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Biomedical subjects

F Hatton

Publications and source records attributed to F Hatton.

At least 19 recordsLinked to original sources
PubMed2000

[Importance of medicolegal data for national cause of death statistics].

OBJECTIVE: The validity of French cause of death statistics largely depends on the transmission of the medical information reported on the dedicated part of the death certificate. Data referring to death causes are collected and analyzed at the Information Department on the cause of death (INSERM SC8). In major urban areas with one or more forensic institutions, it has been observed that the proportion of death certificates indicating ìno particular cause of deathî is higher than the national average. We therefore examined deaths occurring in 1996 in the Lyons region. METHODS: This retrospective study involved 5,208 deaths recorded in Lyons France in 1996. Complementary information on these deaths was obtained from INSERM SC8 and Lyons Medicolegal Institute. RESULTS: It was observed that a large portion of violent deaths occurring in this city in 1996 (more than 30%) were not recorded appropriately in the national statistics due to a lack of communication after autopsy. CONCLUSION: Considering the importance of epidemiology and suicide prevention in the national public health strategy, improved information transmission must be developed in the near future.

Accidents↗
PubMed2000

[Trends in infant mortality in France: frequency and causes from 1950 to 1997].

OBJECTIVES: To present an analysis of the infant mortality trends and causes of death in France from the beginning of the 1950s, neonatal (0-27 days) and post-neonatal mortality (27-364 days) being considered separately. MATERIAL AND METHODS: We used the data from the national registries of births computed by INSEE (National Institute of Statistics and Economic Surveys) and of causes of deaths computed by Inserm (National Institute of Health and Medical Research). We analysed the evolution of the infant death rates from 1950 to 1997, the overall mortality for males and the percentages of causes of death at three different periods. RESULTS: Mortality has changed according to neonatal or post-neonatal ages. A constant improvement was recorded for neonatal mortality up to 1995 (2.9 per 1,000), while there was a stagnation for post-neonatal mortality between 1979 and 1993, followed by a sharp decrease (2.0 per 1,000 in 1995). During the neonatal age the main causes of death are conditions generated in the neonatal period and congenital abnormalities, both decreasing regularly; during the post-neonatal age the main cause is sudden infant death syndrome, which fell dramatically during the last four years. CONCLUSION: Several factors related to medical care, nursing and type of registration are contributing simultaneously to the important variations in mortality found in our results.

Cause of Death↗
PubMed1999

Analysis of mortality in French diabetic patients from death certificates: a comparative study.

This study was implemented in France to determine the causes of death in diabetic patients, whether diabetes was mentioned or not on the death certificate, and to assess the underestimation of the prevalence of diabetes at death. Two stratified random samples of death certificates were selected in the national mortality data base. The first included certificates mentioning diabetes as a cause of death (cases). The second, included certificates with no mention of diabetes (controls). For each certificate, a record form was sent to the certifying physician to ascertain diabetes in the first group and to trace unrecorded diabetes in the second group. In case of diabetes, the characteristics of the patient and his disease were collected (age at onset, treatment, complications ...). We obtained complete data for 325 cases and 959 controls. Among cases, 1% of the subjects were not confirmed as diabetic, while almost 10% of the controls were identified as having diabetes. The corresponding ratio of the corrected prevalence at death to that provided by the French statistics was estimated to 4.0 in men and 3.1 in women. Particular features are that 2% of the total diabetic decedents died from acute metabolic complications (diabetic or hyperosmolar coma, acidoketosis, or acute hypoglycemia), and that 33% of the unreported diabetic decedents under 45 died from trauma or poisoning. These results show that in France, the death rates published in the statistics for diabetes dramatically underestimate the impact of diabetes. A high risk of death is linked to this disease, particularly in people aged under 45, a problem that health deciders should address.

Adult↗
PubMed1998

[Epidemiology of adolescent suicide].

