scholarly journals Mortality among People with Epilepsy: A Retrospective Nationwide Analysis from 2016 to 2019

2021 ◽  
Vol 18 (19) ◽  
pp. 10512
Author(s):  
Kristijonas Puteikis ◽  
Rūta Mameniškienė
Keyword(s):  
General Population ◽  
Retrospective Cohort ◽  
Causes Of Death ◽  
Mortality Data ◽  
Standardized Mortality Ratio ◽  
Mortality Ratio ◽  
External Causes Of Death ◽  
Underlying Cause Of Death ◽  
Adjusted Rate ◽  
External Causes

We estimated age-adjusted mortality and investigated the dominant causes of death as well as comorbidities among people with epilepsy (PWE) in Lithuania, a country with frequent deaths from external causes. From 2016 to 2019, the age-adjusted rate of death among PWE in Lithuania was compared with mortality data in the general population. Each year of analysis, individuals who were diagnosed with epilepsy comprised a retrospective cohort. The standardized mortality ratio (SMR) of PWE varied from 2.93 (95% CI 2.78 to 3.07) to 3.18 (95% CI 3.02 to 3.34). PWE died at least one decade earlier than expected in the general population. The dominant causes of death were cardiovascular diseases (their proportion ranged from 44.8% to 49.3%), cancer (16.7% to 21.3%) and external causes of death (8.5% to 10.9%). The proportion of the latter decreased over time (r = −0.99, p = 0.01), whereas the SMR for external causes of death remained relatively constant. Epilepsy was the underlying cause of death in 163 cases (2.6%), and noted as a condition contributing to death in 1010 cases (15.9%). Cerebrovascular and cardiological conditions and dementia were the most frequent comorbidities among PWE before their death. Epilepsy-unrelated causes of death are relevant contributors to mortality among PWE. There is a need for PWE-oriented societal interventions to reduce the frequency of external deaths beyond the trend in the general population.

scholarly journals Incidence of Suicide in Persons With Cancer

2008 ◽  
Vol 26 (29) ◽  
pp. 4731-4738 ◽  
Author(s):  
Stephanie Misono ◽  
Noel S. Weiss ◽  
Jesse R. Fann ◽  
Mary Redman ◽  
Bevan Yueh
Keyword(s):  
United States ◽  
General Population ◽  
The United States ◽  
Mortality Data ◽  
Standardized Mortality Ratio ◽  
Patients With Cancer ◽  
Suicide Rates ◽  
Increased Risk ◽  
Mortality Ratio ◽  
Adjusted Rate

Purpose The purpose of this study was to characterize suicide rates among patients with cancer in the United States and identify patient and disease characteristics associated with higher suicide rates. Prior studies, mostly in Europe, have suggested that patients with cancer may be at increased risk for suicide, but large cohort studies comparing patients with cancer with the general population have not been performed in the United States. Methods Patients in the study were residents of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program who were diagnosed with cancer from 1973 to 2002. Comparisons with the general US population were based on mortality data collected by the National Center for Health Statistics. This was a retrospective cohort study of suicide in persons with cancer. Results Among 3,594,750 SEER registry patients observed for 18,604,308 person-years, 5,838 suicides were identified, for an age-, sex-, and race-adjusted rate of 31.4/100,000 person-years. In contrast, the suicide rate in the general US population was 16.7/100,000 person-years. Higher suicide rates were associated with male sex, white race, and older age at diagnosis. The highest suicide risks were observed in patients with cancers of the lung and bronchus (standardized mortality ratio [SMR] = 5.74; 95% CI, 5.30 to 6.22), stomach (SMR = 4.68; 95% CI, 3.81 to 5.70), oral cavity and pharynx (SMR = 3.66; 95% CI, 3.16 to 4.22), and larynx (SMR = 2.83; 95% CI, 2.31 to 3.44). SMRs were highest in the first 5 years after diagnosis with cancer. Conclusion Patients with cancer in the United States have nearly twice the incidence of suicide of the general population, and suicide rates vary among patients with cancers of different anatomic sites. Further examination of the psychological experience of patients with cancer, particularly that of patients with certain types of cancer, is warranted.

scholarly journals Disparities in COVID-19 Related Mortality in U.S. Prisons and the General Population

