Methods and problems of the nosological analysis of mortality in the period of COVID-19 pandemic

2021 ◽  
Vol 2 (1) ◽  
pp. 51-58
Author(s):  
O. M. Drapkina ◽  
I. V. Samorodskaya ◽  
E. P. Kakorina ◽  
V. I. Perkhov
Keyword(s):  
Cause Of Death ◽  
Age Groups ◽  
Mortality Rates ◽  
Political Processes ◽  
Rate Of Spread ◽  
Quality Of Medical Care ◽  
Spread Of Infection ◽  
Technology Specialists ◽  
Resource Capacity

The article discusses different approaches to assessing mortality during the COVID-19 pandemic. The analysis of inter­national data shows that different countries use different approaches to assessing mortality from COVID-19 and the increase in mortality from all causes. The most probable reasons for the variability of the increase in mortality rates are the rate of spread of infection, the quality of isolation and quarantine measures, the commitment of the population to their implementation, the resource capacity of the healthcare system and the quality of medical care (both for the treatment of COVID-19 and other diseases), features of living conditions, socio-economic and political processes that are difficult to formalize (and therefore assess the contribution by methods of mathematical statistics). For a correct comparison of excess mortality rates, it will be necessary to calculate standardized indicators and compare data in five-year age groups.In 2021, serious problems should be expected with the comparison of mortality rates in different countries from individual causes. The methodology for recording deaths from COVID-19 and other causes is not uniform at the global level, prob­lems are associated with differences in approaches to determining the primary cause of death, difficulties in determining the cause of death if a patient has multimorbid pathology (especially without postmortem examination). A full-fledged analysis is possible only with transdisciplinary cooperation under the auspices of the WHO of doctors, mathematicians, economists, and information technology specialists.

REORGANIZATION OF A MULTI-SPECIALTY HOSPITAL IN AN UNFAVORABLE EPIDEMIOLOGICAL SITUATION

2020 ◽  
pp. 43-46
Author(s):  
Nikitin A.E. ◽  
Znamenskiy I.А ◽  
Shikhova Yu.A. ◽  
Kuzmina I.V. ◽  
Melchenko D.S. ◽  
...  
Keyword(s):  
Contact Time ◽  
Laboratory Diagnostics ◽  
Protective Equipment ◽  
Timely Manner ◽  
High Quality ◽  
Institu Tions ◽  
Quality Of Medical Care ◽  
Spread Of Infection ◽  
Epidemiological Situation

This study provides a retrospective analysis of work to ensure high quality of medical care in an unfavorable epidemic situation. The consequence of COVID-19 was the implementation of a program to prevent the spread of infection, the re-profiling of medical institu-tions, and the introduction of restrictive and anti-epidemic measures. The experience of our work has shown the effectiveness of changing the order of med-ical care, the organization of the functioning of de-partments and patient routing. The study reflects the measures implemented in the hospital departments, the Department of clinical and laboratory diagnostics, radiation diagnostics and pathology Department. To ensure the safety of patients, it was decided to place patients on a single bed according to the type of infec-tious boxes. The safety of employees was ensured by the use of personal protective equipment, minimiza-tion of contact time with patients, and preventive weekly examination of staff for SARS-CoV-2 infection. The organized and well-coordinated work of the en-tire staff of the institution made it possible to prevent the spread of COVID-19 among employees, to detect cases of infection in a timely manner, and to carry out appropriate isolation and monitoring measures. At the time of completion of infectious diseases departments, the mortality rate among patients was less than 9%. Our experience in reorganizing a multi-specialty facil-ity can be used in the future when working with pa-tients who have undergone COVID-19, as well as in the context of a worsening epidemic situation.

scholarly journals Mortality Associated with Idiopathic Pulmonary Fibrosis in Northeastern Italy, 2008–2020: A Multiple Cause of Death Analysis

2021 ◽  
Vol 18 (14) ◽  
pp. 7249
Author(s):  
Alessandro Marcon ◽  
Elena Schievano ◽  
Ugo Fedeli
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cause Of Death ◽  
Age Groups ◽  
Mortality Rates ◽  
Annual Percent Change ◽  
Northeastern Italy ◽  
Mortality Ratio ◽  
The Impact ◽  
Related Mortality

