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Sample records for all-cause mortality results

  1. Extreme Elevations in Blood Pressure and All-Cause Mortality in a Referred CKD Population: Results from the CRISIS Study.

    Science.gov (United States)

    Ritchie, James; Rainone, Francesco; Green, Darren; Alderson, Helen; Chiu, Diana; Middleton, Rachel; O'Donoghue, Donal; Kalra, Philip A

    2013-01-01

    Hypertension frequently complicates chronic kidney disease (CKD), with studies showing clinical benefit from blood pressure lowering. Subgroups of patients with severe hypertension exist. We aimed to identify patients with the greatest mortality risk from uncontrolled hypertension to define the prevalence and phenotype of patients who might benefit from adjunctive therapies. 1691 all-cause CKD patients from the CRISIS study were grouped by baseline blood pressure-target (extreme (>190 and/or 100 mmHg). Groups were well matched for age, eGFR, and comorbidities. 77 patients had extreme hypertension at recruitment but no increased mortality risk (HR 0.9, P = 0.9) over a median follow-up period of 4.5 years. The 1.2% of patients with extreme hypertension at recruitment and at 12-months had a significantly increased mortality risk (HR 4.3, P = 0.01). This association was not seen in patients with baseline extreme hypertension and improved 12-month blood pressures (HR 0.86, P = 0.5). Most CKD patients with extreme hypertension respond to pharmacological blood pressure control, reducing their risk for death. Patients with extreme hypertension in whom blood pressure control cannot be achieved have an approximate prevalence of 1%. These patients have an increased mortality risk and may be an appropriate group to consider for further therapies, including renal nerve ablation.

  2. Alanine aminotransferase, gamma-glutamyltransferase (GGT) and all-cause mortality: results from a population-based Danish twins study alanine aminotransferase, GGT and mortality in elderly twins

    DEFF Research Database (Denmark)

    Fraser, Abigail; Thinggaard, Mikael; Christensen, Kaare;

    2009-01-01

    Abstract Background/Aims: Alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) are widely used markers of liver disease. Several population-based cohort studies have found associations of these liver enzymes with all-cause mortality. None of these studies controlled for genetic...

  3. Weight at birth and all-cause mortality in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, Lina W; Sørensen, Thorkild I A

    2008-01-01

    investigated the association of birth weight with adult all-cause mortality using a Danish school-based cohort of 216,464 men and women born from 1936 through 1979. The cohort was linked to vital statistic registers. The main outcome was all-cause mortality from ages 25 through 68 years. Associations...... with death from cancer, circulatory disease, and all other causes were also examined. RESULTS: During 5,205,477 person-years of follow-up, 11,149 deaths occurred among men and 6609 among women. The cumulative hazard ratios of the association between birth weight categories and all-cause mortality...... was constant for all ages investigated and did not differ between men and women. Compared with subjects having birth weights in the reference category (3251-3750 g), those with the lowest birth weights (2000-2750 g) had 17% higher mortality (95% confidence interval = 1.11-1.22), and those with the highest...

  4. Waist and hip circumferences and all-cause mortality

    DEFF Research Database (Denmark)

    Bigaard, J; Frederiksen, K; Tjønneland, A

    2004-01-01

    OBJECTIVE: To investigate whether waist and hip circumferences, in addition to body mass index (BMI), are related to all-cause mortality. We studied these associations and tested the usefulness of the waist-to-hip ratio for mortality prediction. DESIGN: A Danish prospective cohort study with data...... collected between 1993 and 1997. SUBJECTS: A total of 27 179 men and 29 875 women born in Denmark and aged 50-64 years were followed for a median of 6.8 years. MEASUREMENTS: BMI, waist and hip circumferences at baseline. RESULTS: The associations between hip circumference and all-cause mortality were...... inverse for both men and women, but only after adjustment for waist circumference, or BMI, or both. The mortality rate ratios of mutually adjusted waist and hip circumferences were 0.63 (95% CI: 0.56, 0.71), and 0.70 (95% CI: 0.63, 0.79) times higher per 10% larger hip circumference in men and women...

  5. Past recreational physical activity, body size, and all-cause mortality following breast cancer diagnosis: results from the Breast Cancer Family Registry.

    Science.gov (United States)

    Keegan, Theresa H M; Milne, Roger L; Andrulis, Irene L; Chang, Ellen T; Sangaramoorthy, Meera; Phillips, Kelly-Anne; Giles, Graham G; Goodwin, Pamela J; Apicella, Carmel; Hopper, John L; Whittemore, Alice S; John, Esther M

    2010-09-01

    Few studies have considered the joint association of body mass index (BMI) and physical activity, two modifiable factors, with all-cause mortality after breast cancer diagnosis. Women diagnosed with invasive breast cancer (n = 4,153) between 1991 and 2000 were enrolled in the Breast Cancer Family Registry through population-based sampling in Northern California, USA; Ontario, Canada; and Melbourne and Sydney, Australia. During a median follow-up of 7.8 years, 725 deaths occurred. Baseline questionnaires assessed moderate and vigorous recreational physical activity and BMI prior to diagnosis. Associations with all-cause mortality were assessed using Cox proportional hazards regression, adjusting for established prognostic factors. Compared with no physical activity, any recreational activity during the 3 years prior to diagnosis was associated with a 34% lower risk of death [hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.51-0.85] for women with estrogen receptor (ER)-positive tumors, but not those with ER-negative tumors; this association did not appear to differ by race/ethnicity or BMI. Lifetime physical activity was not associated with all-cause mortality. BMI was positively associated with all-cause mortality for women diagnosed at age > or =50 years with ER-positive tumors (compared with normal-weight women, HR for overweight = 1.39, 95% CI: 0.90-2.15; HR for obese = 1.77, 95% CI: 1.11-2.82). BMI associations did not appear to differ by race/ethnicity. Our findings suggest that physical activity and BMI exert independent effects on overall mortality after breast cancer.

  6. Coffee intake, cardiovascular disease and all-cause mortality

    DEFF Research Database (Denmark)

    Nordestgaard, Ask Tybjærg; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Coffee has been associated with modestly lower risk of cardiovascular disease and all-cause mortality in meta-analyses; however, it is unclear whether these are causal associations. We tested first whether coffee intake is associated with cardiovascular disease and all-cause mortality...... observationally; second, whether genetic variations previously associated with caffeine intake are associated with coffee intake; and third, whether the genetic variations are associated with cardiovascular disease and all-cause mortality. METHODS: First, we used multivariable adjusted Cox proportional hazard...... regression models evaluated with restricted cubic splines to examine observational associations in 95 366 White Danes. Second, we estimated mean coffee intake according to five genetic variations near the AHR (rs4410790; rs6968865) and CYP1A1/2 genes (rs2470893; rs2472297; rs2472299). Third, we used sex...

  7. Smoking and All-cause Mortality in Older Adults

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    Müezzinler, Aysel; Mons, Ute; Gellert, Carolin

    2015-01-01

    INTRODUCTION: Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality...... risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority....... in people aged ≥60 years. METHODS: Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U...

  8. Adverse childhood experiences and premature all-cause mortality.

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    Kelly-Irving, Michelle; Lepage, Benoit; Dedieu, Dominique; Bartley, Mel; Blane, David; Grosclaude, Pascale; Lang, Thierry; Delpierre, Cyrille

    2013-09-01

    Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality≤50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ≥2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.

  9. Duration of Thyroid Dysfunction Correlates with All-Cause Mortality

    DEFF Research Database (Denmark)

    Laulund, Anne Sofie; Nybo, Mads; Brix, Thomas Heiberg

    2014-01-01

    , gender, CCI and diagnostic setting attenuated the risk estimates (HR 1.23; 95% CI: 1.19-1.28; P...-scale, population-based cohort with long-term follow-up (median 7.4 years), overt and subclinical hyperthyroidism and overt but not subclinical hypothyroidism were associated with increased mortality. Excess mortality with increasing duration of decreased or elevated serum TSH suggests the importance of timely...

  10. Body Mass Index (BMI) and All-Cause Mortality Pooling Project

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    The BMI and All-Cause Mortality Pooling Project quantified the risk associated with being overweight and the extent to which the relationship between BMI and all-cause mortality varies by certain factors.

  11. Red meat and processed meat consumption and all-cause mortality: a meta-analysis.

    Science.gov (United States)

    Larsson, Susanna C; Orsini, Nicola

    2014-02-01

    High consumption of red meat and processed meat has been associated with increased risk of several chronic diseases. We conducted a meta-analysis to summarize the evidence from prospective studies on red meat and processed meat consumption in relationship to all-cause mortality. Pertinent studies were identified by searching PubMed through May 2013 and by reviewing the reference lists of retrieved articles. Prospective studies that reported relative risks with 95% confidence intervals for the association of red meat or processed meat consumption with all-cause mortality were eligible. Study-specific results were combined by using a random-effects model. Nine prospective studies were included in the meta-analysis. The summary relative risks of all-cause mortality for the highest versus the lowest category of consumption were 1.10 (95% confidence interval (CI): 0.98, 1.22; n = 6 studies) for unprocessed red meat, 1.23 (95% CI: 1.17, 1.28; n = 6 studies) for processed meat, and 1.29 (95% CI: 1.24, 1.35; n = 5 studies) for total red meat. In a dose-response meta-analysis, consumption of processed meat and total red meat, but not unprocessed red meat, was statistically significantly positively associated with all-cause mortality in a nonlinear fashion. These results indicate that high consumption of red meat, especially processed meat, may increase all-cause mortality.

  12. Weight at Birth and All-Cause Mortality in Adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, Lina Wøhlk; Sørensen, Thorkild I.A.

    2008-01-01

    was constant for all ages investigated and did not differ between men and women. Compared with subjects having birth weights in the reference category (3251-3750 g), those with the lowest birth weights (2000-2750 g) had 17% higher mortality (95% confidence interval = 1.11-1.22), and those with the highest...

  13. Low Nonfasting Triglycerides and Reduced All-Cause Mortality: A Mendelian Randomization Study

    DEFF Research Database (Denmark)

    Thomsen, Mette; Varbo, Anette; Tybjærg-Hansen, Anne;

    2014-01-01

    Increased nonfasting plasma triglycerides marking increased amounts of cholesterol in remnant lipoproteins are important risk factors for cardiovascular disease, but whether lifelong reduced concentrations of triglycerides on a genetic basis ultimately lead to reduced all-cause mortality is unknown....... We tested this hypothesis.METHODS: Using individuals from the Copenhagen City Heart Study in a Mendelian randomization design, we first tested whether low concentrations of nonfasting triglycerides were associated with reduced all-cause mortality in observational analyses (n = 13 957); second......, whether genetic variants in the triglyceride-degrading enzyme lipoprotein lipase, resulting in reduced nonfasting triglycerides and remnant cholesterol, were causally associated with reduced all-cause mortality (n = 10 208).RESULTS: During a median 24 and 17 years of 100% complete follow-up, 9991 and 4005...

  14. Depressive symptoms and all-cause mortality in people with type 2 diabetes

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    Nefs, Giesje; Pop, Victor J M; Denollet, Johan

    2016-01-01

    BACKGROUND: Depression has been associated with increased all-cause mortality in people with type 2 diabetes. AIMS: To test whether anhedonia, dysphoria and anxiety are differentially associated with all-cause mortality and examine symptom-specific behavioural or pathophysiological mechanisms....... METHOD: A total of 1465 people completed the Edinburgh Postnatal Depression Scale in 2005 and were followed until death or 31 December 2010. Cox regression analyses compared survival time for people with a low v. high baseline dysphoria/anhedonia/anxiety score and identified mediating mechanisms. RESULTS...

  15. Body fat and fat-free mass and all-cause mortality

    DEFF Research Database (Denmark)

    Bigaard, Janne; Frederiksen, Kirsten; Tjønneland, Anne

    2004-01-01

    OBJECTIVE: To investigate whether the association between BMI and all-cause mortality could be disentangled into opposite effects of body fat and fat-free mass (FFM). RESEARCH METHODS AND PROCEDURES: All-cause mortality was studied in the Danish follow-up study "Diet, Cancer and Health" with 27......,178 men and 29,875 women 50 to 64 years old recruited from 1993 to 1997. By the end of year 2001, the median follow-up was 5.8 years, and 1851 had died. Body composition was assessed by bioelectrical impedance. Cox regression models were used to estimate the relationships among body fat mass index (body...... fat mass divided by height squared), FFM index (FFM divided by height squared), and mortality. All analyses were adjusted for smoking habits. RESULTS: Men and women showed similar associations. J-shaped associations were found between body fat mass index and mortality adjusted for FFM and smoking...

  16. Hemoglobin Screening Independently Predicts All-Cause Mortality.

    Science.gov (United States)

    Fulks, Michael; Dolan, Vera F; Stout, Robert L

    2015-01-01

    Objective .- Determine if the addition of hemoglobin testing improves risk prediction for life insurance applicants. Method .- Hemoglobin results for insurance applicants tested from 1993 to 2007, with vital status determined by Social Security Death Master File follow-up in 2011, were analyzed by age and sex with and without accounting for the contribution of other test results. Results .- Hemoglobin values ≤12.0 g/dL (and possibly ≤13.0 g/dL) in females age 50+ (but not age 15.0 g/dL (and possibly >14.0 g/dL) for all females and for hemoglobin values >16.0 g/dL for males. Conclusion .- Hemoglobin testing can add additional independent risk assessment to that obtained from other laboratory testing, BP and build in this relatively healthy insurance applicant population. Multiple studies support this finding at older ages, but data (and the prevalence of diseases impacting hemoglobin levels) are limited at younger ages.

  17. Race, depressive symptoms, and all-cause mortality in the United States

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    Shervin eAssari

    2016-03-01

    Full Text Available Purpose: Despite the well-established association between baseline depressive symptoms and risk of all cause-mortality, limited information exists on racial differences in the residual effects of baseline depressive symptoms above and beyond socio-economic status (SES and physical health on this link. The current study compared Blacks and Whites for the residual effects of depressive symptoms over SES and health on risk of long-term all-cause mortality in the United States. Methods: Data came from the Americans’ Changing Lives Study, a nationally representative longitudinal cohort of U.S. adults with up to 25 years of follow up. The study followed 3,361 Blacks or Whites for all-cause mortality between 1986 and 2011. The main predictor of interest was baseline depressive symptoms measured at 1986 using an 11- item Center for Epidemiological Studies-Depression scale (CES-D. Covariates included baseline demographics (age and gender, SES (education and income, and health [chronic medical conditions (CMC, self-rated health, and body mass index (BMI] measured at 1986. Race (Black versus White was the focal moderator. We ran a series of Cox proportional hazard models, in the pooled sample and also stratified by race. Results: In the pooled sample, higher depressive symptoms at baseline were associated with higher risk of all-cause mortality except when the CMC, SRH, and BMI were added to the model. In this later model, race interacted with baseline depressive symptoms, suggesting a larger effect of depressive symptoms on mortality among Whites compared to Blacks. Among Whites, depressive symptoms were associated with increased risk of mortality, after controlling for SES, but not after controlling for health (CMC, SRH and BMI as well. Among Blacks, depressive symptoms were not associated with mortality before that health was introduced to the model. After controlling for health, baseline depressive symptoms showed an inverse association with all-cause

  18. Housework reduces all-cause and cancer mortality in Chinese men.

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    Ruby Yu

    Full Text Available BACKGROUND: Leisure time physical activity has been extensively studied. However, the health benefits of non-leisure time physical activity, particular those undertaken at home on all-cause and cancer mortality are limited, particularly among the elderly. METHODS: We studied physical activity in relation to all-cause and cancer mortality in a cohort of 4,000 community-dwelling elderly aged 65 and older. Leisure time physical activity (sport/recreational activity and lawn work/yard care/gardening and non-leisure time physical activity (housework, home repairs and caring for another person were self-reported on the Physical Activity Scale for the Elderly. Subjects with heart diseases, stroke, cancer or diabetes at baseline were excluded (n = 1,133. RESULTS: Among the 2,867 subjects with a mean age of 72 years at baseline, 452 died from all-cause and 185 died from cancer during the follow-up period (2001-2012. With the adjustment for age, education level and lifestyle factors, we found an inverse association between risk of all-cause mortality and heavy housework among men, with the adjusted hazard ratio (HR of 0.72 (95%CI = 0.57-0.92. Further adjustment for BMI, frailty index, living arrangement, and leisure time activity did not change the result (HR = 0.71, 95%CI = 0.56-0.91. Among women, however, heavy housework was not associated with all-cause mortality. The risk of cancer mortality was significantly lower among men who participated in heavy housework (HR = 0.52, 95%CI = 0.35-0.78, whereas among women the risk was not significant. Men participated in light housework also were at lower risk of cancer mortality than were their counterparts, however, the association was not significant. Leisure time physical activity was not related to all-cause or cancer mortality in either men or women. CONCLUSION: Heavy housework is associated with reduced mortality and cancer deaths over a 9-year period. The underlying mechanism needs

  19. Loneliness and all-cause mortality in community-dwelling elderly Singaporeans

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    Angelique Chan

    2015-06-01

    Full Text Available Background: Loneliness is a significant risk factor for mortality among older adults. There are several pathways through which loneliness may operate to increase mortality risk, ranging from biological responses and individual perceptions to social interactions and environmental factors. The proportion of single older (65+ person households has doubled in the last ten years in Singapore. Yet little is understood about the relationship between loneliness, social isolation, and mortality risk among older adults, in Singapore and in Asian contexts in general. Objective: To assess the impact of loneliness and social isolation on the risk of all-cause mortality over a four-year period, controlling for demographic characteristics and health status at baseline. Methods: We used data from a longitudinal survey of community-dwelling Singaporean elderly (N=4,522. Loneliness was assessed using the UCLA three-item loneliness scale. Unadjusted and adjusted Cox proportional hazards regressions were used to estimate mortality risk. Results: In the final adjusted model, living arrangements and social networks outside the household were not associated with all-cause mortality. Loneliness increased the risk of all-cause mortality; those sometimes lonely and mostly lonely were 44.0Š (p=0.005 and 39.0Š (p=0.059 more likely to die compared to those not lonely. Conclusions: Loneliness is associated with higher mortality risks among Singaporean elderly. Mental health among the older population is a major public health concern and community interventions are needed to more efficiently identify, raise awareness of, and increase care for the lonely elderly in the community.

  20. Heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heat wave.

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    Gulrez Shah Azhar

    Full Text Available INTRODUCTION: In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8 °C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. METHODS: We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1-31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. RESULTS: The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths. In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest "summer" months of April (r = 0.69, p<0.001, May (r = 0.77, p<0.001, and June (r = 0.39, p<0.05. During a period of more intense heat (May 19-25, 2010, mortality rate ratios were 1.76 [95% CI 1.67-1.83, p<0.001] and 2.12 [95% CI 2.03-2.21] applying reference periods (May 12-18, 2010 from various years. CONCLUSION: The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures

  1. Plasma Soluble CD163 Level Independently Predicts All-Cause Mortality in HIV-1-Infected Individuals

    DEFF Research Database (Denmark)

    Knudsen, Troels Bygum; Ertner, Gideon; Petersen, Janne;

    2016-01-01

    Background: CD163, a monocyte- and macrophage-specific scavenger receptor, is shed as soluble CD163 (sCD163) during the proinflammatory response. Here, we assessed the association between plasma sCD163 levels and progression to AIDS and all-cause mortality among individuals infected with human im.......35 [95% CI, 1.13–1.63], respectively). Conclusions: Plasma sCD163 was an independent marker of all-cause mortality in a cohort of HIV–infected individuals, suggesting that monocyte/macrophage activation may play a role in HIV pathogenesis and be a target of intervention.......Background: CD163, a monocyte- and macrophage-specific scavenger receptor, is shed as soluble CD163 (sCD163) during the proinflammatory response. Here, we assessed the association between plasma sCD163 levels and progression to AIDS and all-cause mortality among individuals infected with human...... immunodeficiency virus type 1 (HIV). Methods: Plasma sCD163 levels were measured in 933 HIV–infected individuals. Hazard ratios (HRs) with 95% confidence intervals (CIs) associated with mortality were computed by Cox proportional hazards regression. Results: At baseline, 86% were receiving antiretroviral treatment...

  2. Prediction of risk of diabetic retinopathy for all-cause mortality, stroke and heart failure

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    Zhu, Xiao-Rong; Zhang, Yong-Peng; Bai, Lu; Zhang, Xue-Lian; Zhou, Jian-Bo; Yang, Jin-Kui

    2017-01-01

    Abstract To examine and quantify the potential relation between diabetic retinopathy (DR) and risk of all-cause mortality, stroke and heart failure (HF). The resources of meta-analysis of epidemiological observational studies were from Pub-med, EMBASE, CINAHL, Cochrane Library, conference, and proceedings. Random/fixed effects models were used to calculate pooled subgroup analysis stratified by different grades of DR was performed to explore the potential source of heterogeneity. Statistical manipulations were undertaken using program STATA. Of the included 25 studies, comprising 142,625 participants, 19 studies were concluded to find the relation of DR to all-cause mortality, 5 for stroke, and 3 for HF. Risk ratio (RR) for all-cause mortality with the presence of DR was 2.33 (95% CI 1.92–2.81) compared with diabetic individuals without DR. Evidences showed a higher risk of all-cause mortality associated with DR in patients with T2D or T1D (RR 2.25, 95% CI 1.91–2.65. RR 2.68, 95% CI 1.34–5.36). According to different grades of DR in patients with T2D, RR for all-cause mortality varied, the risk of nonproliferative diabetic retinopathy (NPDR) was 1.38 (1.11–1.70), while the risk of proliferative diabetic retinopathy (PDR) was 2.32 (1.75–3.06). There was no evidence of significant heterogeneity (Cochran Q test P = 0.29 vs 0.26, I2 = 19.6% vs 22.6%, respectively). Data from 5 studies in relation to DR and the risk of stroke showed that DR was significantly associated with increased risk of stroke (RR = 1.74, 95%CI: 1.35–2.24), compared with patients without DR. Furthermore, DR (as compared with individuals without DR) was associated with a marginal increased risk of HF in patients with diabetes mellitus (DM) (n = 3 studies; RR 2.24, 95% CI 0.98–5.14, P = 0.056). Our results showed that DR increased the risk of all-cause mortality, regardless of the different stages, compared with the diabetic individuals without DR. DR predicted

  3. C-reactive protein and all-cause mortality--the Copenhagen City Heart Study

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    Zacho, Jeppe; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2010-01-01

    We tested whether elevated levels of C-reactive protein is robustly and causally associated with all-cause mortality.......We tested whether elevated levels of C-reactive protein is robustly and causally associated with all-cause mortality....

  4. Annual all-cause mortality rate for patients with diabetic kidney disease in Singapore

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    Yee Gary Ang

    2016-06-01

    Conclusion: Our study estimated the annual all-cause mortality rate for Singaporean patients with diabetic kidney disease by CKD stages and identified predictors of all-cause mortality. This study has affirmed the poor prognosis of these patients and an urgency to intervene early so as to retard the progression to later stages of CKD.

  5. Elevated C-reactive protein, depression, somatic diseases, and all-cause mortality

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    Wium-Andersen, Marie Kim; Orsted, David Dynnes; Nordestgaard, Børge Grønne

    2014-01-01

    population. End points included hospitalization or death with depression and somatic diseases, prescription antidepressant medication use, and all-cause mortality. RESULTS: A doubling in plasma CRP yielded an observed odds ratio (OR) of 1.28 (95% confidence interval [CI]: 1.23-1.33) for hospitalization...... of cancer (p = .002), ischemic heart disease (p = 4 × 10(-99)), chronic obstructive pulmonary disease (p = 6 × 10(-86)), and all-cause mortality (p = .001) examined in the same individuals. CONCLUSIONS: Elevated CRP was associated with increased risk of depression in individuals in the general population......BACKGROUND: Elevated levels of plasma C-reactive protein (CRP) have been associated with many diseases including depression, but it remains unclear whether this association is causal. We tested the hypothesis that CRP is causally associated with depression, and compared these results to those...

  6. Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study

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    Raaschou-Nielsen Ole

    2012-09-01

    Full Text Available Abstract Background Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association. Methods We followed up 52 061 participants in a Danish cohort for mortality in the nationwide Register of Causes of Death, from enrollment in 1993–1997 through 2009, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2 since 1971 as indicator of traffic air pollution and used Cox regression models to estimate mortality rate ratios (MRRs with adjustment for potential confounders. Results Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from cardiovascular disease (MRR, 1.26; 95% confidence interval [CI], 1.06–1.51, per doubling of NO2 concentration and all causes (MRR, 1.13; 95% CI, 1.04–1.23, per doubling of NO2 concentration after adjustment for potential confounders. For participants who ate  Conclusions Traffic air pollution is associated with mortality from cardiovascular diseases and all causes, after adjustment for traffic noise. The association was strongest for people with a low fruit and vegetable intake.

  7. Fruit and vegetable consumption and all-cause mortality: evidence from a large Australian cohort study

    OpenAIRE

    2016-01-01

    Background There is growing evidence for a relationship between fruit and vegetable consumption and all-cause mortality. Few studies, however, specifically explored consuming raw versus cooked vegetables in relation to health and mortality outcomes. The purpose of this study was to examine the relation of all-cause mortality with: a) fruit and vegetable consumption, either combined or separately; b) the consumption of raw versus cooked vegetables in a large cohort of Australian middle-aged an...

  8. Daily sitting time and all-cause mortality: a meta-analysis.

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    Josephine Y Chau

    Full Text Available OBJECTIVE: To quantify the association between daily total sitting and all-cause mortality risk and to examine dose-response relationships with and without adjustment for moderate-to-vigorous physical activity. METHODS: Studies published from 1989 to January 2013 were identified via searches of multiple databases, reference lists of systematic reviews on sitting and health, and from authors' personal literature databases. We included prospective cohort studies that had total daily sitting time as a quantitative exposure variable, all-cause mortality as the outcome and reported estimates of relative risk, or odds ratios or hazard ratios with 95% confidence intervals. Two authors independently extracted the data and summary estimates of associations were computed using random effects models. RESULTS: Six studies were included, involving data from 595,086 adults and 29,162 deaths over 3,565,569 person-years of follow-up. Study participants were mainly female, middle-aged or older adults from high-income countries; mean study quality score was 12/15 points. Associations between daily total sitting time and all-cause mortality were not linear. With physical activity adjustment, the spline model of best fit had dose-response HRs of 1.00 (95% CI: 0.98-1.03, 1.02 (95% CI: 0.99-1.05 and 1.05 (95% CI: 1.02-1.08 for every 1-hour increase in sitting time in intervals between 0-3, >3-7 and >7 h/day total sitting, respectively. This model estimated a 34% higher mortality risk for adults sitting 10 h/day, after taking physical activity into account. The overall weighted population attributable fraction for all-cause mortality for total daily sitting time was 5.9%, after adjusting for physical activity. CONCLUSIONS: Higher amounts of daily total sitting time are associated with greater risk of all-cause mortality and moderate-to-vigorous physical activity appears to attenuate the hazardous association. These findings provide a starting point for identifying a

  9. All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review.

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    Adams, Ted D; Mehta, Tapan S; Davidson, Lance E; Hunt, Steven C

    2015-12-01

    The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in long-term mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide.

  10. Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women

    DEFF Research Database (Denmark)

    Bigaard, J; Frederiksen, K; Tjønneland, A

    2005-01-01

    OBJECTIVE: Waist circumference is directly related to all-cause mortality when adjusted for body mass index (BMI). Body fat and fat-free body mass, when mutually adjusted, show with increasing values an increasing and decreasing relation to all-cause mortality. We investigated the association...... of waist circumference and body composition (body fat and fat-free mass), mutually adjusted, to all-cause mortality. DESIGN: A Danish prospective cohort study with a median follow-up period of 5.8 y. SUBJECTS: In all, 27 178 men and 29 875 women, born in Denmark, aged 50-64 y, and without diagnosis...... of cancer at the time of invitation. MEASUREMENTS: Waist circumference and body composition estimated from impedance measurements. Cox's regression models were used to estimate the mortality rate ratios (RR). RESULTS: Waist circumference was strongly associated with all-cause mortality after adjustment...

  11. Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort.

    Directory of Open Access Journals (Sweden)

    Sylvie Lang

    Full Text Available The effect of statins on all-cause mortality in the general population has been estimated as 0.86 (95%CI 0.79-0.94 for primary prevention. Reported values in HIV-infected individuals have been discordant. We assessed the impact of statin-based primary prevention on all-cause mortality among HIV-infected individuals.Patients were selected among controls from a multicentre nested case-control study on the risk of myocardial infarction. Patients with prior cardiovascular or cerebrovascular disorders were not eligible. Potential confounders, including variables that were associated either with statin use and/or death occurrence and statin use were evaluated within the last 3 months prior to inclusion in the case-control study. Using an intention to continue approach, multiple imputation of missing data, Cox's proportional hazard models or propensity based weighting, the impact of statins on the 7-year all-cause mortality was evaluated.Among 1,776 HIV-infected individuals, 138 (8% were statins users. During a median follow-up of 53 months, 76 deaths occurred, including 6 in statin users. Statin users had more cardiovascular risk factors and a lower CD4 T cell nadir than statin non-users. In univariable analysis, the death rate was higher in statins users (11% vs 7%, HR 1.22, 95%CI 0.53-2.82. The confounders accounted for were age, HIV transmission group, current CD4 T cell count, haemoglobin level, body mass index, smoking status, anti-HCV antibodies positivity, HBs antigen positivity, diabetes and hypertension. In the Cox multivariable model the estimated hazard ratio of statin on all-cause mortality was estimated as 0.86 (95%CI 0.34-2.19 and it was 0.83 (95%CI 0.51-1.35 using inverse probability treatment weights.The impact of statin for primary prevention appears similar in HIV-infected individuals and in the general population.

  12. Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality

    DEFF Research Database (Denmark)

    Guo, Jing; Astrup, Arne; Lovegrove, Julie A

    2017-01-01

    With a growing number of prospective cohort studies, an updated dose-response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up...... associations between dairy products and cardiovascular and all-cause mortality. For future studies it is important to investigate in more detail how dairy products can be replaced by other foods....

  13. Sleep duration and ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Åse Marie; Holtermann, Andreas;

    2013-01-01

    This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association.......This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association....

  14. Functional status and all-cause mortality in serious mental illness.

    Directory of Open Access Journals (Sweden)

    Richard D Hayes

    Full Text Available BACKGROUND: Serious mental illness can affect many aspects of an individual's ability to function in daily life. The aim of this investigation was to determine if the environmental and functional status of people with serious mental illness contribute to the high mortality risk observed in this patient group. METHODS: We identified cases of schizophrenia, schizoaffective and bipolar disorder aged ≥ 15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of activities of daily living (ADLs, living conditions, occupational and recreational activities and relationship factors (Health of the Nation Outcome Scale [HoNOS] subscales on all-cause mortality over a 4-year observation period (2007-10 using Cox regression. RESULTS: We identified 6,880 SMI cases (242 deaths in the observation period. ADL impairment was associated with an increased risk of all-cause mortality (adjusted HR 1.9; 95% CI 1.3-2.8; p = 0.001, p for trend across ADL categories = 0.001 after controlling for a broad range of covariates (including demographic factors, physical health, mental health symptoms and behaviours, socio-economic status and mental health service contact. No associations were found for the other three exposures. Stratification by age indicated that ADLs were most strongly associated with mortality in the youngest (15 to <35 years and oldest (≥ 55 years groups. CONCLUSIONS: Functional impairment in people with serious mental illness diagnoses is a marker of increased mortality risk, possibly in younger age groups as a marker of negative symptomatology.