2020 ◽  
Author(s):  
Kathryn M Nowotny ◽  
David Cloud ◽  
Alysse G. Wurcel ◽  
Lauren Brinkley-Rubinstein
Keyword(s):  
General Population ◽  
Single Case ◽  
Prison Population ◽  
State Level ◽  
Mortality Data ◽  
Standardized Mortality Ratio ◽  
Mortality Ratio ◽  
Prison Systems ◽  
Related Mortality

We provide an analysis of COVID-19 mortality data to assess the potential magnitude of COVID-19 among prison residents. Data were pooled from Covid Prison Project and multiple publicly available national and state level sources. Data analyses consisted of standard epidemiologic and demographic estimates. A single case study was included to generate a more in-depth and multi-faceted understanding of COVID-19 mortality in prisons. The increase in crude COVID-19 mortality rates for the prison population has outpaced the rates for the general population. People in prison experienced a significantly higher mortality burden compared to the general population (standardized mortality ratio (SMR) = 2.75; 95% confidence interval = 2.54, 2.96). For a handful of states (n = 5), these disparities were more extreme, with SMRs ranging from 5.55 to 10.56. Four states reported COVID-19 related death counts that are more than 50% of expected deaths from all-causes in a calendar year. The case study suggested there was also variation in mortality among units within prison systems, with geriatric facilities potentially at highest risk. Understanding the dynamic trends in COVID-19 mortality in prisons as they move in and out of hotspot status is critical.

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

2011 ◽  
Vol 42 (8) ◽  
pp. 1649-1661 ◽  
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.

scholarly journals O6A.6 Mortality experience of in women in south african mining: 2013 – 2015

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A52.2-A52
Author(s):  
Kerry Wilson ◽  
Tahira Kootbodien ◽  
Nisha Naicker
Keyword(s):  
South Africa ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Registration Data ◽  
Vital Registration Data ◽  
External Causes Of Death ◽  
Underlying Cause Of Death ◽  
External Causes

Mining is a high-risk industry with both continued accidents and occupational disease, despite controls introduced in the industry. In this study, we looked at the sex differences in mortality between male and female miners in South Africa.MethodsThe use of vital registration data for monitoring mortality in miners has largely been unexplored in South Africa. Statistics South Africa provides data from 2013 to 2015 which was used in students-t-tests along with proportion tests to investigate differences between death in all women and women miners along with differences in deaths in male miners and women miners. Multiple logistic regression analysis was performed to calculate mortality odds ratios (MORs) for the underlying cause of death in these groups, with adjustments for age, education level, province of death and smoking status.ResultsOf the 8769 deaths recorded with occupation miner ion the years 2013–2015, only 5.7% were in females. Significant differences between all women and women miners were found in age at death (58.8 vs 47.8), no 1 cause of death (ill-defined vs TB) and education (43.6% vs 63.6%). MORs were significantly increased in women miners for TB, HIV and external causes of death compared to all women while being protected from lifestyle and chronic diseases. Women miners compared to male miners had increased odds of HIV death and lifestyle diseases but a similar risk of external causes of death.DiscussionWomen miners appear to die at significantly younger ages than both male miners and other women despite a higher level of education. This may be due to the increased mortality due to HIV and external causes of death. Thus increased controls are required on mines to protect the health of women miners.

scholarly journals Mortality in patients with psychogenic nonepileptic seizures

Neurology ◽  
2020 ◽  
Vol 95 (6) ◽  
pp. e643-e652 ◽  
Author(s):  
Russell Nightscales ◽  
Lara McCartney ◽  
Clarissa Auvrez ◽  
Gerard Tao ◽  
Sarah Barnard ◽  
...  
Keyword(s):  
General Population ◽  
Standardized Mortality Ratio ◽  
Psychogenic Nonepileptic Seizures ◽  
Risk Of Death ◽  
Significant Difference ◽  
Tertiary Hospitals ◽  
Mortality Ratio ◽  
Nonepileptic Seizures ◽  
External Causes ◽  
Drug Resistant Epilepsy