Mortality from idiopathic pulmonary fibrosis (IPF) is increasing in most European countries, but there are no data for Italy. We analysed the registry data from a region in northeastern Italy to assess the trends in IPF-related mortality during 2008–2019, to compare results of underlying vs. multiple cause of death analyses, and to describe the impact of the COVID-19 epidemic in 2020. We identified IPF (ICD-10 code J84.1) among the causes of death registered in 557,932 certificates in the Veneto region. We assessed time trends in annual age-standardized mortality rates by gender and age (40–74, 75–84, and ≥85 years). IPF was the underlying cause of 1310 deaths in the 2251 certificates mentioning IPF. For all age groups combined, the age-standardized mortality rate from IPF identified as the underlying cause of death was close to the European median (males and females: 3.1 and 1.3 per 100,000/year, respectively). During 2008–2019, mortality rates increased in men aged ≥85 years (annual percent change of 6.5%, 95% CI: 2.0, 11.2%), but not among women or for the younger age groups. A 72% excess of IPF-related deaths was registered in March–April 2020 (mortality ratio 1.72, 95% CI: 1.29, 2.24). IPF mortality was increasing among older men in northeastern Italy. The burden of IPF was heavier than assessed by routine statistics, since less than two out of three IPF-related deaths were directly attributed to this condition. COVID-19 was accompanied by a remarkable increase in IPF-related mortality.

Medical Resources and Suicide Prevention

1992 ◽  
Vol 75 (3_suppl) ◽  
pp. 1254-1254
Author(s):  
David Lester
Keyword(s):  
Infant Mortality ◽  
Medical Care ◽  
Suicide Prevention ◽  
Mortality Rates ◽  
Homicide Rates ◽  
Medical Resources ◽  
Suicide Rates ◽  
American States ◽  
Quality Of Medical Care

Infant mortality rates, a measure of the quality of medical care, was associated with homicide rates, but not suicide rates, over nations and over the American states.

Abstract 15: Trends in Atrial Fibrillation-related Cardiovascular Mortality Rates in The United States: 1999-2017

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Nilay Shah ◽  
Rod Passman ◽  
Philip Greenland ◽  
Sadiya Khan
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Black Men ◽  
Cause Of Death ◽  
Age Groups ◽  
White Men ◽  
The United States ◽  
Mortality Rates ◽  
Men And Women ◽  
Black And White

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.

scholarly journals Comparative assessment of mortality and lethality rates of newborns at the regional level

Public Health ◽  
2022 ◽  
Vol 1 (4) ◽  
pp. 34-48
Author(s):  
D. O. Ivanov ◽  
V. K. Yuryev ◽  
Yu. V. Petrenko ◽  
K. E. Moiseeva ◽  
I. I. Mogileva ◽  
...  
Keyword(s):  
Medical Care ◽  
Maternity Care ◽  
Federal District ◽  
Mortality Rates ◽  
Average Hospital ◽  
The North ◽  
Quality Of Medical Care ◽  
The City ◽  
North Western

In order to assess the mortality and lethality rates of newborns in obstetric organizations of the North-Western Federal District in 2013–2019, a comparative analysis of official statistics data was carried out. It was found that in the North-Western Federal District in the period from 2013 to 2019, there was an almost annual decrease in newborn mortality rates. The overall decrease in mortality in maternity care organizations of the Federal District (from 2,5% to 1,9%) was mainly due to a decrease in mortality in obstetric hospitals of the first and second levels (respectively from 3,2% to 1,2% and from 1,7% to 0,7%), while most children died in perinatal centers, where the mortality rate has not changed in recent years (2013 – 4,1%; 2019 – 4,0%). The study showed a decrease in mortality rates in the subjects of the Russian Federation that are part of the federal district, except for the city of St. Petersburg. The average hospital lethality rate of newborns in maternity care organizations of the North-Western Federal District during 2013–2019 was in the range of 1,9%–2,0%, did not change significantly and corresponded to the national average. However, the level of hospital lethality significantly differed in individual subjects of the district – in more than half of them, the level of hospital lethality exceeded the average, while in others it was significantly lower. Thus, the decrease in the mortality and lethality rates of newborns in maternity care organizations indicates an increase in the quality of medical care for children in the North-Western Federal District. dicates an increase in the quality of medical care for children in the North-Western Federal District. 