  15. Dairy Food Intake and All-Cause, Cardiovascular Disease, and Cancer Mortality: The Golestan Cohort Study.

    Science.gov (United States)

    Farvid, Maryam S; Malekshah, Akbar F; Pourshams, Akram; Poustchi, Hossein; Sepanlou, Sadaf G; Sharafkhah, Maryam; Khoshnia, Masoud; Farvid, Mojtaba; Abnet, Christian C; Kamangar, Farin; Dawsey, Sanford M; Brennan, Paul; Pharoah, Paul D; Boffetta, Paolo; Willett, Walter C; Malekzadeh, Reza

    2017-03-29

    We investigated the association between dairy product consumption and all-cause, cardiovascular disease (CVD), and cancer mortality in the Golestan Cohort Study, a prospective cohort study launched in January 2004 in Golestan Province, northeastern Iran. A total of 42,403 men and women participated in the study and completed a diet questionnaire at enrollment. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. We documented 3,291 deaths (1,467 from CVD and 859 from cancer) during 11 years of follow-up (2004-2015). The highest quintile of total dairy product consumption (versus the lowest) was associated with 19% lower all-cause mortality risk (hazard ratio (HR) = 0.81, 95% confidence interval (CI): 0.72, 0.91; Ptrend = 0.006) and 28% lower CVD mortality risk (HR = 0.72, 95% CI: 0.60, 0.86; Ptrend = 0.005). High consumption of low-fat dairy food was associated with lower risk of all-cause (HR = 0.83, 95% CI: 0.73, 0.94; Ptrend = 0.002) and CVD (HR = 0.74, 95% CI: 0.61, 0.89; Ptrend = 0.001) mortality. We noted 11% lower all-cause mortality and 16% lower CVD mortality risk with high yogurt intake. Cheese intake was associated with 16% lower all-cause mortality and 26% lower CVD mortality risk. Higher intake of high-fat dairy food and milk was not associated with all-cause or CVD mortality. Neither intake of individual dairy products nor intake of total dairy products was significantly associated with overall cancer mortality. High consumption of dairy products, especially yogurt and cheese, may reduce the risk of overall and CVD mortality.

  16. Racial-ethnic differences in all-cause and HIV mortality, Florida, 2000–2011

    Science.gov (United States)

    Trepka, Mary Jo; Fennie, Kristopher P.; Sheehan, Diana M.; Niyonsenga, Theophile; Lieb, Spencer; Maddox, Lorene M.

    2016-01-01

    Purpose We compared all-cause and human immunodeficiency virus (HIV) mortality in a population-based, HIV-infected cohort. Methods Using records of people diagnosed with HIV during 2000–2009 from the Florida Enhanced HIV/Acquired Immunodeficiency Syndrome (AIDS) Reporting System, we conducted a proportional hazards analysis for all-cause mortality and a competing risk analysis for HIV mortality through 2011 controlling for individual level factors, neighborhood poverty, and rural/urban status and stratifying by concurrent AIDS status (AIDS within 3 months of HIV diagnosis). Results Of 59,880 HIV-infected people, 32.2% had concurrent AIDS, and 19.3% died. Adjusting for period of diagnosis, age group, sex, country of birth, HIV transmission mode, area level poverty and rural/urban status, non-Hispanic Black (NHB) and Hispanic people had an elevated adjusted hazards ratio (aHR) for HIV mortality relative to non-Hispanic whites (NHB concurrent AIDS: aHR 1.34, 95% CI 1.23–1.47; NHB without concurrent AIDS: aHR 1.41, 95% CI 1.26–1.57; Hispanic concurrent AIDS: aHR 1.18, 95% CI 1.05–1.32; Hispanic without concurrent AIDS: aHR 1.18, 95% CI 1.03–1.36). Conclusions Considering competing causes of death, NHB and Hispanic people had a higher risk of HIV mortality even among those without concurrent AIDS, indicating a need to identify and address barriers to HIV care in these populations. PMID:26948103

  17. Prospective study of coffee consumption and all-cause, cancer, and cardiovascular mortality in Swedish women.

    Science.gov (United States)

    Löf, Marie; Sandin, Sven; Yin, Li; Adami, Hans-Olov; Weiderpass, Elisabete

    2015-09-01

    We investigated whether coffee consumption was associated with all-cause, cancer, or cardiovascular mortality in a prospective cohort of 49,259 Swedish women. Of the 1576 deaths that occurred in the cohort, 956 were due to cancer and 158 were due to cardiovascular disease. We used Cox proportional hazard models with adjustment for potential confounders to estimate multivariable relative risks (RR) and 95 % confidence intervals (CI). Compared to a coffee consumption of 0-1 cups/day, the RR for all cause-mortality was 0.81 (95 % CI 0.69-0.94) for 2-5 cups/day and 0.88 (95 % CI 0.74-1.05) for >5 cups/day. Coffee consumption was not associated with cancer mortality or cardiovascular mortality when analyzed in the entire cohort. However, in supplementary analyses of women over 50 years of age, the RR for all cause-mortality was 0.74 (95 % CI 0.62-0.89) for 2-5 cups/day and 0.86 (95 % CI 0.70-1.06) for >5 cups/day when compared to 0-1 cups/day. In this same subgroup, the RRs for cancer mortality were 1.06 (95 % CI 0.81-1.38) for 2-5 cups/day and 1.40 (95 % CI 1.05-1.89) for >5 cups/day when compared to 0-1 cups/day. No associations between coffee consumption and all-cause mortality, cancer mortality, or cardiovascular mortality were observed among women below 50 years of age. In conclusion, higher coffee consumption was associated with lower all-cause mortality when compared to a consumption of 0-1 cups/day. Furthermore, coffee may have differential effects on mortality before and after 50 years of age.

  18. Income distribution, public services expenditures, and all cause mortality in US states

    OpenAIRE

    2005-01-01

    Introduction: The objective of this paper is to investigate the relation between state and local government expenditures on public services and all cause mortality in 48 US states in 1987, and determine if the relation between income inequality and mortality is conditioned on levels of public services available in these jurisdictions.

  19. All-cause and cause-specific mortality of different migrant populations in Europe

    NARCIS (Netherlands)

    U.Z. Ikram (Umar Z.); J.P. Mackenbach (Johan); S. Harding; G. Rey (Grégoire); R.S. Bhopal (Raj); E. Regidor (Enrique); A. Rosato (Antonio); K. Juel (Knud); K. Stronks (Karien); A.E. Kunst (Anton)

    2015-01-01

    textabstractThis study aimed to examine differences in all-cause mortality and main causes of death across different migrant and local-born populations living in six European countries. We used data from population and mortality registers from Denmark, England & Wales, France, Netherlands, Scotland,

  20. IGF1 as predictor of all cause mortality and cardiovascular disease in an elderly population

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Raymond, Ilan; Kistorp, Caroline;

    2009-01-01

    BACKGROUND: IGF1 is believed to influence ageing and development of cardiovascular disease (CVD) through complex mechanisms. Reduced IGF1 levels might be causally associated with conditions accompanying ageing including development of CVD. However, in animal models reduced GH-IGF1 signalling...... increases lifespan. Reduced IGF1 activity might also be associated with longevity in humans. OBJECTIVE: The objective was to investigate if plasma IGF1 levels were associated with all cause mortality, and the development of chronic heart failure (CHF) and a major CV event. PATIENTS AND DESIGN: A population...... systolic function and without prevalent CVD. Outcomes were ascertained after 5 years using hospital discharge diagnoses. RESULTS: Adjustment for risk factors IGF1 values in the fourth quartile versus values below the fourth quartile was associated with increased mortality (n=103), hazard ratio (HR) 1...

  1. Associations between antioxidants and all-cause mortality among US adults with obstructive lung function.

    Science.gov (United States)

    Ford, Earl S; Li, Chaoyang; Cunningham, Timothy J; Croft, Janet B

    2014-11-28

    Chronic obstructive pulmonary disease is characterised by oxidative stress, but little is known about the associations between antioxidant status and all-cause mortality in adults with this disease. The objective of the present study was to examine the prospective associations between concentrations of α- and β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, Se, vitamin C and α-tocopherol and all-cause mortality among US adults with obstructive lung function. Data collected from 1492 adults aged 20-79 years with obstructive lung function in the National Health and Nutrition Examination Survey III (1988-94) were used. Through 2006, 629 deaths were identified during a median follow-up period of 14 years. After adjustment for demographic variables, the concentrations of the following antioxidants modelled as continuous variables were found to be inversely associated with all-cause mortality among adults with obstructive lung function: α-carotene (P= 0·037); β-carotene (P= 0·022); cryptoxanthin (P= 0·022); lutein/zeaxanthin (P= 0·004); total carotenoids (P= 0·001); vitamin C (Pmortality. No effect modification by sex was detected, but the association between lutein/zeaxanthin concentrations and all-cause mortality varied by smoking status (P interaction= 0·048). The concentrations of lycopene and vitamin C were inversely associated with all-cause mortality in this cohort of adults with obstructive lung function.

  2. Similar support for three different life course socioeconomic models on predicting premature cardiovascular mortality and all-cause mortality

    Directory of Open Access Journals (Sweden)

    Lynch John

    2006-08-01

    Full Text Available Abstract Background There are at least three broad conceptual models for the impact of the social environment on adult disease: the critical period, social mobility, and cumulative life course models. Several studies have shown an association between each of these models and mortality. However, few studies have investigated the importance of the different models within the same setting and none has been performed in samples of the whole population. The purpose of the present study was to study the relation between socioeconomic position (SEP and mortality using different conceptual models in the whole population of Scania. Methods In the present investigation we use socioeconomic information on all men (N = 48,909 and women (N = 47,688 born between 1945 and 1950, alive on January, 1st,1990, and living in the Region of Scania, in Sweden. Focusing on three specific life periods (i.e., ages 10–15, 30–35 and 40–45, we examined the association between SEP and the 12-year risk of premature cardiovascular mortality and all-cause mortality. Results There was a strong relation between SEP and mortality among those inside the workforce, irrespective of the conceptual model used. There was a clear upward trend in the mortality hazard rate ratios (HRR with accumulated exposure to manual SEP in both men (p for trend Conclusion There was a strong relation between SEP and cardiovascular and all-cause mortality, irrespective of the conceptual model used. The critical period, social mobility, and cumulative life course models, showed the same fit to the data. That is, one model could not be pointed out as "the best" model and even in this large unselected sample it was not possible to adjudicate which theories best describe the links between life course SEP and mortality risk.

  3. The Association of Reproductive Hormone Levels and All-Cause, Cancer, and Cardiovascular Disease Mortality in Men

    DEFF Research Database (Denmark)

    Agergaard Holmboe, Stine; Vradi, Eleni; Jensen, Tina Kold

    2015-01-01

    testosterone in relation to CVD mortality, however insignificant. CONCLUSION: The observed positive association of LH and LH/T, but not testosterone, with all-cause mortality suggests that a compensated impaired Leydig cell function may be a risk factor for death by all causes in men. Our findings underpin......: A prospective cohort study consisting of men participating in four independent population-based surveys (MONICA I-III and Inter99) from 1982 to 2001 and followed until December 2012 with complete registry follow-up. SETTING AND PARTICIPANTS: 5,350 randomly selected men from the general population aged 30, 40......, 50, 60 or 70 years at baseline. MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular disease (CVD) mortality and cancer mortality. RESULTS: 1,533 men died during the follow-up period; 428 from CVD and 480 from cancer. Cox proportional hazard models revealed that men in highest LH quartile had...

  4. Long-term weight changes in obese young adult men and subsequent all-cause mortality

    DEFF Research Database (Denmark)

    Zimmermann, E; Berentzen, T L; Ängquist, Lars Henrik;

    2013-01-01

    the two examinations, life-style factors nor exclusion of diseased individuals influenced the results.CONCLUSIONS:Although there were increased mortality of the weight-stable obese compared with controls, there was no association between weight loss and mortality in the obese. Weight gain increased...... change and all-cause mortality in a broad range of body mass index (BMI) in young men.METHODS:Among 362200 Danish draftees, examined between 1943 and 1977, all obese (BMI 31.0 kg m(-2); n=1930), and a random 1% sample of the others (n=3601) were identified at a mean age of 20 years (range: 18-25 years......). All the obese and half the controls were re-examined between 4 and 40 years later (mean age 35 years). Weight changes were defined as: weight loss 0.1 kg m(-2) per year. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression.RESULTS:Among the 908 obese and 1073...

  5. Weight change and all-cause mortality in older adults: A meta-analysis

    Science.gov (United States)

    This meta-analysis of observational cohort studies examined the association between weight change (weight loss, weight gain, and weight fluctuation) and all-cause mortality among older adults. We used PubMed (MEDLINE), Web of Science, and Cochrane Library to identify prospective studies published in...

  6. Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events

    Science.gov (United States)

    Wang, Yan Xiu; Song, Lu; Xing, Ai Jun; Gao, Ming; Zhao, Hai Yan; Li, Chun Hui; Zhao, Hua Ling; Chen, Shuo Hua; Lu, Cheng Zhi; Wu, Shou Ling

    2017-02-01

    The predictive value of cumulative blood pressure (BP) on all-cause mortality and cardiovascular and cerebrovascular events (CCE) has hardly been studied. In this prospective cohort study including 52,385 participants from the Kailuan Group who attended three medical examinations and without CCE, the impact of cumulative systolic BP (cumSBP) and cumulative diastolic BP (cumDBP) on all-cause mortality and CCEs was investigated. For the study population, the mean (standard deviation) age was 48.82 (11.77) years of which 40,141 (76.6%) were male. The follow-up for all-cause mortality and CCEs was 3.96 (0.48) and 2.98 (0.41) years, respectively. Multivariate Cox proportional hazards regression analysis showed that for every 10 mm Hg·year increase in cumSBP and 5 mm Hg·year increase in cumDBP, the hazard ratio for all-cause mortality were 1.013 (1.006, 1.021) and 1.012 (1.006, 1.018); for CCEs, 1.018 (1.010, 1.027) and 1.017 (1.010, 1.024); for stroke, 1.021 (1.011, 1.031) and 1.018 (1.010, 1.026); and for MI, 1.013 (0.996, 1.030) and 1.015 (1.000, 1.029). Using natural spline function analysis, cumSBP and cumDBP showed a J-curve relationship with CCEs; and a U-curve relationship with stroke (ischemic stroke and hemorrhagic stroke). Therefore, increases in cumSBP and cumDBP were predictive for all-cause mortality, CCEs, and stroke.

  7. The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Ekmann, Anette; Osler, Merete; Avlund, Kirsten

    2012-01-01

    Objective To investigate whether fatigue predicts nonfatal ischemic heart disease (IHD) and all-cause mortality in middle-aged men. Methods The study population consisted of 5216 middle-aged men born in the Copenhagen metropolitan area in 1953. At baseline, men free of angina pectoris and previou...... is a potential risk indicator for IHD and mortality. Further research is needed to establish the role of smoking and other life-style characteristics.......% confidence interval [CI] = 1.09-3.61) and all-cause mortality (HR = 3.99, 95% CI = 2.27-7.02). These associations became nonsignificant in multivariable-adjusted models (HR = 1.57, 95% CI = 0.82-3.01 and HR = 1.90, 95% CI = 0.95-3.80). Imputation of missing data did not modify conclusions. Fatigue...

  8. Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Susanna C. Larsson

    2015-09-01

    Full Text Available Results from epidemiological studies of milk consumption and mortality are inconsistent. We conducted a systematic review and meta-analysis of prospective studies assessing the association of non-fermented and fermented milk consumption with mortality from all causes, cardiovascular disease, and cancer. PubMed was searched until August 2015. A two-stage, random-effects, dose-response meta-analysis was used to combine study-specific results. Heterogeneity among studies was assessed with the I2 statistic. During follow-up periods ranging from 4.1 to 25 years, 70,743 deaths occurred among 367,505 participants. The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies. There was substantial heterogeneity among studies of non-fermented milk consumption in relation to mortality from all causes (12 studies; I2 = 94%, cardiovascular disease (five studies; I2 = 93%, and cancer (four studies; I2 = 75% as well as among studies of fermented milk consumption and all-cause mortality (seven studies; I2 = 88%. Thus, estimating pooled hazard ratios was not appropriate. Heterogeneity among studies was observed in most subgroups defined by sex, country, and study quality. In conclusion, we observed no consistent association between milk consumption and all-cause or cause-specific mortality.

  9. Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis.

    Science.gov (United States)

    Crippa, Alessio; Discacciati, Andrea; Larsson, Susanna C; Wolk, Alicja; Orsini, Nicola

    2014-10-15

    Several studies have analyzed the relationship between coffee consumption and mortality, but the shape of the association remains unclear. We conducted a dose-response meta-analysis of prospective studies to examine the dose-response associations between coffee consumption and mortality from all causes, cardiovascular disease (CVD), and all cancers. Pertinent studies, published between 1966 and 2013, were identified by searching PubMed and by reviewing the reference lists of the selected articles. Prospective studies in which investigators reported relative risks of mortality from all causes, CVD, and all cancers for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Twenty-one prospective studies, with 121,915 deaths and 997,464 participants, met the inclusion criteria. There was strong evidence of nonlinear associations between coffee consumption and mortality for all causes and CVD (P for nonlinearity Coffee consumption was not associated with cancer mortality. Findings from this meta-analysis indicate that coffee consumption is inversely associated with all-cause and CVD mortality.

  10. The Effect of Neurobehavioral Test Performance on the All-Cause Mortality among US Population

    Directory of Open Access Journals (Sweden)

    Tao-Chun Peng

    2016-01-01

    Full Text Available Evidence of the association between global cognitive function and mortality is much, but whether specific cognitive function is related to mortality is unclear. To address the paucity of knowledge on younger populations in the US, we analyzed the association between specific cognitive function and mortality in young and middle-aged adults. We analyzed data from 5,144 men and women between 20 and 59 years of age in the Third National Health and Nutrition Examination Survey (1988–94 with mortality follow-up evaluation through 2006. Cognitive function tests, including assessments of executive function/processing speed (symbol digit substitution and learning recall/short-term memory (serial digit learning, were performed. All-cause mortality was the outcome of interest. After adjusting for multiple variables, total mortality was significantly higher in males with poorer executive function/processing speed (hazard ratio (HR 2.02; 95% confidence interval 1.36 to 2.99 and poorer recall/short-term memory (HR 1.47; 95% confidence interval 1.02 to 2.12. After adjusting for multiple variables, the mortality risk did not significantly increase among the females in these two cognitive tests groups. In this sample of the US population, poorer executive function/processing speed and poorer learning recall/short-term memory were significantly associated with increased mortality rates, especially in males. This study highlights the notion that poorer specific cognitive function predicts all-cause mortality in young and middle-aged males.

  11. Delayed effects of obese and overweight population conditions on all-cause adult mortality rate in the USA

    Directory of Open Access Journals (Sweden)

    Albert A Okunade

    2016-09-01

    Full Text Available Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMI to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System (BRFSS data of the 50 US states and the District of Columbia (DC estimates empirical regression models linking the US adult population overweight and obesity rates separately to the all-cause mortality rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid from unexpended caloric intakes (net energy storage provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation to slow premature mortality linked to unhealthy BMIs.

  12. Vitamin D status and incident cardiovascular disease and all-cause mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

    2013-01-01

    Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic...... heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay...

  13. All-cause and cause-specific mortality of different migrant populations in Europe

    DEFF Research Database (Denmark)

    Ikram, Umar Z; Mackenbach, Johan P; Harding, Seeromanie;

    2015-01-01

    Turkey. All-cause mortality was higher in men and women from North Africa (1.09; 1.08-1.11 and 1.19; 1.17-1.22, respectively) and Eastern Europe (1.30; 1.27-1.33 and 1.05; 1.01-1.08, respectively), and women from Sub-Saharan Africa (1.34; 1.30-1.38). The pattern differed by age group and country......This study aimed to examine differences in all-cause mortality and main causes of death across different migrant and local-born populations living in six European countries. We used data from population and mortality registers from Denmark, England & Wales, France, Netherlands, Scotland, and Spain....... We calculated age-standardized mortality rates for men and women aged 0-69 years. Country-specific data were pooled to assess weighted mortality rate ratios (MRRs) using Poisson regression. Analyses were stratified by age group, country of destination, and main cause of death. In six countries...

  14. Renal Function and All-Cause Mortality Risk Among Cancer Patients.

    Science.gov (United States)

    Yang, Yan; Li, Hui-Yan; Zhou, Qian; Peng, Zhen-Wei; An, Xin; Li, Wei; Xiong, Li-Ping; Yu, Xue-Qing; Jiang, Wen-Qi; Mao, Hai-Ping

    2016-05-01

    Renal dysfunction predicts all-cause mortality in general population. However, the prevalence of renal insufficiency and its relationship with mortality in cancer patients are unclear.We retrospectively studied 9465 patients with newly diagnosed cancer from January 2010 to December 2010. Renal insufficiency was defined as an estimated glomerular filtration rate (eGFR) cancer stage in the entire cohort, the corresponding hazard ratios were 1.87 (95% CI, 1.41-2.47) and 1.28 (95% CI, 1.01-1.62) for stage I to III and stage IV, respectively. However, this relationship was not observed after multivariate adjustment. Subgroup analysis found that eGFR cancer (adjusted HR 2.82, 95% CI [1.19-6.70]), but not in those with other cancer. Five hundred fifty-seven patients (6%) had proteinuria. When controlled for potential confounding factors, proteinuria was a risk factor for all-cause mortality among patients in the entire cohort, regardless of cancer stage and eGFR values. When patients were categorized by specific cancer type, the risk of all-cause death was only significant in patients with digestive system cancer (adjusted HR, 1.85 [1.48-2.32]).The prevalence of renal dysfunction was common in patients with newly diagnosed cancer. Patients with eGFR cancer site.

  15. All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

    Directory of Open Access Journals (Sweden)

    C. M. Durward

    2012-01-01

    Full Text Available Mortality risk across metabolic health-by-BMI categories in NHANES-III was examined. Metabolic health was defined as: (1 homeostasis model assessment-insulin resistance (HOMA-IR <2.5; (2 ≤2 Adult Treatment Panel (ATP III metabolic syndrome criteria; (3 combined definition using ≤1 of the following: HOMA-IR ≥1.95 (or diabetes medications, triglycerides ≥1.7 mmol/L, HDL-C <1.04 mmol/L (males or <1.30 mmol/L (females, LDL-C ≥2.6 mmol/L, and total cholesterol ≥5.2 mmol/L (or cholesterol-lowering medications. Hazard ratios (HR for all-cause mortality were estimated with Cox regression models. Nonpregnant women and men were included (n=4373, mean ± SD, age 37.1±10.9 years, BMI 27.3±5.8 kg/m2, 49.4% female. Only 40 of 1160 obese individuals were identified as MHO by all definitions. MHO groups had superior levels of clinical risk factors compared to unhealthy individuals but inferior levels compared to healthy lean groups. There was increased risk of all-cause mortality in metabolically unhealthy obese participants regardless of definition (HOMA-IR HR 2.07 (CI 1.3–3.4, P<0.01; ATP-III HR 1.98 (CI 1.4–2.9, P<0.001; combined definition HR 2.19 (CI 1.3–3.8, P<0.01. MHO participants were not significantly different from healthy lean individuals by any definition. While MHO individuals are not at significantly increased risk of all-cause mortality, their clinical risk profile is worse than that of metabolically healthy lean individuals.

  16. Vitamin D status and incident cardiovascular disease and all-cause mortality: a general population study.

    Science.gov (United States)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta; Jørgensen, Torben; Thuesen, Betina Heinsbæk; Fenger, Mogens; Linneberg, Allan

    2013-06-01

    Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay system in Monica10 and High-performance liquid chromatography in Inter99. Information on CVDs and causes of death was obtained from Danish registries until 31 December 2008. There were 478 cases of IHD, 316 cases of stroke, and 633 deaths during follow-up (mean follow-up 10 years). Cox regression analyses with age as underlying time axis showed a significant association between vitamin D status and all-cause mortality with a HR = 0.95 (P = 0.005) per 10 nmol/l higher vitamin D level. We found no association between vitamin D status and incidence of IHD or stroke (HR = 1.01, P = 0.442 and HR = 1.00, P = 0.920, respectively). In this large general population study, the observed inverse association between serum vitamin D status and all-cause mortality was not explained by a similar inverse association with IHD or stroke.

  17. Association Between Television Viewing Time and All-Cause Mortality: A Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Sun, Jiang-Wei; Zhao, Long-Gang; Yang, Yang; Ma, Xiao; Wang, Ying-Ying; Xiang, Yong-Bing

    2015-12-01

    Findings on the association between television (TV) viewing and all-cause mortality in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of data from prospective cohort studies to quantify this association. Relevant articles were identified by searching MEDLINE (PubMed; National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) from inception to March 1, 2015, and reviewing the reference lists of retrieved articles. Study-specific results were pooled using a random-effects model. Of 2,578 citations identified by the search strategy, 10 cohort studies (61,494 deaths among 647,475 individuals) met the inclusion criteria. The summary relative risk of all-cause mortality for the highest category of TV viewing time versus the lowest was 1.33 (95% confidence interval: 1.20, 1.47), with heterogeneity among studies (I(2) = 66.7%, P(heterogeneity) = 0.001). In dose-response meta-analysis, TV viewing time was statistically significantly associated with all-cause mortality risk in a J-shaped fashion (P(nonlinearity) = 0.001). These results indicate that prolonged TV viewing time might increase the risk of all-cause mortality. Given the high prevalence of excessive TV viewing, public health recommendations or interventions aimed at decreasing the amount of TV viewing time in modern societies are warranted.

  18. Wound healing and all-cause mortality in 958 wound patients treated in home care

    DEFF Research Database (Denmark)

    Zarchi, Kian; Martinussen, Torben; Jemec, Gregor B. E.

    2015-01-01

    to investigate wound healing and all-cause mortality associated with different types of skin wounds. Consecutive skin wound patients who received wound care by home-care nurses from January 2010 to December 2011 in a district in Eastern Denmark were included in this study. Patients were followed until wound...... healing, death, or the end of follow-up on December 2012. In total, 958 consecutive patients received wound care by home-care nurses, corresponding to a 1-year prevalence of 1.2% of the total population in the district. During the study, wound healing was achieved in 511 (53.3%), whereas 90 (9.4%) died...

  19. Joint associations of alcohol consumption and physical activity with all-cause and cardiovascular mortality.

    Science.gov (United States)

    Soedamah-Muthu, Sabita S; De Neve, Melissa; Shelton, Nicola J; Tielemans, Susanne M A J; Stamatakis, Emmanuel

    2013-08-01

    Individual associations of alcohol consumption and physical activity with cardiovascular disease are relatively established, but the joint associations are not clear. Therefore, the aim of this study was to examine prospectively the joint associations between alcohol consumption and physical activity with cardiovascular mortality (CVM) and all-cause mortality. Four population-based studies in the United Kingdom were included, the 1997 and 1998 Health Surveys for England and the 1998 and 2003 Scottish Health Surveys. In men and women, respectively, low physical activity was defined as 0.1 to 5 and 0.1 to 4 MET-hours/week and high physical activity as ≥5 and ≥4 MET-hours/week. Moderate or moderately high alcohol intake was defined as >0 to 35 and >0 to 21 units/week and high levels of alcohol intake as >35 and >21 units/week. In total, there were 17,410 adults without prevalent cardiovascular diseases and complete data on alcohol and physical activity (43% men, median age 55 years). During a median follow-up period of 9.7 years, 2,204 adults (12.7%) died, 638 (3.7%) with CVM. Cox proportional-hazards models were adjusted for potential confounders such as marital status, social class, education, ethnicity, and longstanding illness. In the joint associations analysis, low activity combined with high levels of alcohol (CVM: hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.28 to 2.96, p = 0.002; all-cause mortality: HR 1.64, 95% CI 1.32 to 2.03, p activity combined with no alcohol (CVM: HR 1.93, 95% CI 1.35 to 2.76, p physical activity. Within each given alcohol group, low activity was linked to increased CVM risk (e.g., HR 1.48, 95% CI 1.08 to 2.03, p = 0.014, for the moderate drinking group), but in the presence of high physical activity, high alcohol intake was not linked to increased CVM risk (HR 1.32, 95% CI 0.52 to 3.34, p = 0.555). In conclusion, high levels of drinking and low physical activity appear to increase the risk for cardiovascular and all-cause

  20. Hypoalbuminemia is a strong predictor of 30-day all-cause mortality in acutely admitted medical patients

    DEFF Research Database (Denmark)

    Jellinge, Marlene Ersgaard; Henriksen, Daniel Pilsgaard; Hallas, Peter

    2014-01-01

    -day all-cause mortality in a cohort of acutely admitted medical patients. METHODS: We included all acutely admitted adult medical patients from the medical admission unit at a regional teaching hospital in Denmark. Data on mortality was extracted from the Danish Civil Register to ensure complete......OBJECTIVE: Emergency patients with hypoalbuminemia are known to have increased mortality. No previous studies have, however, assessed the predictive value of low albumin on mortality in unselected acutely admitted medical patients. We aimed at assessing the predictive power of hypoalbuminemia on 30...... (precision of predictions) for hypoalbuminemia was determined. RESULTS: We included 5,894 patients and albumin was available in 5,451 (92.5%). A total of 332 (5.6%) patients died within 30 days of admission. Median plasma albumin was 40 g/L (IQR 37-43). Crude 30-day mortality in patients with low albumin...

  1. Oxidative Stress Predicts All-Cause Mortality in HIV-Infected Patients.

    Directory of Open Access Journals (Sweden)

    Mar Masiá

    Full Text Available We aimed to assess whether oxidative stress is a predictor of mortality in HIV-infected patients.We conducted a nested case-control study in CoRIS, a contemporary, multicentre cohort of HIV-infected patients, antiretroviral-naïve at entry, launched in 2004. Cases were patients who died with available stored plasma samples collected. Two age and sex-matched controls for each case were selected. We measured F2-isoprostanes (F2-IsoPs and malondialdehyde (MDA plasma levels in the first blood sample obtained after cohort engagement.54 cases and 93 controls were included. Median F2-IsoPs and MDA levels were significantly higher in cases than in controls. When adjustment was performed for age, HIV-transmission category, CD4 cell count and HIV viral load at cohort entry, and subclinical inflammation measured with highly-sensitive C-reactive protein (hsCRP, the association of F2-IsoPs with mortality remained significant (adjusted OR per 1 log10 increase, 2.34 [1.23-4.47], P = 0.009. The association of MDA with mortality was attenuated after adjustment: adjusted OR (95% CI per 1 log10 increase, 2.05 [0.91-4.59], P = 0.080. Median hsCRP was also higher in cases, and it also proved to be an independent predictor of mortality in the adjusted analysis: OR (95% CI per 1 log10 increase, 1.39 (1.01-1.91, P = 0.043; and OR (95% CI per 1 log10 increase, 1.46 (1.07-1.99, P = 0.014, respectively, when adjustment included F2-IsoPs and MDA.Oxidative stress is a predictor of all-cause mortality in HIV-infected patients. For plasma F2-IsoPs, this association is independent of HIV-related factors and subclinical inflammation.

  2. Association of CKD-MBD Markers with All-Cause Mortality in Prevalent Hemodialysis Patients: A Cohort Study in Beijing

    Science.gov (United States)

    Li, Duo; Zhang, Ling; Zuo, Li; Jin, Cheng Gang; Li, Wen Ge; Chen, Jin-Bor

    2017-01-01

    The relationships between all-cause mortality and serum intact parathyroid hormone (iPTH), calcium, and phosphate are fairly diverse in patients on maintenance hemodialysis according to prior studies. This study evaluated the association of chronic kidney disease-mineral and bone disorder (CKD-MBD) markers with all-cause mortality in prevalent hemodialysis patients from 2007 to 2012 in Beijing, China. A cohort, involving 8530 prevalent hemodialysis patients who had undergone a 6–70 months follow-up program (with median as 40 months) was formed. Related data was recorded from the database in 120 hemodialysis centers of Beijing Health Bureau (2007 to 2012). Information regarding baseline demographics, blood CKD-MBD markers and all-cause mortality was retrospectively reviewed. By using multivariate Cox regression model analysis, patients with a low iPTH level at baseline were found to have greater risk of mortality (<75pg/ml, HR = 1.36, 95% confidence interval (CI) 1.16–1.60) than those with a baseline iPTH level within 150–300 pg/ml. Similarly, death risk showed an increase when the baseline serum calcium presented a low level (<2.1mmol/L, HR = 1.54; 95% CI 1.37–1.74). Levels of baseline serum phosphorus were not associated with the risk of death. Similar results appeared through the baseline competing risks regression analysis. Patients with a lower level of serum iPTH or calcium are at a higher risk of all-cause mortality compared with those within the range recommended by Kidney Disease Outcome Quality Initiative (KDOQI) guidelines. PMID:28045985

  3. A competing risk approach for the European Heart SCORE model based on cause-specific and all-cause mortality

    DEFF Research Database (Denmark)

    Støvring, Henrik; Harmsen, Charlotte G; Wisløff, Torbjørn;

    2013-01-01

    pressure, and total cholesterol level. The SCORE model, however, is not mathematically consistent and does not estimate all-cause mortality. Our aim is to modify the SCORE model to allow consistent estimation of both CVD-specific and all-cause mortality. Methods: Using a competing risk approach, we first...