ObjectiveTo investigate the hypothesis that patients diagnosed with psychogenic nonepileptic seizures (PNES) on video-EEG monitoring (VEM) have increased mortality by comparison to the general population.MethodsThis retrospective cohort study included patients evaluated in VEM units of 3 tertiary hospitals in Melbourne, Australia, between January 1, 1995, and December 31, 2015. Diagnosis was based on consensus opinion of experienced epileptologists and neuropsychiatrists at each hospital. Mortality was determined in patients diagnosed with PNES, epilepsy, or both conditions by linkage to the Australian National Death Index. Lifetime history of psychiatric disorders in PNES was determined from formal neuropsychiatric reports.ResultsA total of 5,508 patients underwent VEM. A total of 674 (12.2%) were diagnosed with PNES, 3064 (55.6%) with epilepsy, 175 (3.2%) with both conditions, and 1,595 (29.0%) received other diagnoses or had no diagnosis made. The standardized mortality ratio (SMR) of patients diagnosed with PNES was 2.5 (95% confidence interval [CI] 2.0–3.3). Those younger than 30 had an 8-fold higher risk of death (95% CI 3.4–19.8). Direct comparison revealed no significant difference in mortality rate between diagnostic groups. Among deaths in patients diagnosed with PNES (n = 55), external causes contributed 18%, with 20% of deaths in those younger than 50 years attributed to suicide, and “epilepsy” was recorded as the cause of death in 24%.ConclusionsPatients diagnosed with PNES have a SMR 2.5 times above the general population, dying at a rate comparable to those with drug-resistant epilepsy. This emphasizes the importance of prompt diagnosis, identification of risk factors, and implementation of appropriate strategies to prevent potential avoidable deaths.

Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients

2009 ◽  
Vol 15 (11) ◽  
pp. 1263-1270 ◽  
Author(s):  
C. Smestad ◽  
L. Sandvik ◽  
EG Celius
Keyword(s):  
Multiple Sclerosis ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Standardized Mortality Ratio ◽  
Primary Progressive ◽  
Kaplan Meier ◽  
Mortality Ratio ◽  
Underlying Cause Of Death ◽  
Multiple Sclerosis Patients

There are few studies of long-term, cause-specific mortality in multiple sclerosis (MS) relating to population mortality. Our objective was to study survival, excess mortality and causes of death in a cohort of patients with a long history of MS. Patients living in Oslo with definite MS and onset during 1940—80 were included in 2006. Causes of death and mortality in the general population were obtained from the Cause of Death Registry of Statistics Norway. Of the 386 patients included in the study, 263 (68%) had died at inclusion. Median survival from onset was 35 years (Kaplan—Meier: 95% confidence interval 33—37). Primary progressive MS was associated with shorter survival, but mean age at death was similar for relapsing-remitting and primary progressive MS patients. The most frequent underlying cause of death was MS (50%), and infection was often registered as a contributory cause (56%). The all-cause standardized mortality ratio was 2.47. Excess mortality was most marked during the second decade after onset of MS. We conclude that infections are probably the main cause of death in patients with MS, but the frequency is underestimated due to misleading information on death certificates. Excess mortality in patients with MS first appeared during the second decade of the disease. Survival seems to be age-dependent rather than related to disease course.

scholarly journals Men’s Mortality Decline in Lithuania: Sustainable Development or Short-term Changes?

2018 ◽  
Vol 29 (2) ◽  
Author(s):  
Daumantas Stumbrys
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
Compositional Analysis ◽  
Mortality Decline ◽  
Mortality Data ◽  
High Increase ◽  
Demographic Groups ◽  
External Causes Of Death ◽  
External Causes ◽  
Causes Of Deaths

Lithuanian men had the lowest life expectancy among EU countries in 2015. However, since the year 2007 the country is facing the highest positive change in men’s life expectancy over the past 50 years. It is necessary to reveal what causes of deaths in different socio-demographic groups had a major impact on certain life expectancy changes. In this paper we analyse the aggregated mortality data from the Eurostat and Lithuanian Statistics databases. The analysis of the causes of death was implemented by using the de-compositional analysis method. The results show that the increase in life expectancy is determined by mortality decline due to the external causes of death and cardiovascular diseases. The record-high increase in men’s life expectancy in 2007–2015 conceals controversial changes in mortality at different stages of this period.

