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W Casper

Publications and source records attributed to W Casper.

17 recordsLinked to original sources
PubMed1999

An indirect method for the estimation of osteoporotic fractures from injury and fracture profiles.

Study objective was to develop a valid epidemiological method for the estimation of osteoporotic fracture risk, using administrative databases and accounting for variable baseline risks of injury. Design is the secondary analysis of inpatient and outpatient utilization data. A baseline injury risk was estimated by the incidence of primary utilization of medical services for soft tissue injuries (ICD-9 diagnostic codes 910-929), and the risk profile was compared after normalization with the overall primary utilization rate for fractures (ICD-9 diagnostic codes 800-829). The setting is a county with approximately 100,000 inhabitants in the former East Germany. Participants were all inhabitants of the county who had a physician contact (inpatient or outpatient) during 1987-1988, as well as hospital inpatients for all of Germany in 1989. The number of fractures increased with age, especially in women, when compared to the number of fractures expected from the incidence of soft tissue injury. Similar patterns were identified in hospitalization data from East and West Germany. Estimating the prevalence of osteoporosis directly from certain "osteoporotic" fracture types associated with higher age is potentially biased, since it neglects the underlying risk of injury. Our model distinguished the osteoporotic fracture risk as the excess risk over an expected injury-related fracture risk for a given age and sex, and may allow a more valid quantification of osteoporotic fractures in different populations.

Adolescent↗
PubMed1999

A secular trend in hip fracture incidence in East Germany.

The central Inpatient Register of the former German Democratic Republic was used to study the population-based epidemiology of hip fractures among 16.5 million East Germans. Incidence rates for hospital discharges for proximal femoral fractures for the age group 60 years and over were calculated for the years 1971 to 1989, the year before unification. Incidence rates for 1989 are similar to figures reported from the UK and The Netherlands, but lower than Scandinavian rates. A decrease in the admission rate was noted from 1971 to 1974 of 4.5% each year on average, and an increase from 1974 onwards of 4.4% on average. This change was observed to a different extent in all age groups. The female:male ratio of the standardized discharge incidence was stable at 2.3:1 and the female:male ratio of manifest cases increases from 4.1:1 in 1971 to 5.1:1 in 1989. An exponential increase in the incidence rates was observed with age. This apparent rate overestimated both the rate for true incident cases (by about 25-30%, if adjustments are made for readmissions and transfers) and their trend. Adjusted estimates for incident fractures show an increase of 2% annually. Cohort effects due to changed selective forces appear to be one reasonable causal explanation.

Aged↗
PubMed1998

[Disparities in hospital mortality after proximal femoral fractures in East Germany 1989].

The revised and pseudonymized data set of the hospital discharge diagnoses of East Germany (German Democratic Republic, GDR) for 1989 was analyzed regarding the in-hospital case fatality of closed hip fractures (ICD-9 820.0, 820.2, 820.8). The case fatality of 20.2% during an average hospital stay of 60 days including between-ward and between-hospital transfers is high when compared to international data and data for West Germany. Apart from the expected influence of age, fatality was reduced for cervical (intracapsular) fractures, female sex, and for a location of the treating hospital within East Berlin. This reduction of the case fatality within East Berlin by nearly two thirds after adjustment for age, sex, and type of fracture compared to other regions is most likely explained by better medical treatment facitilities within East Berlin, the former capital of the GDR. The regional disparities that were observed during our model analysis give a hint towards the influence that medical care can have on the fatality associated with this on a population level relevant disease.

Adult↗
PubMed1993

[Changes in suicide mortality in Germany].

OBJECTIVE: About one third of the total number of life lost in the period between 1 and 65 years in consequence of "external causes" (E-classification by WHO) in East and in West Germany account alone for "suicide" as a cause of death. Suicide alone produces, e.g. among the male population, a loss in years of life which corresponds to 53% (in East Germany) and to 40% (in West Germany), respectively, of the total number of years of life lost due to cancer of all organic localizations. METHODS: The analysis is based on the official mortality data from 1961 to 1989. The data are analysed by age and sex. SMR, average age of death and PYLL are calculated. RESULTS: A comparative survey of suicide mortality over the period from 1961 to 1989 has shown that there are differences in suicide frequencies between East and West Germany. If related to the whole period, the lowest suicide rates both in the East and in the West have been observed at the end of that period. The suicide mortality rate in the East, however, remained higher than in the West, by 79.9% (male population) and by 70.2% (female population), respectively. The long-term trend is characterised by a slight increase of the suicide gap between East and West among the male population, whereas the difference has diminished in respect of the female population. Sex-related differences are even more distinct than differences between East and West in suicide mortality. Thus, in 1989, the standardized suicide rates among the male population amounted to 2.7 times (West Germany) and 2.8 times (East Germany) of that of the female population, these differences having increased continually during the period from 1961 to 1989. CONCLUSIONS: The results cast justifiable doubts on whether the actual distribution of research capacities and of financial and personnel resources are adequate to cope with the problems raised by the phenomenon of "suicide".

Adolescent↗
PubMed1983

[Epidemiology of accidents in East Germany].

Like in other industrialised countries injuries have, also in the GDR (17.1 Mill. inhabitants), considerable social consequences. This can be illustrated as follows: a daily number of 9800 in-patients or 30% of the surgical bed-capacity in hospitals;--an annual loss of 21.3 million working days which corresponds to 57 500 workingmen;--an annual loss of the produced national income amounting to 1200 million mark;--about 9000 trauma fatalities per year.

Abdominal Injuries↗