  4. Investigation of methodological factors potentially underlying the apparently paradoxical findings on body mass index and all-cause mortality.

    Directory of Open Access Journals (Sweden)

    Grace Joshy

    Full Text Available INTRODUCTION: Findings regarding the association between overweight and all-cause mortality range from significantly lower to higher risk, compared with body-mass-index (BMI within the "normal" range. METHODS: We examined empirically potential methodological explanations for these apparently conflicting results using questionnaire and linked mortality data from 246,314 individuals aged ≥45 years in the Australian 45 and Up Study (11,127 deaths; median follow-up 3.9 years. Hazard ratios (HR for all-cause mortality associated with BMI were modelled according to different methods of accounting for illness at baseline, finer versus broader gradations of BMI and choice of reference group, adjusting for potential confounders. RESULTS: In analyses using the broad World Health Organization (WHO categories, the all-cause mortality HR was significantly lower in the overweight category (25.0-29.99 kg/m², than the normal weight (18.5-24.99 kg/m² category. However, in analyses accounting for baseline illness, which excluded those with pre-existing illness at baseline, ever-smokers and the first 2 years of follow up, absolute age-standardised mortality rates varied up to two-fold between finer BMI categories within the WHO normal weight category; rates were lowest at 22.5-24.99 kg/m² and mortality HRs increased steadily for BMI above (p(trend<0.02 and below (p(trend<0.003 this reference category. Hence, the breadth of the BMI categories used and whether or not baseline illness is accounted for explain the apparent discrepancies between reported BMI-mortality associations. CONCLUSION: Using fine BMI categories and the category with the lowest absolute rates as the reference group and accounting for the potential confounding effects of baseline illness is likely to yield the most reliable risk estimates for establishing the independent relationship of BMI to all-cause mortality. These results and those of other studies indicate that a BMI of 22.5-24.99 kg

  5. No Association between Loss-of-Function Mutations in filaggrin and Diabetes, Cardiovascular Disease, and All-Cause Mortality

    Science.gov (United States)

    Husemoen, Lise Lotte N.; Skaaby, Tea; Jørgensen, Torben; Thyssen, Jacob P.; Meldgaard, Michael; Szecsi, Pal B.; Stender, Steen; Johansen, Jeanne Duus; Linneberg, Allan

    2013-01-01

    Background Common loss-of-function mutations in the filaggrin gene (FLG) are a major predisposing risk factor for atopic disease due to reduced epidermal filaggrin protein levels. We previously observed an association between these mutations and type 2 diabetes and hypothesized that an inherited impairment of skin barrier functions could facilitate low-grade inflammation and hence increase the risk of diabetes and cardiovascular disease. We examined the association between loss-of-function mutations in FLG and diabetes, stroke, ischemic heart disease (IHD), and all-cause mortality in the general population. Methods The R501X and 2282del4 loss-of function mutations in FLG were genotyped in four Danish study populations including a total of 13373 adults aged 15-77 years. Two of the studies also genotyped the R2447X mutation. By linkage to Danish national central registers we obtained information for all participants on dates of diagnoses of diabetes, stroke, and IHD, as well as all-cause mortality. Data were analyzed by Cox proportional hazard models and combined by fixed effect meta-analyses. Results In meta-analyses combining the results from the four individual studies, carriage of loss-of-function mutations in FLG was not associated with incident diabetes (hazard ratio (HR) (95% confidence intervals (CI)) = 0.95 (0.73, 1.23), stroke (HR (95% CI) = 1.27 (0.97, 1.65), ischemic heart disease (HR (95%CI) = 0.92 (0.71, 1.19), and all-cause mortality (HR (95%CI) = 1.02 (0.83, 1.25)). Similar results were obtained when including prevalent cases in logistic regression models. Conclusion Our results suggest that loss-of-function mutations in FLG are not associated with type 2 diabetes, cardiovascular disease, and all-cause mortality. However, larger studies with longer follow-up are needed to exclude any associations. PMID:24367652

  6. No association between loss-of-function mutations in filaggrin and diabetes, cardiovascular disease, and all-cause mortality.

    Directory of Open Access Journals (Sweden)

    Lise Lotte N Husemoen

    Full Text Available BACKGROUND: Common loss-of-function mutations in the filaggrin gene (FLG are a major predisposing risk factor for atopic disease due to reduced epidermal filaggrin protein levels. We previously observed an association between these mutations and type 2 diabetes and hypothesized that an inherited impairment of skin barrier functions could facilitate low-grade inflammation and hence increase the risk of diabetes and cardiovascular disease. We examined the association between loss-of-function mutations in FLG and diabetes, stroke, ischemic heart disease (IHD, and all-cause mortality in the general population. METHODS: The R501X and 2282del4 loss-of function mutations in FLG were genotyped in four Danish study populations including a total of 13373 adults aged 15-77 years. Two of the studies also genotyped the R2447X mutation. By linkage to Danish national central registers we obtained information for all participants on dates of diagnoses of diabetes, stroke, and IHD, as well as all-cause mortality. Data were analyzed by Cox proportional hazard models and combined by fixed effect meta-analyses. RESULTS: In meta-analyses combining the results from the four individual studies, carriage of loss-of-function mutations in FLG was not associated with incident diabetes (hazard ratio (HR (95% confidence intervals (CI = 0.95 (0.73, 1.23, stroke (HR (95% CI = 1.27 (0.97, 1.65, ischemic heart disease (HR (95%CI = 0.92 (0.71, 1.19, and all-cause mortality (HR (95%CI = 1.02 (0.83, 1.25. Similar results were obtained when including prevalent cases in logistic regression models. CONCLUSION: Our results suggest that loss-of-function mutations in FLG are not associated with type 2 diabetes, cardiovascular disease, and all-cause mortality. However, larger studies with longer follow-up are needed to exclude any associations.

  7. Increased Remnant Cholesterol Explains Part of Residual Risk of All-Cause Mortality in 5414 Patients with Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Jepsen, Anne-Marie K; Langsted, Anne; Varbo, Anette;

    2016-01-01

    Danish patients diagnosed with ischemic heart disease. Patients on statins were not excluded. Calculated remnant cholesterol was nonfasting total cholesterol minus LDL and HDL cholesterol. During 35836 person-years of follow-up, 1319 patients died. RESULTS: We examined both calculated and directly......BACKGROUND: Increased concentrations of remnant cholesterol are causally associated with increased risk of ischemic heart disease. We tested the hypothesis that increased remnant cholesterol is a risk factor for all-cause mortality in patients with ischemic heart disease. METHODS: We included 5414......: Increased concentrations of both calculated and measured remnant cholesterol were associated with increased all-cause mortality in patients with ischemic heart disease, which was not the case for increased concentrations of measured LDL cholesterol. This suggests that increased concentrations of remnant...

  8. Wound healing and all-cause mortality in 958 wound patients treated in home care.

    Science.gov (United States)

    Zarchi, Kian; Martinussen, Torben; Jemec, Gregor B E

    2015-09-01

    Skin wounds are associated with significant morbidity and mortality. Data are, however, not readily available for benchmarking, to allow prognostic evaluation, and to suggest when involvement of wound-healing experts is indicated. We, therefore, conducted an observational cohort study to investigate wound healing and all-cause mortality associated with different types of skin wounds. Consecutive skin wound patients who received wound care by home-care nurses from January 2010 to December 2011 in a district in Eastern Denmark were included in this study. Patients were followed until wound healing, death, or the end of follow-up on December 2012. In total, 958 consecutive patients received wound care by home-care nurses, corresponding to a 1-year prevalence of 1.2% of the total population in the district. During the study, wound healing was achieved in 511 (53.3%), whereas 90 (9.4%) died. During the first 3 weeks of therapy, healing was most likely to occur in surgical wounds (surgical vs. other wounds: adjusted hazard ratio [AHR] 2.21, 95% confidence interval 1.50-3.23), while from 3 weeks to 3 months of therapy, cancer wounds, and pressure ulcers were least likely to heal (cancer vs. other wounds: AHR 0.12, 0.03-0.50; pressure vs. other wounds: AHR 0.44, 0.27-0.74). Cancer wounds and pressure ulcers were further associated with a three times increased probability of mortality compared with other wounds (cancer vs. other wounds: AHR 3.19, 1.35-7.50; pressure vs. other wounds: AHR 2.91, 1.56-5.42). In summary, the wound type was found to be a significant predictor of healing and mortality with cancer wounds and pressure ulcers being associated with poor prognosis.

  9. Relation of Periodontitis to Risk of Cardiovascular and All-Cause Mortality (from a Danish Nationwide Cohort Study).

    Science.gov (United States)

    Hansen, Gorm Mørk; Egeberg, Alexander; Holmstrup, Palle; Hansen, Peter Riis

    2016-08-15

    Periodontitis and atherosclerosis are highly prevalent chronic inflammatory diseases, and it has been suggested that periodontitis is an independent risk factor of cardiovascular disease (CVD) and that a causal link may exist between the 2 diseases. Using Danish national registers, we identified a nationwide cohort of 17,691 patients who received a hospital diagnosis of periodontitis within a 15-year period and matched them with 83,003 controls from the general population. We performed Poisson regression analysis to determine crude and adjusted incidence rate ratios of myocardial infarction, ischemic stroke, cardiovascular death, major adverse cardiovascular events, and all-cause mortality. The results showed that patients with periodontitis were at higher risk of all examined end points. The findings remained significant after adjustment for increased baseline co-morbidity in periodontitis patients compared with controls, for example, with adjusted incidence rate ratio 2.02 (95% CI 1.87 to 2.18) for cardiovascular death and 2.70 (95% CI 2.60 to 2.81) for all-cause mortality. Patients with a hospital diagnosis of periodontitis have a high burden of co-morbidity and an increased risk of CVD and all-cause mortality. In conclusion, our results support that periodontitis may be an independent risk factor for CVD.

  10. Pre-dialysis systolic blood pressure-variability is independently associated with all-cause mortality in incident haemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Viknesh Selvarajah

    Full Text Available Systolic blood pressure variability is an independent risk factor for mortality and cardiovascular events. Standard measures of blood pressure predict outcome poorly in haemodialysis patients. We investigated whether systolic blood pressure variability was associated with mortality in incident haemodialysis patients. We performed a longitudinal observational study of patients commencing haemodialysis between 2005 and 2011 in East Anglia, UK, excluding patients with cardiovascular events within 6 months of starting haemodialysis. The main exposure was variability independent of the mean (VIM of systolic blood pressure from short-gap, pre-dialysis blood pressure readings between 3 and 6 months after commencing haemodialysis, and the outcome was all-cause mortality. Of 203 patients, 37 (18.2% patients died during a mean follow-up of 2.0 (SD 1.3 years. The age and sex-adjusted hazard ratio (HR for mortality was 1.09 (95% confidence interval (CI 1.02-1.17 for a one-unit increase of VIM. This was not altered by adjustment for diabetes, prior cardiovascular disease and mean systolic blood pressure (HR 1.09, 95% CI 1.02-1.16. Patients with VIM of systolic blood pressure above the median were 2.4 (95% CI 1.17-4.74 times more likely to die during follow-up than those below the median. Results were similar for all measures of blood pressure variability and further adjustment for type of dialysis access, use of antihypertensives and absolute or variability of fluid intake did not alter these findings. Diastolic blood pressure variability showed no association with all cause mortality. Our study shows that variability of systolic blood pressure is a strong and independent predictor of all-cause mortality in incident haemodialysis patients. Further research is needed to understand the mechanism as this may form a therapeutic target or focus for management.

  11. Association between dietary fiber and lower risk of all-cause mortality: a meta-analysis of cohort studies.

    Science.gov (United States)

    Yang, Yang; Zhao, Long-Gang; Wu, Qi-Jun; Ma, Xiao; Xiang, Yong-Bing

    2015-01-15

    Although in vitro and in vivo experiments have suggested that dietary fiber might have beneficial effects on health, results on the association between fiber intake and all-cause mortality in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to quantitatively assess this association. Pertinent studies were identified by searching articles in PubMed and Web of Knowledge through May 2014 and reviewing the reference lists of the retrieved articles. Study-specific risk estimates were combined using random-effects models. Seventeen prospective studies (1997-2014) that had a total of 67,260 deaths and 982,411 cohort members were included. When comparing persons with dietary fiber intakes in the top tertile with persons whose intakes were in the bottom tertile, we found a statistically significant inverse association between fiber intake and all-cause mortality, with an overall relative risk of 0.84 (95% confidence interval: 0.80, 0.87; I(2) = 41.2%). There was a 10% reduction in risk for per each 10-g/day increase in fiber intake (relative risk = 0.90; 95% confidence interval: 0.86, 0.94; I(2) = 77.2%). The combined estimate was robust across subgroup and sensitivity analyses. No publication bias was detected. A higher dietary fiber intake was associated with a reduced risk of death. These findings suggest that fiber intake may offer a potential public health benefit in reducing all-cause mortality.

  12. Mid-arm muscle circumference as a significant predictor of all-cause mortality in male individuals

    Science.gov (United States)

    Wu, Li-Wei; Lin, Yuan-Yung; Kao, Tung-Wei; Lin, Chien-Ming; Liaw, Fang-Yih; Wang, Chung-Ching; Peng, Tao-Chun; Chen, Wei-Liang

    2017-01-01

    Background Emerging evidences indicate that mid-arm muscle circumference (MAMC) is one of the anthropometric indicators that reflect health and nutritional status, but its correlative effectiveness in all-cause mortality prediction of United States individuals remains uncertain. Methods and findings design We investigated the joint association between MAMC and all-cause mortality in the US general population. A population-based longitudinal study of 6,769 participants aged 40 to 90 years in the third National Health and Nutrition Examination Survey (NHANES III) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. All participants were divided into two groups based on the gender: male and female group; each group was then divided into three subgroups depending on their MAMC level. The tertiles were as follows: T1 (18<27.3), T2 (27.3<29.6), T3 (29.6≤40.0) cm in the male group and T1 (15<22.3), T2 (22.3<24.6), T3 (24.6≤44.0) cm in the female group. Multivariable Cox regression analyses and Kaplan–Meier survival probabilities were utilized to jointly relate all-cause mortality risk to different MAMC level. For all-cause mortality in male participants, multivariable adjusted hazard ratios (HRs) were 0.83 (95% confidence interval (CI): 0.69–0.98; p = 0.033) for MAMC of 27.3–29.6 cm compared with 18–27.3 cm, and 0.76 (95% CI: 0.61–0.95; p = 0.018) for MAMC of 29.6–40 cm compared with 18–27.3 cm. For all-cause mortality in female participants, multivariable adjusted hazard ratios (HRs) were 0.84 (95% confidence interval (CI): 0.69–1.02; p = 0.075) for MAMC of 22.3–24.6 cm compared with 15–22.3 cm, and 0.94 (95% CI: 0.75–1.17; p = 0.583) for MAMC of 24.6–44 cm compared with 15–22.3 cm. Conclusion Results support a lower MAMC is associated with a higher mortality risk in male individuals. PMID:28196081

  13. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns

    Directory of Open Access Journals (Sweden)

    Kouyaté Bocar

    2008-01-01

    Full Text Available Abstract Background Malaria is a leading cause of death in children below five years of age in sub-Saharan Africa. All-cause and malaria-specific mortality rates for children under-five years old in a mesoendemic malaria area (The Gambia were compared with those from a hyper/holoendemic area (Burkina Faso. Methods Information on observed person-years (PY, deaths and cause of death was extracted from online search, using key words: "Africa, The Gambia, Burkina Faso, malaria, Plasmodium falciparum, mortality, child survival, morbidity". Missing person-years were estimated and all-cause and malaria-specific mortality were calculated as rates per 1,000 PY. Studies were classified as longitudinal/clinical studies or surveys/censuses. Linear regression was used to investigate mortality trends. Results Overall, 39 and 18 longitudinal/clinical studies plus 10 and 15 surveys and censuses were identified for The Gambia and Burkina Faso respectively (1960–2004. Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0, but more markedly in The Gambia (from 104.5 to 28.4. The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0–18.3 was higher than that in The Gambia (9.5, 95% CI: 9.1–10.1. Malaria mortality rates did not decline over time in either country. Conclusion Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects. However, there was little decline in malaria mortality suggesting that there had been no major impact of malaria control programmes during this period. The difference in malaria mortality rates across countries points to significant differences in national disease control policies and/or disease transmission patterns.

  14. The combined influence of leisure-time physical activity and weekly alcohol intake on fatal ischaemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Pedersen, Jane Østergaard; Heitmann, Berit Lilienthal; Schnohr, Peter;

    2008-01-01

    AIMS: To determine the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of subsequent fatal ischaemic heart disease (IHD) and all-cause mortality. METHODS AND RESULTS: Prospective cohort study of 11 914 Danes aged 20 years or older and without pre......-existing IHD. During approximately 20 years of follow-up, 1242 cases of fatal IHD occurred and 5901 died from all causes. Within both genders, being physically active was associated with lower hazard ratios (HR) of both fatal IHD and all-cause mortality than being physically inactive. Further, weekly alcohol...... had the highest HR of both fatal IHD and all-cause mortality within each category of weekly alcohol intake. Thus, the HR of both fatal IHD and all-cause mortality were low among the physically active who had a moderate alcohol intake. Conclusion Leisure-time physical activity and a moderate weekly...

  15. Assessing the association between all-cause mortality and multiple aspects of individual social capital among the older Japanese

    Directory of Open Access Journals (Sweden)

    Kondo Naoki

    2011-06-01

    Full Text Available Abstract Background Few prospective cohort studies have assessed the association between social capital and mortality. The studies were conducted only in Western countries and did not use the same social capital indicators. The present prospective cohort study aimed to examine the relationships between various forms of individual social capital and all-cause mortality in Japan. Methods Self-administered questionnaires were mailed to subjects in the Aichi Gerontological Evaluation Study (AGES Project in 2003. Mortality data from 2003 to 2008 were analyzed for 14,668 respondents. Both cognitive and structural components of individual social capital were collected: 8 for cognitive social capital (trust, 3; social support, 3; reciprocity, 2 and 9 for structural social capital (social network. Cox proportional hazard models stratified by sex with multiple imputation were used. Age, body mass index, self-rated health, current illness, smoking history, alcohol consumption, exercise, equivalent income and education were used as covariates. Results During 27,571 person-years of follow-up for men and 29,561 person-years of follow-up for women, 790 deaths in men and 424 in women were observed. In the univariate analyses for men, lower social capital was significantly related to higher mortality in one general trust variable, all generalised reciprocity variables and four social network variables. For women, lower social capital was significantly related to higher mortality in all generalised reciprocity and four social network variables. After adjusting for covariates, lower friendship network was significantly associated with higher all-cause mortality among men (meet friends rarely; HR = 1.30, 95%CI = 1.10-1.53 and women (having no friends; HR = 1.81, 95%CI = 1.02-3.23. Among women, lower general trust was significantly related to lower mortality (most people cannot be trusted; HR = 0.65, 95%CI = 0.45-0.96. Conclusions Friendship network was a good

  16. Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Philippe Laramée

    2015-10-01

    Interpretation: AD was found to significantly increase an individual's risk of all-cause mortality. While abstinence in alcohol-dependent subjects led to greater mortality reduction than non-abstinence, this study suggests that alcohol-dependent subjects can significantly reduce their mortality risk by reducing alcohol consumption.

  17. All-Cause Mortality for Diabetics or Individuals with Hyperglycemia Applying for Life Insurance.

    Science.gov (United States)

    Freitas, Stephen A; MacKenzie, Ross; Wylde, David N; Roudebush, Bradley T; Bergstrom, Richard L; Holowaty, J Carl; Hart, Anna; Rigatti, Steven J; Gill, Stacy J

    2016-01-01

    Diabetics and individuals with lab results consistent with a diagnosis of diabetes or hyperglycemia were extracted from data covering US residents who applied for life insurance between January 2007 and January 2014. Information about these applicants was matched to the Social Security Death Master File (SSDMF) and another commercially available death source file to determine vital status. Due to the inconsistencies of reporting within the death files, there were two cohorts of death cases, one including the imputed year of birth (full cohort of deaths), and the second where the date of birth was known (reduced cohort of deaths). The study had approximately 8.5 million person-years of exposure. Actual to expected (A/E) mortality ratios were calculated using the Society of Actuaries 2008 Valuation Basic Table (2008VBT) select table, age last birthday and the 2010 US population as expected mortality rates. With the 2008VBT as an expected basis, the overall A/E mortality ratio was 3.15 for the full cohort of deaths and 2.56 for the reduced cohort of deaths. Using the US population as the expected basis, the overall A/E mortality ratio was 0.98 for the full cohort of deaths and 0.79 for the reduced cohort. Since there was no smoking status information in this study, all expected bases were not smoker distinct. A/E mortality ratios varied by disease treatment category and were considerably higher in individuals using insulin. A/E mortality ratios decreased with increasing age and took on a J-shaped distribution with increasing BMI (Body Mass Index). The lowest mortality ratios were observed for overweight and obese individuals. The A/E mortality ratio based on the 2008VBT decreased with the increase in applicant duration, which was defined as the time since initial life insurance application.

  18. Differences between immigrants at various durations of residence and host population in all-cause mortality, Canada 1991-2006.

    Science.gov (United States)

    Omariba, D Walter Rasugu; Ng, Edward; Vissandjée, Bilkis

    2014-01-01

    We used data from the 1991-2006 Canadian Census Mortality and Cancer Follow-up Study to compare all-cause mortality for immigrants with that of the Canadian-born population. The study addressed two related questions. First, do immigrants have a mortality advantage over the Canadian-born? Second, if immigrants have a mortality advantage, does it persist as their duration of residence increases? The analysis fitted sex-stratified hazard regression models for the overall sample and for selected countries of birth (UK, China, India, Philippines, and the Caribbean). Predictors were assessed at baseline. Mortality was lower among immigrants than the Canadian-born even after adjusting for a selected group of socio-demographic and socio-economic factors. The mortality differences persisted even after long residence in Canada, but appeared to be dependent on the age of the individual and the country of origin. Interpreted in light of known explanations of immigrant mortality advantage, the results mostly reflect selection effects.

  19. Reduced All-Cause Child Mortality After General Measles Vaccination Campaign in Rural Guinea-Bissau

    DEFF Research Database (Denmark)

    Fisker, Ane Bærent; Rodrigues, Amabelia; Martins, Cesario

    2015-01-01

    BACKGROUND: Randomised trials have shown that measles vaccine (MV) prevents non-measles deaths. MV-campaigns are conducted to eliminate measles infection.The overall mortality effect of MV-campaigns has not been studied. METHODS: Bandim Health Project (BHP) surveys children aged 0-4 years in rural...... Guinea-Bissau through a health and demographic surveillance system. A nationalMV-campaign in 2006 targeted children aged 6 months-15 years. In a Cox proportional-hazards model with age as underlying time-scale we compared mortality for children aged 6-59 months after the campaign with mortality...... in the same age group during the two previous years. RESULTS: 8158 children aged 6-59 months were under BHP surveillance during the 2006-campaign and 7999 and 8108 during similar periods in 2004 and 2005. At least 90% of the eligible children received MV in the campaign. There were 161 non-accident deaths...

  20. Micronutrient intake in relation to all-cause mortality in a prospective Danish cohort

    DEFF Research Database (Denmark)

    Roswall, Nina; Olsen, Anja Viendahl; Christensen, Jane

    2012-01-01

    Background: Few studies have considered source-specific micronutrient intake in relation to mortality under the consideration that dietary and supplemental intake could exhibit different effects. Objective: To evaluate the association between intake of vitamin C, E, folate, beta-carotene from diet...... and supplements, and overall mortality. Furthermore, to examine effect modification by smoking, alcohol intake, and BMI and to investigate if the effect of supplement use differs with dietary micronutrient intake. Methods and Material: In a prospective cohort study of 55,453 middle-aged Danes, information...... regarding diet, supplement use, and lifestyle was collected through questionnaires. During follow-up, 6,767 deaths were identified and incidence rate ratios (IRRs) of mortality related to micronutrient intake were calculated using Cox proportional hazards models. Results: The present study found no effect...

  1. High Rates of All-cause and Gastroenteritis-related Hospitalization Morbidity and Mortality among HIV-exposed Indian Infants

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    Tripathy Srikanth

    2011-07-01

    Full Text Available Abstract Background HIV-infected and HIV-exposed, uninfected infants experience a high burden of infectious morbidity and mortality. Hospitalization is an important metric for morbidity and is associated with high mortality, yet, little is known about rates and causes of hospitalization among these infants in the first 12 months of life. Methods Using data from a prevention of mother-to-child transmission (PMTCT trial (India SWEN, where HIV-exposed breastfed infants were given extended nevirapine, we measured 12-month infant all-cause and cause-specific hospitalization rates and hospitalization risk factors. Results Among 737 HIV-exposed Indian infants, 93 (13% were HIV-infected, 15 (16% were on HAART, and 260 (35% were hospitalized 381 times by 12 months of life. Fifty-six percent of the hospitalizations were attributed to infections; gastroenteritis was most common accounting for 31% of infectious hospitalizations. Gastrointestinal-related hospitalizations steadily increased over time, peaking around 9 months. The 12-month all-cause hospitalization, gastroenteritis-related hospitalization, and in-hospital mortality rates were 906/1000 PY, 229/1000 PY, and 35/1000 PY respectively among HIV-infected infants and 497/1000 PY, 107/1000 PY, and 3/1000 PY respectively among HIV-exposed, uninfected infants. Advanced maternal age, infant HIV infection, gestational age, and male sex were associated with higher all-cause hospitalization risk while shorter duration of breastfeeding and abrupt weaning were associated with gastroenteritis-related hospitalization. Conclusions HIV-exposed Indian infants experience high rates of all-cause and infectious hospitalization (particularly gastroenteritis and in-hospital mortality. HIV-infected infants are nearly 2-fold more likely to experience hospitalization and 10-fold more likely to die compared to HIV-exposed, uninfected infants. The combination of scaling up HIV PMTCT programs and implementing proven health

  2. Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.

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    Anne Sofie Laulund

    Full Text Available INTRODUCTION AND AIM: The association between thyroid dysfunction and mortality is controversial. Moreover, the impact of duration of thyroid dysfunction is unclarified. Our aim was to investigate the correlation between biochemically assessed thyroid function as well as dysfunction duration and mortality. METHODS: Register-based follow-up study of 239,768 individuals with a serum TSH measurement from hospitals and/or general practice in Funen, Denmark. Measurements were performed at a single laboratory from January 1st 1995 to January 1st 2011. Cox regression was used for mortality analyses and Charlson Comorbidity Index (CCI was used as comorbidity score. RESULTS: Hazard ratios (HR with 95% confidence intervals (CI for mortality with decreased (4.0 mIU/L levels of TSH were 2.22; 2.14-2.30; P<0.0001 and 1.28; 1.22-1.35; P<0.0001, respectively. Adjusting for age, gender, CCI and diagnostic setting attenuated the risk estimates (HR 1.23; 95% CI: 1.19-1.28; P<0.0001, mean follow-up time 7.7 years, and HR 1.07; 95% CI: 1.02-1.13; P = 0.004, mean follow-up time 7.2 years for decreased and elevated values of TSH, respectively. Mortality risk increased by a factor 1.09; 95% CI: 1.08-1.10; P<0.0001 or by a factor 1.03; 95% CI: 1.02-1.04; P<0.0001 for each six months a patient suffered from decreased or elevated TSH, respectively. Subdividing according to degree of thyroid dysfunction, overt hyperthyroidism (HRovert 1.12; 95% CI: 1.06-1.19; P<0.0001, subclinical hyperthyroidism (HRsubclinical 1.09; 95% CI: 1.02-1.17; P = 0.02 and overt hypothyroidism (HRovert 1.57; 95% CI: 1.34-1.83; P<0.0001, but not subclinical hypothyroidism (HRsubclinical 1.03; 95% CI: 0.97-1.09; P = 0.4 were associated with increased mortality. CONCLUSIONS AND RELEVANCE: In a large-scale, population-based cohort with long-term follow-up (median 7.4 years, overt and subclinical hyperthyroidism and overt but not subclinical hypothyroidism were associated with increased

  3. Effects of habitual coffee consumption on cardiometabolic disease, cardiovascular health, and all-cause mortality.

    Science.gov (United States)

    O'Keefe, James H; Bhatti, Salman K; Patil, Harshal R; DiNicolantonio, James J; Lucan, Sean C; Lavie, Carl J

    2013-09-17

    Coffee, after water, is the most widely consumed beverage in the United States, and is the principal source of caffeine intake among adults. The biological effects of coffee may be substantial and are not limited to the actions of caffeine. Coffee is a complex beverage containing hundreds of biologically active compounds, and the health effects of chronic coffee intake are wide ranging. From a cardiovascular (CV) standpoint, coffee consumption may reduce the risk of type 2 diabetes mellitus and hypertension, as well as other conditions associated with CV risk such as obesity and depression; but it may adversely affect lipid profiles depending on how the beverage is prepared. Regardless, a growing body of data suggests that habitual coffee consumption is neutral to beneficial regarding the risks of a variety of adverse CV outcomes including coronary heart disease, congestive heart failure, arrhythmias, and stroke. Moreover, large epidemiological studies suggest that regular coffee drinkers have reduced risks of mortality, both CV and all-cause. The potential benefits also include protection against neurodegenerative diseases, improved asthma control, and lower risk of select gastrointestinal diseases. A daily intake of ∼2 to 3 cups of coffee appears to be safe and is associated with neutral to beneficial effects for most of the studied health outcomes. However, most of the data on coffee's health effects are based on observational data, with very few randomized, controlled studies, and association does not prove causation. Additionally, the possible advantages of regular coffee consumption have to be weighed against potential risks (which are mostly related to its high caffeine content) including anxiety, insomnia, tremulousness, and palpitations, as well as bone loss and possibly increased risk of fractures.

  4. All-cause and cause-specific mortality among US youth: socioeconomic and rural-urban disparities and international patterns.

    Science.gov (United States)

    Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad; Kogan, Michael D

    2013-06-01

    We analyzed international patterns and socioeconomic and rural-urban disparities in all-cause mortality and mortality from homicide, suicide, unintentional injuries, and HIV/AIDS among US youth aged 15-24 years. A county-level socioeconomic deprivation index and rural-urban continuum measure were linked to the 1999-2007 US mortality data. Mortality rates were calculated for each socioeconomic and rural-urban group. Poisson regression was used to derive adjusted relative risks of youth mortality by deprivation level and rural-urban residence. The USA has the highest youth homicide rate and 6th highest overall youth mortality rate in the industrialized world. Substantial socioeconomic and rural-urban gradients in youth mortality were observed within the USA. Compared to their most affluent counterparts, youth in the most deprived group had 1.9 times higher all-cause mortality, 8.0 times higher homicide mortality, 1.5 times higher unintentional-injury mortality, and 8.8 times higher HIV/AIDS mortality. Youth in rural areas had significantly higher mortality rates than their urban counterparts regardless of deprivation levels, with suicide and unintentional-injury mortality risks being 1.8 and 2.3 times larger in rural than in urban areas. However, youth in the most urbanized areas had at least 5.6 times higher risks of homicide and HIV/AIDS mortality than their rural counterparts. Disparities in mortality differed by race and sex. Socioeconomic deprivation and rural-urban continuum were independently related to disparities in youth mortality among all sex and racial/ethnic groups, although the impact of deprivation was considerably greater. The USA ranks poorly in all-cause mortality, youth homicide, and unintentional-injury mortality rates when compared with other industrialized countries.

