scholarly journals A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5948 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Antonio Bernabe-Ortiz
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Communicable Diseases ◽  
Chronic Obstructive ◽  
Mortality Trends ◽  
Obstructive Pulmonary Disease ◽  
Final Cause ◽  
Study Country ◽  
Underlying Causes ◽  
Final Causes

BackgroundThe underlying cause of death is used to study country and global mortality trends and profiles. The final cause of death could also inform the ultimately cause of death in individuals with underlying conditions. Whether there is a pattern between the underlying and final cause of death has not been explored using national death registries. We studied what final causes of death were most common among selected underlying causes using national death registries in Peru, 2015.MethodsUnderlying and final causes of death were classified according to their ICD-10 codes. Underlying causes included chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), diabetes, and selected cancers (cervix, breast, stomach, prostate, and lung). Final causes were categorized as: communicable, cardiovascular, and cancers. Descriptive statistics were used.ResultsA total of 77,065 death registries were analyzed; cases had a mean age of 69.4 (SD: 19.3) years at death and were mostly men (53.9%). When the underlying cause was HTN, the most frequent final cause was cardiovascular diseases (82.3%). For all the other underlying causes, the most frequent final cause was communicable diseases: COPD (86.4%), CKD (79.3%), cancer (76.5%), and diabetes (68.3%).ConclusionsIn four selected underlying causes of death there was a divergence with respect to the final cause, suggesting there was a shift from non-communicable to communicable causes. Although efforts should be deployed to prevent underlying non-communicable diseases, potential communicable complications should not be neglected.

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

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.

scholarly journals Mortality in Emergency Services in a University Teaching Hospital: A Retrospective Study

2019 ◽  
Vol 41 (2) ◽  
pp. 17-20
Author(s):  
Tirtha Man Shrestha ◽  
Ramesh P Aacharya ◽  
Ram P Neupane ◽  
Bigyan Prajapati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Septic Shock ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Emergency Services ◽  
University Teaching ◽  
Chronic Obstructive ◽  
Age Group ◽  
Obstructive Pulmonary Disease

Introduction: Emergency services are the gateway between the community and hospital that provides 24-hour access for most needy patients in critical and emergency conditions. Mortality rate varies in emergency department across the world and even in different emergency units of the same hospital. This retrospective study was done in adult emergency services of a tertiary hospital to determine mortality rate and analyze causes of death. Methods: A retrospective observational study of mortality cases to analyze mortality rate and causes of death of patients for a period of 6 months between October 2017 to March 2018 was carried out in the adult emergency services of Tribhuvan University Teaching Hospital, Kathmandu. Data required were collected from copies of death certificates. Results: During the study period, a total of 128 patients died in emergency, accounting 0.5% of total patient. Male deaths (52.3%) were slightly higher compared to female deaths (47.7%). Age group 66-75 years had the highest (24.2%) of total mortalities in the emergency. The most common immediate cause of death was sepsis/septic shock (21.9%) followed by cardiopulmonary arrest, aspiration, respiratory failure, other causes of shock and poisoning. The commonest antecedent cause of death was attributed to respiratory causes. Similarly, the most common contributory cause of death was chronic obstructive pulmonary disease. Conclusion: Older age group is prone to the mortality risk. Sepsis/septic shock was the most common immediate cause of death. Pneumonia was the most common antecedent causes of death. Chronic obstructive pulmonary disease was the commonest contributory cause.

scholarly journals Discordance in investigator-reported and adjudicated sudden death in TIOSPIR

2017 ◽  
Vol 3 (1) ◽  
pp. 00073-2016 ◽  
Author(s):  
Robert A. Wise ◽  
Peter R. Kowey ◽  
George Austen ◽  
Achim Mueller ◽  
Norbert Metzdorf ◽  
...  
Keyword(s):  
Sudden Death ◽  
Cause Of Death ◽  
Causes Of Death ◽  
System Organ Class ◽  
Chronic Obstructive ◽  
Supporting Evidence ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Class Level ◽  
Underlying Cause Of Death