scholarly journals Клиническая и нейрофизиологическая характеристика неонатального периода детей, родившихся от ранних преждевременных родов

2019 ◽  
pp. 32-38
Keyword(s):  
Infant Mortality ◽  
Neonatal Period ◽  
Mortality Rates ◽  
Mortality And Morbidity ◽  
Typical Sample ◽  
High Infant Mortality ◽  
Nervous System Function ◽  
Quality Of Medical Care ◽  
Neurological Pathology

In recent years, there has been a decrease in perinatal and infant mortality rates in the world due to improvements in the quality of medical care for children born in early pre-term birth (32 and less weeks of gestation) (Baranov A.A., Namazova-Baranova L.S., Kurenkov A.L., etc., 2014). Complications of prematurity are the main causes of high infant mortality and morbidity in premature infants, the risk of complications increases with severity of immaturity (Sakharova E.S., 2017). Objective – to study the clinical and neurophysiological features of the neonatal period in children born at the gestational age of 32 weeks or less. Materials and methods: a cohort prospective study of the physical, neurological and neurophysiological status of 85 children born at the age of up to 32 weeks of pregnancy was conducted by a typical sample. Eelectroencephalography (Neuro-Facilities Copyright © 201-2018 Neurosoft) was performed, visual and auditory potentials were determined (Neuro-SPECTR Copyright © 2012-2018 Neurosoft), NSG. Results: on the basis of the obtained data, the dependence of the state of health and severity of neurological pathology on the period of gestation at birth, the severity of hypoxia and the severity of brain damage at birth was confi rmed. It was found out that the main manifestation of the nervous system function in children born at 32 and less weeks of gestation at 38-40 weeks of post-conceptual age is neurophysiological immaturity.

scholarly journals Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

2020 ◽  
Author(s):  
Elisabeth França ◽  
Lenice Harumi Ishitani ◽  
Renato Teixeira ◽  
Bruce B. Duncan ◽  
Fatima Marinho ◽  
...  
Keyword(s):  
Cause Of Death ◽  
State Level ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Inverse Association ◽  
Socioeconomic Groups ◽  
Temporal Relationships ◽  
Icd 10 ◽  
Level 1

Abstract Background: Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods: We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three and four digit ICD-10 codes considered as GC were selected and classified into four categories, according to the GBD study proposal. GCs levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996-2005 and 2006-2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state‐level estimates. Results: Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1-2 GCs in 1996-2005, but both SDI and completeness had a non-expected significant direct association with levels 3-4. In 2006-2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996-2016, but GCs levels 3-4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion: Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

scholarly journals Quality of cause-of-death data in Brazil: Garbage codes among registered deaths in 2000 and 2015

2019 ◽  
Vol 22 (suppl 3) ◽  
Author(s):  
Renato Azeredo Teixeira ◽  
Mohsen Naghavi ◽  
Mark Drew Crosland Guimarães ◽  
Lenice Harumi Ishitani ◽  
Elizabeth Barboza França
Keyword(s):  
Data Quality ◽  
Cause Of Death ◽  
Age Groups ◽  
Health Assessment ◽  
Mortality Data ◽  
Laboratory Findings ◽  
Northern Regions ◽  
Icd 10 ◽  
Death Data

ABSTRACT Introduction: reliability of mortality data is essential for health assessment and planning. In Brazil, a high proportion of deaths is attributed to causes that should not be considered as underlying causes of deaths, named garbage codes (GC). To tackle this issue, in 2005, the Brazilian Ministry of Health (MoH) implements the investigation of GC-R codes (codes from chapter 18 “Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, ICD-10”) to improve the quality of cause-of-death data. This study analyzes the GC cause of death, considered as the indicator of data quality, in Brazil, regions, states and municipalities in 2000 and 2015. Methods: death records from the Brazilian Mortality Information System (SIM) were used. Analysis was performed for two GC groups: R codes and non-R codes, such as J18.0-J18.9 (Pneumonia unspecified). Crude and age-standardized rates, number of deaths and proportions were considered. Results: an overall improvement in the quality of mortality data in 2015 was detected, with variations among regions, age groups and size of municipalities. The improvement in the quality of mortality data in the Northeastern and Northern regions for GC-R codes is emphasized. Higher GC rates were observed among the older adults (60+ years old). The differences among the areas observed in 2015 were smaller. Conclusion: the efforts of the MoH in implementing the investigation of GC-R codes have contributed to the progress of data quality. Investment is still necessary to improve the quality of cause-of-death statistics.