  5. Capture-recapture analysis of all-cause mortality data in Bohol, Philippines

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    Sanvictores Diozele

    2011-04-01

    Full Text Available Abstract Background Despite the importance of mortality data for effective planning and monitoring of health services, official reporting systems rarely capture every death. The completeness of death reporting and the subsequent effect on mortality estimates were examined in six municipalities of Bohol province in the Philippines using a system review and capture-recapture analysis. Methods Reports of deaths were collected from records at local civil registration offices, health centers and hospitals, and parish churches. Records were reconciled using a specific set of matching criteria, and both a two-source and a three-source capture-recapture analysis was conducted. For the two-source analysis, civil registry and health data were combined due to dependence between these sources and analyzed against the church data. Results Significant dependence between civil registration and health reporting systems was identified. There were 8,075 unique deaths recorded in the study area between 2002 and 2007. We found 5% to 10% of all deaths were not reported to any source, while government records captured only 77% of all deaths. Life expectancy at birth (averaged for 2002-2007 was estimated at 65.7 years and 73.0 years for males and females, respectively. This was one to two years lower than life expectancy estimated from reconciled reported deaths from all sources, and four to five years lower than life expectancy estimated from civil registration data alone. Reporting patterns varied by age and municipality, with childhood deaths more underreported than adult deaths. Infant mortality was underreported in civil registration data by 62%. Conclusions Deaths are underreported in Bohol, with inconsistent reporting procedures contributing to this situation. Uncorrected mortality measures would subsequently be misleading if used for health planning and evaluation purposes. These findings highlight the importance of ensuring that official mortality estimates

  6. Association between Six Minute Walk Test and All-Cause Mortality, Coronary Heart Disease-Specific Mortality, and Incident Coronary Heart Disease

    Science.gov (United States)

    Yazdanyar, Ali; Aziz, Michael M; Enright, Paul L; Edmundowicz, Daniel; Boudreau, Robert; Sutton-Tyrell, Kim; Kuller, Lewis; Newman, Anne B

    2015-01-01

    Objectives To examine the association between six-minute walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. Methods We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants with a 6 MWT and without prevalent cardiovascular disease. Results During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, 504 deaths of which 100 were coronary heart disease-related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 meters: HR 1.7; 95% CI, 1.2-2.5; <290 meters: HR 2.1; 95% CI, 1.4-3.0). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT <290 meters was not significant. Discussion Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults. PMID:24695552

  7. Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population

    Science.gov (United States)

    Gand, Elise; Ragot, Stéphanie; Bankir, Lise; Piguel, Xavier; Fumeron, Frédéric; Halimi, Jean-Michel; Marechaud, Richard; Roussel, Ronan; Hadjadj, Samy; Study group, SURDIAGENE

    2017-01-01

    Objective. Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa). We examined the association of UNa with mortality in a cohort of type 2 diabetes (T2D) patients. Methods. Patients were followed for all-cause death and cardiovascular death. Baseline UNa was measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition of UNa to a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI) index. Results. Participants (n = 1,439) were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded. UNa independently predicted all-cause and cardiovascular mortality. An increase of one standard deviation of UNa was associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality. UNa improved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%, P = 0.04 and rIDI = 4.6%, P = 0.02, resp.). Conclusions. In T2D, UNa was an independent predictor of mortality (low concentration is associated with increased risk) and improved modestly its prediction in addition to traditional risk factors. PMID:28255559

  8. Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population

    Directory of Open Access Journals (Sweden)

    Pierre-Jean Saulnier

    2017-01-01

    Full Text Available Objective. Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa. We examined the association of UNa with mortality in a cohort of type 2 diabetes (T2D patients. Methods. Patients were followed for all-cause death and cardiovascular death. Baseline UNa was measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition of UNa to a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI index. Results. Participants (n=1,439 were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded. UNa independently predicted all-cause and cardiovascular mortality. An increase of one standard deviation of UNa was associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality. UNa improved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%, P=0.04 and rIDI = 4.6%, P=0.02, resp.. Conclusions. In T2D, UNa was an independent predictor of mortality (low concentration is associated with increased risk and improved modestly its prediction in addition to traditional risk factors.

  9. Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study

    NARCIS (Netherlands)

    Streppel, M.T.; Ocke, M.C.; Boshuizen, H.C.; Kok, F.J.; Kromhout, D.

    2008-01-01

    Background: Little is known about the effects of dietary fiber intake on long-term mortality. Objective: We aimed to study recent and long-term dietary fiber intake in relation to coronary heart disease and all-cause mortality. Design: The effects of recent and long-term dietary fiber intakes on mor

  10. Estimating the Time-Varying Joint Effects of Obesity and Smoking on All-Cause Mortality Using Marginal Structural Models.

    Science.gov (United States)

    Banack, Hailey R; Kaufman, Jay S

    2016-01-15

    Obesity and smoking are independently associated with a higher mortality risk, but previous studies have reported conflicting results about the relationship between these 2 time-varying exposures. Using prospective longitudinal data (1987-2007) from the Atherosclerosis Risk in Communities Study, our objective in the present study was to estimate the joint effects of obesity and smoking on all-cause mortality and investigate whether there were additive or multiplicative interactions. We fit a joint marginal structural Poisson model to account for time-varying confounding affected by prior exposure to obesity and smoking. The incidence rate ratios from the joint model were 2.00 (95% confidence interval (CI): 1.79, 2.24) for the effect of smoking on mortality among nonobese persons, 1.31 (95% CI: 1.13, 1.51) for the effect of obesity on mortality among nonsmokers, and 1.97 (95% CI: 1.73, 2.22) for the joint effect of smoking and obesity on mortality. The negative product term from the exponential model revealed a submultiplicative interaction between obesity and smoking (β = -0.28, 95% CI: -0.45, -0.11; P obesity.

  11. The relation of ambulatory heart rate with all-cause mortality among middle-aged men: a prospective cohort study.

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    Mette Korshøj

    Full Text Available The aim of this study was to investigate the association between average 24-hour ambulatory heart rate and all-cause mortality, while adjusting for resting clinical heart rate, cardiorespiratory fitness, occupational and leisure time physical activity as well as classical risk factors. A group of 439 middle-aged male workers free of baseline coronary heart disease from the Belgian Physical Fitness Study was included in the analysis. Data were collected by questionnaires and clinical examinations from 1976 to 1978. All-cause mortality was collected from the national mortality registration with a mean follow-up period of 16.5 years, with a total of 48 events. After adjustment for all before mentioned confounders in a Cox proportional hazards regression analysis, a significant increased risk for all-cause mortality was found among the tertile of workers with highest average ambulatory heart rate compared to the tertile with lowest ambulatory heart rate (Hazard ratio = 3.21, 95% confidence interval: 1.22-8.44. No significant independent association was found between resting clinic heart rate and all-cause mortality. The study indicates that average 24-hour ambulatory heart rate is a strong predictor of all-cause mortality independent from resting clinic heart rate, cardiorespiratory fitness, occupational and leisure time physical activity and other classical risk factors among healthy middle-aged workers.

  12. Spending on vegetable and fruit consumption could reduce all-cause mortality among older adults

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    Lo Yuan-Ting

    2012-12-01

    Full Text Available Abstract Background Few studies have evaluated the linkage between food cost and mortality among older adults. This study considers the hypothesis that greater food expenditure in general, and particularly on more nutritious plant and animal-derived foods, decreases mortality in older adults. Methods This study uses the 1999–2000 Elderly Nutrition and Health Survey in Taiwan and follows the cohort until 2008, collecting 24-hr dietary recall data for 1781 participants (874 men and 907 women aged 65 y or older. Using monthly mean national food prices and 24-hr recall, this study presents an estimate of daily expenditures for vegetable, fruit, animal-derived, and grain food categories. Participants were linked to the national death registry. Results Of the 1781 original participants, 625 died during the 10-y follow-up period. Among the 4 food categories, the fourth and fifth expenditure quintiles for vegetables and for fruits had the highest survival rates. After adjusting for co-variates, higher (Q4 vegetable and higher fruit (Q4 food expenditures referent to Q1 were significantly predictive of reduced mortality (HR = 0.55, 95% CI: 0.39-0.78 and HR = 0.64, 95% CI: 0.42–0.99, respectively and the risk decreased by 12% and 10% for every NT$15 (US$0.50 increase in their daily expenditures. Animal-derived and grain food spending was not predictive of mortality. Conclusion Greater and more achievable vegetable and fruit affordability may improve food security and longevity for older adults.

  13. The number of years lived with obesity and the risk of all-cause and cause-specific mortality

    DEFF Research Database (Denmark)

    Abdullah, Asnawi; Wolfe, Rory; Stoelwinder, Johannes U;

    2011-01-01

    ) of the Framingham Cohort Study were followed up every 2 years from 1948 for up to 48 years. The association between obesity duration and all-cause and cause-specific mortality was analysed using time-dependent Cox models adjusted for body mass index. The role of biological intermediates and chronic diseases...... with the risk of mortality. This needs to be taken into account when estimating its burden on mortality....

  14. Chronic kidney disease: an independent risk factor of all-cause mortality for elderly Chinese patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Shi-Hui Fu; Ping Ye; Lei-Ming Luo; Bing Zhu; Yu-Xiao Zhang; Shuang-Yan Yi; Yuan Liu; Tie-Hui Xiao; Liang Wang; Yong-Yi Bai; Cai-Yi Lu

    2012-01-01

    Objective To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF). Methods The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality. Results The median age of the entire cohort was 85 years (60-100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9%(67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004-1.064], CKD (HR: 1.705; 95% CI: 1.132-2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI:1.284-2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036-2.777), elevated resting heart rate (HR: 1.021; 95% CI:1.009-1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843-0.925) were independent risk factors of mortality for elderly patients with CHF. Conclusions CKD was an independent risk factor of mortality for elderly Chinese patients with CHF.

  15. Sexual Orientation and All-Cause Mortality Among US Adults Aged 18 to 59 Years, 2001-2011.

    Science.gov (United States)

    Cochran, Susan D; Björkenstam, Charlotte; Mays, Vickie M

    2016-05-01

    To determine whether sexual minorities have an earlier mortality than do heterosexuals, we investigated associations between sexual orientation assessed in the 2001 to 2010 National Health and Nutrition Examination Surveys (NHANES) and mortality in the 2011 NHANES-linked mortality file. Mortality follow-up time averaged 69.6 months after NHANES. By 2011, 338 individuals had died. Sexual minorities evidenced greater all-cause mortality than did heterosexuals after adjusting for demographic confounding. These effects generally disappeared with further adjustment for NHANES-detected health and behavioral differences.

  16. Relationship between Body Mass Index Reference and All-Cause Mortality: Evidence from a Large Cohort of Thai Adults

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    Vasoontara Yiengprugsawan

    2014-01-01

    Full Text Available We investigate variation in body mass index (BMI reference and 5-year all-cause mortality using data from 87151 adult Open University students nationwide. Analyses focused on BMI reference bands: “normal” (≥18.5 to <23, “lower normal” (≥18.5 to <20.75, “upper normal” (≥20.75 to <23, and “narrow Western normal” (≥23 to <25. We report hazard ratios (HR and 95% Confidence Intervals adjusting for covariates. Compared to lower normal, adults aged 35–65 years who were obese (BMI ≥ 30 were twice as likely to die during the follow-up (HR 2.37; 1.01–5.70. For the same group, when using narrow Western normal as the reference, the results were similar (HR 3.02; 1.26–7.22. However, different combinations of BMI exposure and reference band produce quite different results. Older age persons belonging to Asian overweight BMI category (≥23 to <25 were relatively protected from mortality (HR 0.57; 0.34–0.96 and HR 0.49; 0.28–0.84 when assessed using normal (≥18.5 to <23 and upper normal (≥20.75 to <23 as reference bands. Use of different “normal” reference produced varying mortality relationships in a large cohort of Thai adults. Caution is needed when interpreting BMI-mortality data.

  17. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term.

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    Chun Sen Wu

    Full Text Available Term birth is a gestational age from 259 days to 293 days. However trends in mortality according to gestational ages in days have not yet been described in this time period.Based on nation-wide registries, we conducted a population-based cohort study among all children born at term in Denmark from 1997 to 2004 to estimate differences in mortality across gestational ages in days among singletons born at term. We studied early-neonatal mortality, neonatal mortality, infant mortality, and five-year mortality. Children were followed from birth up to the last day of the defined mortality period or December 31, 2009. A total of 360,375 singletons born between 259 and 293 days of gestation were included in the study. Mortality decreased with increasing gestational age in days and the highest mortality was observed among children born at 37 week of gestation. A similar pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications.This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which call for cautions when inducing labor in term pregnancies just reaching 37 weeks of gestation. The findings support that 37 weeks of gestation should be defined as early term.

  18. Prospective associations between household-, work-, and leisure-based physical activity and all-cause mortality among older Taiwanese adults.

    Science.gov (United States)

    Chen, Li-Jung; Fox, Kenneth R; Ku, Po-Wen; Sun, Wen-Jung; Chou, Pesus

    2012-09-01

    Most studies on the health effects of leisure time physical activity have focused on mortality. There has been limited research regarding physical activity undertaken at work or around the home and mortality. This study assessed the associations between leisure, work, and household physical activity and subsequent all-cause mortality among older adults aged 65 years and older (n = 2133) in Taiwan, over 8 years. Physical activity was evaluated with the Physical Activity Scale for the Elderly. Cox proportional hazard models were used to estimate the association of physical activity with the risk of mortality. This study demonstrated that a low level of total physical activity is predictive of increased all-cause mortality in both men and women in an East Asian population. It also indicates that leisure- and household-related but not work-related activity are significant contributors to this relationship.

  19. Dietary patterns, biomarkers of atherosclerosis, cardiovascular and all-cause mortality

    NARCIS (Netherlands)

    Sijtsma, F.P.C.

    2015-01-01

    Summary belonging to the thesis entitled ‘Dietary patterns, biomarkers of atherosclerosis, cardiovascular and all-cause mortality’ The long history of epidemiologic studies on diet and cardiovascular disease (CVD) has traditionally relied on analysis of specific nutrient

  20. Predictive Value of Carotid Distensibility Coefficient for Cardiovascular Diseases and All-Cause Mortality: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Chuang Yuan

    Full Text Available The aim of the present study is to determine the pooled predictive value of carotid distensibility coefficient (DC for cardiovascular (CV diseases and all-cause mortality.Arterial stiffness is associated with future CV events. Aortic pulse wave velocity is a commonly used predictor for CV diseases and all-cause mortality; however, its assessment requires specific devices and is not always applicable in all patients. In addition to the aortic artery, the carotid artery is also susceptible to atherosclerosis, and is highly accessible because of the surficial property. Thus, carotid DC, which indicates the intrinsic local stiffness of the carotid artery and may be determined using ultrasound and magnetic resonance imaging, is of interest for the prediction. However, the role of carotid DC in the prediction of CV diseases and all-cause mortality has not been thoroughly characterized, and the pooled predictive value of carotid DC remains unclear.A meta-analysis, which included 11 longitudinal studies with 20361 subjects, was performed.Carotid DC significantly predicted future total CV events, CV mortality and all-cause mortality. The pooled risk ratios (RRs of CV events, CV mortality and all-cause mortality were 1.19 (1.06-1.35, 95%CI, 9 studies with 18993 subjects, 1.09 (1.01-1.18, 95%CI, 2 studies with 2550 subjects and 1.65 (1.15-2.37, 95%CI, 6 studies with 3619 subjects, respectively, for the subjects who had the lowest quartile of DC compared with their counterparts who had higher quartiles. For CV events, CV mortality and all-cause mortality, a decrease in DC of 1 SD increased the risk by 13%, 6% and 41% respectively, whereas a decrease in DC of 1 unit increased the risk by 3%, 1% and 6% respectively.Carotid DC is a significant predictor of future CV diseases and all-cause mortality, which may facilitate the identification of high-risk patients for the early diagnosis and prompt treatment of CV diseases.

  1. Elevated resting heart rate, physical fitness and all-cause mortality

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Suadicani, Poul; Hein, Hans Ole

    2013-01-01

    To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max).......To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max)....

  2. Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Holmgaard, Dennis Back; Mygind, Lone H; Titlestad, Ingrid L

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is hallmarked by inflammatory processes and a progressive decline of lung function. YKL-40 is a potential biomarker of inflammation and mortality in patients suffering from inflammatory lung disease, but its prognostic value in patients with COPD remains...... unknown. We investigated whether high plasma YKL-40 was associated with increased mortality in patients with moderate to very severe COPD....

  3. Impact of body composition changes on risk of all-cause mortality in older adults

    DEFF Research Database (Denmark)

    Graf, Christophe E; Herrmann, François R; Spoerri, Adrian

    2016-01-01

    PURPOSE: This study evaluates the relationship between body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) changes and mortality in persons ≥65 years. METHODS: Adults ≥65 years with at least two body composition measurements (BCM) between 1990 and 2011 were included. We......: FFMI loss is related to increased mortality in older persons....

  4. Traffic air pollution and mortality from cardiovascular disease and all causes

    DEFF Research Database (Denmark)

    Raaschou-Nielsen, Ole; Andersen, Zorana Jovanovic; Jensen, Steen Solvang;

    2012-01-01

    Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association.......Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association....

  5. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term

    DEFF Research Database (Denmark)

    Wu, Chunsen; Sun, Yuelian; Nohr, Ellen Aagaard

    2015-01-01

    pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications. CONCLUSIONS: This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which...... of the defined mortality period or December 31, 2009. A total of 360,375 singletons born between 259 and 293 days of gestation were included in the study. Mortality decreased with increasing gestational age in days and the highest mortality was observed among children born at 37 week of gestation. A similar...... call for cautions when inducing labor in term pregnancies just reaching 37 weeks of gestation. The findings support that 37 weeks of gestation should be defined as early term....

  6. Apple intake is inversely associated with all-cause and disease-specific mortality in elderly women.

    Science.gov (United States)

    Hodgson, Jonathan M; Prince, Richard L; Woodman, Richard J; Bondonno, Catherine P; Ivey, Kerry L; Bondonno, Nicola; Rimm, Eric B; Ward, Natalie C; Croft, Kevin D; Lewis, Joshua R

    2016-03-14

    Higher fruit intake is associated with lower risk of all-cause and disease-specific mortality. However, data on individual fruits are limited, and the generalisability of these findings to the elderly remains uncertain. The objective of this study was to examine the association of apple intake with all-cause and disease-specific mortality over 15 years in a cohort of women aged over 70 years. Secondary analyses explored relationships of other fruits with mortality outcomes. Usual fruit intake was assessed in 1456 women using a FFQ. Incidence of all-cause and disease-specific mortality over 15 years was determined through the Western Australian Hospital Morbidity Data system. Cox regression was used to determine the hazard ratios (HR) for mortality. During 15 years of follow-up, 607 (41·7%) women died from any cause. In the multivariable-adjusted analysis, the HR for all-cause mortality was 0·89 (95% CI 0·81, 0·97) per sd (53 g/d) increase in apple intake, HR 0·80 (95% CI 0·65, 0·98) for consumption of 5-100 g/d and HR 0·65 (95% CI 0·48, 0·89) for consumption of >100 g/d (an apple a day), compared with apple intake of apple intake was associated with lower risk for cancer mortality, and that higher total fruit and banana intakes were associated lower risk of CVD mortality (Papple consumption may contribute to lower risk of mortality.

  7. All-cause and Cardiovascular mortality among ethnic German immigrants from the Former Soviet Union: a cohort study

    Directory of Open Access Journals (Sweden)

    Becher Heiko

    2006-01-01

    Full Text Available Abstract Background Migration is a phenomenon of particular Public Health importance. Since 1990, almost 2 million ethnic Germans (Aussiedler have migrated from the former Soviet Union (FSU to Germany. This study compares their overall and cardiovascular disease (CVD mortality to that of Germany's general population. Because of high overall and CVD mortality in the FSU and low socio-economic status of Aussiedler in Germany, we hypothesize that their mortality is higher. Methods We conducted a retrospective cohort study for 1990–2002 with data of 34,393 Aussiedler. We assessed vital status at population registries and causes of death at the state statistical office. We calculated standardized mortality ratios (SMRs for the whole cohort and substrata of covariables such as age, sex and family size. To assess multivariate effects, we used Poisson regression. Results 1657 cohort members died before December 31, 2002, and 680 deaths (41.03% were due to CVD. The SMR for the whole cohort was 0.85 (95%-CI 0.81–0.89 for all causes of death and 0.79 (95%-CI 0.73–0.85 for CVD. SMRs were higher than one for younger Aussiedler and lower for older ones. There was no clear effect of duration of stay on SMRs. For 1990–93, SMRs were significantly lower than in subsequent years. In families comprising at least five members upon arrival in Germany, SMRs were significantly lower than in smaller families. Conclusion In contrast to our hypothesis on migrants' health, overall and CVD mortality among Aussiedler is lower than in Germany's general population. Possible explanations are a substantially better health status of Aussiedler in the FSU as compared to the local average, a higher perceived socio-economic status of Aussiedler in Germany, or selection effects. SMR differences between substrata need further exploration, and risk factor data are needed.

  8. All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study.

    Directory of Open Access Journals (Sweden)

    Gillian A Hawker

    Full Text Available BACKGROUND: Because individuals with osteoarthritis (OA avoid physical activities that exacerbate symptoms, potentially increasing risk for cardiovascular disease (CVD and death, we assessed the relationship between OA disability and these outcomes. METHODS: In a population cohort aged 55+ years with at least moderately severe symptomatic hip and/or knee OA, OA disability (Western Ontario McMaster Universities (WOMAC OA scores; Health Assessment Questionnaire (HAQ walking score; use of walking aids and other covariates were assessed by questionnaire. Survey data were linked to health administrative data to determine the relationship between baseline OA symptom severity to all-cause mortality and occurrence of a composite CVD outcome (acute myocardial infarction, coronary revascularization, heart failure, stroke or transient ischemic attack over a median follow-up of 13.2 and 9.2 years, respectively. RESULTS: Of 2156 participants, 1,236 (57.3% died and 822 (38.1% experienced a CVD outcome during follow-up. Higher (worse baseline WOMAC function scores and walking disability were independently associated with a higher all-cause mortality (adjusted hazard ratio, aHR, per 10-point increase in WOMAC function score 1.04, 95% confidence interval, CI 1.01-1.07, p = 0.004; aHR per unit increase in HAQ walking score 1.30, 95% CI 1.22-1.39, p<0.001; and aHR for those using versus not using a walking aid 1.51, 95% CI 1.34-1.70, p<0.001. In survival analysis, censoring on death, risk of our composite CVD outcome was also significantly and independently associated with greater baseline walking disability ((aHR for use of a walking aid = 1.27, 95% CI 1.10-1.47, p = 0.001; aHR per unit increase in HAQ walking score = 1.17, 95% CI 1.08-1.27, p<0.001. CONCLUSIONS: Among individuals with hip and/or knee OA, severity of OA disability was associated with a significant increase in all-cause mortality and serious CVD events after controlling for multiple confounders

  9. Global Longitudinal Strain Is a Superior Predictor of All-Cause Mortality in Heart Failure With Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Sengeløv, Morten; Jørgensen, Peter Godsk; Jensen, Jan Skov;

    2015-01-01

    OBJECTIVES: The purpose of this study was to investigate the prognostic value of global longitudinal strain (GLS) in heart failure with reduced ejection fraction (HFrEF) patients in relation to all-cause mortality. BACKGROUND: Measurement of myocardial deformation by 2-dimensional speckle tracking...

  10. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pelle, Aline J; Smith, Otto R F

    2009-01-01

    Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF....

  11. Relation of Periodontitis to Risk of Cardiovascular and All-Cause Mortality (from a Danish Nationwide Cohort Study)

    DEFF Research Database (Denmark)

    Hansen, Gorm Mørk; Egeberg, Alexander; Holmstrup, Palle

    2016-01-01

    Periodontitis and atherosclerosis are highly prevalent chronic inflammatory diseases, and it has been suggested that periodontitis is an independent risk factor of cardiovascular disease (CVD) and that a causal link may exist between the 2 diseases. Using Danish national registers, we identified...... a nationwide cohort of 17,691 patients who received a hospital diagnosis of periodontitis within a 15-year period and matched them with 83,003 controls from the general population. We performed Poisson regression analysis to determine crude and adjusted incidence rate ratios of myocardial infarction, ischemic...... stroke, cardiovascular death, major adverse cardiovascular events, and all-cause mortality. The results showed that patients with periodontitis were at higher risk of all examined end points. The findings remained significant after adjustment for increased baseline co-morbidity in periodontitis patients...

  12. Changes in physical activity and all-cause mortality in COPD.

    Science.gov (United States)

    Vaes, Anouk W; Garcia-Aymerich, Judith; Marott, Jacob L; Benet, Marta; Groenen, Miriam T J; Schnohr, Peter; Franssen, Frits M E; Vestbo, Jørgen; Wouters, Emiel F M; Lange, Peter; Spruit, Martijn A

    2014-11-01

    Little is known about changes in physical activity in subjects with chronic obstructive pulmonary disease (COPD) and its impact on mortality. Therefore, we aimed to study changes in physical activity in subjects with and without COPD and the impact of physical activity on mortality risk. Subjects from the Copenhagen City Heart Study with at least two consecutive examinations were selected. Each examination included a self-administered questionnaire and clinical examination. 1270 COPD subjects and 8734 subjects without COPD (forced expiratory volume in 1 s 67±18 and 91±15% predicted, respectively) were included. COPD subjects with moderate or high baseline physical activity who reported low physical activity level at follow-up had the highest hazard ratios of mortality (1.73 and 2.35, respectively; both pphysical activity, no differences were found in survival between unchanged or increased physical activity at follow-up. In addition, subjects without COPD with low physical activity at follow-up had the highest hazard ratio of mortality, irrespective of baseline physical activity level (p≤0.05). A decline to low physical activity at follow-up was associated with an increased mortality risk in subjects with and without COPD. These observational data suggest that it is important to assess and encourage physical activity in the earliest stages of COPD in order to maintain a physical activity level that is as high as possible, as this is associated with better prognosis.

  13. Educational level as a contextual and proximate determinant of all cause mortality in Danish adults

    DEFF Research Database (Denmark)

    Osler, M; Prescott, E

    2003-01-01

    , exercise, alcohol use, and body mass index) and contextual factors (local area unemployment, income share, and household composition) were included in the Cox model. CONCLUSION: In this study the educational level of an area influenced subject's mortality, but first after adjustment for behavioural......): 0.87 (95% CI 0.77 to 0.98) and individual level (HR: 0.76 (95% CI 0.64 to 0.88) were inversely associated with mortality, when comparing the higest educated groups with the least educated. However, at parish level the effect was only present, when information on subject's income, behaviour (smoking...

  14. Serum Calcification Propensity Predicts All-Cause Mortality in Predialysis CKD

    Science.gov (United States)

    Ford, Martin L.; Tomlinson, Laurie A.; Bodenham, Emma; McMahon, Lawrence P.; Farese, Stefan; Rajkumar, Chakravarthi; Holt, Stephen G.; Pasch, Andreas

    2014-01-01

    Medial arterial calcification is accelerated in patients with CKD and strongly associated with increased arterial rigidity and cardiovascular mortality. Recently, a novel in vitro blood test that provides an overall measure of calcification propensity by monitoring the maturation time (T50) of calciprotein particles in serum was described. We used this test to measure serum T50 in a prospective cohort of 184 patients with stages 3 and 4 CKD, with a median of 5.3 years of follow-up. At baseline, the major determinants of serum calcification propensity included higher serum phosphate, ionized calcium, increased bone osteoclastic activity, and lower free fetuin-A, plasma pyrophosphate, and albumin concentrations, which accounted for 49% of the variation in this parameter. Increased serum calcification propensity at baseline independently associated with aortic pulse wave velocity in the complete cohort and progressive aortic stiffening over 30 months in a subgroup of 93 patients. After adjustment for demographic, renal, cardiovascular, and biochemical covariates, including serum phosphate, risk of death among patients in the lowest T50 tertile was more than two times the risk among patients in the highest T50 tertile (adjusted hazard ratio, 2.2; 95% confidence interval, 1.1 to 5.4; P=0.04). This effect was lost, however, after additional adjustment for aortic stiffness, suggesting a shared causal pathway. Longitudinally, serum calcification propensity measurements remained temporally stable (intraclass correlation=0.81). These results suggest that serum T50 may be helpful as a biomarker in designing methods to improve defenses against vascular calcification. PMID:24179171

  15. Meta-analysis : High-dosage vitamin E supplementation may increase all-cause mortality

    NARCIS (Netherlands)

    Miller, ER; Pastor-Barriuso, R; Dalal, D; Riemersma, RA; Appel, LJ; Guallar, E

    2005-01-01

    Background: Experimental models and observational studies suggest that vitamin E supplementation may prevent cardiovascular disease and cancer. However, several trials of high-dosage vitamin E supplementation showed non-statistically significant increases in total mortality. Purpose: To perform a me

  16. Telomere length predicts all-cause mortality in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Astrup, A S; Tarnow, L; Jorsal, Anders;

    2010-01-01

    Type 1 diabetic patients with diabetic nephropathy have increased mortality and morbidity compared with normoalbuminuric patients. Telomere length in proliferative cells is inversely related to the total number of cell divisions, and therefore to biological age. We aimed to evaluate differences...... in telomere length in patients with type 1 diabetes with or without diabetic nephropathy; we also evaluated the prognostic value of telomere length....

  17. The effect of atmospheric thermal conditions and urban thermal pollution on all-cause and cardiovascular mortality in Bangladesh

    Energy Technology Data Exchange (ETDEWEB)

    Burkart, Katrin, E-mail: katrin.burkart@geo.hu-berlin.de [Humboldt-Universitaet zu Berlin, Geography Department, Climatological Section, Unter den Linden 6, 10099 Berlin (Germany); Schneider, Alexandra; Breitner, Susanne [Helmholtz Zentrum Muenchen, Institute of Epidemiology (Germany); Khan, Mobarak Hossain; Kraemer, Alexander [Universitaet Bielefeld, School of Public Health (Germany); Endlicher, Wilfried [Humboldt-Universitaet zu Berlin, Geography Department, Climatological Section, Unter den Linden 6, 10099 Berlin (Germany)

    2011-08-15

    This study assessed the effect of temperature and thermal atmospheric conditions on all-cause and cardiovascular mortality in Bangladesh. In particular, differences in the response to elevated temperatures between urban and rural areas were investigated. Generalized additive models (GAMs) for daily death counts, adjusted for trend, season, day of the month and age were separately fitted for urban and rural areas. Breakpoint models were applied for determining the increase in mortality above and below a threshold (equivalent) temperature. Generally, a 'V'-shaped (equivalent) temperature-mortality curve with increasing mortality at low and high temperatures was observed. Particularly, urban areas suffered from heat-related mortality with a steep increase above a specific threshold. This adverse heat effect may well increase with ongoing urbanization and the intensification of the urban heat island due to the densification of building structures. Moreover, rising temperatures due to climate change could aggravate thermal stress. - Highlights: > Temperature exhibits a strong influence on mortality in Bangladesh. > Mortality increases at low and high end of the temperature range. > Temperature is increased in the urban area of Dhaka, particular during summer. > Urban areas are facing increased risk of heat-related mortality. > Urbanization and climate change are likely to increase heat-related mortality. - Mortality in Bangladesh is strongly affected by thermal atmospheric conditions with particularly urban areas facing excess mortality above a specific threshold temperature.

  18. Oral health in relation to all-cause mortality: the IPC cohort study

    Science.gov (United States)

    Adolph, Margaux; Darnaud, Christelle; Thomas, Frédérique; Pannier, Bruno; Danchin, Nicolas; Batty, G. David; Bouchard, Philippe

    2017-01-01

    We evaluated the association between oral health and mortality. The study population comprised 76,188 subjects aged 16–89 years at recruitment. The mean follow-up time was 3.4 ± 2.4 years. Subjects with a personal medical history of cancer or cardiovascular disease and death by casualty were excluded from the analysis. A full-mouth clinical examination was performed in order to assess dental plaque, dental calculus and gingival inflammation. The number of teeth and functional masticatory units 10 missing teeth and functional masticatory units 10 missing teeth (HR = 2.31, [95% CI: 1.40–3.82]) and functional masticatory units oral health and mortality. PMID:28294149

  19. Physical activity and risk of all-cause and cardiovascular disease mortality in diabetic adults from Great Britain: pooled analysis of 10 population-based cohorts.