Accurate and consistent determination of cause of death is challenging in chronic obstructive pulmonary disease (COPD) patients. TIOSPIR (N=17 135) compared the safety and efficacy of tiotropium Respimat 5/2.5 µg with HandiHaler 18 µg in COPD patients. All-cause mortality was a primary end-point. A mortality adjudication committee (MAC) assessed all deaths. We aimed to investigate causes of discordance in investigator-reported and MAC-adjudicated causes of death and their impact on results, especially cardiac and sudden death.The MAC provided independent, blinded assessment of investigator-reported deaths (n=1302) and assigned underlying cause of death. Discordance between causes of death was assessed descriptively (shift tables).There was agreement between investigator-reported and MAC-adjudicated deaths in 69.4% of cases at the system organ class level. Differences were mainly observed for cardiac deaths (16.4% investigator, 5.1% MAC) and deaths assigned to general disorders including sudden death (17.4% investigator, 24.6% MAC). Reasons for discrepancies included investigator attribution to the immediate (e.g. myocardial infarction (MI)) over the underlying cause of death (e.g. COPD) and insufficient information for a definitive cause.Cause-specific mortality varies in COPD, depending on the method of assignment. Sudden death, witnessed and unwitnessed, is common in COPD and often attributed to MI without supporting evidence.

scholarly journals Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates

2021 ◽  
Author(s):  
Eric Monterrubio-Flores ◽  
María D Ramírez-Villalobos ◽  
Juan Espinosa-Montero ◽  
Bernardo Hernandez ◽  
Simón Barquera ◽  
...  
Keyword(s):  
Case Fatality ◽  
Logistic Models ◽  
Communicable Diseases ◽  
Chronic Obstructive ◽  
Fatality Rate ◽  
Younger Adults ◽  
Obstructive Pulmonary Disease ◽  
Non Communicable Diseases ◽  
Risk Of Death ◽  
Mexican Adults

Abstract Background People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults. Objectives To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2. Methods We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models. Results We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions. Conclusion In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.

Mortality Profile Related to Systemic Lupus Erythematosus: A Multiple Cause-of-death Analysis

2012 ◽  
Vol 39 (3) ◽  
pp. 496-503 ◽  
Author(s):  
DEBORAH C.C. SOUZA ◽  
AUGUSTO H. SANTO ◽  
EMILIA I. SATO
Keyword(s):  
Renal Failure ◽  
Cause Of Death ◽  
Lupus Erythematosus ◽  
Digestive System ◽  
Causes Of Death ◽  
Circulatory System ◽  
Systemic Lupus ◽  
Circulatory System Diseases ◽  
Underlying Causes ◽  
Digestive System Diseases

Objective.To analyze the mortality profile related to systemic lupus erythematosus (SLE) in the state of São Paulo, Brazil.Methods.For the 1985–2007 period, we analyzed all death certificates (n = 4815) on which SLE was listed as an underlying (n = 3133) or non-underlying (n = 1682) cause of death. We evaluated sex, age, and the causes of death, comparing the first and last 5 years of the period, as well as determining the observed/expected death ratio (O/E ratio).Results.For SLE as an underlying cause, the mean age at death was 35.77 years (SD 15.12) and the main non-underlying causes of death were renal failure, circulatory system diseases, pneumonia, and septicemia. Over the period, the proportional mention of infectious causes and circulatory system diseases increased, whereas renal diseases decreased. For SLE as a non-underlying cause of death, the most common underlying causes of death were circulatory, respiratory, genitourinary, and digestive system diseases, and certain infections. The overall death O/E ratio was > 1 for renal failure, tuberculosis, septicemia, pneumonia, and digestive system diseases, as well as for circulatory system diseases at < 50 years of age, particularly acute myocardial infarct.Conclusion.Unlike in developed countries, renal failure and infectious diseases are still the most frequent causes of death. The increase in SLE deaths associated with infection, especially pneumonia and septicemia, is worrisome. The judicious use of immunosuppressive therapy together with vigorous treatment of cardiovascular comorbidities is crucial to the successful management of SLE and to improving survival of patients with SLE.

scholarly journals Incidence, Prevalence, and Mortality Trends in Chronic Obstructive Pulmonary Disease over 2001 to 2011: A Public Health Point of View of the Burden

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Mariève Doucet ◽  
Louis Rochette ◽  
Denis Hamel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cohort Analysis ◽  
Chronic Obstructive ◽  
Mortality Trends ◽  
Obstructive Pulmonary Disease ◽  
Incidence Trends ◽  
All Cause Mortality ◽  
Over Time ◽  
Incidence Prevalence

