of mortality in two cohorts of cosmonauts: those with and without spaceflight experience. The study aim is to research the causes and mortality rates of astronauts who have made and did not fly into space. Methods. A cohort study of mortality of 263 male cosmonauts was conducted, 118 cosmonauts with spaceflight experience formed cohort 1, 145 cosmonauts without it - cohort 2. The follow-up period was 59 yrs. (01.01.1960-31.12.2018) with 8351,4 person-years obtained. The reference group for both cohorts was the male population of Russia, cohort 2 was also the reference group for the cohort 1. Mortality risk was assessed using standardized mortality ratio (SMR) with 95% confidence interval (95% CI). Results. Death risk from all causes (A00-Y98) for each cohort was significantly lower than that for the male population (SMR=0,39, 95% CI 0,28-0,54 for cohort 1; SMR=0,53, 95% CI 0,41-0,69 for cohort 2). Moreover, the risk of death for cosmonauts with spaceflight experience is also lower than for cosmonauts without it (SMR=0,66, 95% CI 0,46-0,91). The most common causes of death in both cohorts were circulatory system diseases, and cosmonauts without spaceflight experience died at a younger age. Conclusion. Further research is required to understand the true influence of extreme working conditions on cosmonauts’ health, especially in the long-term period.

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Mortality in first-contact psychosis patients in the UK: a cohort study

Psychological Medicine ◽

10.1017/s0033291711002807 ◽

2011 ◽

Vol 42 (8) ◽

pp. 1649-1661 ◽

Cited By ~ 32

Author(s):

R. Dutta ◽

R. M. Murray ◽

J. Allardyce ◽

P. B. Jones ◽

J. E. Boydell

Keyword(s):

General Population ◽

Causes Of Death ◽

Circulatory System ◽

Standardized Mortality Ratio ◽

Risk Of Death ◽

Weak Evidence ◽

Catchment Areas ◽

Mortality Ratio ◽

The Uk ◽

First Contact

BackgroundThe excess mortality following first-contact psychosis is well recognized. However, the causes of death in a complete incidence cohort and mortality patterns over time compared with the general population are unknown.MethodAll 2723 patients who presented for the first time with psychosis in three defined catchment areas of the UK in London (1965–2004, n=2056), Nottingham (1997–1999, n=203) and Dumfries and Galloway (1979–1998, n=464) were traced after a mean of 11.5 years follow-up and death certificates were obtained. Data analysis was by indirect standardization.ResultsThe overall standardized mortality ratio (SMR) for first-contact psychosis was 184 [95% confidence interval (CI) 167–202]. Most deaths (84.2%, 374/444) were from natural causes, although suicide had the highest SMR (1165, 95% CI 873–1524). Diseases of the respiratory system and infectious diseases had the highest SMR of the natural causes of death (232, 95% CI 183–291). The risk of death from diseases of the circulatory system was also elevated compared with the general population (SMR 139, 95% CI 117–164) whereas there was no such difference for neoplasms (SMR 111, 95% CI 86–141). There was strong evidence that the mortality gap compared with the general population for all causes of death (p<0.001) and all natural causes (p=0.01) increased over the four decades of the study. There was weak evidence that cardiovascular deaths may be increasing relative to the general population (p=0.07).ConclusionsPeople with first-contact psychosis have an overall mortality risk that is nearly double that of the general population. Most excess deaths are from natural causes. The widening of the mortality gap over the last four decades should be of concern to all clinicians involved in delivering healthcare.

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

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000300022 ◽

2013 ◽

Vol 21 (3) ◽

pp. 811-819 ◽

Cited By ~ 3

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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Mortality Rate Due to Circulatory and Alcohol-Dependent Diseases in Different Climatic Zones of Russia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.537 ◽

2019 ◽

Vol 7 (11) ◽

pp. 1867-1872

Author(s):

Tatiana P. Yakovleva ◽

Natalia I. Nikitina ◽

Zhanna R. Gardanova ◽

Natalia S. Mikhailova ◽

Albina V. Gaponenko ◽

...