Among the more noticeable health and social indicators used for adolescents, the epidemiologic data on suicide point out one of the most serious risks in the present context of violence. In France, during the year 1995, 5,324 adolescent deaths from 14 to 24 of age were reported. The corresponding mortality rate is 66 for 100,000. The cause-of-death distribution shows the importance of violent deaths among adolescents. Actually, these deaths represent 70% of the 5,324 adolescent deaths. The proportion is higher for males (74%) than for females (60%). The most part of these violent deaths is due to accidents, especially transport accidents (38%). Deaths due to suicides are lower, however they constitute a significant part of the deaths concerning adolescents: 11% of the deaths that occurred from 15 to 19 of age, 17% of the deaths that occurred from 20 to 24 of age. At this time of life, the percentage of suicides is higher than for the whole population, where suicides are only responsible for 2% of the total deaths.

Adolescent↗
PubMed1997

[Medical certificate of neonatal death].

A specific neonatal death certificate has been put into use in France since April 1997. It must be completed for any infants born alive and deceased between 0 and 27 days. Its content is presented together with the results of an evaluation of its use performed during a 3 month period in 1996. This certificate is aimed to improve the mortality statistics of the neonatal period, thus helping to better define the priorities in the medical care and prevention fields.

Cause of Death↗
PubMed1996

AIDS-related conditions: study of a representative sample of 1203 patients deceased in 1992 in France.

BACKGROUND: Little representative information exists on the frequency of human immunodeficiency virus (HIV)-related diseases among the overall AIDS population. The objective of this research is to assess the nature, frequency and characteristics of these diseases among AIDS patients during their last year of life and to analyse these frequencies according to the mode of transmission and other socio-demographic and medical characteristics. METHODS: To obtain comprehensive data, we conducted an investigation based on retrospective collection of clinical information on a representative sample (1203 deaths) of all AIDS deaths that occurred in France during 1992. RESULTS: The frequency of the diseases was markedly higher than the one described in the AIDS surveillance registers and varied between homosexuals and intravenous drug users (IVDU). After controlling for other variables (age, CD4 counts, survival times) by means of logistic regression, homosexuality remained a significant explaining factor for Kaposi's sarcoma, cytomegalovirus infections, herpes simplex and cryptosporidiosis. In contrast, HIV encephalopathy, hepatitis, mental disorders, invasive candidiasis and cachexia were more frequent in male IVDU. Few differences were observed by sex. CONCLUSIONS: Several factors may explain the differences: variation in exposure to infectious agents, general health status, use of medical care and direct influence of the mode of HIV transmission. These data are of particular value for medical services in planning the magnitude of health care needs among the AIDS population overall, for clinicians and researchers for advancing the understanding of the natural history of AIDS and in the definition of prophylactic strategies against opportunistic infections.

AIDS Dementia Complex↗
PubMed1995

Autopsies of sudden infant death syndrome--classification and epidemiology.

An enquiry into sudden infant death syndrome (SIDS) in 1987 furnished us with detailed epidemiological data for 281 cases that underwent a thorough post-mortem examination. This analysis uses these data to evaluate the role the autopsy plays in explaining sudden death. The cases were classified into three diagnostic groups: explained causes of death (group 1), unexplained deaths with anomalies (group 2), and no anomaly (group 3). These 281 cases show the three essential features that characterize SIDS: over-representation of males, increased deaths during the second and third months of life, and increased deaths during winter. The autopsy examination revealed that many of these deaths had a medical explanation. Almost half were assigned to group 1. At the time of autopsy, no precise pathology could be diagnosed for 147 deaths; of these, 140 showed histological anomalies. There were only seven sudden deaths for which no abnormal sign was evident at the autopsy. These results are compared with those of similar studies and discussed in connection with three factors: the initial selection of cases, the nature and degree of the investigations, and the possible interpretations of the symptoms uncovered.

Autopsy↗
PubMed1995

[Death due to drug addiction in Ile-de-France].