Predictors of Survival and Causes of Death in Japanese Patients with Systemic Sclerosis

2011 ◽  
Vol 38 (9) ◽  
pp. 1931-1939 ◽  
Author(s):  
ATSUSHI HASHIMOTO ◽  
SATOKO TEJIMA ◽  
TOSHIHIRO TONO ◽  
MAIKO SUZUKI ◽  
SUMIAKI TANAKA ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
General Population ◽  
Sudden Death ◽  
Causes Of Death ◽  
Japanese Patients ◽  
Standardized Mortality Ratio ◽  
Kaplan Meier ◽  
Common Causes ◽  
Mortality Ratio ◽  
Pulmonary Arterial

Objective.To clarify the mortality rates, causes of death, and contributing clinical factors in Japanese patients with systemic sclerosis (SSc).Methods.A cohort of 405 patients with SSc, who attended our institution during the period 1973 to 2008, was retrospectively analyzed until the end of 2009. Clinical data were obtained from medical records or autopsy reports.Results.The 405 patients with SSc consisted of 310 (76.5%) survivors, 86 (21.2%) who died, and 9 who were lost to followup. Diffuse cutaneous SSc and involvement of organs other than the gastrointestinal tract were more frequent in patients who died, and were associated with a worse prognosis according to Kaplan-Meier analysis. Female sex, limited cutaneous SSc, anticentromere antibody (ACA), and overlap with Sjögren’s syndrome (SS) were factors favoring a better prognosis, while overlap with myositis contributed to a poor prognosis. The overall 10-year survival rate was 88%. The patients with SSc had a significantly higher mortality than the general population (standardized mortality ratio 2.76), but the patients with ACA or overlapping SS did not. The most common causes of death were unknown ones including sudden death, followed by malignancy and infection. In patients with pulmonary arterial hypertension, sudden death was the most common cause of mortality.Conclusion.The overall mortality rate of patients with SSc was higher than that of the general population, probably because of poor prognostic factors including organ involvement. These factors should be carefully monitored during followup.

scholarly journals Mortality in Russia: the second epidemiological revolution that never was

2015 ◽  
pp. 4-33 ◽  
Author(s):  
Anatoly Vishnevsky
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
Age Distribution ◽  
Circulatory System ◽  
Developed Countries ◽  
Significant Rise ◽  
Past Half Century ◽  
External Causes Of Death ◽  
External Causes ◽  
Age Of Death

The article looks at different approaches to the conceptualization of the modern stage of mortality reduction (the "new stages” of the epidemiological transition, "the second epidemiological revolution”, the “health transition”). During this stage, which has lasted for at least half a century, revolutionary changes have taken place in most developed countries. These changes manifest themselves in the drastic expansion of the degree of control over non-infectious causes of death—particularly over diseases of the circulatory system, neoplasms, and other non-communicable diseases, as well as over external causes of death. As a consequence of these changes, there has been a rapid shift of deaths from the abovementioned causes to older ages, an increase in the mean age of death from these causes, and, ultimately, a significant rise in life expectancy. Russia, unfortunately, is watching this revolution from the outside, without taking any part in it. The age distribution of deaths from major classes of causes of death in Russia has not changed over the past half-century, life expectancy has stagnated, and Russia has increasingly lagged behind the majority of developed countries with respect to this indicator. Thus, the “second epidemiological revolution” has not yet to occur in Russia.

scholarly journals Mortality from external causes in Russia over half a century

2015 ◽  
pp. 85-108
Author(s):  
Ekaterina Kvasha ◽  
Tatiana Kharkova ◽  
Valeriy Yumaguzin
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
Circulatory System ◽  
Developed Countries ◽  
Large Contribution ◽  
Mortality Trends ◽  
Undetermined Intent ◽  
External Causes Of Death ◽  
Excess Number ◽  
External Causes

The article discusses long-term mortality trends (since 1956) from external causes of death in Russia. Russia has long lagged behind developed countries in this domain. The level of mortality from external causes of death remains high and its structure is still archaic with large contribution of homicides, alcohol poisoning and injuries of undetermined intent. Excess number of deaths from life tables of Russia and Western European countries is compared. It is shown that in Russia the greatest excess losses are associated with mortality from poisonings among both sexes, suicide among men and homicide among women. Mortality from external causes, along with mortality from diseases of the circulatory system, has had a significant impact on life expectancy. In general, over the period 1956-2012 the increase in mortality from external causes in the 15-64 age group reduced life expectancy by 2.6 years for males and 0.7 years for females. The decline, starting in 2003, of mortality from external causes of death has slightly reduced the gap between Russia and developed countries, bringing the current Russian level closer to those levels reached in Russia in the mid-1960s and 1980s. However, given the fluctuations of mortality from external causes, it is premature to say whether the current decline in mortality is robust.

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