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PubMed1991

[Problems of codification of cause of death: comparison of the mortality data of the ISTAT and the Regional Mortality Registry of Tuscany].

A two-part study was undertaken to assess the comparability of the coding of underlying cause of death between ISTAT (Central Statistics Office providing "national" mortality statistics) and RMR (Mortality Registry of Tuscany Region providing "local" mortality statistics). In Part I was compared mortality data of the Province of Florence (years 1985-1986) from the files of ISTAT with those of RMR. The source of the cause of death is the same for both systems (ISTAT certificate), but the data collection and coding of RMR are different from those of ISTAT. In Part II was compared a set of 219 Tuscany death certificates (year 1988) coded by ISTAT and RMR. The results showed an high degree of completeness of RMR (only--0.65% vs. ISTAT) and a satisfactory level of correspondence in the number of deaths for circulatory diseases, for neoplasms and for cancers of most important sites (lung, stomach, intestine, pancreas, breast). Discrepancies were found for some other diseases; for some of these causes of death, also age-adjusted mortality rates showed discrepancies (for example ischaemic heart disease). The cause of these differences have been analyzed.

Adolescent↗
PubMed1991

Impact of the human immunodeficiency virus epidemic on mortality in children, United States.

To assess the effect of the human immunodeficiency virus (HIV) epidemic on mortality in US children younger than 15 years of age and to identify associated causes of death, the authors examined final national mortality statistics for 1988, the most recent year for which such data are available. In 1988, there were 249 deaths attributed to HIV/acquired immunodeficiency syndrome (AIDS) in children younger than 15 years of age. Associated causes of death listed most frequently on 270 death certificates with any mention of HIV/AIDS included conditions within the AIDS surveillance case definition (30%), pneumonia (excluding Pneumocystis carinii pneumonia) (17%), septicemia (10%), and noninfectious respiratory diseases (8%). The impact of HIV/AIDS as a cause of death was most striking in the 1-through 4-year-old age group and in black and Hispanic children, particularly in the Northeast. By 1988 in New York State, HIV/AIDS was the first and second leading cause of death in Hispanic and black children 1 through 4 years of age, accounting for 15% and 16%, respectively, of all deaths in these age-race groups. With an estimated 1500 to 2000 HIV-infected children born in 1989, the impact of HIV on mortality in children will become more severe.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Current trends in perinatal mortality statistics at the New Jersey Obstetric Center].

The study presents an overview of the changes in perinatal mortality rates at the Statewide Perinatal Center of New Jersey during the past decades. According to the data, the increase in the rate of cesarean sections from 4.5 percent to 17 percent, and the comparable reduction of the rates of manipulative intrapartum and extraction procedures, contributed significantly to the decrease of the perinatal mortality rates from 51/1000 to 17/1000 between 1971 and 1983. Of the new technical tools, those utilized for the evaluation of fetal well-being antepartum appeared to be more useful then those used intrapartum. On account of the high prevalence of genital infections in the population, the recent acceptance in the service of the use of invasive intrapartum technology, appears to have impacted unfavorably upon the perinatal mortality trends. The increased rate of births of premature babies, the widespread abuse of habit forming drugs in the community, and the routine use of procedures requiring artificial rupture of the membranes, probably all contributed to the rapid increase of the perinatal mortality rate in the Center from 15/1000 in 1986 to 28/1000 in 1988. It is concluded that perinatal care is a complex medical and social task. The overall result of the relevant efforts depends to a great extent upon the social environment, and the moral standing, educational level and motivation of the recipients.

Humans↗
PubMed1990

Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States.

To assess the effect of the human immunodeficiency virus (HIV) on mortality in US women 15 to 44 years of age and to identify associated causes of death, we examined final (1980 through 1987) and provisional (1988) national mortality statistics. Between 1985 and 1988, the death rate for HIV/acquired immunodeficiency syndrome (AIDS) quadrupled (0.6 per 100,000 to 2.5 per 100,000), and by 1987, HIV/AIDS had become one of the 10 leading causes of death. In 1988, the death rate for black women (10.3 per 100,000) was nine times the rate for white women (1.2 per 100,000). The majority of deaths in both black and white women occurred in women 25 to 34 years of age, for whom HIV-related deaths accounted for 11% and 3% of all deaths in 1988, respectively. Among 1157 death certificates that included any mention of HIV/AIDS in 1987, other leading diagnoses included drug abuse (27%), Pneumocystis carinii pneumonia (20%), other pneumonias (14%), septicemia (10%), other infections not in the AIDS surveillance definition (7%), nephritis (6%), liver diseases (4%), and anemias (4%). If current mortality trends continue, HIV/AIDS can be expected to become one of the five leading causes of death by 1991 in women of reproductive age. Because women infected with HIV are the major source of infection for infants, these trends in AIDS mortality in women forecast the impact of HIV on mortality in children as well.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Causes of death: an assessment of global patterns of mortality around 1985.

