scholarly journals The age vector of risk factors for mortality of young Muscovites

2021 ◽  
Vol 2 (2) ◽  
pp. 15-25
Author(s):  
Victoria G. Semyonova ◽  
Alla E. Ivanova ◽  
Tamara P. Sabgayda ◽  
Galina N. Evdokushkina

European-like life expectancy levels in Moscow are attributable to the prevalence of older population and the manifold increase in the working-age population mortality, especially among young people. The goal of the study is to identify the age-specific risk factors for Moscow youth mortality. This analysis is based on the official Russian Statistics Service’ data on mortality in the age groups of 15–24 and 25–34 years between 2000 and 2019. As demonstrated, during the study period, the Moscow youth mortality rates decreased twofold between both age groups. Starting from 2017, the mortality rate of Moscow youth began to increase, mainly among the 15–24-year-olds. The age vector of the youth mortality structure indicates a change in risk factors associated with age: while adolescents die from external causes, i.e. specific risks directly leading to death, later on youth mortality is more often associated with long-term behavioral factors indirectly resulting in death (such as sexual conduct as a risk factor for HIV/AIDS mortality, alcohol as the main cause for deaths from digestive system diseases and mental disorders, drugs as a risk factor for deaths from cardiovascular diseases and mental disorders). It is important to take note of the wide age range of the population classified as «young»: while it might be justified in legal and social context, in the demographic context it blurs the differences in mortality among people of different ages. Moreover, the abnormally high level and contribution of mortality from inaccurately described conditions, which the Moscow youth suffered from in the 2000s, calls into question the official rates of mortality due to underlying causes, primarily injuries, poisonings, and circulatory diseases. At the same time, given the increase in the young people’s overall mortality in the recent years, the extremely high mortality rates from inaccurately described conditions make it difficult to identify health priorities for the Moscow youth and, therefore, do not allow determining the reserves for their effective decline.

Author(s):  
Svetlana V. Ustavshchikova ◽  

Reducing the mortality rate of the population: general, in childhood and people of working age is a priority goal of the federal and regional authorities. However, an increase in the proportion of the population in older ages in the total population, and an increase in life expectancy leads to an aging of the population as a whole, and, consequently, to an increase (all other things being equal) of the relative mortality rates of the entire population. The potential for mortality reduction is a reduction in mortality due to external causes: from accidents, poisoning, injuries, drug and alcohol exposure. Strengthening the physical and mental health of the population will also contribute to this component decrease.


Author(s):  
Oleh Lyubinets ◽  
Marta Kachmarska ◽  
Katarzyna Maria Sygit ◽  
Elżbieta Cipora ◽  
Jaroslaw Grshybowskyj

This paper presents a comparative assessment of mortality in Poland and Ukraine, including due to alcohol consumption, by sex, place of residence, and age groups. Mortality from alcohol consumption is and remains one of the health problems of the state’s population. The aim of this study was to establish the difference in mortality, including due to alcohol consumption, in the two neighboring countries. The analysis was conducted in 2008 and 2018 according to statistical institutions in Poland and Ukraine. Data from the codes of the International Statistical Classification of Diseases of the 10th edition: F10, G31.2, G62.1, I42.6, K70, K86.0, and X45 were used to calculate mortality due to alcohol consumption. The share of mortality caused by alcohol consumption in Ukraine in 2008 was 3.52%, and 1.83% in 2018. At the same time, in Poland, there is an increase in this cause of death from 1.72% to 2.36%. Mortality caused by alcohol consumption is the main share of mortality in the section “Mental and behavioral disorders” in both Ukraine, at 73–74%, and Poland, at 82–92%. Changes in the mortality rate in the cities and villages of Ukraine and Poland showed different trends: Poland nated, a significant increase in mortality, while in Ukraine it has halved on average. Overall and alcohol mortality rates in both countries were higher among the male population. The analysis of mortality among people of working age showed that the highest proportion of deaths from alcohol consumption in both countries was among people aged 25–44. Despite the geographical proximity, and similarity of natural and climatic characteristics and population, mortality rates in each country reflect the difference in the medical and demographic situation, and the effectiveness of state social approaches to public health.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Piotr Bandosz ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Tomasz Zdrojewski ◽  
Julia Critchley ◽  
...  