scholarly journals Trends in overall mortality and from diseases of the circulatory system in elderly individuals in Rio Branco, Acre, 1980-2012

2018 ◽  
Vol 21 (2) ◽  
pp. 143-154
Author(s):  
Polyana Caroline de Lima Bezerra ◽  
Gina Torres Rego Monteiro
Keyword(s):  
Cause Of Death ◽  
Elderly Women ◽  
Circulatory System ◽  
The Elderly ◽  
Mortality Rates ◽  
Elderly Persons ◽  
System Disease ◽  
Disease Mortality ◽  
Overall Mortality

Abstract Objective: To analyze trends in general mortality and circulatory system disease mortality among elderly persons living in the city of Rio Branco, Acre, Brazil, from 1980 to 2012. Method: A study of the cause of death of elderly people was carried out from the data available in the Brazilian Mortality Information System. Crude and age-based overall and circulatory system mortality rates were calculated. The trend analyses of these rates were performed using the JoinPoint Regression program. Results: Despite the reductions in mortality rates, diseases of the circulatory system remained the main cause of death of the elderly in Rio Branco. The decrease in overall mortality rates was higher among elderly women and those aged 70 years or older. There was a tendency for death rates due to diseases of the circulatory system to decline among elderly men and grow among elderly women. Conclusion: The mortality rate among the elderly in Rio Branco revealed a declining trend. Deaths from diseases of the circulatory system were the leading cause of death, suggesting that research should be carried out to assess the need for investment to ensure that increased longevity is accompanied by good quality of life.

scholarly journals The Role of Comorbid Diseases in Geographic Disparities of Mortality From Septicemia Among Older Adults Across the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 140-141
Author(s):  
Julia Kravchenko ◽  
Igor Akushevich
Keyword(s):  
Cause Of Death ◽  
Kidney Diseases ◽  
Subcutaneous Tissue ◽  
Age Groups ◽  
The United States ◽  
Mortality Rates ◽  
Geographic Disparities ◽  
The Us ◽  
Comorbid Diseases

Abstract Sepsis is a prominent cause of death in the US. However, few studies examined its regional variations. Using the Multiple-Cause-of-Death and 5%-Medicare data, we analyzed mortality among the US patients aged 65+ who had septicemia and various comorbid diseases in the states with the highest (HI,FL,AZ,CT,CO, and MN––a.k.a. leading states) and lowest (AR,TN, LA,OK,KY,AL,MS, and WV–a.k.a. lagging states) life expectancy. In 2010-2018, age-adjusted mortality from septicemia was almost twice as high in lagging (85.2±0.5/100,000) comparing to leading (45.2±0.3/100,000) states. Between-the-states difference was the most pronounced at age 65-74 (44.7±0.4 vs. 20.8±0.2) and gradually reduced in older age groups. Higher mortality from septicemia in the lagging US states could be, at least in part, because of poorer health of the beneficiaries who enter Medicare at age 65. Mortality rates were the highest among septicemia patients who had comorbid cancer, ischemic heart disease, influenza/pneumonia, or kidney failure. Mortality rates of patients with co-existing Alzheimer’s disease or arterial hypertension were lower, but these comorbidities contributed most to geographic disparities. The role of complications due to surgical and other medical procedures in disparities across the states was minimal. Substantial contributions to geographic disparities in septicemia mortality were detected not only for well-known and highly-lethal comorbidities such as diabetes, heart failure, and kidney diseases, but also for less frequently discussed conditions with lower per se mortality such as disease of intestine, skin/subcutaneous tissue, and cystitis, urethritis, or unspecified infections of urinary tract.

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