The aim of a cooperative study, carried out by the Paris Forensic Medicine Institute and the French National Institute of Health and Medical Research (INSERM SC8) was to assess the number of drug addiction-related deaths occurring in the Paris region in 1990. There were 253 deaths including 92 in Paris and 161 in Paris suburbs. A large percentage of these deaths were not recorded in the National death statistics registry (only 36% of all the deaths and only 24% of the Paris deaths had been registered). The overall drug addiction mortality in the Paris region is 29.4 per million inhabitants and is highest among the 25-29 year age group. Rates decrease rapidly after 30 years of age and are extremely low after 40. Mortality is highest in unmarried men and in the inactive population with a wide variability according to site of residence. Rates are much higher in Paris than in the suburbs. For the 20-29 year population in Paris, drug addiction has an important impact on the mortality figures for the general population, causing 12% of all deaths. It is the third cause of death after AIDS and suicide.

Adolescent↗
PubMed1992

Death certificate coding practices related to diabetes in European countries--the 'EURODIAB Subarea C' Study.

The objective of this study was to compare and analyse coding practices for diabetes mortality data in nine European countries (Belgium, Republic of Ireland, France, Germany, Malta, The Netherlands, Northern Ireland, Scotland and Switzerland). In each country, a sample of 200 coded death certificates, which mentioned diabetes, was randomly sampled. All death certificates were recoded at the WHO Collaborating Centre for the Classification of Diseases in the French language. The results show wide differences between national coding and central coding. Discrepancies in the underlying cause of death existed at the 3-digit coding level for 26% of all death certificates and for 44% at the 4-digit level. Coding in Northern Ireland and Malta was characterized by a marked tendency to choose diabetes less frequently. In contrast, in The Netherlands and, to a lesser extent, in the Republic of Ireland and France, diabetes was more frequently selected as the underlying cause of death. Most of the differences concerned the coding of an association involving diabetes and circulatory system diseases. In some countries, these coding differences influence the reported level of diabetes mortality. For Northern Ireland and Malta, the number of certificates with diabetes as the underlying cause of death was more than doubled after central recoding and for The Netherlands, in contrast, it was almost halved. To explain the differences a number of factors are considered: a lack of information from the International Classification of Diseases (ICD), on the application of the coding rules, between-country differences in cause of death certification practices, a divergence of opinion about the causal role of diabetes when it is associated with other conditions, a lack of homogeneity between countries in data collection procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗
PubMed1992

[Risk factors of sudden infant death and of death by accidents. According to a national survey in the total postneonatal death].

BACKGROUND: The incidence of sudden infant death syndrome (SIDS) peaks at 2-4 month of age and during the colder months of the year. Other risk factors such as sex, birth weight, maternal age and multiple pregnancy also seem to be shared by the other causes of death after the neonatal period. POPULATION AND METHODS: A retrospective, exhaustive survey of all deaths of infants aged 28 days-one year was carried out between September 1986 to December 1987. The control group was a representative sample of the live births in France during 1989. The deaths were classified into 3 groups: group I, 1184 SIDS, group II 228 SIDS remaining unexplained after autopsy (out of 315 autopsied SIDS), and group III 83 accidental deaths. The factors studied were: sex, birth weight, maternal age, number of infants born from the pregnancy. The risk factors were measured by Odds Ratios and the variables related to mortality were introduced into a logistic model. RESULTS: Incidence of deaths peaked between the 2nd and the 4th month of age in groups I and II while deaths were evenly distributed throughout the first year in group III. Colder months, male gender, low birthweight, multiple birth and the young age of the mother all increased the risk of death in SIDS (groups I and II) but the same factors were also linked to accidental deaths. CONCLUSION: The results confirm those of earlier reports and raise the question why the risk factors for accidental deaths are similar to those for explained or unexplained SIDS, except for infant age.

Accidents↗
PubMed1992

[Trends in mortality characteristics in Aids in France 1983-1990].