Cause-of-death statistics are available for virtually the entire population of the developed world (1.17 billion in 1985) and thus estimates of the mortality pattern in these countries can be made with some confidence, notwithstanding the artefacts which arise due to differences in diagnostic and certification practices between countries. In the developing countries, cause-of-death estimation is much more difficult due to the paucity of mortality statistics. Nonetheless, there are several sources of information on mortality, ranging from surveillance systems and small-scale community studies to complete vital registration, which can be exploited to estimate mortality patterns. Of the 50 million deaths which occur throughout the world each year, roughly 39 million (78%) occur in developing countries. For the developing countries as a whole, infectious and parasitic diseases are estimated to have accounted for almost one-half of all deaths in 1985. Diarrhoeal diseases, acute respiratory diseases (primarily pneumonia) and tuberculosis each claimed about 3-5 million deaths in the developing world in the mid-1980s, with a further 2.6 million due to measles and whooping cough. Perinatal conditions are estimated to have been responsible for a little over 3.2 million deaths in 1985 in developing countries, one-quarter of which were due to neonatal tetanus alone. Maternal causes claimed the lives of about 0.5 million women. At the same time, the chronic diseases are emerging as a leading cause of death in several regions of the developing world, particularly Latin America and East Asia. Circulatory and specific degenerative diseases are estimated to have caused about 6.5 million deaths in 1985. Chronic lung diseases and cancer are each thought to have claimed about 2.5 million lives in 1985. External causes also probably accounted for 2.0-2.5 million deaths.

Australia↗
PubMed1989

New approaches for epidemiologic studies of mortality statistics.

Finding and analyzing multiple causes of death-rather than single causes-has major epidemiologic advantages. Besides helping to reveal the magnitude of the causes or morbid conditions leading to death, it also demonstrates that deaths are usually the result of several simultaneous or sequential causes. This article reviews ways that multiple cause of death data have been analyzed in order to improve our knowledge of these causes and other relevant health factors.

Cause of Death↗
PubMedDate not supplied

Methodological alternatives for measuring premature mortality.

Although crude and age-adjusted mortality statistics are frequently used to quantify public health problems, they are heavily influenced by the underlying disease processes of the elderly. Alternative measures have been developed to reflect the mortality experience of younger age groups (i.e., premature mortality). We evaluated four different methods for tabulating premature mortality, one method weighted by the remaining life expectancy at death and three methods with constant end points using age spans from birth to 65 years, birth to 75 years, and 1 to 65 years. These alternatives provide dramatically different descriptions of premature mortality in the United States in 1984. In general, the constant end-point methods emphasize the different pattern of mortality among younger persons, while premature mortality computed by the remaining life expectancy method more closely resembles the pattern of crude mortality. Although no single method is preferable for all purposes, the constant end-point method best differentiates the leading causes of premature death.

Adolescent↗
PubMed1988

The current epidemiology of pertussis in the developed world: UK and West Germany.

The existence of well established national reporting systems for monitoring pertussis incidence and vaccine uptake in the United Kingdom has allowed the epidemiology of whooping cough and the impact of vaccination to be studied in detail. The increase in pertussis morbidity that followed the decline in vaccine uptake in recent years confirms the continuing need for mass vaccination in a developed country. There is also evidence that pertussis may be responsible for many more deaths than official mortality statistics show. A national study of vaccine efficacy demonstrated over 80% protection against clinical disease during the first 5 years after vaccination. However, there is evidence that the current whole cell vaccine may protect less well against infection with agglutinogen serotype 3 than type 2 organisms which supports the view that both these antigens should be included in acellular vaccines to achieve good protection. In West Germany, unlike the UK, there are no national statistics on pertussis incidence, no national vaccination policy and no figures for vaccine uptake. Local studies have shown that vaccination rates are low and that pertussis is prevalent, particularly in the 2-4 year age-group, which is typical of a country with low uptake; similarly serotype 2 predominates.

Child↗
PubMed1988

Mortality in Mamre, 1981-1987.

Mortality statistics for Mamre were extracted from the Regional Services Council records for 1981-1987. The standardised mortality ratios were 0,70 for males and 0,55 for females. The age-specific mortality rates, including the infant mortality rate (23.6/1,000 live births), were lower than the national rates for coloureds. Non-natural causes of death were well above the national level. The high proportion of non-natural deaths is reflected in potential years of life lost (PYLL) for this cause--58% among males and 43% among females. Diseases of the circulatory system accounted for 19% and 17% of PYLL, and carcinomas for 7% and 14%.

Black or African American↗
PubMed1987

[Neonatal respiratory distress syndrome in Switzerland--a comparison of a survey and official statistics].

A survey in all neonatal intensive care units in Switzerland showed that most children with a birth weight below 2000 g (identified in the birth statistics) are hospitalised in those units. Also comparison with the official neonatal mortality statistics shows that most neonatal deaths occur in these units. High agreement was found between diagnosis in hospitalised children and those recorded on death certificates. 40% of neonatal mortality in Switzerland are still due to neonatal respiratory distress syndrome.

Cross-Sectional Studies↗
PubMed1986

Importance of using standardized birth weight increments to report neonatal mortality data.