Background. An increase of chronic obstructive pulmonary disease (COPD) prevalence was reported in Canada despite the decline of the main risk factor.Objectives. To estimate incidence, prevalence, and mortality of COPD from 2001 to 2011 and establish the COPD burden by the evaluation of the age-period-cohort effects on incidence trends and the comorbidities prevalence estimations.Methods. A retrospective population-based cohort was built using Quebec health administrative data. Change in trends was measured by relative percentage of changes and by joinpoint regression. After a descriptive analysis of the trends, an age-period-cohort analysis was performed on incidence rates.Results. Overall increase in prevalence along with a decrease of incidence and all-cause mortality was observed. Over time, all age-standardized trends were higher in men than women. Despite higher rates, the number of incident and prevalent cases in women exceeds men since 2004. The curve analysis by age groups showed over time a downshift for both sexes in incidence and all-cause mortality. Further analysis showed the presence of a cohort effect in women.Conclusion. The burden of COPD has risen over time. Women younger than 65 years old have been identified as at-risk group for healthcare planning.

scholarly journals Underlying causes of death with changing mortality among adults in the United States, 2013-2017

2020 ◽  
Author(s):  
Xin Hu ◽  
Yong Lin ◽  
Lanjing Zhang
Keyword(s):  
Causes Of Death ◽  
The United States ◽  
Nutritional Deficiencies ◽  
Accidental Poisoning ◽  
Linear Regression Models ◽  
Mortality Trends ◽  
Annual Percent Change ◽  
Percent Change ◽  
Specific Mortality ◽  
Underlying Causes

AbstractOverall mortality among U.S. adults was stable in the past years, while racial disparity was found in 10 leading causes of death or age-specific mortality in U.S. Blacks or African Americans. However, the trends in sex- and race-adjusted age-standardized cause-specific mortality are poorly understood. This study was aimed at identifying the UCD with sex- and race-adjusted, age-standardized mortality that was changing in recent years. We extracted the data of underlying causes of death (UCD) from the Multiple Cause of Death database of the Centers for Disease Control and Prevention (CDC). Multivariable log-linear regression models were used to estimate trends in sex- and race-adjusted, age-standardized mortality during 2013-2017. A total of 31,029,133 deaths were identified. Among the list of 113 UCD compiled by the CDC, there were 29 UCD with upward trend, 33 UCD with downward trend and 56 UCD with no significant trend. The 2 UCD with largest annual percent change were both nutrition related (annual percent change= 17.73, 95% CI [15.13-20.33] for malnutrition and annual percent change= 17.49, 95% CI [14.94-20.04] for Nutritional deficiencies), followed by Accidental poisoning and exposure to noxious substances. This study thus reported the UCD with changing mortality in recent years, which was sex- and race-adjusted and age-standardized. More efforts and resources should be focused on understanding, prevention and control of the mortality linked to these UCD. Continuous monitoring of mortality trends is recommended.

scholarly journals Management of chronic obstructive pulmonary disease exacerbations in Internal Medicine

2013 ◽  
pp. 199-214
Author(s):  
Gelorma Belmonte ◽  
Marilena Muratori ◽  
Paolo Leandri ◽  
Angelo Pasquale ◽  
Massimo Reta ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Cause Of Death ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Wide Range

Introduction: Chronic obstructive pulmonary disease (COPD) is the second leading cause of hospitalization in Internal Medicine departments in Italy and the fourth leading cause of death all over the word. By 2020, COPD will be the third leading cause of death and the fifth leading cause of disability. It is — along with chronic congestive heart failure — one of the most common causes of unscheduled hospital readmissions, and as such it represents a significant economic burden for the health-care system. Exacerbations of COPD are important events in the natural history of this prevalent condition. Discussion: This review provides a comprehensive state-of-the-art look at prevention and management of COPD exacerbations. Treatment of these episodes has to be tailored to the severity of the clinical presentation. We now have a wide range of therapeutic available options, based on the results of clinical trials. Management of the acute event should include the necessary measures (mainly the administration of inhaled short-acting bronchodilators, inhaled or oral corticosteroids, and antibiotics), with or without oxygen and ventilator support. Conclusions: To improve the management of COPD exacerbations, the focus of care must be shifted from the episodic acute complications to their systematic prevention. The management of COPD, which is often associated with multiple co-morbidities, is complex and requires a tailored, multifaceted and multidisciplinary approach. Integrated care for COPD also requires that patients be informed about their condition, that they participate actively in their care, and that they have easy access to the necessary health-care services.

scholarly journals Short-term mortality risks among patients with non-metastatic bladder cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Menghe Zhai ◽  
Chenye Tang ◽  
Ming Li ◽  
Xin Chen ◽  
Yigang Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Causes Of Death ◽  
Heart Diseases ◽  
Chronic Obstructive ◽  
Second Malignancies ◽  
Short Term ◽  
Obstructive Pulmonary Disease ◽  
The Us