From 1983 to 1990, the number of AIDS deaths in France (8119 deaths overall), increased substnatially but the annual rate of progression has fallen since 1987 (+35% in 1990). The socio-demographic characteristics of the deaths remained quite steady with the exception of the proportion of subjects living in Paris which decreased. The proportion of AIDS deaths out of all deaths is still low for the entire population (5 deaths out of 1000 in 1990) but appears important in some sub-groups. In 1990, AIDS represents for the 25-34 years old group, 12 deaths out of 100 for males and 7 deaths out of 100 for females and for the 25-44 years old group, 15 deaths out of 100 for nonmarried males and 4 deaths out of 10 for males working in an information or artistic profession. Furthermore, it accounts, in 1989, for the third of the deaths of males between 25 and 44 years living in Paris. The analyse tends to show that there is not an important under-declaration of AIDS deaths in France.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Reasons for the underreporting of maternal mortality in France, as indicated by a survey of all deaths among women of childbearing age.

Although maternal mortality is higher in France than in other European countries, hospital data prove that maternal deaths are underestimated. To assess the degree of underestimation and investigate the reasons for it, a retrospective survey was carried out among the certifying doctors of the 3045 deaths that occurred among women aged 15-44 years, from December 1988 to March 1989. Doctors were asked for information on the obstetric condition of the women and their health before death. Some 88.2% of those approached responded. Sociodemographic information was obtained from the French national record of causes of death. Although doctors reported gravid puerperal conditions on 41 death certificates, only 24 deaths were classified in the maternal mortality category of the International Classification of Diseases. The other 17 deaths were classified elsewhere. The present survey permitted the identification of 27 additional deaths of which 16 were considered as having obstetric causes. Of the 68 deaths in pregnant or puerperal women which occurred during the survey period, 54 were classified as having obstetric causes. No sociodemographic differences were found between the deaths registered in the national record and the newly identified maternal deaths. All deaths occurring during or after parturition were reported to the national record, but most of the deaths from abortion were identified from the survey. The discussion deals with the misclassification of maternal deaths and the difficulty of determining the underlying cause of deaths involving complex diseases or uncertain pathogenesis.

Adolescent↗
PubMed1991

[Causes and risk factors in post-neonatal mortality in France in 1987 according to a national survey].

A stagnation in postneonatal mortality (28 days-1 year) is reported in France as in other similar countries. More than fifty per cent of these deaths are registered under the sudden infant death syndrome, a cause which is classified in the symptoms and ill-defined conditions chapter of the International Classification of Diseases. To establish the actual rate of sudden infant death syndrome (SIDS) it was necessary to carry out a specific retrospective survey. All postneonatal deaths (3917) registered in France from September 1986 to December 1987 were studied by means of questionnaires sent to the certifying doctor and to the families. The sudden infant death rate is estimated at 1.2 per 1,000 and the risk factors of the total postneonatal deaths are birthweight, prematurity, transfer into neonatal care unit, and age of the mother.

Adult↗
PubMed1991

[Maternal mortality in France. Frequency and reasons for its under-estimation in the statistics of medical cause of death. Group of Experts on Maternal Mortality].

All deaths of women of reproductive age notified in France over four months were the subject of an enquiry carried out through the post to the doctors who had written the certificates of death. The objective was to try to evaluate the true maternal mortality on a national scale. This enquiry was carried out on 4,102 female deaths and showed that 68 of these (1.6%) were in pregnant or puerperal women. 45 of these deaths were classified as maternal which was twice the number that showed up on the official statistics of the causes of death. On one hand the under notification--due to failure to realise that the patient was pregnant at the time of certification, and on the other hand the under registration because of the complexity of the pathological states explain this under estimation. The frequency of maternal mortality has been evaluated at 18 per 100,000 live births and 60% of these deaths are considered as due to a direct obstetric cause. The most frequent causes are embolisms, then haemorrhages and hypertension of pregnancy.

Adolescent↗