Keyword(s):

Climatic Zone ◽

Male Population ◽

Climatic Zones ◽

Female Population ◽

Risk Of Death ◽

Average Annual Temperature ◽

Circulatory System Diseases ◽

Murmansk Region ◽

The Impact ◽

Alcohol Dependent

AIM: Evaluation of the impact of climatic factors on the formation of mortality due to circulatory diseases and a group of diseases related to alcohol consumption identified as alcohol-dependent. METHODS: The study subject was the adult population residing in different climatic zones of Russia: in the second, third and fourth zones, with different conditions: average annual temperature (5.2°C; 1-2°C; -2.0°C), snow cover duration (≤ 150 days, ≤ 180 days, ≈ 220 days) sunshine duration and the presence of polar night and polar day in the territory of the fourth climatic zone. The assessment “impact-case of death” was carried out by calculating the standardized incidence ratio (SIR) with 95% confidence intervals (CI) for circulatory system diseases (CSD) and alcohol-dependent diseases (ADD) in accordance with the international classification of diseases (ICD-X). RESULTS: The SIR of death from alcohol-dependent diseases for the female population in the 4th climatic zone (Murmansk Region) was the highest: the SIR of death from ADD 1.87; 95% CI (1.5-2.7), the SIR of death from CSD 1.3; 95% CI (1.2-2.3). For the female population in the 3rd climatic zone (Novosibirsk Region), the SIR of death has amounted to: SIRADD 1.52; 95% CI (1.2-1.87), SIRCSD 1.14; 95 CI (1.01-1.3). Living in the 3rd climatic zone was not so important for the health of the male population: the SIR of death from CSD 1.1; 95% CI (1.05-1.13); the SIR of death from ADD 0.8; 95% CI (0.65-0.98). However, living in the 4th climatic zone (Murmansk Region) poses a higher risk of death for the male population: SIRCSD 1.22 (22.0%); 95% CI (1.02-3.95); SIRADD 1.45 (45.0%); 95% CI (0.98-2.1). CONCLUSION: Living in high northern latitudes contributes to higher levels of mortality, both female and male, from circulatory and alcohol-dependent diseases.

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Geografias da Diabetes Mellitus em Portugal: Como as Condições do Contexto Influenciam o Risco de Morrer

Acta Médica Portuguesa ◽

10.20344/amp.4019 ◽

2014 ◽

Vol 27 (3) ◽

pp. 309 ◽

Cited By ~ 10

Author(s):

Paula Santana ◽

Cláudia Costa ◽

Adriana Loureiro ◽

João Raposo ◽

José Manuel Boavida

Keyword(s):

Diabetes Mellitus ◽

Relative Risk ◽

Rural Areas ◽

Public Health Problem ◽

Standardized Mortality Ratio ◽

Geographic Pattern ◽

Bayesian Hierarchical ◽

Risk Of Death ◽

Mortality Ratio ◽

Relative Risk Of Death

Introduction: Diabetes Mellitus is a public health problem that is on the increase throughout the world, including in Portugal. This paper aims to identify the changing geographic pattern of this cause of death in Portugal and its association with sociomaterial deprivation. Material and Methods: This is a transversal ecological study of the deaths by Diabetes Mellitus in Portuguese municipalities in three periods (1989-1993, 1999-2003 and 2006-2010). It uses a Bayesian hierarchical model in order to obtain a smooth standardized mortality ratio and the relative risk of death by Diabetes Mellitus associated to sociomaterial deprivation. Results: In 1989-1993, the highest smooth standardized mortality ratio values were found in coastal urban municipalities (80% of municipalities with smooth standardized mortality ratio ≥ 161, of which 60% are urban); in 2006-2010, the opposite was found, with the highest smooth standardized mortality ratio values occurring in rural areas in southern inland regions (76.9% of municipalities with smooth standardized mortality ratio ≥ 161, of which 69.2% are rural), particularly the Alentejo. The relative risk of death by Diabetes Mellitus increases with vulnerability associated to social and economic conditions in the area of residence, and is significant in the last two periods (relative risk: 1.00; IC95%: 0.98-1.02). Discussion: Diabetes Mellitus presents a geographic pattern marked by coastal-inland and urban-rural asymmetry. However, this has been altering over the last twenty years. 48% of the population reside in municipalities where the smooth standardized mortality ratio has increased in the last twenty years, particularly in the rural areas of inland Portugal. Conclusion: The highest smooth standardized mortality ratio are currently found in rural municipalities with the highest index of sociomaterial deprivation. Keywords: Demography; Diabetes Mellitus/epidemiology; Diabetes Mellitus/mortality; Portugal; Socioeconomic Factors.