Background: Poland has experienced one of the most dramatic declines in coronary heart disease (CHD) mortality rates in recent decades. This decline reflects the use of evidence based treatments and, crucially, population wide changes in diet. Our aim is to explore the potential for further gains in Poland by achieving population wide reductions in smoking, dietary salt and saturated fat intake and physical inactivity levels. Methods: A validated and updated policy model was used to forecast potential decreases in CHD deaths by 2020 as consequence of lifestyle and dietary changes in the population. Data from the most recent Polish risk factor survey was used for the baseline (2011). We modeled two different policy scenarios regarding possible future changes in risk factors: A) conservative scenario: reduction of smoking prevalence and physically inactivity rates by 5% between 2011 and 2020, and reduction of dietary consumption of energy from saturated fats by 1% and of salt by 10%. B) ideal scenario: reduction of smoking and physically inactivity prevalence by 15%, and dietary reduction of energy from saturated fats by 3% and of salt by 30%. We also conducted extensive sensitivity analysis using different counterfactual scenarios of future mortality trends. Results: Baseline scenarios. By assuming continuing declines in mortality and no future improvements in risk factors the predicted number of CHD deaths in 2020 would be approximately 13,600 (9,838-18,184) while if mortality rates remain stable, the predicted number of deaths would approximate 22,200 (17,792-26,688). Conservative scenario. Assuming continuing declines in mortality, small changes in risk factors could result in approximately 1,500 (688-2,940) fewer deaths. This corresponds to a 11% mortality reduction. Under the ideal scenario, our model predicted some 4,600 (2,048-8,701) fewer deaths (a 34% mortality reduction). Reduction in smoking prevalence by 5% (conservative scenario) or 15% (ideal scenario) could result in mortality reductions of 4.5% and 13.8% respectively. Decreases in salt intake by 10% or 30% might reduce CHD deaths by 3.0% and 8.6% respectively. Replacing 1% or 3% of dietary saturated fats by poly-unsaturates could reduce CHD deaths by 2.6% or 7.7% Lowering the prevalence of physically inactive people by 5%-15% could decrease CHD deaths by 1.2%-3.7%. Conclusion: Small and eminently feasible population reductions in lifestyle related risk factors could substantially decrease future number of CHD deaths in Poland, thus consolidating the earlier gains.


2020 ◽  
Vol 5 (2) ◽  
pp. 99-104
Author(s):  
Evgenii L. Borschuk ◽  
Dmitrii N. Begun ◽  
Tatyana V. Begun

Objectives - to study the mortality indicators, their dynamics and structure, in the population of the Orenburg region in the period of 2011-2017. Material and methods. The study was conducted using the data from the territorial authority of statistics in the Orenburg region in the period from 2011 to 2017. The analytical, demographic and statistical methods were implemented for the study of the demographic indicators. Results. Cities and municipal settlements of the Orenburg region with high mortality indicators were included in the second and fourth clusters during the cluster analysis. The first and third clusters included cities and municipal settlements with an average mortality. The most favorable position has the Orenburg area with the lowest mortality rate in the region in 2017 - 8.4%. The dynamics of mortality rates among the male and female population tends to decrease, more pronounced dynamics is in men. Though, the male population is characterized by higher mortality rates in all age groups. The leading position among the causes of death is taken by diseases of the circulatory system (46.3% of the total mortality). The second position is occupied by tumors (17.2%), the third - by external causes (8.4%). Mortality from circulatory system diseases and from external causes has reduced. The dynamics of mortality from tumors does not change significantly. The rank of leading causes of death is not identical in the clusters: in the third and fourth clusters, the other causes occupy the second place in the structure of mortality, while tumors occupy the third. Conclusion. In the Orenburg region, the mortality rate is higher than overage in the Russian Federation by 0.9 per 1000 people. The study revealed significant territorial differences in the mortality rates. In general, the mortality among men in all age groups is higher than the mortality of women. The mortality rate from diseases of the circulatory system plays the leading role in the structure of mortality, but has the tendency for decline. Until 2006, the mortality from external causes ranked the second place, now the second place is taken by death from tumors The mortality from external causes is decreasing; mortality from tumors does not change significantly. The obtained results could be used by local authorities in developing the program of public health protection and assessing its effectiveness.


Curationis ◽  
2007 ◽  
Vol 30 (4) ◽  
Author(s):  
Y.Q. Li ◽  
S.C.D. Wright

Cardiovascular disease is the most common and yet one of the most preventable causes of death in the world. Rapid urbanization in South Africa is accompanied by rapid changes in lifestyle and environmental exposure that increase the burden of chronic cardiovascular diseases. Risk factors, modifiable or nonmodifiable, exist that increases a person’s chances of developing cardiovascular disease. Though some knowledge is available about the prevalence of the risk factors in South Africa, no information is available regarding the community of Ga-Rankuwa. The purpose of the study was therefore to investigate the prevalence of risk factors for cardiovascular disease amongst the working-age people (18-40 years) in Ga-Rankuwa community. A quantitative survey was done and the sample was selected from zone 1,2,4, and 16 of Ga-Rankuwa from July 2005 to October 2005. The sampling method was census sampling (n=604). The data-gathering was self-report using a structured questionnaire as well as physical measurement. Data were analysed using descriptive statistics. The results indicated that risk factors, specifically obesity, physical inactivity and hypertension, were very prevalent in Ga-Rankuwa community. Different distributions of risk factors exist in the various sex and age groups. This finding again emphasises the importance of not developing health interventions with a single focus, for example hypertension or obesity. The risk factors are interwoven and affect each other. It is important to initiate a comprehensive health project to lower the risk factors of cardiovascular disease in the Ga-Rankuwa community.