    Science.gov (United States)

    Sadarangani, Kabir P; Hamer, Mark; Mindell, Jenny S; Coombs, Ngaire A; Stamatakis, Emmanuel

    2014-04-01

    OBJECTIVE To examine associations between specific types of physical activity and all-cause and cardiovascular disease (CVD) mortality in a large nationally representative sample of adults with diabetes from Great Britain. RESEARCH DESIGN AND METHODS There were a total of 3,038 participants (675 deaths) with diabetes in the Health Survey for England and the Scottish Health Surveys conducted between 1997 and 2008. Participants aged ≥50 years at baseline were followed up for an average of 75.2 months for all-cause and CVD mortality. Data were collected on self-reported frequency, duration, and intensity of participation in sports and exercise, walking, and domestic physical activity, from which the number of MET-hours/week were derived. Sex-specific medians of time spent in each type of physical activity (for those physically active) were calculated, and Cox proportional hazards regression conducted to examine type-specific associations between the level of physical activity and all-cause and CVD mortality risk. RESULTS Inverse associations with all-cause and CVD mortality were observed for overall physical activity in a dose-response manner after adjusting for covariates. Compared with those who individuals were inactive, participants who reported some activity, but below the recommended amount, or who met the physical activity recommendations had a 26% (95% CI 39-11) and 35% (95% CI 47-21) lower all-cause mortality, respectively. Similar results were found for below/above median physical activity levels. Sports and exercise participation was inversely associated with all-cause (but not CVD) mortality, as were above average levels of walking. Domestic physical activity was not associated with mortality. CONCLUSIONS Moderate physical activity levels were associated with better prognosis in diabetic adults.

  20. The effect of atmospheric thermal conditions and urban thermal pollution on all-cause and cardiovascular mortality in Bangladesh.

    Science.gov (United States)

    Burkart, Katrin; Schneider, Alexandra; Breitner, Susanne; Khan, Mobarak Hossain; Krämer, Alexander; Endlicher, Wilfried

    2011-01-01

    This study assessed the effect of temperature and thermal atmospheric conditions on all-cause and cardiovascular mortality in Bangladesh. In particular, differences in the response to elevated temperatures between urban and rural areas were investigated. Generalized additive models (GAMs) for daily death counts, adjusted for trend, season, day of the month and age were separately fitted for urban and rural areas. Breakpoint models were applied for determining the increase in mortality above and below a threshold (equivalent) temperature. Generally, a 'V'-shaped (equivalent) temperature-mortality curve with increasing mortality at low and high temperatures was observed. Particularly, urban areas suffered from heat-related mortality with a steep increase above a specific threshold. This adverse heat effect may well increase with ongoing urbanization and the intensification of the urban heat island due to the densification of building structures. Moreover, rising temperatures due to climate change could aggravate thermal stress.

  1. Is type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients?

    Science.gov (United States)

    Condén, Emelie; Rosenblad, Andreas; Wagner, Philippe; Leppert, Jerzy; Ekselius, Lisa; Åslund, Cecilia

    2017-03-01

    Background Type D personality refers to a combination of simultaneously high levels of negative affectivity and social inhibition. The present study aimed to examine whether type D personality was independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality. Design This was a prospective cohort study. Methods Utilising data from the Västmanland Myocardial Infarction Study, 946 post-acute myocardial infarction patients having data on the DS14 instrument used to measure type D personality were followed-up for recurrent myocardial infarction and all-cause mortality until 9 December 2015. Data were analysed using Cox regression, adjusted for established risk factors. Results In total, 133 (14.1%) patients suffered from type D personality. During a mean follow-up time for recurrent myocardial infarction of 5.7 (3.2) years, 166 (17.5%) patients were affected by recurrent myocardial infarction, of which 26 (15.7%) had type D personality, while during a mean follow-up time for all-cause mortality of 6.3 (2.9) years, 321 (33.9%) patients died, of which 42 (13.1%) had type D personality. After adjusting for established risk factors, type D personality was not significantly associated with recurrent myocardial infarction or all-cause mortality using any of the previously proposed methods for measuring type D personality. A weak association was found between the social inhibition part of type D personality and a decreased risk of all-cause mortality, but this association was not significant after taking missing data into account in a multiple imputation analysis. Conclusions No support was found for type D personality being independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality.

  2. Glycated haemoglobin and the risk of cardiovascular disease, diabetes and all-cause mortality in the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Eskesen, K; Jensen, M T; Galatius, S;

    2013-01-01

    Individuals with diabetes mellitus (DM) have a considerably elevated risk of developing serious health problems including cardiovascular disease (CVD). Long-term elevated levels of blood glucose in nondiabetic individuals may also be associated with increased risk of CVD. The aim of this study...... was to investigate the relationships between glycated haemoglobin A(1c) (HbA(1c) ) and CVD, DM and all-cause mortality....

  3. Perceived Social Support Trajectories and the All-Cause Mortality Risk of Older Mexican American Women and Men.

    Science.gov (United States)

    Hill, Terrence D; Uchino, Bert N; Eckhardt, Jessica L; Angel, Jacqueline L

    2016-04-01

    Although numerous studies of non-Hispanic Whites and Blacks show that social integration and social support tend to favor longevity, it is unclear whether this general pattern extends to the Mexican American population. Building on previous research, we employed seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the association between perceived social support trajectories and the all-cause mortality risk of older Mexican Americans. Growth mixture estimates revealed three latent classes of support trajectories: high, moderate, and low. Cox regression estimates indicated that older Mexican American men in the low support trajectory tend to exhibit a higher mortality risk than their counterparts in the high support trajectory. Social support trajectories were unrelated to the mortality risk of older Mexican American women. A statistically significant interaction term confirmed that social support was more strongly associated with the mortality risk of men.

  4. Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients.

    Science.gov (United States)

    Kwon, Young Eun; Kee, Youn Kyung; Yoon, Chang-Yun; Han, In Mee; Han, Seung Gyu; Park, Kyoung Sook; Lee, Mi Jung; Park, Jung Tak; Han, Seung H; Yoo, Tae-Hyun; Kim, Yong-Lim; Kim, Yon Su; Yang, Chul Woo; Kim, Nam-Ho; Kang, Shin-Wook

    2016-02-01

    Subjective global assessment (SGA) is associated with mortality in end-stage renal disease (ESRD) patients. However, little is known whether improvement or deterioration of nutritional status after dialysis initiation influences the clinical outcome. We aimed to elucidate the association between changes in nutritional status determined by SGA during the first year of dialysis and all-cause mortality in incident ESRD patients. This was a multicenter, prospective cohort study. Incident dialysis patients with available SGA data at both baseline and 12 months after dialysis commencement (n = 914) were analyzed. Nutritional status was defined as well nourished (WN, SGA A) or malnourished (MN, SGA B or C). The patients were divided into 4 groups according to the change in nutritional status between baseline and 12 months after dialysis commencement: group 1, WN to WN; group 2, MN to WN; group 3, WN to MN; and group 4, MN to MN. Cox proportional hazard analysis was performed to clarify the association between changes in nutritional status and mortality. Being in the MN group at 12 months after dialysis initiation, but not at baseline, was a significant risk factor for mortality. There was a significant difference in the 3-year survival rates among the groups (group 1, 92.2%; group 2, 86.0%; group 3, 78.2%; and group 4, 63.5%; log-rank test, P nutritional status assessed by SGA during the first year of dialysis were associated with all-cause mortality in incident ESRD patients.

  5. A systematic review and meta-analysis of nut consumption and incident risk of CVD and all-cause mortality.

    Science.gov (United States)

    Mayhew, Alexandra J; de Souza, Russell J; Meyre, David; Anand, Sonia S; Mente, Andrew

    2016-01-28

    Dietary patterns containing nuts are associated with a lower risk of CVD mortality, and increased nut consumption has been shown to have beneficial effects on CVD risk factors including serum lipid levels. Recent studies have reported on the relationship between nut intake and CVD outcomes and mortality. Our objective was to systematically review the literature and quantify associations between nut consumption and CVD outcomes and all-cause mortality. Five electronic databases (through July 2015), previous reviews and bibliographies of qualifying articles were searched. In the twenty included prospective cohort studies (n 467 389), nut consumption was significantly associated with a lower risk of all-cause mortality (ten studies; risk ratio (RR) 0·81; 95 % CI 0·77, 0·85 for highest v. lowest quantile of intake, P het=0·04, I 2=43 %), CVD mortality (five studies; RR 0·73; 95 % CI 0·68, 0·78; P het=0·31, I 2=16 %), all CHD (three studies; RR 0·66; 95 % CI 0·48, 0·91; P het=0·0002, I 2=88 %) and CHD mortality (seven studies; RR 0·70; 95 % CI 0·64, 0·76; P het=0·65, I 2=0 %), as well as a statistically non-significant reduction in the risk of non-fatal CHD (three studies; RR 0·71; 95 % CI 0·49, 1·03; P het=0·03, I 2=72 %) and stroke mortality (three studies; RR 0·83; 95 % CI 0·69, 1·00; P het=0·54, I 2=0 %). No evidence of association was found for total stroke (two studies; RR 1·05; 95 % CI 0·69, 1·61; P het=0·04, I 2=77 %). Data on total CVD and sudden cardiac death were available from one cohort study, and they were significantly inversely associated with nut consumption. In conclusion, we found that higher nut consumption is associated with a lower risk of all-cause mortality, total CVD, CVD mortality, total CHD, CHD mortality and sudden cardiac death.

  6. Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts.

    Directory of Open Access Journals (Sweden)

    Emmanuel Stamatakis

    Full Text Available BACKGROUND: There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. METHODS: The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. RESULTS: In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89 and cancer (HR = 0.60, 95% CI 0.43-0.85 mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. CONCLUSIONS: Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

  7. Renin–angiotensin system inhibition is not associated with increased sudden cardiac death, cardiovascular mortality or all-cause mortality in patients with aortic stenosis

    DEFF Research Database (Denmark)

    Bang, Casper N; Greve, Anders M; Køber, Lars

    2014-01-01

    BACKGROUND: Renin-angiotensin system inhibition (RASI) is frequently avoided in aortic stenosis (AS) patients because of fear of hypotension. We evaluated if RASI with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) increased mortality in patients with mild...... to moderate AS. METHODS: All patients (n=1873) from the Simvastatin and Ezetimibe in Aortic Stenosis study: asymptomatic patients with AS and preserved left ventricular (LV) ejection fraction were included. Risks of sudden cardiac death (SCD), cardiovascular death and all-cause mortality according to RASI...... treatment were analyzed by multivariable time-varying Cox models and propensity score matched analyses. RESULTS: 769 (41%) patients received RASI. During a median follow-up of 4.3 ± 0.9 years, 678 patients were categorized as having severe AS, 545 underwent aortic valve replacement, 40 SCDs, 103...

  8. The Effect of Coffee and Quantity of Consumption on Specific Cardiovascular and All-Cause Mortality: Coffee Consumption Does Not Affect Mortality.

    Science.gov (United States)

    Loomba, Rohit S; Aggarwal, Saurabh; Arora, Rohit R

    2016-01-01

    Previous studies have examined whether or not an association exists between the consumption of caffeinated coffee to all-cause and cardiovascular mortality. This study aimed to delineate this association using population representative data from the National Health and Nutrition Examination Survey III. Patients were included in the study if all the following criteria were met: (1) follow-up mortality data were available, (2) age of at least 45 years, and (3) reported amount of average coffee consumption. A total of 8608 patients were included, with patients stratified into the following groups of average daily coffee consumption: (1) no coffee consumption, (2) less than 1 cup, (3) 1 cup a day, (4) 2-3 cups, (5) 4-5 cups, (6) more than 6 cups a day. Odds ratios, 95% confidence intervals, and P values were calculated for univariate analysis to compare the prevalence of all-cause mortality, ischemia-related mortality, congestive heart failure-related mortality, and stroke-related mortality, using the no coffee consumption group as reference. These were then adjusted for confounding factors for a multivariate analysis. P coffee consumption and mortality, although this became insignificant on multivariate analysis. Coffee consumption, thus, does not seem to impact all-cause mortality or specific cardiovascular mortality. These findings do differ from those of recently published studies. Coffee consumption of any quantity seems to be safe without any increased mortality risk. There may be some protective effects but additional data are needed to further delineate this.

  9. Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease.

    Science.gov (United States)

    Nakamura, Koshi; Nakagawa, Hideaki; Murakami, Yoshitaka; Kitamura, Akihiko; Kiyama, Masahiko; Sakata, Kiyomi; Tsuji, Ichiro; Miura, Katsuyuki; Ueshima, Hirotsugu; Okamura, Tomonori

    2015-11-01

    Little is known about the magnitude and nature of the combined effect of chronic kidney disease (CKD) and smoking on cardiovascular diseases. We studied this in a Japanese population using a pooled analysis of 15,468 men and 19,154 women aged 40-89 years enrolled in 8 cohort studies. The risk of mortality from all-causes and cardiovascular disease was compared in 6 gender-specific categories of baseline CKD status (non-CKD or CKD) and smoking habits (lifelong never smoked, former smokers, or currently smoking). CKD was defined as a decreased level of estimated glomerular filtration rate (under 60 ml/min per 1.73 m(2)) and/or dipstick proteinuria. Hazard ratios were estimated for each category, relative to never smokers without CKD. During the follow-up period (mean 14.8 years), there were 6771 deaths, 1975 of which were due to cardiovascular diseases. In both men and women, current or former smokers with CKD had the first or second highest crude mortality rates from all-cause and cardiovascular diseases among the 6 categories. After adjustment for age and other major cardiovascular risk factors, the hazard ratios in male and female current smokers with CKD were 2.26 (95% confidence interval, 1.95-2.63) and 1.78 (1.36-2.32) for all-causes, and 2.66 (2.04-3.47) and 1.71 (1.10-2.67) for cardiovascular diseases, respectively. Thus, coexistence of CKD and smoking may markedly increase the risk of all-cause and cardiovascular mortality.

  10. Differences in all-cause mortality: A comparison between immigrants and the host population in Norway 1990-2012

    Directory of Open Access Journals (Sweden)

    Astri Syse

    2016-03-01

    Full Text Available Background: Differences in all-cause mortality between immigrants and host populations may provide insight into health inequities that could be reduced. Objective: Death risks of adult immigrants were compared to those of the host population to assess effects of country of origin, duration of residence, calendar period, and sociodemographic characteristics, i.e., sex, education, and marital and parental status. Methods: Registry data encompassing the entire Norwegian population age 25-79 in 1990-2012 were used to compare death risks in various immigrant groups and the host population, using discrete-time hazard regression models with time-varying covariates. Results: Over 451,000 deaths occurred in around 4.4 million individuals. After adjusting for sex, age, and calendar period, immigrants had an 8Š survival advantage (odds ratio (OR 0.92. Death-risk estimates for immigrants were lowered pronouncedly by further adjustment of sociodemographic factors (OR 0.81. The greatest survival advantage was observed among immigrants with a short duration of residence. With increasing lengths of stay, immigrants' risk of death became similar to that of the host population. The survival advantage was most pronounced for younger, unmarried, and childless immigrants. Although the survival of Central and Eastern European immigrants improved over time, none of the groups had a higher adjusted death risk than the host population. Conclusions: Immigrants have a 20Š survival advantage compared to the host population. The convergence in mortality with increasing duration of residence suggests that 'healthy migrant' and 'acculturation' effects counteract each other, and warrants further research on the health and welfare of long-term immigrants.

  11. The combined impact of adherence to five lifestyle factors on all-cause, cancer and cardiovascular mortality

    DEFF Research Database (Denmark)

    Petersen, Kristina E N; Johnsen, Nina F; Olsen, Anja

    2015-01-01

    guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international......·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population....... and national health recommendations. A Cox proportional hazards model was used to estimate hazard ratios (HR) with 95 % CI. During a median follow-up of 14 years, 3941 men and 2827 women died. Among men, adherence to one additional health recommendation was associated with an adjusted HR of 0·73 (95 % CI 0...

  12. ACE genotype, phenotype and all-cause mortality in different cohorts of patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Færch, Louise H; Sejling, Anne-Sophie; Lajer, Maria

    2015-01-01

    AIMS: Carrying the D-allele of the angiotensin-converting enzyme (ACE) I/D polymorphism and high ACE activity are prognostic factors in diabetic nephropathy, which predicts mortality in type 1 diabetes. We studied the association between the ACE D-allele and ACE phenotype and long-term all......-cause mortality in three single-institution outpatient cohorts. METHODS: Genotype-based analyses were performed in 269 patients from Hillerød Hospital (HIH) (follow-up: 12 years) and in 439 patients with diabetic nephropathy and 437 patients with persistent normoalbuminuria from the Steno Diabetes Center (SDC...... the ACE D-allele and high spontaneous serum ACE activity were associated with 12-year excess mortality. These findings could not be reproduced in two other cohorts with persistent normoalbuminuria or diabetic nephropathy....

  13. Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

    Science.gov (United States)

    Lassale, Camille; Gunter, Marc J.; Romaguera, Dora; Peelen, Linda M.; Van der Schouw, Yvonne T.; Beulens, Joline W. J.; Freisling, Heinz; Muller, David C.; Ferrari, Pietro; Huybrechts, Inge; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Affret, Aurélie; Overvad, Kim; Dahm, Christina C.; Olsen, Anja; Roswall, Nina; Tsilidis, Konstantinos K.; Katzke, Verena A.; Kühn, Tilman; Buijsse, Brian; Quirós, José-Ramón; Sánchez-Cantalejo, Emilio; Etxezarreta, Nerea; Huerta, José María; Barricarte, Aurelio; Bonet, Catalina; Khaw, Kay-Tee; Key, Timothy J.; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Fasanelli, Francesca; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Boer, Jolanda M. A.; Sonestedt, Emily; Nilsson, Lena Maria; Renström, Frida; Weiderpass, Elisabete; Skeie, Guri; Lund, Eiliv; Moons, Karel G. M.; Riboli, Elio; Tzoulaki, Ioanna

    2016-01-01

    Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72–0.79) to 0.88 (0.84–0.92) for all-cause, 0.76 (0.69–0.83) to 0.84 (0.76–0.92) for CVD and 0.78 (0.73–0.83) to 0.91 (0.85–0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors. PMID:27409582

  14. Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study.

    Science.gov (United States)

    Lassale, Camille; Gunter, Marc J; Romaguera, Dora; Peelen, Linda M; Van der Schouw, Yvonne T; Beulens, Joline W J; Freisling, Heinz; Muller, David C; Ferrari, Pietro; Huybrechts, Inge; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Affret, Aurélie; Overvad, Kim; Dahm, Christina C; Olsen, Anja; Roswall, Nina; Tsilidis, Konstantinos K; Katzke, Verena A; Kühn, Tilman; Buijsse, Brian; Quirós, José-Ramón; Sánchez-Cantalejo, Emilio; Etxezarreta, Nerea; Huerta, José María; Barricarte, Aurelio; Bonet, Catalina; Khaw, Kay-Tee; Key, Timothy J; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Fasanelli, Francesca; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Boer, Jolanda M A; Sonestedt, Emily; Nilsson, Lena Maria; Renström, Frida; Weiderpass, Elisabete; Skeie, Guri; Lund, Eiliv; Moons, Karel G M; Riboli, Elio; Tzoulaki, Ioanna

    2016-01-01

    Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72-0.79) to 0.88 (0.84-0.92) for all-cause, 0.76 (0.69-0.83) to 0.84 (0.76-0.92) for CVD and 0.78 (0.73-0.83) to 0.91 (0.85-0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors.

  15. Wine intake, ABO phenotype, and risk of ischemic heart disease and all-cause mortality: the Copenhagen Male Study-a 16-year follow-up

    DEFF Research Database (Denmark)

    Suadicani, P.; Hein, H.O.; Gyntelberg, F.

    2008-01-01

    were ABO phenotypes, alcohol intake (wine, beer, and spirits), tobacco smoking history, leisure-time, physical activity, social class, and age. During 16 years, 1985-1986 to end of 2001, 197 subjects (6.5%) died due to IHD, and 1,204 (39.8%) from all causes. Among non-O phenotypes (A, B, and AB...... and not significantly U-shaped. The difference in the predictive role of wine intake between phenotype O and phenotype A men was supported in a statistical test for interaction. A similar association was found for all-cause mortality. The results suggest that the effect of wine intake on IHD and all-cause mortality...

  16. Association of versican turnover with all-cause mortality in patients on haemodialysis

    DEFF Research Database (Denmark)

    Genovese, Federica; Karsdal, Morten A; Leeming, Diana J

    2014-01-01

    patients with a 5-years follow-up, using a robust competitive enzyme-linked immunosorbent assays. Association between VCANM plasma concentration and survival was assessed by Kaplan-Meier analysis and adjusted Cox model. RESULTS: Haemodialysis patients with plasma VCANM concentrations in the lowest quartile...... had increased risk of death (odds ratio, as compared to the highest quartile: 7.1, psurvival of 152 days compared to 1295 days for patients with plasma VCANM in the highest quartile. Multivariate analysis showed that low VCANM (p... with cardiovascular diseases. The objective of the study was to investigate the association of versican turnover assessed in plasma with survival in haemodialysis patients. METHODS: A specific matrix metalloproteinase-generated neo-epitope fragment of versican (VCANM) was measured in plasma of 364 haemodialysis...

  17. Associations of all-cause mortality with census-based neighbourhood deprivation and population density in Japan: a multilevel survival analysis.

    Directory of Open Access Journals (Sweden)

    Tomoki Nakaya

    Full Text Available BACKGROUND: Despite evidence that neighbourhood conditions affect residents' health, no prospective studies of the association between neighbourhood socio-demographic factors and all-cause mortality have been conducted in non-Western societies. Thus, we examined the effects of areal deprivation and population density on all-cause mortality in Japan. METHODS: We employed census and survival data from the Japan Public Health Center-based Prospective Study, Cohort I (n = 37,455, consisting of middle-aged residents (40 to 59 years at the baseline in 1990 living in four public health centre districts. Data spanned between 1990 and 2010. A multilevel parametric proportional-hazard regression model was applied to estimate the hazard ratios (HRs of all-cause mortality by two census-based areal variables--areal deprivation index and population density--as well as individualistic variables such as socioeconomic status and various risk factors. RESULTS: We found that areal deprivation and population density had moderate associations with all-cause mortality at the neighbourhood level based on the survival data with 21 years of follow-ups. Even when controlling for individualistic socio-economic status and behavioural factors, the HRs of the two areal factors (using quartile categorical variables significantly predicted mortality. Further, this analysis indicated an interaction effect of the two factors: areal deprivation prominently affects the health of residents in neighbourhoods with high population density. CONCLUSIONS: We confirmed that neighbourhood socio-demographic factors are significant predictors of all-cause death in Japanese non-metropolitan settings. Although further study is needed to clarify the cause-effect relationship of this association, the present findings suggest that health promotion policies should consider health disparities between neighbourhoods and possibly direct interventions towards reducing mortality in densely

  18. Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.

    Directory of Open Access Journals (Sweden)

    Carole D Mitnick

    Full Text Available RATIONALE: A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. OBJECTIVES: This study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort. METHODS: This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. MEASUREMENTS AND MAIN RESULTS: In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7 drugs. Cure or completion was achieved in 66.1% (442 of patients; death occurred in 20.8% (139. Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89, compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93. CONCLUSIONS: The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.

  19. High diet quality is associated with a lower risk of cardiovascular disease and all-cause mortality in older men.

    Science.gov (United States)

    Atkins, Janice L; Whincup, Peter H; Morris, Richard W; Lennon, Lucy T; Papacosta, Olia; Wannamethee, S Goya

    2014-05-01

    Although diet quality is implicated in cardiovascular disease (CVD) risk, few studies have investigated the relation between diet quality and the risks of CVD and mortality in older adults. This study examined the prospective associations between dietary scores and risk of CVD and all-cause mortality in older British men. A total of 3328 men (aged 60-79 y) from the British Regional Heart Study, free from CVD at baseline, were followed up for 11.3 y for CVD and mortality. Baseline food-frequency questionnaire data were used to generate 2 dietary scores: the Healthy Diet Indicator (HDI), based on WHO dietary guidelines, and the Elderly Dietary Index (EDI), based on a Mediterranean-style dietary intake, with higher scores indicating greater compliance with dietary recommendations. Cox proportional hazards regression analyses assessed associations between quartiles of HDI and EDI and risk of all-cause mortality, CVD mortality, CVD events, and coronary heart disease (CHD) events. During follow-up, 933 deaths, 327 CVD deaths, 582 CVD events, and 307 CHD events occurred. Men in the highest compared with the lowest EDI quartile had significantly lower risks of all-cause mortality (HR: 0.75; 95% CI: 0.60, 0.94; P-trend = 0.03), CVD mortality (HR: 0.63; 95% CI: 0.42, 0.94; P-trend = 0.03), and CHD events (HR: 0.66; 95% CI: 0.45, 0.97; P-trend = 0.05) but not CVD events (HR: 0.79; 95% CI: 0.60, 1.05; P-trend = 0.16) after adjustment for sociodemographic, behavioral, and cardiovascular risk factors. The HDI was not significantly associated with any of the outcomes. The EDI appears to be more useful than the HDI for assessing diet quality in relation to CVD and morality risk in older men. Encouraging older adults to adhere to the guidelines inherent in the EDI criteria may have public health benefits.

  20. Wine intake, ABO phenotype, and risk of ischemic heart disease and all-cause mortality: the Copenhagen Male Study--a 16-year follow-up.

    Science.gov (United States)

    Suadicani, Poul; Hein, Hans Ole; Gyntelberg, Finn

    2008-11-01

    The association of alcohol intake with ischemic heart disease (IHD) and all-cause mortality may depend on ABO phenotype. We tested this hypothesis in a 16-year follow-up of 3,022 Caucasian men aged 53-74 years without overt cardiovascular disease. Potential risk factors and confounders included were ABO phenotypes, alcohol intake (wine, beer, and spirits), tobacco smoking history, leisure-time physical activity, social class, and age. During 16 years, 1985-1986 to end of 2001, 197 subjects (6.5%) died due to IHD, and 1,204 (39.8%) from all causes. Among non-O phenotypes (A, B, and AB) significantly fewer men who died due to IHD were wine consumers, 43.9% versus 55.7%, P8 beverages/wk (the highest quintile) the HR was 0.3 (0.2-0.8), Pwine intake with IHD mortality was slightly and not significantly U-shaped. The difference in the predictive role of wine intake between phenotype O and phenotype A men was supported in a statistical test for interaction. A similar association was found for all-cause mortality. The results suggest that the effect of wine intake on IHD and all-cause mortality among middle-aged and elderly men may depend on ABO phenotypes.

  1. Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality

    Energy Technology Data Exchange (ETDEWEB)

    Buckens, C.F. [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Graaf, Y. van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Verkooijen, H.M.; Mali, W.P.; Jong, P.A. de [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); Isgum, I.; Mol, C.P. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Verhaar, H.J. [University Medical Center Utrecht, Department of Geriatric Medicine, Utrecht (Netherlands); Vliegenthart, R.; Oudkerk, M. [Medical Center Groningen, Department of Radiology, Utrecht (Netherlands); Aalst, C.M. van; Koning, H.J. de [Erasmus MC Rotterdam, Department of Public Health, Rotterdam (Netherlands)

    2015-01-15

    Further survival benefits may be gained from low-dose chest computed tomography (CT) by assessing vertebral fractures and bone density. We sought to assess the association between CT-measured vertebral fractures and bone density with all-cause mortality in lung cancer screening participants. Following a case-cohort design, lung cancer screening trial participants (N = 3,673) who died (N = 196) during a median follow-up of 6 years (inter-quartile range: 5.7-6.3) were identified and added to a random sample of N = 383 from the trial. We assessed vertebral fractures using Genant and acute;s semiquantative method on sagittal reconstructions and measured bone density (Hounsfield Units (HU)) in vertebrae. Cox proportional hazards modelling was used to determine if vertebral fractures or bone density were independently predictive of mortality. The prevalence of vertebral fractures was 35 % (95 % confidence interval 30-40 %) among survivors and 51 % (44-58 %) amongst cases. After adjusting for age, gender, smoking status, pack years smoked, coronary and aortic calcium volume and pulmonary emphysema, the adjusted hazard ratio (HR) for vertebral fracture was 2.04 (1.43-2.92). For each 10 HU decline in trabecular bone density, the adjusted HR was 1.08 (1.02-1.15). Vertebral fractures and bone density are independently associated with all-cause mortality. (orig.)

  2. Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Terence Dwyer

    Full Text Available Self-reported physical activity has been inversely associated with mortality but the effect of objectively measured step activity on mortality has never been evaluated. The objective is to determine the prospective association of daily step activity on mortality among free-living adults.Cohort study of free-living adults residing in Tasmania, Australia between 2000 and 2005 who participated in one of three cohort studies (n = 2 576 total participants. Daily step activity by pedometer at baseline at a mean of 58.8 years of age, and for a subset, repeated monitoring was available 3.7 (SD 1.3 years later (n = 1 679. All-cause mortality (n = 219 deaths was ascertained by record-linkage to the Australian National Death Index; 90% of participants were followed-up over ten years, until June 2011. Higher daily step count at baseline was linearly associated with lower all-cause mortality (adjusted hazard ratio AHR, 0.94; 95% CI, 0.90 to 0.98 per 1 000 steps; P = 0.004. Risk was altered little by removing deaths occurring in the first two years. Increasing baseline daily steps from sedentary to 10 000 steps a day was associated with a 46% (95% CI, 18% to 65%; P = 0.004 lower risk of mortality in the decade of follow-up. In addition, those who increased their daily steps over the monitoring period had a substantial reduction in mortality risk, after adjusting for baseline daily step count (AHR, 0.39; 95% CI, 0.22 to 0.72; P = 0.002, or other factors (AHR, 0.38; 95% CI, 0.21-0.70; P = 0.002.Higher daily step count was linearly associated with subsequent long term mortality among free living adults. These data are the first to quantify mortality reductions using an objective measure of physical activity in a free living population. They strongly underscore the importance of physical inactivity as a major public health problem.

  3. High tobacco consumption is causally associated with increased all-cause mortality in a general population sample of 55 568 individuals, but not with short telomeres

    DEFF Research Database (Denmark)

    Rode, Line; Bojesen, Stig E; Weischer, Maren

    2014-01-01

    BACKGROUND: High cumulative tobacco consumption is associated with short telomeres and with increased all-cause mortality. We tested the hypothesis that high tobacco consumption is causally associated with short telomeres and with increased all-cause mortality. METHODS: We studied 55,568 individu......BACKGROUND: High cumulative tobacco consumption is associated with short telomeres and with increased all-cause mortality. We tested the hypothesis that high tobacco consumption is causally associated with short telomeres and with increased all-cause mortality. METHODS: We studied 55...... short telomeres explained only +0.4% (-3.5%, +4.3%) of the association between high tobacco consumption and increased all-cause mortality. CONCLUSIONS: High tobacco consumption is causally associated with increased all-cause mortality. High cumulative tobacco consumption is associated with short...

  4. Sickness absence due to specific mental diagnoses and all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants of Sweden.

    Directory of Open Access Journals (Sweden)

    Ellenor Mittendorfer-Rutz

    Full Text Available BACKGROUND: Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality. METHODS: A cohort of all 4 857 943 individuals living in Sweden on 31.12.2004 (aged 16-64 years, not sickness absent, or on retirement or disability pension, was followed from 01.01.2005 through 31.12.2008 for all-cause and cause-specific mortality (suicide, cancer, circulatory disease through linkage of individual register data. Individuals with at least one new sick-leave spell with a mental diagnosis in 2005 were compared to individuals with no sickness absence. Hazard ratios (HR and 95% confidence intervals (CI were estimated by Cox regression, adjusting for age, sex, education, country of birth, family situation, area of residence, and pre-existing morbidity (diagnosis-specific hospital inpatient (2000-2005 and outpatient (2001-2005 care. RESULTS: In the multivariate analyses, mental sickness absence in 2005 was associated with an increased risk for all-cause mortality: HR: 1.65, 95% CI: 1.47-1.86 in women and in men: 1.73, 1.57-1.91; for suicide, cancer (both smoking and non-smoking related as well as mortality due to circulatory disease only in men. Estimates for cause-specific mortality ranged from 1.48 to 3.37. Associations with all-cause mortality were found for all mental sickness absence diagnostic groups studied. CONCLUSIONS: Knowledge about the prognosis of patients sickness absent with specific mental diagnoses is of crucial clinical importance in health care. Sickness absence due to specific mental diagnoses may here be used as a risk indictor for subsequent mortality.

