Still’s Disease Mortality Trends in France, 1979–2016: A Multiple-Cause-of-Death Study

Still’s disease (SD) is often considered a benign disease, with low mortality rates. However, few studies have investigated SD mortality and its causes and most of these have been single-center cohort studies. We sought to examine mortality rates and causes of death among French decedents with SD. We performed a multiple-cause-of-death analysis on data collected between 1979 and 2016 by the French Epidemiological Center for the Medical Causes of Death. SD-related mortality rates were calculated and compared with the general population (observed/expected ratios, O/E). A total of 289 death certificates mentioned SD as the underlying cause of death (UCD) (n = 154) or as a non-underlying causes of death (NUCD) (n = 135). Over the study period, the mean age at death was 55.3 years (vs. 75.5 years in the general population), with differences depending on the period analyzed. The age-standardized mortality rate was 0.13/million person-years and was not different between men and women. When SD was the UCD, the most frequent associated causes were cardiovascular diseases (n = 29, 18.8%), infections (n = 25, 16.2%), and blood disorders (n = 11, 7.1%), including six cases (54%) with macrophage activation syndrome. As compared to the general population, SD decedents aged <45 years were more likely to die from a cardiovascular event (O/E = 3.41, p < 0.01); decedents at all ages were more likely to die from infection (O/E = 7.96–13.02, p < 0.001).

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Sarcoidosis-related mortality in France: a multiple-cause-of-death analysis

European Respiratory Journal ◽

10.1183/13993003.00457-2016 ◽

2016 ◽

Vol 48 (6) ◽

pp. 1700-1709 ◽

Cited By ~ 34

Author(s):

Yvan Jamilloux ◽

Delphine Maucort-Boulch ◽

Sébastien Kerever ◽

Mathieu Gerfaud-Valentin ◽

Christiane Broussolle ◽

...

Keyword(s):

General Population ◽

Cause Of Death ◽

Causes Of Death ◽

Mortality Rates ◽

Chronic Respiratory Disease ◽

Death Certificates ◽

Country Level ◽

Underlying Cause Of Death ◽

And Gender ◽

Related Mortality

We evaluated mortality rates and underlying causes of death among French decedents with sarcoidosis from 2002 to 2011.We used data from the French Epidemiological Centre for the Medical Causes of Death to 1) calculate sarcoidosis-related mortality rates, 2) examine differences by age and gender, 3) determine underlying and nonunderlying causes of death, 4) compare with the general population (observed/expected ratios), and 5) analyse regional differences.1662 death certificates mentioning sarcoidosis were recorded. The age-standardised mortality rate was 3.6 per million population and significantly increased over the study period. The mean age at death was 70.4 years (versus 76.2 years for the general population). The most common underlying cause of death was sarcoidosis. Sarcoidosis decedents were more likely to be males when aged <65 years. When sarcoidosis was the underlying cause of death, the main other mentions on death certificates were chronic respiratory and cardiovascular diseases. The overall observed/expected ratio was >1 for infectious disease, tuberculosis and chronic respiratory disease, and <1 for neoplasms. We observed a north–south gradient of age-standardised mortality ratio at the country level.Despite the limitation of possibly capturing the more severe cases of sarcoidosis, this study may help define and prioritise preventive interventions.

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Four Decades of COPD Mortality Trends: Analysis of Trends and Multiple Causes of Death

Journal of Clinical Medicine ◽

10.3390/jcm10051117 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1117

Author(s):

Alberto Fernández-García ◽

Mónica Pérez-Ríos ◽

Alberto Fernández-Villar ◽

Gael Naveira ◽

Cristina Candal-Pedreira ◽

...