Author(s):  
Katherine E Goodman ◽  
Laurence S Magder ◽  
Jonathan D Baghdadi ◽  
Lisa Pineles ◽  
Andrea R Levine ◽  
...  

Abstract Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from COVID-19 remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April – June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66,646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12,388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26 – 1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96 – 1.06), and hypertension without chronic complications was only a risk factor in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17 – 2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; p-values ≤ 0.002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.


2017 ◽  
Vol 34 (11-12) ◽  
pp. 938-945 ◽  
Author(s):  
Qing Feng ◽  
Yu-Hang Ai ◽  
Hua Gong ◽  
Long Wu ◽  
Mei-Lin Ai ◽  
...  

Background: Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk factors for death, short-term, and long-term prognosis. Methods: The retrospective study included patients in ICU from January 2015 to June 2016. After excluding 58 patients, 175 were assigned to either an SAE or a non-SAE group (patients with sepsis but no encephalopathy). The sensitivity of the diagnostic criteria was compared between sepsis 1.0 and 3.0, respectively. Between-group differences in baseline data, Acute Physiology and Chronic Health Evaluation II score (APACHE II score), Sequential Organ Failure Assessment score (SOFA score), etiological data, biochemical indicators, and 28-day and 180-day mortality rates were analyzed. Survival outcomes and long-term prognosis were observed, and risk factors for death were analyzed through 180-day follow-up. Results: The sensitivity did not differ significantly between the diagnostic criteria of sepsis 1.0 and 3.0 ( P = .286). The 42.3% incidence of SAE presented a significantly high APACHE II and SOFA scores as well as 28-day mortality and 180-day mortality (all P < .001). The incidence of death was 37.1%. The multivariate stepwise regression analysis demonstrated that the risk of death in SAE group was significantly higher than the non-SAE group ( P < .001). Sepsis-associated encephalopathy is a risk factor for sepsis-related death (relative risk [RR] = 2.868; 95% confidence interval: 1.730-4.754; P < .001). Although males showed a significantly high rate of 28-day and 180-day mortality ( P = .035 and .045), it was not an independent risk factor for sepsis-related death ( P = .072). The long-term prognosis of patients with sepsis was poor with decreased quality of life. No significant difference was observed in prognosis between the SAE and non-SAE groups ( P > .05). Conclusion: Both diagnostic criteria cause misdiagnosis, and the sensitivity did not differ significantly. The incidence of SAE was high, and 28-day and 180-day mortality rates were significantly higher than those without SAE. Sepsis-associated encephalopathy is a risk factor for poor outcome. The overall long-term prognosis of patients with sepsis was poor, and the quality of life decreased.


2014 ◽  
Vol 143 (7) ◽  
pp. 1360-1367 ◽  
Author(s):  
I. H. M. FRIESEMA ◽  
M. SCHOTSBORG ◽  
M. E. O. C. HECK ◽  
W. VAN PELT

SUMMARYShiga toxin-producingEscherichia coli(STEC) infections have been associated with severe illness. Ruminants are seen as the main reservoir and the major transmission route is considered to be foodborne. In The Netherlands, a case-control study was conducted, using data collected during 2008–2012. Patients were interviewed and controls completed a self-administered questionnaire. Patients travelling abroad were excluded from the analyses. STEC O157 and non-O157 were examined separately and differentiated into two age groups (<10 years, ⩾10 years). We included 130 O157 cases, 78 non-O157 cases and 1563 controls. In both age groups of O157 patients, raw spreadable sausage was the main risk factor for infection. For STEC non-O157 cases aged <10 years, contact with farm animals was the main risk factor and in non-O157 cases aged ⩾10 years, consumption of beef was the main risk factor. During 2008–2012, risk factors for STEC infections in the Dutch population differed between age groups and serogroup categories, and were related to eating meat and contact with farm animals. Advising the public about the risks of consuming raw or undercooked meat (products) and hygiene habits in case of contact with farm animals, could help in the prevention of STEC infections.


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