  5. Whole-grain products and whole grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Frederiksen, Kirsten; Christensen, Jane

    2015-01-01

    No study has yet investigated the intake of different types of whole grain (WG) in relation to all-cause and cause-specific mortality in a healthy population. The aim of the present study was to investigate the intake of WG products and WG types in relation to all-cause and cause-specific mortali......%CI 0·86, 0·91) for a doubling of intake). In particular, intake of breakfast cereals and non-white bread was associated with lower mortality. We also found lower all-cause mortality with total intake of different WG types (women: MRR 0·88 (95%CI 0·86, 0·92); men: MRR 0·88 (95%CI 0·86, 0...... quartile compared with the lowest for breakfast cereals, non-white bread, total WG products, oat, rye (only men), wheat and total WG types. The MRR for highest v. lowest quartile of intake of total WG products was 0·68 (95% CI 0·62, 0·75, P for trend over quartiles , 0·0001) for women and 0·75 (95%CI 0......, the analyses of cause-specific mortality according to quartiles of WG intake supported these results. In conclusion, higher intake of WG products and WG types was associated with lower mortality among participants in the HELGA cohort. The study indicates that intake of WG is an important aspect of diet...

  6. Disability and all-cause mortality in the older population: evidence from the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Pongiglione, Benedetta; De Stavola, Bianca L; Kuper, Hannah; Ploubidis, George B

    2016-08-01

    Despite the vast body of literature studying disability and mortality, evidence to support their association is scarce. This work investigates the role of disability in explaining all-cause mortality among individuals aged 50+ who participated in the English Longitudinal Study of Aging. The aim is to explain the gender paradox in health and mortality by analysing whether the association of disability with mortality differs between women and men. Disability was conceived following the International Classification of Functioning, Disability and Health (ICF), proposed by the WHO, that conceptualizes disability as a combination of three components: impairment, activity limitation and participation restriction. Latent variable models were used to identify domain-specific factors and general disability. The association of the latter with mortality up to 10 years after enrolment was estimated using discrete-time survival analysis. Our work confirms the validity of the ICF framework and finds that disability is strongly associated with mortality, with a time-varying effect among men, and a smaller constant effect for women. Adjusting for demographic, socioeconomic and behavioural factors attenuated the association for both sexes, but overall the effects remained high and significant. These findings confirm the existence of gender paradox by showing that, when affected by disability, women survive longer than men, although if men survive the first years they appear to become more resilient to disability. Sensitivity analyses suggested that the gender paradox cannot be solely explained by gender-specific health conditions: there must be other mechanisms acting within the pathway between disability and mortality that need to be explored.

  7. Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009.

    Science.gov (United States)

    Singh, Gopal K; Siahpush, Mohammad

    2014-04-01

    This study examined trends in rural-urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural-urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural-urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005-2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005-2009 than in 1990-1992. Causes of death contributing most to the increasing rural-urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer's disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.

  8. Effect of Urate-Lowering Therapy on All-Cause and Cardiovascular Mortality in Hyperuricemic Patients without Gout: A Case-Matched Cohort Study

    Science.gov (United States)

    Chen, Jiunn-Horng; Lan, Joung-Liang; Cheng, Chi-Fung; Liang, Wen-Miin; Lin, Hsiao-Yi; Tsay, Gregory J; Yeh, Wen-Ting; Pan, Wen-Harn

    2015-01-01

    Objectives An increased risk of mortality in patients with hyperuricemia has been reported. We examined (1) the risk of all-cause and cardiovascular disease (CVD) mortality in untreated hyperuricemic patients who did not receive urate-lowering therapy (ULT), and (2) the impact of ULT on mortality risk in patients with hyperuricemia. Methods In this retrospective case-matched cohort study during a mean follow-up of 6.4 years, 40,118 Taiwanese individuals aged ≥17 years who had never used ULT and who had never had gout were examined. The mortality rate was compared between 3,088 hyperuricemic patients who did not receive ULT and reference subjects (no hyperuricemia, no gout, no ULT) matched for age and sex (1:3 hyperuricemic patients/reference subjects), and between 1,024 hyperuricemic patients who received ULT and 1,024 hyperuricemic patients who did not receive ULT (matched 1:1 based on their propensity score and the index date of ULT prescription). Cox proportional hazard modeling was used to estimate the respective risk of all-cause and CVD (ICD-9 code 390–459) mortality. Results After adjustment, hyperuricemic patients who did not receive ULT had increased risks of all-cause (hazard ratio, 1.24; 95% confidence interval, 0.97–1.59) and CVD (2.13; 1.34–3.39) mortality relative to the matched reference subjects. Hyperuricemic patients treated with ULT had a lower risk of all-cause death (0.60; 0.41–0.88) relative to hyperuricemic patients who did not receive ULT. Conclusion Under-treatment of hyperuricemia has serious negative consequences. Hyperuricemic patients who received ULT had potentially better survival than patients who did not. PMID:26683302

  9. All-cause mortality benefit of coronary revascularization vs. medical therapy in patients without known coronary artery disease undergoing coronary computed tomographic angiography: results from CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry)

    Science.gov (United States)

    Min, James K.; Berman, Daniel S.; Dunning, Allison; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk-Jae; Cheng, Victor; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Cury, Ricardo; Delago, Augustin; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp; Karlsberg, Ronald P.; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Plank, Fabian; Raff, Gilbert; Villines, Todd; Labounty, Troy M.; Shaw, Leslee J.

    2012-01-01

    Aims To date, the therapeutic benefit of revascularization vs. medical therapy for stable individuals undergoing invasive coronary angiography (ICA) based upon coronary computed tomographic angiography (CCTA) findings has not been examined. Methods and results We examined 15 223 patients without known coronary artery disease (CAD) undergoing CCTA from eight sites and six countries who were followed for median 2.1 years (interquartile range 1.4–3.3 years) for an endpoint of all-cause mortality. Obstructive CAD by CCTA was defined as a ≥50% luminal diameter stenosis in a major coronary artery. Patients were categorized as having high-risk CAD vs. non-high-risk CAD, with the former including patients with at least obstructive two-vessel CAD with proximal left anterior descending artery involvement, three-vessel CAD, and left main CAD. Death occurred in 185 (1.2%) patients. Patients were categorized into two treatment groups: revascularization (n = 1103; 2.2% mortality) and medical therapy (n = 14 120, 1.1% mortality). To account for non-randomized referral to revascularization, we created a propensity score developed by logistic regression to identify variables that influenced the decision to refer to revascularization. Within this model (C index 0.92, χ2 = 1248, P < 0.0001), obstructive CAD was the most influential factor for referral, followed by an interaction of obstructive CAD with pre-test likelihood of CAD (P = 0.0344). Within CCTA CAD groups, rates of revascularization increased from 3.8% for non-high-risk CAD to 51.2% high-risk CAD. In multivariable models, when compared with medical therapy, revascularization was associated with a survival advantage for patients with high-risk CAD [hazards ratio (HR) 0.38, 95% confidence interval 0.18–0.83], with no difference in survival for patients with non-high-risk CAD (HR 3.24, 95% CI 0.76–13.89) (P-value for interaction = 0.03). Conclusion In an intermediate-term follow-up, coronary revascularization is

  10. Racial disparities in all-cause mortality among younger commercially insured women with incident metastatic breast cancer.

    Science.gov (United States)

    Leopold, Christine; Wagner, Anita K; Zhang, Fang; Lu, Christine Y; Earle, Craig; Nekhlyudov, Larissa; Degnan, Dennis-Ross; Frank Wharam, J

    2016-07-01

    Racial disparities in breast cancer mortality persist and are likely related to multiple factors. Over the past decade, progress has been made in treating metastatic breast cancer, particularly in younger women. Whether disparities exist in this population is unknown. Using administrative claims data between 2000 and 2011 (OptumInsight, Eden Prairie, MN) of members insured through a large national US health insurer, we identified women aged 25-64 years diagnosed with incident metastatic breast cancer diagnosed between November 1, 2000, and December 31, 2008. We examined time from diagnosis to death, with up to 3 years of follow-up. We stratified analyses by geocoded race and socio-economic status, age-at-diagnosis, morbidity score, US region of residence, urban/non-urban, and years of diagnosis. We constructed Kaplan-Meier survival plots and analyzed all-cause mortality using multivariate Cox proportional hazard models. Among 6694 women with incident metastatic breast cancer (78 % Caucasian, 4 % African American, and 18 % other), we found higher mortality rates among women residing in predominantly African American versus Caucasian neighborhoods (hazard ratio (HR) 1.84; 95 % confidence interval, CI 1.39-2.45), women with high versus lower morbidity (HR 1.30 [1.12-1.51]), and women whose incident metastatic diagnosis was during 2000-2004 versus 2005-2008 (HR 1.60 [1.39-1.83]). Caucasian (HR 0.61 [0.52-0.71]) but not African American women (HR not significant) experienced improved mortality in 2005-2008 versus 2000-2004. Despite insured status, African American women and women with multi-morbidity had poorer survival. Only Caucasian women had improved mortality over time. Modifiable risk factors for increased mortality need to be addressed in order to reduce disparities.

  11. Elevated serum uric acid level as a predictor for cardiovascular and all-cause mortality in Chinese patients with high cardiovascular risk

    Institute of Scientific and Technical Information of China (English)

    Yongquan Wu; Meijing Li; Jue Li; Yingyi Luo; Yan Xing; Dayi Hu

    2008-01-01

    Objective To assess the predictive value of serum uric acid levels for cardiovascular and all-cause mortality in a large prospective population based study.Methods The study was based on 3648 participants in Shanghai and Beijing,who were inpatients with high cardiovascular(CV) risk at baseLine (2004.7 to 2005.1),and blood was taken.Follow-up for death from cardiovascular disease and any cause was complete until January 1,2006.Results The mean follow-up was 1 years.There were 303 deaths during follow-up,of which 121 were cardiovascular.Crude mortality rates were 8.3 % for all patients,6.8% for female patients (116/1715),and 9.7% (187/1933) for male patients.Among men,patients in the lower and higher uric acid groups had increased cardiac and overall mortality risks compared with patients in the normal uric acid groups.Similar relation was found in women but not statistically significant.After adjusting for other conventional risk factors (age,diabetes,hypertension,diuretic use and smoking),baseline uric acid level was still associated with increased risk for death from cardiovascular disease (P=0.005),or death from all causes (P=0.014) Conclusion Our data suggest that abnormal serum uric acid levels are independently and significantly associated with risk of cardiovascular and all-cause mortality.(J Geriatr Cardiol 2008;5:15-20)

  12. Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Freiberg, Jacob J; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD......, myocardial infarction (MI), and all-cause mortality. METHODS: We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years...... of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. RESULTS: Compared with participants with nonfasting remnant cholesterol cholesterol of 0.5-0.99 mmol/L (19.3-38.2 mg/dL) to 2...

  13. Low systolic blood pressure and mortality from all-cause and vascular diseases among the rural elderly in Korea; Kangwha cohort study.

    Science.gov (United States)

    Yi, Sang-Wook; Hong, Seri; Ohrr, Heechoul

    2015-01-01

    The association between low systolic blood pressure (SBP) and vascular diseases is unclear. The aim of this study was to prospectively examine the association between SBP, especially low SBP, and mortality from all causes and vascular diseases among the elderly in Korea. Six thousand two hundred ninety four residents in a rural community were followed-up for deaths from 1985 to 2008. The adjusted hazard ratios (aHR) and 95% confidence intervals were calculated by Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. Among the elderly aged 65 and above, the lowest SBP (100 mm Hg) group had an elevated aHR for mortality from vascular diseases (aHR = 2.1, 95% CI = 1.2-3.9) including stroke (aHR = 2.4, 95% CI = 0.9-6.3) and ischemic heart diseases (aHR = 5.1, 95% CI = 1.0-26.0) compared to those with SBP of 100-119 mm Hg, while higher SBP was associated with higher mortality. This J-curve association was generally maintained when analysis was restricted to those with fair or good self-rated health, or those with no known vascular diseases. In people below 65, increasing SBP nearly monotonically increased the mortality from all-cause and vascular diseases. Our results suggest that elderly persons with low SBP should be treated with caution, since low SBP may increase vascular mortality.

  14. Night-shift work increases morbidity of breast cancer and all-cause mortality: a meta-analysis of 16 prospective cohort studies.

    Science.gov (United States)

    Lin, Xiaoti; Chen, Weiyu; Wei, Fengqin; Ying, Mingang; Wei, Weidong; Xie, Xiaoming

    2015-11-01

    Night-shift work (NSW) has previously been related to incidents of breast cancer and all-cause mortality, but many published studies have reported inconclusive results. The aim of the present study was to quantify a potential dose-effect relationship between NSW and morbidity of breast cancer, and to evaluate the association between NSW and risk of all-cause mortality. The outcomes included NSW, morbidity of breast cancer, cardiovascular mortality, cancer-related mortality, and all-cause mortality. Sixteen investigations were included, involving 2,020,641 participants, 10,004 incident breast cancer cases, 7185 cancer-related deaths, 4820 cardiovascular end points, and 2480 all-cause mortalities. The summary risk ratio (RR) of incident breast cancer for an increase of NSW was 1.057 [95% confidence interval (CI) 1.014-1.102; test for heterogeneity p = 0.358, I(2) = 9.2%]. The combined RR (95% CI) of breast cancer risk for NSW vs daytime work was: 1.029 (0.969-1.093) in the 20-year exposure lengths. The overall RR was 1.089 (95% CI 1.016-1.166) in a fixed-effects model (test for heterogeneity p = 0.838, I(2) = 0%) comparing rotating NSW and day work. Night-shift work was associated with an increased risk of cardiovascular death (RR 1.027, 95% CI 1.001-1.053), and all-cause death 1.253 (95% CI 0.786-1.997). In summary, NSW increased the risk of breast cancer morbidity by: 1.9% for 5 years, 2.5% for 5-10 years, 7.4% for 10-20 years, and 8.8% for >20-years of NSW. Additionally, rotating NSW enhanced the morbidity of breast cancer by 8.9%. Moreover, NSW was associated with a 2.7% increase in cardiovascular death.

  15. Health factors and risk of all-cause, cardiovascular, and coronary heart disease mortality: findings from the MONICA and HAPIEE studies in Lithuania.

    Directory of Open Access Journals (Sweden)

    Abdonas Tamosiunas

    Full Text Available AIMS: This study investigated the trends and levels of the prevalence of health factors, and the association of all-cause and cardiovascular (CVD mortality with healthy levels of combined risk factors among Lithuanian urban population. METHODS: Data from five general population surveys in Kaunas, Lithuania, conducted between 1983 and 2008 were used. Healthy factors measured at baseline include non-smoking, normal weight, normal arterial blood pressure, normal level of total serum cholesterol, normal physical activity and normal level of fasting glucose. Among 9,209 men and women aged 45-64 (7,648 were free from coronary heart disease (CHD and stroke at baseline, 1,219 death cases from any cause, 589 deaths from CVD, and 342 deaths from CHD occurred during follow up. Cox proportional hazards regression was used to estimate the association between health factors and mortality from all causes, CVD and CHD. RESULTS: Between 1983 and 2008, the proportion of subjects with 6 healthy levels of risk factors was higher in 2006-2008 than in 1983-1984 (0.6% vs. 0.2%; p = 0.09, although there was a significant increase in fasting glucose and a decline in intermediate physical activity. Men and women with normal or intermediate levels of risk factors had significantly lower all-cause, CVD and CHD mortality risk than persons with high levels of risk factors. Subjects with 5-6 healthy factors had hazard ratio (HR of CVD mortality 0.35 (95% confidence interval (CI 0.15-0.83 compared to average risk in the whole population. The hazard ratio for CVD mortality risk was significant in men (HR 0.34, 95% CI 0.12-0.97 but not in women (HR 0.38, 95% CI 0.09-1.67. CONCLUSIONS: An inverse association of most healthy levels of cardiovascular risk factors with risk of all-cause and CVD mortality was observed in this urban population-based cohort. A greater number of cardiovascular health factors were related with significantly lower risk of CVD mortality, particularly among

  16. All-Cause Mortality of Low Birthweight Infants in Infancy, Childhood, and Adolescence: Population Study of England and Wales.

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    W John Watkins

    2016-05-01

    Full Text Available Low birthweight (LBW is associated with increased mortality in infancy, but its association with mortality in later childhood and adolescence is less clear. We investigated the association between birthweight and all-cause mortality and identified major causes of mortality for different birthweight groups.We conducted a population study of all live births occurring in England and Wales between 1 January 1993 and 31 December 2011. Following exclusions, the 12,355,251 live births were classified by birthweight: 500-1,499 g (very LBW [VLBW], n = 139,608, 1,500-2,499 g (LBW, n = 759,283, 2,500-3,499 g (n = 6,511,411, and ≥3,500 g (n = 4,944,949. The association of birthweight group with mortality in infancy (<1 y of age and childhood/adolescence (1-18 y of age was quantified, with and without covariates, through hazard ratios using Cox regression. International Classification of Diseases codes identified causes of death. In all, 74,890 (0.61% individuals died between birth and 18 y of age, with 23% of deaths occurring after infancy. Adjusted hazard ratios for infant deaths were 145 (95% CI 141, 149 and 9.8 (95% CI 9.5, 10.1 for the VLBW and LBW groups, respectively, compared to the ≥3,500 g group. The respective hazard ratios for death occurring at age 1-18 y were 6.6 (95% CI 6.1, 7.1 and 2.9 (95% CI 2.8, 3.1. Male gender, the youngest and oldest maternal age bands, multiple births, and deprivation (Index of Multiple Deprivation score also contributed to increased deaths in the VLBW and LBW groups in both age ranges. In infancy, perinatal factors, particularly respiratory issues and infections, explained 84% and 31% of deaths in the VLBW and LBW groups, respectively; congenital malformations explained 36% and 23% in the LBW group and ≥2,500 g groups (2,500-3,499 g and ≥3,500 g groups combined, respectively. Central nervous system conditions explained 20% of deaths in childhood/adolescence in the VLBW group, with deaths from neoplasms and

  17. No Obesity Paradox—BMI Incapable of Adequately Capturing the Relation of Obesity with All-Cause Mortality: An Inception Diabetes Cohort Study

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    Mohammadreza Bozorgmanesh

    2014-01-01

    Full Text Available Background. To reconcile “the obesity paradox,” we tested if (1 the contribution of anthropometric measures to mortality was nonlinear and (2 the confounding of hip circumference contributed to the obesity paradox recently observed among diabetic patients. Methods. We analyzed data of diabetic patients attending a community-based prospective, “Tehran lipid and glucose study.” In the mortality analysis, anthropometric measures—body mass index (BMI, waist, and hip circumference—were assessed using Cox models incorporating cubic spline functions. Results. During 12 990 person-years follow-up, BMI levels below 27 and those above 40 kg·m−2 were associated with increased mortality. When we added waist circumference to the BMI in the multivariate-adjusted model, the steepness of BMI-mortality association curve slope for values below 27 kg·m−2 increased, whereas the steepness of BMI-mortality association curve slope for values above this threshold decreased. Further adjusting the model for hip circumference, the steepness of the slopes of the association curve moved towards null on both extremes and no associations between BMI and all-cause mortality remained. Conclusion. BMI harbors intermixed positive and negative confounding effects on mortality of waist and hip circumference. Failing to control for the confounding effect of hip circumference may stymie unbiased hazard estimation and render conclusions paradoxical.

  18. Time Trends in Incidence and Mortality of Acute Myocardial Infarction, and All-Cause Mortality following a Cardiovascular Prevention Program in Sweden.

    Directory of Open Access Journals (Sweden)

    Gunilla Journath

    Full Text Available In 1988, a cardiovascular prevention program which combined an individual and a population-based strategy was launched within primary health-care in Sollentuna, a municipality in Stockholm County. The aim of this study was to investigate time trends in the incidence of and mortality from acute myocardial infarction and all-cause mortality in Sollentuna compared with the rest of Stockholm County during a period of two decades following the implementation of a cardiovascular prevention program.The average population in Sollentuna was 56,589 (49% men and in Stockholm County (Sollentuna included 1,795,504 (49% men during the study period of 1987-2010. Cases of hospitalized acute myocardial infarction and death were obtained for the population of Sollentuna and the rest of Stockholm County using national registries of hospital discharges and deaths. Acute myocardial infarction incidence and mortality were estimated using the average population of Sollentuna and Stockholm in 1987-2010.During the observation period, the incidence of acute myocardial infarction decreased more in Sollentuna compared with the rest of Stockholm County in women (-22% vs. -7%; for difference in slope <0.05. There was a trend towards a greater decline in Sollentuna compared to the rest of Stockholm County in the incidence of acute myocardial infarction (in men, acute myocardial mortality, and all-cause mortality but the differences were not significant.During a period of steep decline in acute myocardial infarction incidence and mortality in Stockholm County the municipality of Sollentuna showed a stronger trend in women possibly compatible with favorable influence of a cardiovascular prevention program.ClinicalTrials.gov NCT02212145.

  19. Retinopathy and CKD as Predictors of All-Cause and Cardiovascular Mortality: National Health and Nutrition Examination Survey (NHANES) 1988–1994

    Science.gov (United States)

    Ricardo, Ana C.; Grunwald, Juan E.; Parvathaneni, Sharmila; Goodin, Sean; Ching, Alice; Lash, James P.

    2014-01-01

    Background Retinopathy is associated with increased mortality risk in general populations. We evaluated the joint effect of retinopathy and chronic kidney disease (CKD) on mortality in a representative sample of US adults. Study Design Prospective cohort study. Setting & Participants 7,640 adults from the National Health and Nutrition Examination Survey (NHANES) 1988–1994 with mortality linkage through 12/31/2006. Predictors CKD, defined as low estimated glomerular filtration rate (eGFR; <60 ml/min/1.73 m2) or albuminuria (urine protein-creatinine ratio ≥30mg/g), and retinopathy, defined as presence of microaneurysms, hemorrhages, exudates, microvascular abnormalities, or other evidence of diabetic retinopathy by fundus photograph. Outcomes All-cause and cardiovascular mortality. Measurements Multivariable-adjusted Cox proportional hazards. Results Overall, 4.6% of participants had retinopathy and 15% had CKD. Mean age was 56 years, 53% were women and 81% non-Hispanic white. Prevalence of retinopathy in CKD was 11%. We identified 2,634 deaths during 14.5 years’ follow-up. In multivariable analyses, compared with individuals with neither CKD nor retinopathy, the HRs for all-cause mortality were 1.02 (95% CI, 0.75–1.38), 1.52 (95% CI, 1.35–1.72), and 2.39 (95% CI, 1.77–3.22) for individuals with retinopathy only, for those with CKD only, and for those with both CKD and retinopathy, respectively. Corresponding HRs for cardiovascular mortality were 0.96 (95% CI, 0.50–1.84), 1.72 (95% CI, 1.47–2.00) and 2.96 (95% CI, 2.11–4.15), respectively. There was a significant synergistic interaction between retinopathy and CKD on all-cause mortality (p=0.04). Limitations Presence of retinopathy was evaluated only once. Small sample size of some of the subpopulations studied. Conclusions In the presence of CKD, retinopathy is a strong predictor of mortality in this adult population. PMID:24656452

  20. Measures of anticholinergic drug exposure, serum anticholinergic activity, and all-cause postdischarge mortality in older hospitalized patients with hip fractures

    NARCIS (Netherlands)

    Mangoni, Arduino A; van Munster, Barbara C; Woodman, Richard J; de Rooij, Sophia E

    2013-01-01

    OBJECTIVES: To assess possible associations between anticholinergic drug exposure and serum anticholinergic activity (SAA) and their capacities to predict all-cause mortality in older hospitalized patients. SETTING: Academic medical center. PARTICIPANTS AND MEASUREMENTS: Data on clinical characteris

  1. Measures of anticholinergic drug exposure, serum anticholinergic activity, and all-cause postdischarge mortality in older hospitalized patients with hip fractures

    NARCIS (Netherlands)

    Mangoni, Arduino A.; van Munster, Barbara C.; Woodman, Richard J.; de Rooij, Sophia E.

    2013-01-01

    Objectives: To assess possible associations between anticholinergic drug exposure and serum anticholinergic activity (SAA) and their capacities to predict all-cause mortality in older hospitalized patients. Setting: Academic medical center. Participants and Measurements: Data on clinical characteris

  2. Urinary biomarkers are associated with incident cardiovascular disease, all-cause mortality and deterioration of kidney function in type 2 diabetic patients with microalbuminuria

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine W;

    2016-01-01

    AIMS/HYPOTHESIS: We evaluated two urinary biomarkers reflecting different aspects of renal pathophysiology as potential determinants of incident cardiovascular disease (CVD), all-cause mortality and a reduced estimated GFR (eGFR) in patients with type 2 diabetes and microalbuminuria but without...... diabetes and microalbuminuria receiving multifactorial treatment, higher urinary HGF was associated with incident CVD and all-cause mortality, and higher adiponectin was associated with CVD and deterioration in renal function....

  3. The Impact of Superoxide Dismutase-1 Genetic Variation on Cardiovascular and All-Cause Mortality in a Prospective Cohort Study: The Yamagata (Takahata) Study

    Science.gov (United States)

    Otaki, Yoichiro; Watanabe, Tetsu; Nishiyama, Satoshi; Takahashi, Hiroki; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo; Shibata, Yoko; Sato, Hidenori; Kawasaki, Ryo; Daimon, Makoto; Ueno, Yoshiyuki; Kato, Takeo; Kayama, Takamasa; Kubota, Isao

    2016-01-01

    Background Oxidative stress is a major cause of cardiovascular disease. Superoxide dismutase-1 (SOD1) is an antioxidant that protects against oxidative stress. Deoxyribonucleic acid (DNA) variations such as single nucleotide polymorphism (SNP) or haplotypes within the SOD gene are reportedly associated with the development of cardiovascular disease. However, it remains to be determined whether SOD1 variability is associated with cardiovascular or all-cause mortality in the general population. Methods and Results This prospective cohort study included 2799 subjects who participated in a community-based health study with a 10-year follow-up. We genotyped 639 SNPs and found the association of SNP rs1041740 and rs17880487 within a SOD1 gene with cardiovascular mortality. There were 193 deaths during the follow-up period including 57 cardiovascular deaths. Multivariate Cox proportional hazard regression analysis revealed that the homozygous T-allele of rs1041740 was associated with all-cause and cardiovascular deaths after adjusting for confounding factors. The net reclassification index was significantly improved by adding rs1041740 as a cardiovascular risk factor. On the other hand, cardiovascular death was not observed in homozygous T-allele carriers of rs17880487. Haplotype analysis identified the haplotype with T-allele of rs1041740 and that with T-allele of rs17880487 as increasing and decreasing susceptibility for cardiovascular mortality, and it had complementary SNP sequences. Conclusion Variation in the SOD1 gene was associated with cardiovascular deaths in the general population. PMID:27755600

  4. Resting heart rate is associated with cardiovascular and all-cause mortality after adjusting for inflammatory markers: The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Marott, Jacob L; Allin, Kristine H

    2012-01-01

    Aims: To investigate the association between resting heart rate (RHR) and markers of chronic low-grade inflammation. Also, to examine whether elevated resting heart rate is independently associated with cardiovascular and all-cause mortality in the general population, or whether elevated RHR...... is merely a marker of chronic low-grade inflammation. Methods and results: A group of 6518 healthy subjects from the the Danish general population were followed for 18 years during which 1924 deaths occurred. Subjects underwent assessment of baseline RHR, conventional cardiovascular risk factors, high...

  5. Occupational class inequalities in all-cause and cause-specific mortality among middle-aged men in 14 European populations during the early 2000s.

    Directory of Open Access Journals (Sweden)

    Marlen Toch-Marquardt

    Full Text Available This study analyses occupational class inequalities in all-cause mortality and four specific causes of death among men, in Europe in the early 2000s, and is the most extensive comparative analysis of occupational class inequalities in mortality in Europe so far. Longitudinal data, obtained from population censuses and mortality registries in 14 European populations, from around the period 2000-2005, were used. Analyses concerned men aged 30-59 years and included all-cause mortality and mortality from all cancers, all cardiovascular diseases (CVD, all external, and all other causes. Occupational class was analysed according to five categories: upper and lower non-manual workers, skilled and unskilled manual workers, and farmers and self-employed combined. Inequalities were quantified with mortality rate ratios, rate differences, and population attributable fractions (PAF. Relative and absolute inequalities in all-cause mortality were more pronounced in Finland, Denmark, France, and Lithuania than in other populations, and the same countries (except France also had the highest PAF values for all-cause mortality. The main contributing causes to these larger inequalities differed strongly between countries (e.g., cancer in France, all other causes in Denmark. Relative and absolute inequalities in CVD mortality were markedly lower in Southern European populations. We conclude that relative and absolute occupational class differences in all-cause and cause specific mortality have persisted into the early 2000's, although the magnitude differs strongly between populations. Comparisons with previous studies suggest that the relative gap in mortality between occupational classes has further widened in some Northern and Western European populations.

  6. Intake of vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a European diabetic population

    DEFF Research Database (Denmark)

    Nöthlings, Ute; Schulze, Matthias B; Weikert, Cornelia

    2008-01-01

    .81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies...

  7. Fitness, work, and leisure-time physical activity and ischaemic heart disease and all-cause mortality among men with pre-existing cardiovascular disease

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

    2010-01-01

    OBJECTIVE: Our aim was to study the relative impact of physical fitness, physical demands at work, and physical activity during leisure time on ischaemic heart disease (IHD) and all-cause mortality among employed men with pre-existing cardiovascular disease (CVD). METHOD: We carried out a 30-year...... physical work demands and leisure-time physical activity using a self-reported questionnaire. Results Among 274 men with a history of CVD, 93 men died from IHD. Using male employees with a history of CVD and a low level of fitness as the reference group, our Cox analyses - adjusted for age, blood pressure......, smoking, alcohol consumption, body mass index, diabetes, hypertension, physical work demands, leisure-time physical activity, and social class - showed a substantially reduced risk for IHD mortality among employees who were intermediately fit [VO (2)Max range 25-36; hazard ratio (HR) 0.54, 95% confidence...

  8. Anxiety and Depressive Symptoms as Predictors of All-Cause Mortality among People with Insulin-Naïve Type 2 Diabetes

    DEFF Research Database (Denmark)

    Iversen, Marjolein M; Nefs, Giesje; Tell, Grethe S

    2016-01-01

    AIM: To examine whether elevated anxiety and/or depressive symptoms are related to all-cause mortality in people with Type 2 diabetes, not using insulin. METHODS: 948 participants in the community-wide Nord-Trøndelag Health Survey conducted during 1995-97 completed the Hospital Anxiety...... and Depression Scale with subscales of anxiety (HADS-A) and depression (HADS-D). Elevated symptoms were defined as HADS-A or HADS-D ≥8. Participants with type 2 diabetes, not using insulin, were followed until November 21, 2012 or death. Cox regression analyses were used to estimate associations between baseline...... elevated anxiety symptoms, elevated depressive symptoms and mortality, adjusting for sociodemographic factors, HbA1c, cardiovascular disease and microvascular complications. RESULTS: At baseline, 8% (n = 77/948) reported elevated anxiety symptoms, 9% (n = 87/948) elevated depressive symptoms and 10% (n...

  9. Health-related quality of life and all-cause mortality in patients with diabetes on dialysis

    Directory of Open Access Journals (Sweden)

    Østhus Tone Britt

    2012-08-01

    Full Text Available Abstract Background This study tests the hypotheses that health-related quality of life (HRQOL in prevalent dialysis patients with diabetes is lower than in dialysis patients without diabetes, and is at least as poor as diabetic patients with another severe complication, i.e. foot ulcers. This study also explores the mortality risk associated with diabetes in dialysis patients. Methods HRQOL was assessed using the Short Form-36 Health Survey (SF-36, in a cross-sectional study of 301 prevalent dialysis patients (26% with diabetes, and compared with diabetic patients not on dialysis (n = 221, diabetic patients with foot ulcers (n = 127, and a sample of the general population (n = 5903. Mortality risk was assessed using a Kaplan-Meier plot and Cox proportional hazards analysis. Results Self-assessed vitality, general and mental health, and physical function were significantly lower in dialysis patients with diabetes than in those without. Vitality (p = 0.011 and general health (p Conclusions Physical aspects of HRQOL were perceived very low in dialysis patients with diabetes, and lower than in other dialysis patients and diabetic patients without dialysis. Mental aspects predicted mortality in dialysis patients with diabetes. Increased awareness and measures to assist physical function impairment may be particularly important in diabetes patients on dialysis.