Keyword(s):

Cause Of Death ◽

Causes Of Death ◽

Chronic Obstructive ◽

Joinpoint Regression ◽

Mortality Trend ◽

Mortality Trends ◽

Obstructive Pulmonary Disease ◽

Underlying Cause Of Death ◽

Copd Mortality ◽

Age Of Death

There is little information on chronic obstructive pulmonary disease (COPD) mortality trends, age of death, or male:female ratio. This study therefore sought to analyze time trends in mortality with COPD recorded as the underlying cause of death from 1980 through 2017, and with COPD recorded other than as the underlying cause of death. We conducted an analysis of COPD deaths in Galicia (Spain) from 1980 through 2017, including those in which COPD was recorded other than as the underlying cause of death from 2015 through 2017. We calculated the crude and standardized rates, and analyzed mortality trends using joinpoint regression models. There were 43,234 COPD deaths, with a male:female ratio of 2.4. Median age of death was 82 years. A change point in the mortality trend was detected in 1996 with a significant decrease across the sexes, reflected by an annual percentage change of −3.8%. Taking deaths into account in which COPD participated or contributed without being the underlying cause led to an overall 42% increase in the mortality burden. The most frequent causes of death when COPD was not considered to be the underlying cause were bronchopulmonary neoplasms and cardiovascular diseases. COPD mortality has decreased steadily across the sexes in Galicia since 1996, and age of death has also gradually increased. Multiple-cause death analysis may help prevent the underestimation of COPD mortality.

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Abstract P059: Multiple Cause-of-Death Analysis Reveals Under Reporting of Disease Burden for Diabetes

Circulation ◽

10.1161/circ.135.suppl_1.p059 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Katherine G Hastings ◽

Jiaqi Hu ◽

Nadejda Marques ◽

Eric J Daza ◽

Mark Cullen ◽

...

Keyword(s):

Ethnic Groups ◽

Cause Of Death ◽

Causes Of Death ◽

Mortality Rates ◽

Minority Populations ◽

Race Ethnicity ◽

Underlying Cause Of Death ◽

The Impact ◽

Racial Ethnic ◽

The U.S

Introduction: Despite being considerably under reported as the underlying cause of death on death certificates, and consequently on mortality figures, diabetes is among the ten leading causes of death in the U.S. A multiple cause-of-death analysis shows the extent to which diabetes is associated with other leading causes of death. Hypothesis: Analysis of multiple-cause-of-death will confirm prevalence rates of diabetes among racial/ethnic minority populations, demonstrate the impact of diabetes in association with other causes of death, and highlight variations of burden of disease among different racial/ethnic groups. Methods: Causes of death were identified using the Multiple Cause Mortality Files of the National Center for Health Statistics from 2003 to 2012. Age-adjusted mortality rates were calculated for diabetes both as the underlying cause of death (UCD) and as multiple causes of death (MCD) by racial/ethnic groups (NHWs, Blacks, Asians, and Hispanic/Latinos). Frequencies and proportions were calculated by race/ethnicity groups. Linear regression model was used for number of causes per death. Results: A total of 2,335,198 decedents had diabetes listed as MCD in the U.S. national death records from 2003-2012. Mortality rates of diabetes as MCD were 3.4 times than UCD for Asians, 2.9 times for Blacks, 2.9 times for Hispanics and 3.7 times for NHWs (Figure). Minority populations had higher proportion of deaths with diabetes reported as MCD than NHWs (1.7 times higher for Hispanics, 1.5 times higher for Blacks and Asians). Adjusting for age, gender, and race/ethnicity, there were 1.7 more causes per death co-occurred for diabetes decedents compared to decedents who died due to all other causes (95% CI: 1.714, 1.718). Conclusions: Our findings underscore the importance of a multiple-cause-of-death approach in the analyses for a more comprehensive understanding of the impact of diabetes.

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Sickle Cell Disease Mortality in California and Georgia 2004-2008

Blood ◽

10.1182/blood.v124.21.439.439 ◽

2014 ◽

Vol 124 (21) ◽

pp. 439-439

Author(s):

Susan Paulukonis ◽

Todd Griffin ◽

Mei Zhou ◽

James R. Eckman ◽

Robert Hagar ◽

...