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Relationship between Volume and Survival in Closed Intensive Care Units Is Weak and Apparent Only in Mechanically Ventilated Patients

Anesthesiology ◽

10.1097/aln.0b013e31829c3029 ◽

2013 ◽

Vol 119 (4) ◽

pp. 871-879 ◽

Cited By ~ 9

Author(s):

Rafael Fernández ◽

Susana Altaba ◽

Lluis Cabre ◽

Victoria Lacueva ◽

Antonio Santos ◽

...

Keyword(s):

Hospital Mortality ◽

Standardized Mortality Ratio ◽

Hospital Level ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Risk Of Death ◽

Mortality Ratio ◽

Low Volume ◽

Predicted Risk ◽

Ventilated Patients

Abstract Background: Recent studies have found an association between increased volume and increased intensive care unit (ICU) survival; however, this association might not hold true in ICUs with permanent intensivist coverage. Our objective was to determine whether ICU volume correlates with survival in the Spanish healthcare system. Methods: Post hoc analysis of a prospective study of all patients admitted to 29 ICUs during 3 months. At ICU discharge, the authors recorded demographic variables, severity score, and specific ICU treatments. Follow-up variables included ICU readmission and hospital mortality. Statistics include logistic multivariate analyses for hospital mortality according to quartiles of volume of patients. Results: The authors studied 4,001 patients with a mean predicted risk of death of 23% (range at hospital level: 14–46%). Observed hospital mortality was 19% (range at hospital level: 11–35%), resulting in a standardized mortality ratio of 0.81 (range: 0.5–1.3). Among the 1,923 patients needing mechanical ventilation, the predicted risk of death was 32% (14–60%) and observed hospital mortality was 30% (12–61%), resulting in a standardized mortality ratio of 0.96 (0.5–1.7). The authors found no correlation between standardized mortality ratio and ICU volume in the entire population or in mechanically ventilated patients. Only mechanically ventilated patients in very low-volume ICUs had slightly worse outcome. Conclusion: In the currently studied healthcare system characterized by 24/7 intensivist coverage, the authors found wide variability in outcome among ICUs even after adjusting for severity of illness but no relationship between ICU volume and outcome. Only mechanically ventilated patients in very low-volume centers had slightly worse outcomes.

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Reasons for discontinuing clozapine: matched, case–control comparison with risperidone long-acting injection

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.051979 ◽

2009 ◽

Vol 194 (2) ◽

pp. 165-167 ◽

Cited By ~ 67

Author(s):

David M. Taylor ◽

Petrina Douglas-Hall ◽

Banke Olofinjana ◽

Eromona Whiskey ◽

Arwel Thomas

Keyword(s):

Adverse Effects ◽

Control Group ◽

Clinical Environment ◽

Risk Of Death ◽

Increased Risk ◽

Common Causes ◽

Control Comparison ◽

Mortality Ratio ◽

Matched Case ◽

Long Acting

BackgroundClozapine has a range of serious adverse effects that may give rise to an increased risk of death.AimsTo compare reasons for discontinuation of clozapine with reasons for discontinuation of risperidone long-acting injection in age-matched individuals treated in the same clinical environment.MethodComparison of patients receiving clozapine and an age-matched control group receiving risperidone injection.ResultsWe established outcome for 529 consecutive patients receiving clozapine and 250 receiving risperidone (161 discontinuers from each group were compared). Adverse effects (odds ratio OR=2.19, 95% CI 1.31–3.67) and death (OR=7.0, 95% CI 2.09–23.5) were more commonly observed as reasons for discontinuation of clozapine than of risperidone. Clozapine was less likely to be withdrawn because of ineffectiveness than was risperidone (OR=0.034, 95% CI 0.01–0.14). Standardised mortality ratio (SMR) was significantly raised for patients receiving clozapine (SMR=4.17, 95% CI 2.78–6.26). Pneumonia was the most common single cause of death.ConclusionsClozapine use in patients with severe mental illness was associated with a significantly increased risk of death compared with that for the general population. Causation could not be established. Adverse effects and death are common causes of clozapine discontinuation.