  10. Prognostic value of physicians' assessment of compliance regarding all-cause mortality in patients with type 2 diabetes: primary care follow-up study

    Directory of Open Access Journals (Sweden)

    Rüter Gernot

    2006-07-01

    Full Text Available Abstract Background Whether the primary care physician's assessment of patient compliance is a valuable prognostic marker to identify patients who are at increased risk of death, or merely reflects measurement of various treatment parameters such as HbA1C or other laboratory markers is unclear. The objective of this prospective cohort study was to investigate the prognostic value of the physicians' assessment of patient compliance and other factors with respect to all-cause mortality during a one year follow-up period. Methods A prospective cohort study was conducted among 1014 patients with type 2 diabetes aged 40 and over (mean age 69 years, SD 10.4, 45% male who were under medical treatment in 11 participating practices of family physicians and internists working in primary care in a defined region in South Germany between April and June 2000. Baseline data were gathered from patients and physicians by standardized questionnaire. The physician's assessment of patient compliance was assessed by means of a 4-point Likert scale (very good, rather good, rather bad, very bad. In addition, we carried out a survey among physicians by means of a questionnaire to find out which aspects for the assessment of patient compliance were of importance to make this assessment. Active follow-up of patients was conducted after one year to determine mortality. Results During the one year follow-up 48 (4.7% of the 1014 patients died. Among other factors such as patient type (patients presenting at office, nursing home or visited patients, gender, age and a history of macrovascular disease, the physician's assessment of patient compliance was an important predictor of all-cause mortality. Patients whose compliance was assessed by the physician as "very bad" (6% were significantly more likely to die during follow-up (OR = 2.67, 95% CI 1.02–6.97 after multivariable adjustment compared to patients whose compliance was assessed as "rather good" (45% or "very good

  11. Dose-response relationship of physical activity to premature and total all-cause and cardiovascular disease mortality in walkers.

    Directory of Open Access Journals (Sweden)

    Paul T Williams

    Full Text Available PURPOSE: To assess the dose-response relationships between cause-specific mortality and exercise energy expenditure in a prospective epidemiological cohort of walkers. METHODS: The sample consisted of the 8,436 male and 33,586 female participants of the National Walkers' Health Study. Walking energy expenditure was calculated in metabolic equivalents (METs, 1 MET = 3.5 ml O2/kg/min, which were used to divide the cohort into four exercise categories: category 1 (≤ 1.07 MET-hours/d, category 2 (1.07 to 1.8 MET-hours/d, category 3 (1.8 to 3.6 MET-hours/d, and category 4 (≥ 3.6 MET-hours/d. Competing risk regression analyses were use to calculate the risk of mortality for categories 2, 3 and 4 relative to category 1. RESULTS: 22.9% of the subjects were in category 1, 16.1% in category 2, 33.3% in category 3, and 27.7% in category 4. There were 2,448 deaths during the 9.6 average years of follow-up. Total mortality was 11.2% lower in category 2 (P = 0.04, 32.4% lower in category 3 (P<10(-12 and 32.9% lower in category 4 (P = 10(-11 than in category 1. For underlying causes of death, the respective risk reductions for categories 2, 3 and 4 were 23.6% (P = 0.008, 35.2% (P<10(-5, and 34.9% (P = 0.0001 for cardiovascular disease mortality; 27.8% (P = 0.18, 20.6% (P = 0.07, and 31.4% (P = 0.009 for ischemic heart disease mortality; and 39.4% (P = 0.18, 63.8% (P = 0.005, and 90.6% (P = 0.002 for diabetes mortality when compared to category 1. For all related mortality (i.e., underlying and contributing causes of death combined, the respective risk reductions for categories 2, 3 and 4 were 18.7% (P = 0.22, 42.5% (P = 0.001, and 57.5% (P = 0.0001 for heart failure; 9.4% (P = 0.56, 44.3% (P = 0.0004, and 33.5% (P = 0.02 for hypertensive diseases; 11.5% (P = 0.38, 41.0% (P<10(-4, and 35.5% (P = 0.001 for dysrhythmias: and 23.2% (P = 0.13, 45.8% (P = 0.0002, and 41.1% (P

  12. The combined relationship of occupational and leisure-time physical activity with all-cause mortality among men, accounting for physical fitness.

    Science.gov (United States)

    Clays, Els; Lidegaard, Mark; De Bacquer, Dirk; Van Herck, Koen; De Backer, Guy; Kittel, France; de Smet, Patrick; Holtermann, Andreas

    2014-03-01

    The aim of this study was to assess the combined relationship of occupational physical activity and leisure-time physical activity with all-cause mortality among men, while accounting for physical fitness. The prospective Belgian Physical Fitness Study included 1,456 male workers aged 40-55 years who were free of coronary heart disease at baseline. Baseline data were collected through questionnaires and clinical examinations from 1976 to 1978. To estimate physical fitness, a submaximal graded exercise test was performed on a bicycle ergometer. Total mortality was registered during a mean follow-up period of 16.9 years. Main results were obtained through Cox proportional hazards regression analysis. A total of 145 deaths were registered during follow-up. After adjustment for confounders, a significantly increased mortality rate was observed in workers who had low levels of both physical activity types (hazard ratio = 2.07, 95% confidence interval: 1.03, 4.19) but also in workers combining high occupational physical activity and low leisure-time physical activity (hazard ratio = 2.04, 95% confidence interval: 1.07, 3.91); the latter finding was particularly pronounced among workers with a low physical fitness level. The present results confirm the existence of a complex interplay among different physical activity settings and fitness levels in predicting mortality.

  13. Seasonal variations of all-cause and cause-specific mortality by age, gender, and socioeconomic condition in urban and rural areas of Bangladesh

    Directory of Open Access Journals (Sweden)

    Burkart Katrin

    2011-08-01

    Full Text Available Abstract Background Mortality exhibits seasonal variations, which to a certain extent can be considered as mid-to long-term influences of meteorological conditions. In addition to atmospheric effects, the seasonal pattern of mortality is shaped by non-atmospheric determinants such as environmental conditions or socioeconomic status. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures. The pressures of climate change make an understanding of the interdependencies between season, climate and health especially important. Methods This study investigated daily death counts collected within the Sample Vital Registration System (VSRS established by the Bangladesh Bureau of Statistics (BBS. The sample was stratified by location (urban vs. rural, gender and socioeconomic status. Furthermore, seasonality was analyzed for all-cause mortality, and several cause-specific mortalities. Daily deviation from average mortality was calculated and seasonal fluctuations were elaborated using non parametric spline smoothing. A seasonality index for each year of life was calculated in order to assess the age-dependency of seasonal effects. Results We found distinctive seasonal variations of mortality with generally higher levels during the cold season. To some extent, a rudimentary secondary summer maximum could be observed. The degree and shape of seasonality changed with the cause of death as well as with location, gender, and SES and was strongly age-dependent. Urban areas were seen to be facing an increased summer mortality peak, particularly in terms of cardiovascular mortality. Generally, children and the elderly faced stronger seasonal effects than youths and young adults. Conclusion This study clearly demonstrated the complex and dynamic nature of seasonal impacts on mortality. The modifying effect of spatial and population characteristics were highlighted. While tropical regions have

  14. N-terminal pro-brain natriuretic peptide and cardiovascular or all-cause mortality in the general population: A meta-analysis

    Science.gov (United States)

    Geng, Zhaohua; Huang, Lan; Song, Mingbao; Song, Yaoming

    2017-01-01

    The prognostic role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the general population remains controversial. We conducted this meta-analysis to investigate the association between baseline NT-proBNP concentrations and cardiovascular or all-cause mortality in the general population. PubMed and Embase databases were systematically searched from their inception to August 2016. Prospective observational studies that investigated the association between baseline NT-proBNP concentrations and cardiovascular or all-cause mortality in the general population were eligible. A summary of the hazard ratio (HR) and 95% confidence interval (CI) of mortality were calculated by the highest versus the lowest category of NT-proBNP concentrations. Eleven studies with a total of 25,715 individuals were included. Compared individuals in the highest with those in the lowest category of NT-proBNP, the pooled HR was 2.44 (95% CI 2.11–2.83) for all-cause mortality, 3.77 (95% CI 2.85–5.00) for cardiovascular mortality, and 2.35 (95% CI 1.45–3.82) for coronary heart disease mortality, respectively. Subgroup analyses indicated that the effects of NT-proBNP on the risk of cardiovascular mortality (RR 2.27) and all-cause mortality (RR 3.00) appeared to be slightly lower among men. Elevated NT-proBNP concentrations appeared to be independently associated with increased risk of cardiovascular and all-cause mortality in the general population. PMID:28134294

  15. Occupational noise exposure, social class, and risk of ischemic heart disease and all-cause mortality - a 16-year follow-up in the Copenhagen Male Study

    DEFF Research Database (Denmark)

    Suadicani, Poul; Hein, Hans Ole; Gyntelberg, Finn

    2012-01-01

    OBJECTIVE: Long-term exposure to occupational noise may be associated with an increased risk of ischemic heart disease (IHD) and all-cause mortality. However, the issue remains unsettled. Only a small number of longitudinal studies have been carried out, and control for potential confounders...... including a strong correlate of noise exposure namely social class may have been insufficient. METHODS: We carried out a 16-year follow-up of 2998 men aged 53-75 years without overt cardiovascular disease. RESULT: Overall, 197 men (6.6%) died due to IHD and 1192 (39.8%) from all-causes. Of the 2998 men......, 1008 (33.6%) reported exposure to occupational noise for ≥5 years [mean 25.4, standard deviation (SD) 12.5 years]; among these men, 47.3% reported hearing impairment versus only 24.8% among unexposed men (63.0%). Referencing unexposed men, the hazard ratio (HR) for IHD mortality was 0.97 [95...

  16. The Pretreatment Neutrophil/Lymphocyte Ratio Is Associated with All-Cause Mortality in Black and White Patients with Non-metastatic Breast Cancer.

    Science.gov (United States)

    Rimando, Joseph; Campbell, Jeff; Kim, Jae Hee; Tang, Shou-Ching; Kim, Sangmi

    2016-01-01

    The pretreatment neutrophil/lymphocyte ratio (NLR), derived from differential white blood cell counts, has been previously associated with poor prognosis in breast cancer. Little data exist, however, concerning this association in Black patients, who are known to have lower neutrophil counts than other racial groups. We conducted a retrospective cohort study of 236 Black and 225 non-Hispanic White breast cancer patients treated at a single institution. Neutrophil and lymphocyte counts were obtained from electronic medical records. Univariate and multivariate Cox regression models were used to determine hazard ratios (HRs) and 95% confidence intervals (95% CIs) of all-cause mortality and breast cancer-specific mortality in relation to pretreatment NLR. Overall, there were no associations between an elevated pretreatment NLR (NLR ≥3.7) and all-cause or breast cancer-specific mortality. Among patients without metastasis at the time of diagnosis, an elevated pretreatment NLR was independently associated with all-cause mortality, with a multivariable HR of 2.31 (95% CI: 1.10-4.86). Black patients had significantly lower NLR values than White patients, but there was no evidence suggesting racial heterogeneity of the prognostic utility of NLR. Pretreatment NLR was an independent predictor of all-cause mortality but not breast cancer-specific mortality in non-metastatic breast cancer patients.

  17. Short-term effect of dust storms on the risk of mortality due to respiratory, cardiovascular and all-causes in Kuwait

    Science.gov (United States)

    Al-Taiar, Abdullah; Thalib, Lukman

    2014-01-01

    This study aimed to investigate the impact of dust storms on short-term mortality in Kuwait. We analyzed respiratory and cardiovascular mortality as well as all-cause mortality in relation to dust storm events over a 5-year study period, using data obtained through a population-based retrospective ecological time series study. Dust storm days were identified when the national daily average of PM10 exceeded 200 μg/m3. Generalized additive models with Poisson link were used to estimate the relative risk (RR) of age-stratified daily mortality associated with dust events, after adjusting for potential confounders including weather variables and long-term trends. There was no significant association between dust storm events and same-day respiratory mortality (RR = 0.96; 95 %CI 0.88-1.04), cardiovascular mortality (RR = 0.98; 95 %CI 0.96-1.012) or all-cause mortality (RR = 0.99; 95 %CI 0.97-1.00). Overall our findings suggest that local dust, that most likely originates from crustal materials, has little impact on short-term respiratory, cardiovascular or all-cause mortality.

  18. Single nucleotide polymorphisms in obesity-related genes and all-cause and cause-specific mortality: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Ruczinski Ingo

    2009-10-01

    Full Text Available Abstract Background The aim of this study was to examine the associations between 16 specific single nucleotide polymorphisms (SNPs in 8 obesity-related genes and overall and cause-specific mortality. We also examined the associations between the SNPs and body mass index (BMI and change in BMI over time. Methods Data were analyzed from 9,919 individuals who participated in two large community-based cohort studies conducted in Washington County, Maryland in 1974 (CLUE I and 1989 (CLUE II. DNA from blood collected in 1989 was genotyped for 16 SNPs in 8 obesity-related genes: monoamine oxidase A (MAOA, lipoprotein lipase (LPL, paraoxonase 1 and 2 (PON1 and PON2, leptin receptor (LEPR, tumor necrosis factor-α (TNFα, and peroxisome proliferative activated receptor-γ and -δ (PPARG and PPARD. Data on height and weight in 1989 (CLUE II baseline and at age 21 were collected from participants at the time of blood collection. All participants were followed from 1989 to the date of death or the end of follow-up in 2005. Cox proportional hazards regression was used to obtain the relative risk (RR estimates and 95% confidence intervals (CI for each SNP and mortality outcomes. Results The results showed no patterns of association for the selected SNPs and the all-cause and cause-specific mortality outcomes, although statistically significant associations (p PPARG rs4684847 and all-cause mortality (CC: reference; CT: RR 0.99, 95% CI 0.89, 1.11; TT: RR 0.60, 95% CI 0.39, 0.93 and cancer-related mortality (CC: reference; CT: RR 1.01, 95% CI 0.82, 1.25; TT: RR 0.22, 95% CI 0.06, 0.90 and TNFα rs1799964 and cancer-related mortality (TT: reference; CT: RR 1.23, 95% CI 1.03, 1.47; CC: RR 0.83, 95% CI 0.54, 1.28. Additional analyses showed significant associations between SNPs in LEPR with BMI (rs1137101 and change in BMI over time (rs1045895 and rs1137101. Conclusion Findings from this cohort study suggest that the selected SNPs are not associated with overall

  19. Heat effects of ambient apparent temperature on all-cause mortality in Cape Town, Durban and Johannesburg, South Africa: 2006-2010.

    Science.gov (United States)

    Wichmann, Janine

    2017-06-01

    Due to climate change, an increase of 3-4°C in ambient temperature is projected along the South African coast and 6-7°C inland during the next 80years. The objective of this study was to investigate the association between daily ambient apparent temperature (Tapp) and daily all-cause non-accidental mortality (hereafter mortality) in Cape Town, Durban and Johannesburg during a 5-year study period (2006-2010). Susceptibility by sex and age groups (Cape Town, Durban and Johannesburg. A 3.3%, 2.6% and 2.8% increase in mortality per IQR increase in Tapp (lag0-1) was observed in Cape Town, Durban and Johannesburg, respectively above the city-specific thresholds. The elderly were more at risk in Cape Town and Johannesburg. No difference in risk was observed for males and females in the three cities. In the meta-analysis an overall significant increase of 0.9% in mortality per 1°C increase in Tapp (lag0-1) was observed for all age groups combined in the three cities. For the ≥65year group a significant increase of 2.1% in mortality was observed. In conclusion, the risks for all age groups combined and the elderly are similar to those reported in studies from developed and developing countries. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased Tapp in the country due to climate change. Future research should investigate the association between Tapp and cause-specific mortality and also morbidity.

  20. Higher plasma soluble Receptor for Advanced Glycation End Products (sRAGE) levels are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes

    DEFF Research Database (Denmark)

    Nin, Johanna W M; Jorsal, Anders; Ferreira, Isabel;

    2010-01-01

    To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunct......To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal...... dysfunction, low-grade inflammation, arterial stiffness, and advanced glycation end products (AGEs)....

  1. Vegetarian diet and all-cause mortality: Evidence from a large population-based Australian cohort - the 45 and Up Study.

    Science.gov (United States)

    Mihrshahi, Seema; Ding, Ding; Gale, Joanne; Allman-Farinelli, Margaret; Banks, Emily; Bauman, Adrian E

    2017-04-01

    The vegetarian diet is thought to have health benefits including reductions in type 2 diabetes, hypertension, and obesity. Evidence to date suggests that vegetarians tend to have lower mortality rates when compared with non-vegetarians, but most studies are not population-based and other healthy lifestyle factors may have confounded apparent protective effects. The aim of this study was to evaluate the association between categories of vegetarian diet (including complete, semi and pesco-vegetarian) and all-cause mortality in a large population-based Australian cohort. The 45 and Up Study is a cohort study of 267,180 men and women aged ≥45years in New South Wales (NSW), Australia. Vegetarian diet status was assessed by baseline questionnaire and participants were categorized into complete vegetarians, semi-vegetarians (eat meat≤once/week), pesco-vegetarians and regular meat eaters. All-cause mortality was determined by linked registry data to mid-2014. Cox proportional hazards models quantified the association between vegetarian diet and all-cause mortality adjusting for a range of potential confounding factors. Among 243,096 participants (mean age: 62.3years, 46.7% men) there were 16,836 deaths over a mean 6.1years of follow-up. Following extensive adjustment for potential confounding factors there was no significant difference in all-cause mortality for vegetarians versus non-vegetarians [HR=1.16 (95% CI 0.93-1.45)]. There was also no significant difference in mortality risk between pesco-vegetarians [HR=0.79 (95% CI 0.59-1.06)] or semi-vegetarians [HR=1.12 (95% CI 0.96-1.31)] versus regular meat eaters. We found no evidence that following a vegetarian diet, semi-vegetarian diet or a pesco-vegetarian diet has an independent protective effect on all-cause mortality.

  2. All-cause mortality and risk factors in a cohort of retired military male veterans, Xi'an, China: an 18-year follow up study

    Directory of Open Access Journals (Sweden)

    Li Liang S

    2007-10-01

    Full Text Available Abstract Background Risk factors of all-cause mortality have not been reported in Chinese retired military veterans. The objective of the study was to examine the risk factors and proportional mortality in a Chinese retired military male cohort. Methods A total of 1268 retired military men aged 55 or older were examined physically and interviewed using a standard questionnaire in 1987. The cohort was followed up every two years and the study censored date was June30, 2005 with a follow-up of up to 18 years. Death certificates were obtained from hospitals and verified by two senior doctors. Data were entered (double entry by Foxbase, and analysis was carried out by SAS for Windows 8.2. Multivariate Cox proportional hazard regression model was used to compute hazard ratio (HR and 95% confidence interval (CI. Results The total person-years of follow-up was 18766.28. Of the initial cohort of 1268 men, 491 had died, 748 were alive and 29 were lost to follow up. Adjusted mortality (adjusted for age, blood pressure, body mass index, cholesterol, triglycerides, alcohol, exercise, and existing disease was 2,616 per 100,000 person years. The proportional mortality of cancer, vascular disease and Chronic Obstructive Pulmonary Disease (COPD were 39.71%, 28.10% and 16.90% respectively. Multivariate analysis showed that age, cigarettes per day, systolic blood pressure, triglyceride, family history of diseases (hypertension, stroke and cancer, existing diseases (stroke, diabetes and cancer, body mass index, and age of starting smoking were associated with all-cause mortality, HR (95%CI was1.083(1.062–1.104, 1.026(1.013–1.039, 1.009(1.003–1.015, 1.002(1.001–1.003, 1.330(1.005–1.759, 1.330(1.005–1.759, 1.444(1.103–1.890, 2.237(1.244–4.022, 1.462(1.042–2.051, 2.079(1.051–4.115, 0.963(0.931–0.996and 0.988(0.978–0.999respectively. Compared with never-smokers, current smokers had increased risks of total mortality [HR 1.369(1.083–1

  3. Relation between early life socioeconomic position and all cause mortality in two generations. A longitudinal study of Danish men born in 1953 and their parents

    DEFF Research Database (Denmark)

    Osler, Merete; Andersen, Anne-Marie Nybo; Batty, G David;

    2005-01-01

    OBJECTIVE: To examine (1) the relation between parental socioeconomic position and all cause mortality in two generations, (2) the relative importance of mother's educational status and father's occupational status on offspring mortality, and (3) the effect of factors in the family environment...... triads of father, mother, and offspring constituted of the cohort of men born in 1953, their parents, and grandparents. The educational status of mothers showed no independent effect on total mortality when father's occupational social class was included in the model in either of the triads. Low material...... wealth was the indicator that remained significantly associated with adult all cause mortality in a model also including parental social position and the intellectual climate of the family in 1968. In the men born in 1953 the influence of material wealth was strongest for deaths later in adult life...

  4. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis

    DEFF Research Database (Denmark)

    Grøntved, Anders; Hu, Frank B

    2011-01-01

    Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available....

  5. Alcohol consumption, new onset of diabetes after transplantation, and all-cause mortality in renal transplant recipients

    NARCIS (Netherlands)

    Zelle, Dorien M.; Agarwal, Pramod K.; Ramirez, Jessica L. Pinto; van der Heide, Jaap J. Homan; Corpeleijn, Eva; Gans, Reinold O. B.; Navis, Gerjan; Bakker, Stephan J. L.

    2011-01-01

    Background. Renal transplant recipients (RTR) are often advised to refrain from alcohol because of possible interaction with their immunosuppressive medication. Although moderate alcohol consumption is associated with reduced risk of diabetes and mortality in the general population, this is unknown

  6. Cardiac troponin and C-reactive protein for predicting all-cause and cardiovascular mortality in patients with chronic kidney disease: a meta-analysis.

    Science.gov (United States)

    Li, Wei-Jie; Chen, Xu-Miao; Nie, Xiao-Ying; Zhang, Jing; Cheng, Yun-Jiu; Lin, Xiao-Xiong; Wu, Su-Hua

    2015-04-01

    Elevated serum levels of cardiac troponin and C-reactive protein are associated with all-cause and cardiovascular mortality in patients with end-stage renal disease. However, the relationship between these two biomarker levels and mortality in patients with chronic kidney disease remains unclear. We conducted a meta-analysis to quantify the association of cardiac troponin and C-reactive protein levels with all-cause and cardiovascular mortality in patients with chronic kidney disease. Relevant studies were identified by searching the MEDLINE database through November 2013. Studies were included in the meta-analysis if they reported the long-term all-cause or cardiovascular mortality of chronic kidney disease patients with abnormally elevated serum levels of cardiac troponin or C-reactive protein. Summary estimates of association were obtained using a random-effects model. Thirty-two studies met our inclusion criteria. From the pooled analysis, cardiac troponin and C-reactive protein were significantly associated with all-cause (HR 2.93, 95% CI 1.97-4.33 and HR 1.21, 95% CI 1.14-1.29, respectively) and cardiovascular (HR 3.27, 95% CI 1.67-6.41 and HR 1.19, 95% CI 1.10-1.28, respectively) mortality. In the subgroup analysis of cardiac troponin and C-reactive protein, significant heterogeneities were found among the subgroups of population for renal replacement therapy and for the proportion of smokers and the C-reactive protein analysis method. Elevated serum levels of cardiac troponin and C-reactive protein are significant associated with higher risks of all-cause and cardiovascular mortality in patients with chronic kidney disease. Further studies are warranted to explore the risk stratification in chronic kidney disease patients.

  7. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts.

    Science.gov (United States)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew; de Jong, Paul; Gansevoort, Ron T; van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew S; de Jong, Paul E; Gansevoort, Ron T; Levey, Andrew; El-Nahas, Meguid; Eckardt, Kai-Uwe; Kasiske, Bertram L; Ninomiya, Toshiharu; Chalmers, John; Macmahon, Stephen; Tonelli, Marcello; Hemmelgarn, Brenda; Sacks, Frank; Curhan, Gary; Collins, Allan J; Li, Suying; Chen, Shu-Cheng; Hawaii Cohort, K P; Lee, Brian J; Ishani, Areef; Neaton, James; Svendsen, Ken; Mann, Johannes F E; Yusuf, Salim; Teo, Koon K; Gao, Peggy; Nelson, Robert G; Knowler, William C; Bilo, Henk J; Joosten, Hanneke; Kleefstra, Nanno; Groenier, K H; Auguste, Priscilla; Veldhuis, Kasper; Wang, Yaping; Camarata, Laura; Thomas, Beverly; Manley, Tom

    2011-06-01

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative meta-analysis of 10 cohorts with 266,975 patients selected because of increased risk for chronic kidney disease, defined as a history of hypertension, diabetes, or cardiovascular disease. Risk for all-cause mortality was not associated with eGFR between 60-105 ml/min per 1.73 m², but increased at lower levels. Hazard ratios at eGFRs of 60, 45, and 15 ml/min per 1.73 m² were 1.03, 1.38 and 3.11, respectively, compared to an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log risk for all-cause mortality without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 10, 30 and 300 mg/g were 1.08, 1.38, and 2.16, respectively compared to a ratio of five. Albuminuria and eGFR were multiplicatively associated with all-cause mortality, without evidence for interaction. Similar associations were observed for cardiovascular mortality. Findings in cohorts with dipstick data were generally comparable to those in cohorts measuring albumin-to-creatinine ratios. Thus, lower eGFR and higher albuminuria are risk factors for all-cause and cardiovascular mortality in high-risk populations, independent of each other and of cardiovascular risk factors.

  8. Neighbourhood Characteristics and Long-Term Air Pollution Levels Modify the Association between the Short-Term Nitrogen Dioxide Concentrations and All-Cause Mortality in Paris.

    Directory of Open Access Journals (Sweden)

    Séverine Deguen

    Full Text Available While a great number of papers have been published on the short-term effects of air pollution on mortality, few have tried to assess whether this association varies according to the neighbourhood socioeconomic level and long-term ambient air concentrations measured at the place of residence. We explored the effect modification of 1 socioeconomic status, 2 long-term NO2 ambient air concentrations, and 3 both combined, on the association between short-term exposure to NO2 and all-cause mortality in Paris (France.A time-stratified case-crossover analysis was performed to evaluate the effect of short-term NO2 variations on mortality, based on 79,107 deaths having occurred among subjects aged over 35 years, from 2004 to 2009, in the city of Paris. Simple and double interactions were statistically tested in order to analyse effect modification by neighbourhood characteristics on the association between mortality and short-term NO2 exposure. The data was estimated at the census block scale (n=866.The mean of the NO2 concentrations during the five days prior to deaths were associated with an increased risk of all-cause mortality: overall Excess Risk (ER was 0.94% (95%CI=[0.08;1.80]. A higher risk was revealed for subjects living in the most deprived census blocks in comparison with higher socioeconomic level areas (ER=3.14% (95%CI=[1.41-4.90], p<0.001. Among these deprived census blocks, excess risk was even higher where long-term average NO2 concentrations were above 55.8 μg/m3 (the top tercile of distribution: ER=4.84% (95%CI=[1.56;8.24], p for interaction=0.02.Our results show that people living in census blocks characterized by low socioeconomic status are more vulnerable to air pollution episodes. There is also an indication that people living in these disadvantaged census blocks might experience even higher risk following short-term air pollution episodes, when they are also chronically exposed to higher NO2 levels.

  9. Changes in physical activity in leisure time and the risk of myocardial infarction, ischemic heart disease, and all-cause mortality

    DEFF Research Database (Denmark)

    Petersen, Christina Bjørk; Grønbæk, Morten; Helge, Jørn Wulff;

    2012-01-01

    Physical activity is associated to a lower risk of mortality from all-causes and from coronary heart disease. The long-term effects of changes in physical activity on coronary heart disease are, however, less known. We examined the association between changes in leisure time physical activity...

  10. Eosinophilia is associated with increased all-cause mortality after a follow-up of 30 years in a general population sample

    NARCIS (Netherlands)

    Hospers, JJ; Schouten, JP; Weiss, ST; Postma, DS; Rijcken, B

    2000-01-01

    We investigated whether allergy is associated with increased all-cause mortality. Two allergy markers, peripheral blood eosinophilia (greater than or equal to 275 eosinophilic cells per mm(3)) and positive skin tests (sum score greater than or equal to 3), were available for 5,383 subjects of a coho

  11. Increased all-cause mortality with use of psychotropic medication in dementia patients and controls: A population-based register study

    DEFF Research Database (Denmark)

    Jennum, Poul; Baandrup, Lone; Ibsen, Rikke;

    2015-01-01

    We aimed to evaluate all-cause mortality of middle-aged and elderly subjects diagnosed with dementia and treated with psychotropic drugs as compared with controls subjects. Using data from the Danish National Patient Registry, n=26,821 adults with a diagnosis of dementia were included. They were ...

  12. Adherence to a healthy diet according to the world health organization guidelines and all-cause mortality in elderly adults from europe and the United States

    NARCIS (Netherlands)

    Jankovic, N.; Geelen, A.; Streppel, M.T.; Groot, L.C.P.G.M. de; Orfanos, P.; Hooven, E.H. van den; Pikhart, H.; Boffetta, P.; Trichopoulou, A.; Bobak, M.; Bueno-De-Mesquita, H.B.; Kee, F.; Franco, O.H.; Park, Y.; Hallmans, G.; Tjonneland, A.; May, A.M.; Pajak, A.; Malyutina, S.; Kubinova, R.; Amiano, P.; Kampman, E.; Feskens, E.J.

    2014-01-01

    The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly

  13. Fitness, work, and leisure-time physical activity and ischaemic heart disease and all-cause mortality among men with pre-existing cardiovascular disease

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

    2010-01-01

    Our aim was to study the relative impact of physical fitness, physical demands at work, and physical activity during leisure time on ischaemic heart disease (IHD) and all-cause mortality among employed men with pre-existing cardiovascular disease (CVD)....

  14. The reverse J shaped association between serum total 25- hydroxyvitamin D and all-cause mortality: The impact of assay standardization

    Science.gov (United States)

    The impact of standardizing the originally measured serum total 25-hydroxyvitamin D [25(OH)D] values from Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) on the association between 25(OH)D and rate of all-cause mortality was evaluated. Values were standardized to gold ...

  15. Meta-analysis of the effects of carvedilol versus metoprolol on all-cause mortality and hospitalizations in patients with heart failure.

    Science.gov (United States)

    Briasoulis, Alexandros; Palla, Mohan; Afonso, Luis

    2015-04-15

    Long-term treatment with appropriate doses of carvedilol or metoprolol is currently recommended for patients with heart failure with reduced ejection fraction (HFrEF) to decrease the risk of death, hospitalizations, and patients' symptoms. It remains unclear if the β blockers used in patients with HFrEF are equal or carvedilol is superior to metoprolol types. We performed a meta-analysis of the comparative effects of carvedilol versus metoprolol tartrate and succinate on all-cause mortality and/or hospitalization. We conducted an Embase and MEDLINE search for prospective controlled trials and cohort studies of patients with HFrEF who were received to treatment with carvedilol versus metoprolol. We identified 4 prospective controlled and 6 cohort studies with 30,943 patients who received carvedilol and 69,925 patients on metoprolol types (tartrate and succinate) with an average follow-up duration of 36.4 months. All-cause mortality was reduced in prospective studies with carvedilol versus metoprolol tartrate. Neither all-cause mortality nor hospitalizations were significantly different between carvedilol and metoprolol succinate in the cohort studies. In conclusion, in patients with HFrEF, carvedilol and metoprolol succinate have similar effects in reducing all-cause mortality.

  16. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    NARCIS (Netherlands)

    Geleijnse, J.M.

    2015-01-01

    Background

    Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countrie

  17. Increased orosomucoid in urine is an independent predictor of cardiovascular and all-cause mortality in patients with type 2 diabetes at 10 years of follow-up

    DEFF Research Database (Denmark)

    Svendstrup, Mathilde; Christiansen, Merete Skovdal; Magid, Erik;

    2013-01-01

    To evaluate whether increased urinary orosomucoid excretion rate (UOER) is an independent predictor of cardiovascular and all-cause mortality in type 2 diabetes (T2DM) and type 1 diabetes (T1DM) at 10years of follow-up....