Keyword(s):

African American ◽

Cause Of Death ◽

Sickle Cell ◽

Causes Of Death ◽

Mortality Rates ◽

Population Based ◽

Age Group ◽

Death Certificates ◽

Underlying Causes ◽

Underlying Cause Of Death

Abstract On-going public health surveillance efforts in sickle cell disease (SCD) are critical for understanding the course and outcomes of this disease over time. Once nearly universally fatal by adolescence, many patients are living well into adulthood and sometimes into retirement years. Previous SCD mortality estimates have relied on data from death certificates alone or from deaths of patients receiving care in high volume hematology clinics, resulting in gaps in reporting and potentially biased conclusions. The Registry and Surveillance System for Hemoglobinopathies (RuSH) project collected and linked population-based surveillance data on SCD in California and Georgia from a variety of sources for years 2004-2008. These data sources included administrative records, newborn screening reports and health insurance claims as well as case reports of adult and pediatric patients receiving care in the following large specialty treatment centers: Georgia Comprehensive Sickle Cell Center, Georgia Regents University, Georgia Comprehensive Sickle Cell Center at Grady Health Systems and Children's Healthcare of Atlanta in Georgia, and Children's Hospital Los Angeles and UCSF Benioff Children's Hospital Oakland in California. Cases identified from these combined data sources were linked to death certificates in CA and GA for the same years. Among 12,143 identified SCD cases, 640 were linked to death certificates. Combined SCD mortality rates by age group at time of death are compared to combined mortality rates for all African Americans living in CA and GA. (Figure 1). SCD death rates among children up to age 14 and among adults 65 and older were very similar to those of the overall African American population. In contrast, death rates from young adulthood to midlife were substantially higher in the SCD population. Overall, only 55% of death certificates linked to the SCD cases had SCD listed in any of the cause of death fields. Thirty-four percent (CA) and 37% (GA) had SCD as the underlying cause of death. An additional 22% and 20% (CA and GA, respectively) had underlying causes of death that were not unexpected for SCD patients, including related infections such as septicemia, pulmonary/cardiac causes of death, renal failure and stroke. The remaining 44% (CA) and 43% (GA) had underlying causes of death that were either not related to SCD (e.g., malignancies, trauma) or too vague to be associated with SCD (e.g., generalized pulmonary or cardiac causes of death. Figure 2 shows the number of deaths by state, age group at death and whether the underlying cause of death was SCD specific, potentially related to SCD or not clearly related to SCD. While the number of deaths was too small to use for life expectancy calculations, there were more deaths over age 40 than under age 40 during this five year period. This effort represents a novel, population-based approach to examine mortality in SCD patients. These data suggest that the use of death certificates alone to identify deceased cases may not capture all-cause mortality among all SCD patients. Additional years of surveillance are needed to provide better estimates of current life expectancy and the ability to track and monitor changes in mortality over time. On-going surveillance of the SCD population is required to monitor changes in mortality and other outcomes in response to changes in treatments, standards of care and healthcare policy and inform advocacy efforts. This work was supported by the US Centers for Disease Control and Prevention and the National Heart, Lung and Blood Institute, cooperative agreement numbers U50DD000568 and U50DD001008. Figure 1: SCD-Specific & Overall African American Mortality Rates in CA and GA, 2004 – 2008. Figure 1:. SCD-Specific & Overall African American Mortality Rates in CA and GA, 2004 – 2008. Figure 2: Deaths (Count) Among Individuals with SCD in CA and GA, by Age Group and Underlying Cause of Death, 2004-2008 (N=615) Figure 2:. Deaths (Count) Among Individuals with SCD in CA and GA, by Age Group and Underlying Cause of Death, 2004-2008 (N=615) Disclosures No relevant conflicts of interest to declare.