Abstract Background Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. The objective of the current study was to assess and quantify cause of death after bladder cancer diagnosis. Methods The custom Surveillance, Epidemiology, and End Results (SEER) dataset for standardized mortality ratios (SMRs) was utilized to identify 24,074 patients who were diagnosed with nonmetastatic (M0) bladder cancer from 2014 to 2015. SMRs for causes of death were calculated. Risk factors for bladder cancer-specific mortality, competing mortality, second-cancer mortality, and noncancer mortality were determined using either multivariable Cox or competing risk regression models. Results Among all the 4179 (17.4%) deaths occurred during the follow-up period, almost half of them (44.2%) were attributed to non-bladder cancer cause, including second non-bladder cancer (10%) and other non-cancer causes (34.2%). The most common noncancer causes of death were heart diseases followed by chronic obstructive pulmonary disease. Patients had a higher risk of death from second malignancies (SMR, 1.59; 95% CI, 1.47–1.74) compared with death from first malignancies in the US general population, and also had higher risks of death from heart diseases (SMR, 1.29; 95% CI, 1.18–1.40) and chronic obstructive pulmonary disease (SMR, 1.52; 95% CI, 1.29–1.79) compared with the US general population. Additionally, some risk factors for competing second malignancies or noncancer mortality were determined, such as age, gender, marital status and treatment modalities. Conclusions Death from non-bladder cancer cause contributed to almost half of all deaths in bladder cancer survivors during the short-term follow-up period. These findings can inform medical management and assist clinicians in counseling those survivors regarding their short-term health risks.

scholarly journals A Deep Artificial Neural Network−Based Model for Prediction of Underlying Cause of Death From Death Certificates: Algorithm Development and Validation

10.2196/17125 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e17125 ◽  
Author(s):  
Louis Falissard ◽  
Claire Morgand ◽  
Sylvie Roussel ◽  
Claire Imbaud ◽  
Walid Ghosn ◽  
...  
Keyword(s):  
Neural Network ◽  
Cause Of Death ◽  
Deep Neural Network ◽  
Causes Of Death ◽  
State Of The Art ◽  
Death Certificates ◽  
Current State ◽  
Underlying Causes ◽  
Artificial Neural ◽  
Underlying Cause Of Death

Background Coding of underlying causes of death from death certificates is a process that is nowadays undertaken mostly by humans with potential assistance from expert systems, such as the Iris software. It is, consequently, an expensive process that can, in addition, suffer from geospatial discrepancies, thus severely impairing the comparability of death statistics at the international level. The recent advances in artificial intelligence, specifically the rise of deep learning methods, has enabled computers to make efficient decisions on a number of complex problems that were typically considered out of reach without human assistance; they require a considerable amount of data to learn from, which is typically their main limiting factor. However, the CépiDc (Centre d’épidémiologie sur les causes médicales de Décès) stores an exhaustive database of death certificates at the French national scale, amounting to several millions of training examples available for the machine learning practitioner. Objective This article investigates the application of deep neural network methods to coding underlying causes of death. Methods The investigated dataset was based on data contained from every French death certificate from 2000 to 2015, containing information such as the subject’s age and gender, as well as the chain of events leading to his or her death, for a total of around 8 million observations. The task of automatically coding the subject’s underlying cause of death was then formulated as a predictive modelling problem. A deep neural network−based model was then designed and fit to the dataset. Its error rate was then assessed on an exterior test dataset and compared to the current state-of-the-art (ie, the Iris software). Statistical significance of the proposed approach’s superiority was assessed via bootstrap. Results The proposed approach resulted in a test accuracy of 97.8% (95% CI 97.7-97.9), which constitutes a significant improvement over the current state-of-the-art and its accuracy of 74.5% (95% CI 74.0-75.0) assessed on the same test example. Such an improvement opens up a whole field of new applications, from nosologist-level batch-automated coding to international and temporal harmonization of cause of death statistics. A typical example of such an application is demonstrated by recoding French overdose-related deaths from 2000 to 2010. Conclusions This article shows that deep artificial neural networks are perfectly suited to the analysis of electronic health records and can learn a complex set of medical rules directly from voluminous datasets, without any explicit prior knowledge. Although not entirely free from mistakes, the derived algorithm constitutes a powerful decision-making tool that is able to handle structured medical data with an unprecedented performance. We strongly believe that the methods developed in this article are highly reusable in a variety of settings related to epidemiology, biostatistics, and the medical sciences in general.

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