Neonatal mortality statistics are frequently reported in 100-g increments of birth weight. We tabulated our mortality statistics using two methods of incrementation: 500 to 599 g, 600 to 699 g, 700 to 799 g, etc. (method A) and 501 to 600 g, 601 to 700 g, 701 to 800 g, etc (method B). In each 100-g weight group, the mortality was less using method B. The average reduction in mortality using method B was 4.1%. Use of the two different methods creates difficulty in making meaningful comparisons of various published reports. We recommend that all future studies use method A, as that method is more consistent with previous recommendations of the World Health Organization.

Birth Weight↗
PubMed1986

Discordance between male and female deaths due to the respiratory distress syndrome.

General neonatal mortality statistics and those for the respiratory distress syndrome (RDS) were examined for the State of Wisconsin from 1979 through 1982. The objectives were to ascertain whether there are differences in total neonatal mortality related to sex and birth weight, to determine the veracity of reported gender differences in deaths due to RDS, and to assess the contribution of other risk factors for neonatal mortality to overall and sex-specific deaths occurring secondary to RDS. Additionally, a prospective analysis was performed at one perinatal center during a 5-year period in attempts to determine whether gender remained a significant factor in deaths due to RDS after adjusting for incidence. Overall, the most frequent diagnoses in those who died were RDS (15.6%), deaths due to complications of pregnancy (8%), immaturity (4.2%), and asphyxia (3.4%). The majority of fatalities for both sexes occur in neonates weighing less than 1 kg and the percentage of deaths attributable to RDS is greatest between 1 and 1.5 kg. The difference between sexes is also maximal in the latter weight group. Deaths secondary to RDS are greater for males regardless of Apgar score at one and five minutes, mode of delivery, maternal age, or ancillary diagnosis. These data suggest that deaths secondary to RDS are consistently greater in male neonates and that delivery within a limited "window" of time during gestation increases male susceptibility to fatal RDS.

Apgar Score↗
PubMed1986

[Definition and classification of perinatal mortality].

Analysis of problems related to the classification of perinatal mortality was made possible through the evaluation of data collected from the medical records of nine maternity hospitals in South-Hainaut. Medical records of 135 fetal and early neonatal deaths were investigated. Perinatal mortality statistics were compiled on the basis of five different definitions of perinatal mortality. Depending on which definition was used, perinatal mortality varied between 10.2% and 15.1%. This study shows that reporting of perinatal mortality in hospital registries according to the legal requirement is incomplete. Standard data should be collected for each pregnancy product, on the basis of clearly defined, national and international accepted definitions. It is suggested that the 1975 recommendations of the World Health Organization (International Classification of Diseases, 9th edition), be used for definition and classification of perinatal mortality.

Belgium↗
PubMed1979

[Incidence and mortality of malignant lymphomas in the GDR].

Based on data from the cancer register of the German Democratic Republic established in 1952 and on the official mortality statistics, incidence of and mortality from malignant lymphomas (ICD 200-203) in the GDR are analysed. Age-specific incidence and mortality of Hodgkin's disease show a peak in the age group of 25-30 years and rise steadily from 45 years on up to the highest age. Lymphosarcoma and reticulosarcoma increase slowly from infancy to old age, whereas multiple myeloma is a disease of the elderly and extremely rare before the age of 40. The apparent increase of malignant lymphoma may be due to underregistration at the beginning of the cancer register. In the past years mortality from Hodgkin's disease is slowly decreasing, thus reflecting progress in methods of treatment and results.

Adolescent↗
PubMedDate not supplied

Perinatal and neonatal mortality and morbidity in Lusaka, 1976.

A prospective study of perinatal and neonatal mortality and morbidity at the University Teaching Hospital (UTH), Lusaka for 1976 is presented. The early neonatal mortality of the babies born in hospital was 28.7 per 1000 live-births; it was 239.96 per 1000 admissions of those born outside the hospital. The still-birth rate in the hospital-born babies was 25.2 per 1000 deliveries; the perinatal mortality was 53.3 per 1000 deliveries; and the neonatal mortality in the hospital-born was 31.1 per 1000 live-births. The cause of death were asphyxia, infections could injury, respiratory distress syndrome, congenital malformation and intracranial haemmorrhage. If the perinatal and neonatal mortality and morbidity are to be reduced, much effort and co-operation of all concerned with the health of the expectant mother, and her child are required. Records of birth-weights, stillbirth, and causes of deaths in the University Teaching Hospital (UTH) for the year 1976 have been analysed. The aim is to provide a basis for future comparisons and improvement of the care given to newborns.

Female↗
PubMedDate not supplied

[Perinatal mortality. Statistics from the Gynecological and Obstetrical Service of the Notre-Dame-de-Bon-Secours Hospital (1961-1975)].

The authors present their statistics for perinatal mortality from 1961 to 1975. In the last 5 years this mortality is less than 15 per 1000, in spite of an increase in the numbers of pathological pregnancies. Over and above progress in obstetrics and neonatology that has occurred, this result can be attributed in part to the quality of supervision carried out by the senior obstetricians and in part to the existence of pathological consultation which takes place between colleagues about the therapy to be carried out in multidisciplinary meetings.

Female↗