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Opportunities and Problems of Analysis of Mortality from Myocardial Infarction According to Medical Certificates of Death (on the Example of the Tula Region)

Kardiologiia ◽

10.18087/cardio.2019.7.n417 ◽

2019 ◽

Vol 59 (7) ◽

pp. 5-10

Author(s):

O. M. Drapkina ◽

I. V. Samorodskaya ◽

D. Sh. Vaisman

Keyword(s):

Myocardial Infarction ◽

Cause Of Death ◽

Causes Of Death ◽

Professional Community ◽

Mortality Rates ◽

Electronic Database ◽

Ministry Of Health ◽

Icd 10 ◽

Underlying Cause Of Death

Aim: to analyze the quality of completion medical certificates of death (MCD) of residents of the Tula region, in which in 2017 acute and subsequent myocardial infarction (MI) was listed as the underlying cause of death (UCD) or as multiple causes of death (MC).Materials and methods. From the electronic database (DB) of MCD of residents of Tula region for 2017 we selected all MSD in which MI was written down irrespective of a section of MCD. A total of 689 MSD (43.8% men and 56.2% women) were analyzed.Results. Mean age of the deceased was 72.6±11.3 years (men 67.25±0.62; women 76.7±9.8; p<0.001). Multimorbid pathology was registered in 31.5% of the deceased. In 77.9% of cases myocardial infarction was selected as the UCD and in 22.1% – as a complication of other diseases. Among registered MI complications were hemotamponade (24.5%), cardiogenic shock (3.6%), ventricular fibrillation (0.3%), heart failure (50.2%). Complications of MI were not listed in 3.9% of MCD. Analysis of MCD showed that their completion did not comply with established ICD-10 rules and recommendations of Ministry of Health of RF; all lines were filled out only in 1% of completed MCD. Also, problems of determining the initial cause of death when myocardial infarction occurred in the presence of multimorbid pathology were revealed.Conclusion. Mortality analysis using solely UCD leads to decreasing mortality rates from MI, and unsatisfactory quality of filling the MCD decreases the ability to identify MC, that prevents the correction of priorities in the organization of medical care. The revealed problems of coding causes of death require urgent solutions from the professional community of cardiologists, pathologists, and the Ministry of Health.

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A Study of Multiple Causes of Death in Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.150166 ◽

2015 ◽

Vol 42 (12) ◽

pp. 2221-2228 ◽

Cited By ~ 18

Author(s):

Frederico A.G. Pinheiro ◽

Deborah C.C. Souza ◽

Emilia I. Sato

Keyword(s):

Rheumatoid Arthritis ◽

General Population ◽

Cause Of Death ◽

Causes Of Death ◽

Linear Regression Analysis ◽

Immunosuppressive Treatment ◽

Age At Death ◽

The Mean ◽

Underlying Cause Of Death ◽

Related Mortality

Objective.To evaluate rheumatoid arthritis (RA)–related mortality in the state of São Paulo (Brazil).Methods.Data from all death certificates (DC) from 1996 to 2010 were analyzed using a multiple cause-of-death method. We compared the results from 2 subperiods (1996–2000 and 2006–2010).Results.We found 3955 DC related to RA — 27.6% with RA as the underlying cause of death (UCD) and 72.4% with RA as the nonunderlying cause of death (NUCD). Ninety percent of RA-related deaths occurred at age ≥ 50 years. The mean ages at death were 67.1 ± 13.3 and 67.9 ± 13 years for RA as the UCD and NUCD, respectively. The most frequent NUCD associated with RA were pneumonia, sepsis, renal failure, interstitial lung disease, and heart failure. In the last subperiod, there was an increase in infectious causes. When RA was an NUCD, we observed a decrease in the mean age at death for the last subperiod (p = 0.021). The most common UCD were circulatory and respiratory system diseases. Comparing the mean age at death between RA-related deaths and the general population when deaths occurred at ages beyond 50 years, the linear regression analysis showed a downward curve for RA-related death (p < 0.001 and r = −0.795), while for the general population, as expected, the curve had an upward pattern (p < 0.001 and r = 0.993).Conclusion.Unexpectedly, RA-related deaths occurred at earlier ages in the more recent subperiod. Cardiovascular disease remained the most important cause, and infectious diseases are an increasing cause of death associated with RA, raising the question of whether infections were related to the more vigorous immunosuppressive treatment recommended by recent guidelines.

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148. Fungal Disease Mortality Trends, United States, 1999–2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.458 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S204-S204

Author(s):

Mitsuru Toda ◽

Brendan R Jackson ◽

Li Deng ◽

Gordana Derado ◽

Tom M Chiller ◽

...