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P.1.03 Mortality analysis in different exposure groups of coal miners in rostov region of the russian federation

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.209 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A78.1-A78

Author(s):

Igor Bukhtiyarov ◽

Tatyana Pictushanskaya ◽

Galina Tikhonova ◽

Tatyana Gorchakova ◽

Maria Bryleva ◽

...

Keyword(s):

Occupational Health ◽

Reference Group ◽

Reference Population ◽

Standardized Mortality Ratio ◽

Long Term Effects ◽

Coal Miners ◽

Male Population ◽

Regional Center ◽

Rostov Region

IntroductionThe Rostov region was one of the largest centers of coal mining in Russia during XIX–XX centuries. The long-term effects of work in coal mines were investigated with the use of database of the Rostov regional center of occupational health.AimAssessment of mortality risks in different exposure groups of coal miners.MethodsA cohort of 9980 coal miners with established occupational diseases was formed by the Rostov regional center of occupational health. The follow-up period was 26 years (01.01.1990–31.12.2015). By the end of the follow-up period 1898 miners were alive and 8082 died. In result there were 1 38 768 person-years of follow-up. The male population of Rostov region was used as reference group.Two different exposure groups were created. First one included main professions – clearing face miners and shaft miners (5941 persons, 79 978 person-years). Maximum dust concentrations reached 270–300 mg/m3, vibration levels – 130 dB, noise levels – 130 dBA. The second one included miners of auxiliary professions (shot-firers, wiremen, loco drivers, etc.) – 4039 persons, 58 790 person-years. The maximum exposure levels were lower, 100–130 mg/m3, 110 dB, 105 dBA, respectively.ResultsThe standardized mortality ratio in the cohort (SMR) was 1.47 (CI 1.42–1.51). In the group with length of service up to 10 years, SMR=1.01 (0.91–1.13), 10–19 years SMR=1.33 (1.27–1.39), 20 years and more SMR=1.91 (1.80–2.02).In both groups the SMR was higher than in reference population. SMR=1.57 (1.50–1.63) and SMR=1.32 (1.25–1.39) respectively. The difference between subgroups was also statistically significant SMR=1.19 (1.14–1.24)ConclusionResults of follow up demonstrated elevated risks of mortality for former coal miners. A ‘dose (time) – effect’ relationship for mortality levels were also established.

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Fetal and maternal factors are associated with mortality due to circulatory system disorders in children

Revista de Saúde Pública ◽

10.11606/s1518-8787.2019053000793 ◽

2019 ◽

Vol 53 ◽

pp. 31

Author(s):

Thais Rocha Salim ◽

Gabriel Porto Soares ◽

Carlos Henrique Klein ◽

Gláucia Maria Moraes Oliveira

Keyword(s):

Information System ◽

Maternal Age ◽

Maternal Education ◽

Cohort Analysis ◽

Circulatory System ◽

Education Level ◽

Maternal Factors ◽

Risk Of Death ◽

Relative Risks ◽

Circulatory System Diseases

OBJECTIVE: To analyze the association of characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level, with death from diseases or malformations of the circulatory system in children under 18 years of age. METHODS: The Brazilian Information System on Live Births and Information System on Mortality databases were linked and evaluated following a longitudinal cohort analysis strategy. The following independent variables were evaluated: characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level. Dependent variables were death from diseases or malformations of the circulatory system in children under 18 years of age. Crude relative risks were estimated and relative risks were adjusted for the variables. RESULTS: 6,380 deaths were linked to 4,282,260 birth records, yielding 5,062 pairs considered as true. Low birth weight (RR = 2.26), asphyxia at 1 (RR = 1.72) and 5 minutes (RR = 1.51), prematurity (RR = 1.50), maternal age ≥ 40 years (RR = 2.06), and low maternal education level (RR = 1.45) increased the probability of death caused by circulatory system diseases. In the association with death by malformations of the circulatory system, the predictive variables showed the same association profile, but with greater intensity. CONCLUSIONS: Fetal and maternal factors are associated with increased mortality due to diseases and malformations of the circulatory system. Measures to control these factors and improve access to their diagnosis and treatment would contribute to reducing the number of deaths caused by diseases and malformations of the circulatory system. However, the identification of environmental influences during gestation and birth on the risk of death should be carefully considered due to being influenced by genetic factors.