Keyword(s):

United States ◽

Cause Of Death ◽

Age Distribution ◽

Mortality Rates ◽

Fungal Disease ◽

Vital Statistics ◽

Fungal Diseases ◽

Mortality Trends ◽

Disease Mortality ◽

Standardized Mortality Rate

Abstract Background Fungal diseases can lead to substantial morbidity and mortality, although research funding has been disproportionately low compared with other infectious diseases. Despite dramatic changes in immunosuppressive therapy over the past two decades, the U.S. mortality burden of fungal diseases has not been recently assessed. Methods We analyzed fungal disease-associated mortality trends during 1999–2017 using multiple cause-of-death mortality records from the National Vital Statistics System. We calculated age-standardized rates for aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcosis, histoplasmosis, mucormycosis, pneumocystosis, unspecified mycoses, and other mycoses based on the age distribution of the 2000 U.S. population. Results Among over 47 million deaths, 86,058 (0.2%) people had one or more fungal diseases listed on the death certificate as an underlying or contributing cause of death (median 4,431 annually) (Figure 1). The age-standardized mortality rate was 2.2/100,000 population in 1999. By 2017, rates declined by 47% to 1.2. The largest declines occurred for pneumocystosis and cryptococcosis, diseases particularly associated with HIV, by 66–70% from 1999 to 2007 and by 3–6% from 2008 to 2017. During 1999–2017, rates for aspergillosis, candidiasis, and other mycoses declined by 46–56%, although rates for candidiasis and other mycoses increased (10% and 31%, respectively) from 2013 to 2017. Overall, the steepest declines were seen in infants and younger adults (Figure 2). Age-standardized mortality rates for fungal diseases as underlying and contributing cause of death, per 100,000 people, by year and fungal disease type, United States, 1999–2017 Age-specific mortality rates for fungal diseases as underlying and contributing cause of death, per 100,000 people, by year and age group, United States, 1999–2017 Conclusion Fungal disease-associated mortality rates declined by half from 1999 to 2017. Improved treatment of HIV and availability of new antifungals likely influenced the decline. However, fungal diseases are still documented in thousands of deaths annually, and rates differed substantially by disease. Better prevention, diagnosis, and treatment are needed to reduce mortality from fungal diseases. Disclosures All Authors: No reported disclosures

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Premature Mortality in Canada

University of Toronto Journal of Public Health ◽

10.33137/utjph.v1i1.33812 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Catherine Liang ◽

Emmalin Buajitti ◽

Laura Rosella

Keyword(s):

Cause Of Death ◽

Descriptive Analysis ◽

Premature Mortality ◽

Mortality Rates ◽

Vital Statistics ◽

Income Quintile ◽

Mortality Trends ◽

Premature Deaths ◽

Central Canada ◽

Over Time

Introduction: Premature mortality (deaths before age 75) is a well-established metric of population health and health system performance. In Canada, underlying differences between provinces/territories present a need for stratified mortality trends. Methods: Using data from the Canadian Vital Statistics Database, a descriptive analysis of sex-specific adult premature deaths over 1992-2015 was conducted by province, census divisions (CD), socioeconomic status (SES), age, and underlying cause of death. Premature mortality rates were calculated as the number of deaths per 100,000 individuals aged 18 to 74, per 8-year era. SES was measured using the income quintile of the neighbourhood of residence. Absolute and relative inequalities were respectively summarized using slope and relative indices of inequality, produced via unadjusted linear regression of the mortality rate on income rank. Results: Premature mortality in Canada declined by 21% for males and 13% for females between 1992-1999 and 2008-2015. The greatest reductions were in Central Canada, while Newfoundland saw notable increases. CD-level improvements appeared mostly in the southern half of Canada. As of 2008-2015, Newfoundland, Nova Scotia, and Nunavut had the highest mortality rates. Low area-level income was associated with higher mortality. SES inequalities grew over time. Newfoundland’s between-quintile differences rose from 1292 to 2389 deaths per 100k males, or 1.33 to 2.12-fold, and 586 to 1586 per 100k females, or 1.24 to 1.74-fold. In 2008-2015, mortality rates of the bottom quintile in Manitoba and Saskatchewan were more than 2.5 times those of the top. Mortality increased with age, and varied regionally. Low mortality in Central Canada and BC, and high mortality in the Territories were consistent across eras and sexes. Cause of death distributions shifted with age and sex, with more external deaths in younger males. Conclusion: Improvements were seen in adult premature mortality rates over time, but were unequal across geographies. Evidence exists for growing socioeconomic disparities in mortality.