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Krajské mestá Slovenska v kontexte príčin smrti

10.5817/cz.muni.p210-9896-2021-64 ◽

2021 ◽

Author(s):

Katarína Vilinová ◽

Jozef Kudlej

Keyword(s):

Causes Of Death ◽

Slovak Republic ◽

Circulatory System ◽

Economic Changes ◽

Mortality And Morbidity ◽

Circulatory System Diseases ◽

Common Causes ◽

Demographic Processes ◽

External Causes ◽

The Right

Interest in the health of the population is intensifying today. The main reasons include social, political and economic changes, but also the ongoing pandemic related to the spread of the COVID-19 virus. Due to many demographic changes in recent years, the study of the health status of the population emphasizes one of the demographic processes, which is mortality. The structure of the causes of death is very often monitored. After the stabilization of mortality and morbidity from infectious diseases in the eighties, civilization diseases such as circulatory system diseases and tumors came to the forefront of social interest in Slovakia. This indicator is also important in terms of the right direction in the field of regional development in relation to health care in individual regions. The aim of the paper is to characterize the structure of causes of death in regional cities of Slovakia. This paper will be based on data from the Statistical Office of the Slovak Republic for the period 1996-2017. The main methods used in the work will be methods of analysis, synthesis, as well as graphic and cartographic methods. In all regional cities of Slovakia, diseases of the circulatory system clearly dominated in men and women during the entire period under review. They were followed by cancer and external causes. The group of five most common causes was supplemented by diseases of the respiratory and digestive system.

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Impact of Operator Expertise on Collection of the APACHE II Score and on the Derived Risk of Death and Standardized Mortality Ratio

Anaesthesia and Intensive Care ◽

10.1177/0310057x0503300506 ◽

2005 ◽

Vol 33 (5) ◽

pp. 585-590 ◽

Cited By ~ 6

Author(s):

D. Ledoux ◽

S. Finfer ◽

S. Mckinley

Keyword(s):

Goodness Of Fit ◽

Characteristic Curve ◽

Receiver Operator Characteristic Curve ◽

Clinical Staff ◽

Apache Ii ◽

Apache Ii Score ◽

Standardized Mortality Ratio ◽

Risk Of Death ◽

Mortality Ratio ◽

The Impact

We assessed the impact of operator expertise on collection of the APACHE II score, the derived risk of death and standardized mortality ratio in 465 consecutive patients admitted to a multi-disciplinary tertiary hospital ICU. Research coordinators and junior clinical staff independently collected the APACHE II variables; experts (senior clinical staff) rescored 20 % of the records. Agreement was moderate between junior clinical staff and research coordinators or senior clinical staff for most variables of the acute physiology score (weighted κ<0.6); agreement between research coordinators and senior clinical staff data collectors was good (weighted κ >0.75). The APACHE II score and its derived risk of death (ROD) were significantly lower using the junior clinical staff dataset compared to research coordinators and senior clinical staff (APACHE II score: 13.4±9.2 vs 16.8±8.5 vs 17.1±7.7, P<0.001; ROD: 14.7%±22.4% vs 21.6%±22.6% vs 20.8%±22.4%, P<0.01 respectively). The discriminative capacity was not altered by the lack of agreement (area under Receiver Operator Characteristic curve >0.8) but calibration of ROD from the junior clinical staff dataset was poor (Goodness-of-fit: P=0.001). The standardized mortality ratio (SMR) was higher with the junior clinical staff dataset (SMR: 1.22, 95% CI: 0.96-1.52 vs 0.87, 95% CI: 0.70-1.06 vs 0.76, 95% CI: 0.40-1.3 calculated from junior clinical staff, research coordinators and senior clinical staff data-sets respectively). We conclude that the expertise of data collectors significantly influences the APACHE II score, the derived risk of death and the standardized mortality ratio. Given the importance of such scores, ICUs should be provided with sufficient resources to train and employ dedicated data collectors.

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