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Stillbirth, newborn and infant mortality: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

International Journal of Epidemiology ◽

10.1093/ije/dyy129 ◽

2019 ◽

Vol 48 (Supplement_1) ◽

pp. i54-i62 ◽

Cited By ~ 6

Author(s):

Ana M B Menezes ◽

Fernando C Barros ◽

Bernardo L Horta ◽

Alicia Matijasevich ◽

Andréa Dâmaso Bertoldi ◽

...

Keyword(s):

Black Women ◽

Infant Mortality ◽

Low Income ◽

Causes Of Death ◽

Mortality Rates ◽

Population Based ◽

Birth Cohorts ◽

Mortality Trends ◽

Death Rates ◽

Economic Inequalities

Abstract Background Infant-mortality rates have been declining in many low- and middle-income countries, including Brazil. Information on causes of death and on socio-economic inequalities is scarce. Methods Four birth cohorts were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. Surveillance in hospitals and vital registries, accompanied by interviews with doctors and families, detected fetal and infant deaths and ascertained their causes. Late-fetal (stillbirth)-, neonatal- and post-neonatal-death rates were calculated. Results All-cause and cause-specific death rates were reduced. During the study period, stillbirths fell by 47.8% (from 16.1 to 8.4 per 1000), neonatal mortality by 57.0% (from 20.1 to 8.7) and infant mortality by 62.0% (from 36.4 to 13.8). Perinatal causes were the leading causes of death in the four cohorts; deaths due to infectious diseases showed the largest reductions, with diarrhoea causing 25 deaths in 1982 and none in 2015. Late-fetal-, neonatal- and infant-mortality rates were higher for children born to Brown or Black women and to low-income women. Absolute socio-economic inequalities based on income—expressed in deaths per 1000 births—were reduced over time but relative inequalities—expressed as ratios of mortality rates—tended to remain stable. Conclusion The observed improvements are likely due to progress in social determinants of health and expansion of health care. In spite of progress, current levels remain substantially greater than those observed in high-income countries, and social and ethnic inequalities persist.

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COMPARISON OF AGE AND BIOLOGICAL SEX MORTALITY TRENDS BETWEEN ADULTS WITH AND WITHOUT DOWN SYNDROME

Innovation in Aging ◽

10.1093/geroni/igz038.1276 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S352-S352

Author(s):

James D Stevens ◽

Scott D Landes ◽

Margaret A Turk

Keyword(s):

Cerebral Palsy ◽

Respiratory Diseases ◽

Causes Of Death ◽

Age At Death ◽

Mortality Trends ◽

Male And Female ◽

Biological Sex ◽

The Us ◽

Underlying Cause Of Death ◽

Health And Mortality

Abstract Distinct mortality trends emerge from comparisons of mean and median age at death and specific causes of death between adults with and without cerebral palsy. We compare standardized mortality odds ratios (SMORs) for 20 leading causes of death for 11,895 adults with cerebral palsy and 13,047,988 without cerebral palsy in the US between 2012 and 2016. Male and female decadents with cerebral palsy died significantly younger than male and female decadents without cerebral palsy, and were more likely to die from respiratory diseases, choking, and unknown causes. Public health and preventive care efforts should account for respiratory, swallowing, and nutrition risks, as well as mortality trends’ variation across age and biological sex. The CDC and WHO could better surveil this population’s health and mortality by disallowing certifiers from using cerebral palsy as the underlying cause of death as the practice leads to high rates of unknown causes of death.

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