  18. Plasma COOH-Terminal Proendothelin-1 A marker of fatal cardiovascular events, all-cause mortality, and new-onset albuminuria in type 2 diabetes? (ZODIAC-29)

    NARCIS (Netherlands)

    Drion, Iefke; Kleefstra, Nanne; Landman, Gijs W. D.; Alkhalaf, Alaa; Struck, Joachim; Groenier, Klaas H.; Bakker, Stephan J. L.; Bilo, Henk J. G.

    2012-01-01

    OBJECTIVE-The aim of this study was to investigate the association between plasma COOH-terminal proendothelin-1 (CT-proET-1) and fatal cardiovascular events, all-cause mortality, and new-onset albuminuria in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-A total of 1,225 patients with ty

  19. Risk of all-cause mortality associated with nonfatal AIDS and serious non-AIDS events among adults infected with HIV

    DEFF Research Database (Denmark)

    Neuhaus, Jacqueline; Angus, Brian; Kowalska, Justyna Dominika;

    2010-01-01

    Among patients with HIV, the risk of death associated with different AIDS events has been quantified, but the risk of death associated with non-AIDS events has not been examined. We compared the risk of all-cause mortality following AIDS versus serious non-AIDS (SNA) events in the Strategies for ...

  20. Clarithromycin for stable coronary heart disease increases all-cause and cardiovascular mortality and cerebrovascular morbidity over 10years in the CLARICOR randomised, blinded clinical trial

    DEFF Research Database (Denmark)

    Winkel, Per; Hilden, Jørgen; Hansen, Jørgen Fischer

    2015-01-01

    BACKGROUND: The CLARICOR trial reported that clarithromycin compared with placebo increased all-cause mortality in patients with stable coronary heart disease. This study investigates the effects of clarithromycin versus placebo during 10years follow up. METHODS: The CLARICOR trial is a randomise...

  1. Midregional Fragment of Proadrenomedullin, New-Onset Albuminuria, and Cardiovascular and All-Cause Mortality in Patients With Type 2 Diabetes (ZODIAC-30)

    NARCIS (Netherlands)

    Landman, Gijs W. D.; van Dijk, Peter R.; Drion, Iefke; van Hateren, Kornelis J. J.; Struck, Joachim; Groenier, Klaas H.; Gans, Rijk O. B.; Bilo, Henk J. G.; Bakker, Stephan J. L.; Kleefstra, Nanne

    2014-01-01

    OBJECTIVEThe midregional fragment of proadrenomedullin (MR-proADM) is a marker of endothelial dysfunction and has been associated with a variety of diseases. Our aim was to investigate whether MR-proADM is associated with new-onset albuminuria and cardiovascular (CV) and all-cause mortality in patie

  2. Cancer incidence and all-cause mortality in HIV-positive patients in Northeastern Algeria before and during the era of highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Karima Chaabna

    2016-01-01

    Conclusions: Since 1998, the proportion of HIV-positive patients treated with HAART increased, reaching 84% in 2010, all-cause mortality decreased, and cancer remained rare. However, almost all patients who died during the study seemed to be diagnosed at a late stage of the disease, emphasizing the need for earlier diagnosis of HIV in Algeria.

  3. Higher plasma levels of advanced glycation end products are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes

    DEFF Research Database (Denmark)

    Nin, Johanna W; Jorsal, Anders; Ferreira, Isabel;

    2011-01-01

    OBJECTIVE: To investigate the associations of plasma levels of advanced glycation end products (AGEs) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunction, low...

  4. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    . Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1...

  5. Effects of sample attrition in a longitudinal study of the association between alcohol intake and all-cause mortality

    DEFF Research Database (Denmark)

    Thygesen, Lau C; Johansen, Christoffer; Keiding, Niels;

    2008-01-01

    to evaluate how attrition affected the association between alcohol intake and mortality. The statistical methods used for dealing with missing values were complete case analysis, carry last observation forward, simple imputations, multiple imputation and weighting. FINDINGS: Abstinence and high alcohol intake......, current smoking, physical inactivity and high body mass index increased the odds of dropping out, whereas being married, more years of education, skilled occupation, high income and large residential area decreased the odds. Attrition was associated with increased mortality and incidence rates of heart...

  6. Retinal Vessel Diameters and Their Relationship with Cardiovascular Risk and All-Cause Mortality in the Inter99 Eye Study

    DEFF Research Database (Denmark)

    Drobnjak, Dragana; Munch, Inger Christine; Glümer, Charlotte

    2016-01-01

    Purpose. To describe associations between retinal vessel diameters and cardiovascular risk markers and mortality. Methods. The present study included 908 persons aged 30 to 60 years. Vessel diameters were expressed as central retinal venular equivalent (CRVE) and central retinal arteriolar equiva...

  7. Sodium and potassium intake and risk of cardiovascular events and all-cause mortality: the Rotterdam Study

    NARCIS (Netherlands)

    Geleijnse, J.M.; Witteman, J.C.M.; Stijnen, T.; Kloos, M.W.; Hofman, A.; Grobbee, D.E.

    2007-01-01

    Background Dietary electrolytes influence blood pressure, but their effect on clinical outcomes remains to be established. We examined sodium and potassium intake in relation to cardiovascular disease (CVD) and mortality in an unselected older population. Methods A case¿cohort analysis was performed

  8. HDL cholesterol as a residual risk factor for vascular events and all cause mortality in patients with type 2 diabetes

    NARCIS (Netherlands)

    Sharif, Shahnam; Van Der Graaf, Yolanda; Nathoe, Hendrik M.; de Valk, Harold W.; Visseren, Frank L J; Westerink, Jan

    2016-01-01

    OBJECTIVE: To evaluate whether low HDL cholesterol (HDL-c) levels are a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes and whether it remains a residual risk factor when attaining low LDL cholesterol (LDL-c) treatment goals or when LDL-c is treated with intensi

  9. Identification of genomic loci associated with resting heart rate and shared genetic predictors with all-cause mortality

    NARCIS (Netherlands)

    Eppinga, Ruben N.; Hagemeijer, Yanick; Burgess, Stephen; Hinds, David A.; Stefansson, Kari; Gudbjartsson, Daniel F.; van Veldhuisen, Dirk J.; Munroe, Patricia B.; Verweij, Niek; van der Harst, Pim

    2016-01-01

    Resting heart rate is a heritable trait correlated with life span. Little is known about the genetic contribution to resting heart rate and its relationship with mortality. We performed a genome-wide association discovery and replication analysis starting with 19.9 million genetic variants and study

  10. Meta-analysis: low-dose intake of vitamin E combined with other vitamins or minerals may decrease all-cause mortality.

    Science.gov (United States)

    Jiang, Shan; Pan, Zhenyu; Li, Hui; Li, Fenglan; Song, Yanyan; Qiu, Yu

    2014-01-01

    It has been suggested that vitamin E alone or combined with other vitamins or minerals can prevent oxidative stress and slow oxidative injury-related diseases, such as cardiovascular disease and cancer. A comprehensive search of PubMed/MEDLINE, EMBASE and the Cochrane Library was performed. Relative risk was used as an effect measure to compare the intervention and control groups. A total of 33 trials were included in the meta-analysis. Neither vitamin E intake alone (RR=1.01; 95% CI, 0.97 to 1.04; p=0.77) nor vitamin E intake combined with other agents (RR=0.97; 95% CI, 0.89 to 1.06; p=0.55) was correlated with all-cause mortality. Subgroup analyses revealed that low-dose vitamin E supplementation combined with other agents is associated with a statistically significant reduction in all-cause mortality (RR=0.92; 95% CI, 0.86 to 0.98; p=0.01), and vitamin E intake combined with other agents is associated with a statistically significant reduction in mortality rates among individuals without probable or confirmed diseases (RR=0.92; 95% CI, 0.86 to 0.99; p=0.02). Neither vitamin E intake alone nor combined with other agents is associated with a reduction in all-cause mortality. But a low dose (vitamin E combined with other agents is correlated with a reduction in all-cause mortality, and vitamin E intake combined with other agents is correlated with a reduction in the mortality rate among individuals without probable or confirmed diseases.

  11. Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

    Science.gov (United States)

    Benisi-Kohansal, Sanaz; Saneei, Parvane; Salehi-Marzijarani, Mohammad; Larijani, Bagher; Esmaillzadeh, Ahmad

    2016-11-01

    No conclusive information is available about the relation between the consumption of whole grains and the risk of mortality. We aimed to conduct a meta-analysis of prospective cohort studies to summarize the relation between whole-grain intake and risk of mortality from all causes, cardiovascular disease, and total and specific cancers. A systematic search of the literature published earlier than March 2015 was conducted in Medline and PubMed, SCOPUS, EMBASE, and Cochrane Library to identify relevant articles. Prospective cohort studies that examined the association of total whole-grain intake or specific whole-grain foods with risk of mortality from all causes, cardiovascular disease, and total and specific cancers were considered. Twenty prospective cohort studies were included in the systematic review: 9 studies reported total whole-grain intake and 11 others reported specific whole-grain food intake. In a follow-up period of 5.5 to 26 y, there were 191,979 deaths (25,595 from cardiovascular disease, 32,746 from total cancers, and 2671 from specific cancers) in 2,282,603 participants. A greater intake of both total whole grains and specific whole-grain foods was significantly associated with a lower risk of all-cause mortality in the meta-analysis. The pooled RR for all-cause mortality for an increase of 3 servings total whole grains/d (90 g/d) was 0.83 (95% CI: 0.79, 0.88). Total whole-grain intake (0.84; 95% CI: 0.76, 0.93) and specific whole-grain foods (0.82; 95% CI: 0.75, 0.90) were also associated with a reduced risk of mortality from cardiovascular disease. Each additional 3 servings total whole grains/d was associated with a 25% lower risk of mortality from cardiovascular disease. An inverse association was observed between whole-grain intake and risk of mortality from total cancers (0.94; 95% CI: 0.91, 0.98). We found an inverse association between whole-grain intake and mortality from all causes, cardiovascular disease, and total cancers.

  12. Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

    OpenAIRE

    Tota-Maharaj, R; Joshi, PH; Budoff, MJ.; Whelton, SP; Zeb, I.; Rumberger, JA; Al-Mallah, MH; Blumenthal, RS; Nasir, K; Blaha, MJ

    2014-01-01

    © 2015 Elsevier Inc. Although the traditional Agatston coronary artery calcium (CAC) score is a powerful predictor of mortality, it is unknown if the regional distribution of CAC further improves cardiovascular risk prediction. We retrospectively studied 23,058 patients referred for Agatston CAC scoring, of whom 61% had CAC (n= 14,084). CAC distribution was defined as the number of vessels with CAC (0 to 4, including left main). For multivessel CAC, "diffuse" CAC was defined by decreasing per...

  13. Risk of cardiovascular disease and all-cause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: a meta-analysis of retrospective cohort studies

    Institute of Scientific and Technical Information of China (English)

    CHEN Xin; YANG Li; ZHAI Suo-di

    2012-01-01

    Background The difference of cardiovascular effects between rosiglitazone and pioglitazone treatment for diabetic patients has not been thoroughly studied.We performed a meta-analysis to compare the risk of cardiovascular adverse effects in patients with type 2 diabetes treated with rosiglitazone compared to pioglitazone.Methods The Cochrane Library,PubMed,and Embase were searched to identify retrospective cohort studies assessing cardiovascular outcomes with rosiglitazone and pioglitazone.Meta-analysis of retrospective cohort studies was conducted using RevMan 5.0 software to calculate risk ratios.Results Of the 74 references identified,eight studies involving 945 286 patients fit the inclusion criteria for the analysis.The results of meta-analyses showed that,compared with pioglitazone,rosiglitazone therapy significantly increased the risk of myocardial infarction (risk ratios (RR) 1.17,95% confidence interval (CI) 1.04-1.32; P=0.01),the risk of heart failure (RR 1.18,95% CI 1.02-1.36; P=0.03),and total mortality (RR 1.13,95% CI 1.08-1.20; P <0.00001).Conclusion Compared with pioglitazone,rosiglitazone was associated with an increased risk of myocardial infarction,heart failure,and all-cause mortality in diabetic patients.

  14. The combined impact of five lifestyle factors on all-cause, cancer, and cardiovascular mortality – A prospective cohort study among Danish men and women

    DEFF Research Database (Denmark)

    Petersen, Kristina Elin; Johnsen, Nina Føns; Olsen, Anja;

    2015-01-01

    Individual lifestyle factors have been associated with lifestyle diseases and premature mortality by an accumulating body of evidence. The impact of a combination of lifestyle factors on mortality has been investigated in several studies, but few have applied a simple index taking national...... guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international......·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population....

  15. Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten; Østergaard, Marie Louise Drivsholm; Benros, Michael Eriksen

    2015-01-01

    significantly associated with increased risk of all-cause mortality, both individually (alcohol, HR 1·52 [95% CI 1·40-1·65], pdepression, only substance use disorders of alcohol...... (bipolar disorder, HR 1·52 [95% CI 1·27-1·81], pdepression, 2·01 [1·86-2·18], pdepression, 2·27 [1·98-2·60], pcause mortality individually. INTERPRETATION: Mortality in people with mental illness......BACKGROUND: People with severe mental illness have both increased mortality and are more likely to have a substance use disorder. We assessed the association between mortality and lifetime substance use disorder in patients with schizophrenia, bipolar disorder, or unipolar depression. METHODS...

  16. All-cause mortality in patients with type 2 diabetes in association with achieved hemoglobin A(1c, systolic blood pressure, and low-density lipoprotein cholesterol levels.

    Directory of Open Access Journals (Sweden)

    Hou-Hsien Chiang

    Full Text Available BACKGROUND: To identify the ranges of hemoglobin A(1c (HbA1c, systolic blood pressure (SBP, and low-density lipoprotein cholesterol (LDL-C levels which are associated with the lowest all-cause mortality. METHODS: A retrospective cohort of 12,643 type 2 diabetic patients (aged ≥18 years were generated from 2002 to 2010, in Far-Eastern Memorial Hospital, New Taipei city, Taiwan. Patients were identified to include any outpatient diabetes diagnosis (ICD-9: 250, and drug prescriptions that included any oral hypoglycemic agents or insulin prescribed during the 6 months following their first outpatient visit for diabetes. HbA1c, SBP, and LDL-C levels were assessed by the mean value of all available data, from index date to death or censor date. Deaths were ascertained by matching patient records with the Taiwan National Register of Deaths. RESULTS: Our results showed general U-shaped associations, where the lowest hazard ratios occurred at HbA1c 7.0-8.0%, SBP 130-140 mmHg, and LDL-C 100-130 mg/dL. The risk of mortality gradually increases if the patient's mean HbA1c, SBP, or LDL-C during the follow-up period was higher or lower than these ranges. In comparison to the whole population, the adjusted hazard ratio (95% CI for patients with HbA1c 7.0-8.0%, SBP 130-140 mmHg, and LDL-C 100-130 mg/dL were 0.69 (0.62-0.77, 0.80 (0.72-0.90, and 0.68 (0.61-0.75, respectively. CONCLUSIONS: In our type 2 diabetic cohort, the patients with HbA1c 7.0-8.0%, SBP 130-140 mmHg, or LDL-C 100-130 mg/dL had the lowest all-cause mortality. Additional research is needed to confirm these associations and to further investigate their detailed mechanisms.

  17. Impact of microalbuminuria on incident coronary heart disease, cardiovascular and all-cause mortality: a meta-analysis of prospective studies.

    Science.gov (United States)

    Xia, Fang; Liu, Guanghua; Shi, Yifu; Zhang, Yan

    2015-01-01

    This study is to investigate the magnitude of relationship between microalbuminuria and incident coronary heart disease (CHD) and mortality in the general population by conducting a meta-analysis. A comprehensive literature search in Pubmed and Embase database was performed prior to March 2014. Only prospective studies investigating the presence of microalbuminuria and incident CHD, cardiovascular disease (CVD), and mortality and were selected. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated by the presence of microalbuminuria versus without microalbuminuria. Finally, we identified 8 prospective studies involving 114,105 individuals. Participants with microalbuminuria were associated with 69% greater risk of CVD (RR=1.69; 95% CI 1.41-2.02) and 41% greater risk of CHD (RR=1.41; 95% CI 1.17-1.69). Participants with microalbuminuria were also associated with 57% greater risk of cardiovascular mortality (RR=1.57; 95% CI 1.20-2.06) and 65% greater risk of all-cause mortality (RR=1.65; 95% CI 1.45-1.88). Microalbuminuria is an independent predictor for CHD, CVD, and all-cause mortality in the general population. Early detection of microalbuminuria in the general population is likely to identify patients at increased risk of CVD and mortality.

  18. Historical trends and regional differences in all-cause and amenable mortality among American Indians and Alaska Natives since 1950.

    Science.gov (United States)

    Kunitz, Stephen J; Veazie, Mark; Henderson, Jeffrey A

    2014-06-01

    American Indian and Alaska Native (AI/AN) death rates declined over most of the 20th century, even before the Public Health Service became responsible for health care in 1956. Since then, rates have declined further, although they have stagnated since the 1980s. These overall patterns obscure substantial regional differences. Most significant, rates in the Northern and Southern Plains have declined far less since 1949 to 1953 than those in the East, Southwest, or Pacific Coast. Data for Alaska are not available for the earlier period, so its trajectory of mortality cannot be ascertained. Socioeconomic measures do not adequately explain the differences and rates of change, but migration, changes in self-identification as an AI/AN person, interracial marriage, and variations in health care effectiveness all appear to be implicated.

  19. Sleep duration and risk of all-cause mortality: A flexible, non-linear, meta-regression of 40 prospective cohort studies.

    Science.gov (United States)

    Liu, Tong-Zu; Xu, Chang; Rota, Matteo; Cai, Hui; Zhang, Chao; Shi, Ming-Jun; Yuan, Rui-Xia; Weng, Hong; Meng, Xiang-Yu; Kwong, Joey S W; Sun, Xin

    2017-04-01

    Approximately 27-37% of the general population experience prolonged sleep duration and 12-16% report shortened sleep duration. However, prolonged or shortened sleep duration may be associated with serious health problems. A comprehensive, flexible, non-linear meta-regression with restricted cubic spline (RCS) was used to investigate the dose-response relationship between sleep duration and all-cause mortality in adults. Medline (Ovid), Embase, EBSCOhost-PsycINFO, and EBSCOhost-CINAHL Plus databases, reference lists of relevant review articles, and included studies were searched up to Nov. 29, 2015. Prospective cohort studies investigating the association between sleep duration and all-cause mortality in adults with at least three categories of sleep duration were eligible for inclusion. We eventually included in our study 40 cohort studies enrolling 2,200,425 participants with 271,507 deaths. A J-shaped association between sleep duration and all-cause mortality was present: compared with 7 h of sleep (reference for 24-h sleep duration), both shortened and prolonged sleep durations were associated with increased risk of all-cause mortality (4 h: relative risk [RR] = 1.05; 95% confidence interval [CI] = 1.02-1.07; 5 h: RR = 1.06; 95% CI = 1.03-1.09; 6 h: RR = 1.04; 95% CI = 1.03-1.06; 8 h: RR = 1.03; 95% CI = 1.02-1.05; 9 h: RR = 1.13; 95% CI = 1.10-1.16; 10 h: RR = 1.25; 95% CI = 1.22-1.28; 11 h: RR = 1.38; 95% CI = 1.33-1.44; n = 29; P < 0.01 for non-linear test). With regard to the night-sleep duration, prolonged night-sleep duration was associated with increased all-cause mortality (8 h: RR = 1.01; 95% CI = 0.99-1.02; 9 h: RR = 1.08; 95% CI = 1.05-1.11; 10 h: RR = 1.24; 95% CI = 1.21-1.28; n = 13; P < 0.01 for non-linear test). Subgroup analysis showed females with short sleep duration a day (<7 h) were at high risk of all-cause mortality (4 h: RR = 1.07; 95% CI = 1.02-1.13; 5 h: RR = 1.08; 95

  20. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    . Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  1. Markers of inflammation and endothelial dysfunction are associated with incident cardiovascular disease, all-cause mortality, and progression of coronary calcification in type 2 diabetic patients with microalbuminuria

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine Willum

    2016-01-01

    BACKGROUND: We evaluated markers of inflammation and endothelial dysfunction and their associations with incident cardiovascular disease (CVD), all-cause mortality and progression of coronary artery calcium (CAC) in patients with type 2 diabetes (T2D) and microalbuminuria but without known coronary...... artery disease (CAD). METHODS: Prospective study including 200 patients receiving multifactorial treatment. Markers of inflammation (TNF-ɑ, sICAM-1, sICAM-3, hsCRP, SAA, IL-1β, IL-6, IL-8) and endothelial dysfunction (thrombomodulin, sVCAM-1, sICAM-1, sICAM-3, sE-selectin, sP-selectin) were measured...... with T2D and microalbuminuria without known CAD and receiving multifactorial treatment, biomarkers of inflammation and endothelial dysfunction were independently associated with CVD, all-cause mortality and CAC progression. Especially TNF-ɑ was a robust determinant, even after adjusting for NT...

  2. Low Systolic Blood Pressure and Mortality From All-Cause and Vascular Diseases Among the Rural Elderly in Korea; Kangwha Cohort Study

    OpenAIRE

    Yi, Sang-Wook; Hong, Seri; Ohrr, Heechoul

    2015-01-01

    Abstract The association between low systolic blood pressure (SBP) and vascular diseases is unclear. The aim of this study was to prospectively examine the association between SBP, especially low SBP, and mortality from all causes and vascular diseases among the elderly in Korea. Six thousand two hundred ninety four residents in a rural community were followed-up for deaths from 1985 to 2008. The adjusted hazard ratios (aHR) and 95% confidence intervals were calculated by Cox proportional haz...

  3. Left Ventricular Global Longitudinal Strain (GLS Is a Superior Predictor of All-Cause and Cardiovascular Mortality When Compared to Ejection Fraction in Advanced Chronic Kidney Disease.

    Directory of Open Access Journals (Sweden)

    Rathika Krishnasamy

    Full Text Available Echocardiographic global longitudinal strain (GLS is increasingly recognised as a more effective technique than conventional ejection fraction (EF in detecting subtle changes in left ventricular (LV function. This study investigated the prognostic value of GLS over EF in patients with advanced Chronic Kidney Disease (CKD.The study included 183 patients (57% male, 63% on dialysis with CKD stage 4, 5 and 5Dialysis (D. 112 (61% of patients died in a follow up of 7.8 ± 4.4 years and 41% of deaths were due to cardiovascular (CV disease. GLS was calculated using 2-dimensional speckle tracking and EF was measured using Simpson's biplane method. Cox proportional hazard models were used to assess the association of measures of LV function and all- cause and CV mortality.The mean GLS at baseline was -13.6 ± 4.3% and EF was 45 ± 11%. GLS was a significant predictor of all-cause [Hazard Ratio (HR 1.09 95%; Confidence Interval (CI 1.02-1.16; p = 0.01] and CV mortality (HR 1.16 95%; CI 1.04-1.30; p = 0.008 following adjustment for relevant clinical variables including LV mass index (LVMI and EF. GLS also had greater predictive power for both all- cause and CV mortality compared to EF. Impaired GLS (>-16% was associated with a 5.6-fold increased unadjusted risk of CV mortality in patients with preserved EF.In this cohort of patients with advanced CKD, GLS is a more sensitive predictor of overall and CV mortality compared to EF. Studies of larger populations in CKD are required to confirm that GLS provides additive prognostic value in patients with preserved EF.

  4. Influence of Androgen Deprivation Therapy on All-Cause Mortality in Men With High-Risk Prostate Cancer and a History of Congestive Heart Failure or Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, CT (United States); Beckman, Joshua A. [Department of Cardiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Beard, Clair J.; Martin, Neil E. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Choueiri, Toni K. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Hu, Jim C. [Division of Urologic Surgery, Brigham and Women' s/Faulkner Hospital, Harvard Medical School, Boston, MA (United States); Hoffman, Karen E. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Dosoretz, Daniel E. [21st Century Oncology, Fort Myers, FL (United States); Moran, Brian J. [Chicago Prostate Center, Westmont, IL (United States); Salenius, Sharon A. [21st Century Oncology, Fort Myers, FL (United States); Braccioforte, Michelle H. [Chicago Prostate Center, Westmont, IL (United States); Kantoff, Philip W. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Ennis, Ronald D. [Department of Radiation Oncology, St. Luke' s-Roosevelt and Beth Israel Hospitals, Continuum Cancer Centers of New York, Albert Einstein College of Medicine, New York, NY (Israel)

    2012-03-15

    Purpose: It is unknown whether the excess risk of all-cause mortality (ACM) observed when androgen deprivation therapy (ADT) is added to radiation for men with prostate cancer and a history of congestive heart failure (CHF) or myocardial infarction (MI) also applies to those with high-risk disease. Methods and Materials: Of 14,594 men with cT1c-T3aN0M0 prostate cancer treated with brachytherapy-based radiation from 1991 through 2006, 1,378 (9.4%) with a history of CHF or MI comprised the study cohort. Of these, 22.6% received supplemental external beam radiation, and 42.9% received a median of 4 months of neoadjuvant ADT. Median age was 71.8 years. Median follow-up was 4.3 years. Cox multivariable analysis tested for an association between ADT use and ACM within risk groups, after adjusting for treatment factors, prognostic factors, and propensity score for ADT. Results: ADT was associated with significantly increased ACM (adjusted hazard ratio [AHR] = 1.76; 95% confidence interval [CI], 1.32-2.34; p = 0.0001), with 5-year estimates of 22.71% with ADT and 11.62% without ADT. The impact of ADT on ACM by risk group was as follows: high-risk AHR = 2.57; 95% CI, 1.17-5.67; p = 0.019; intermediate-risk AHR = 1.75; 95% CI, 1.13-2.73; p = 0.012; low-risk AHR = 1.52; 95% CI, 0.96-2.43; p = 0.075). Conclusions: Among patients with a history of CHF or MI treated with brachytherapy-based radiation, ADT was associated with increased all-cause mortality, even for patients with high-risk disease. Although ADT has been shown in Phase III studies to improve overall survival in high-risk disease, the small subgroup of high-risk patients with a history of CHF or MI, who represented about 9% of the patients, may be harmed by ADT.

  5. The combined impact of five lifestyle factors on all-cause, cancer, and cardiovascular mortality – A prospective cohort study among Danish men and women

    DEFF Research Database (Denmark)

    Petersen, Kristina Elin; Johnsen, Nina Føns; Olsen, Anja

    2015-01-01

    Individual lifestyle factors have been associated with lifestyle diseases and premature mortality by an accumulating body of evidence. The impact of a combination of lifestyle factors on mortality has been investigated in several studies, but few have applied a simple index taking national guidel......·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population.......Individual lifestyle factors have been associated with lifestyle diseases and premature mortality by an accumulating body of evidence. The impact of a combination of lifestyle factors on mortality has been investigated in several studies, but few have applied a simple index taking national...... guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international...

  6. Whole-grain products and whole grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Frederiksen, Kirsten; Christensen, Jane;

    2015-01-01

    April 2008 in the Danish sub-cohort, 15 December 2009 in the Norwegian sub-cohort and 15 February 2009 in the Swedish sub-cohort). In the analyses of continuous WG variables, we found lower all-cause mortality with higher intake of total WG products (women: MRR 0·89 (95%CI 0·86, 0·91); men: MRR 0·89 (95......·91) for a doubling of intake). In particular, WG oat, rye and wheat were associated with lower mortality. The associations were found in both women and men and for different causes of deaths. In the analyses of quartiles of WG intake in relation to all-cause mortality, we found lower mortality in the highest......·68, 0·81, P for trend over quartiles , 0·0001) for men. The MRR for highest v. lowest quartile of intake of total WG types was 0·74 (95%CI 0·67, 0·81, P for trend over quartiles , 0·0001) for women and 0·75 (95% CI 0·68, 0·82, P for trend over quartiles , 0·0001) for men. Despite lower statistical power...

  7. Elevated levels of plasma osteoprotegerin are associated with all-cause mortality risk and atherosclerosis in patients with stages 3 to 5 chronic kidney disease

    Directory of Open Access Journals (Sweden)

    M.M. Nascimento

    2014-11-01

    Full Text Available Osteoprotegerin (OPG regulates bone mass by inhibiting osteoclast differentiation and activation, and plays a role in vascular calcification. We evaluated the relationship between osteoprotegerin levels and inflammatory markers, atherosclerosis, and mortality in patients with stages 3-5 chronic kidney disease. A total of 145 subjects (median age 61 years, 61% men; 36 patients on hemodialysis, 55 patients on peritoneal dialysis, and 54 patients with stages 3-5 chronic kidney disease were studied. Clinical characteristics, markers of mineral metabolism (including fibroblast growth factor-23 [FGF-23] and inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6 [IL-6], and the intima-media thickness (IMT in the common carotid arteries were measured at baseline. Cardiac function was assessed by color tissue Doppler echocardiography. After 36 months follow-up, the survival rate by Kaplan-Meier analysis was significantly different according to OPG levels (χ 2=14.33; P=0.002. Increased OPG levels were positively associated with IL-6 (r=0.38, P<0.001, FGF-23 (r=0.26, P<0.001 and hsCRP (r=0.0.24, P=0.003. In addition, OPG was positively associated with troponin I (r=0.54, P<0.001 and IMT (r=0.39, P<0.0001. Finally, in Cox analysis, only OPG (HR=1.07, 95%CI=1.02-1.13 and hsCRP (HR=1.02, 95%CI=1.01-1.04 were independently associated with increased risk of death. These results suggested that elevated levels of serum OPG might be associated with atherosclerosis and all-cause mortality in patients with chronic kidney disease.

  8. Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: a decade-long historical cohort study.

    Directory of Open Access Journals (Sweden)

    Tetyana Kendzerska

    2014-02-01

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA has been reported to be a risk factor for cardiovascular (CV disease. Although the apnea-hypopnea index (AHI is the most commonly used measure of OSA, other less well studied OSA-related variables may be more pathophysiologically relevant and offer better prediction. The objective of this study was to evaluate the relationship between OSA-related variables and risk of CV events. METHODS AND FINDINGS: A historical cohort study was conducted using clinical database and health administrative data. Adults referred for suspected OSA who underwent diagnostic polysomnography at the sleep laboratory at St Michael's Hospital (Toronto, Canada between 1994 and 2010 were followed through provincial health administrative data (Ontario, Canada until May 2011 to examine the occurrence of a composite outcome (myocardial infarction, stroke, congestive heart failure, revascularization procedures, or death from any cause. Cox regression models were used to investigate the association between baseline OSA-related variables and composite outcome controlling for traditional risk factors. The results were expressed as hazard ratios (HRs and 95% CIs; for continuous variables, HRs compare the 75th and 25th percentiles. Over a median follow-up of 68 months, 1,172 (11.5% of 10,149 participants experienced our composite outcome. In a fully adjusted model, other than AHI OSA-related variables were significant independent predictors: time spent with oxygen saturation <90% (9 minutes versus 0; HR = 1.50, 95% CI 1.25-1.79, sleep time (4.9 versus 6.4 hours; HR = 1.20, 95% CI 1.12-1.27, awakenings (35 versus 18; HR = 1.06, 95% CI 1.02-1.10, periodic leg movements (13 versus 0/hour; HR = 1.05, 95% CI 1.03-1.07, heart rate (70 versus 56 beats per minute [bpm]; HR = 1.28, 95% CI 1.19-1.37, and daytime sleepiness (HR = 1.13, 95% CI 1.01-1.28.The main study limitation was lack of information about continuous positive

  9. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Wang, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M.; Bhutta, Zulfiqar A.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Chen, Alan Zian; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H.; Fraser, Maya S.; Pullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Hay, Simon I.; Huynh, Chantal; Johnson, Catherine; Kassebaum, Nicholas J.; Kinfu, Yohannes; Kulikoff, Xie Rachel; Kutz, Michael; Kyu, Hmwe H.; Larson, Heidi J.; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S.; Lind, Margaret; Lozano, Rafael; Marquez, Neal; Mensah, George A.; Mikesell, Joe; Mokdad, Ali H.; Mooney, Meghan D.; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M.; Pinho, Christine; Roth, Gregory A.; Salomon, Joshua A.; Sandar, Logan; Silpakit, Naris; Sligar, Amber; Sorensen, Reed J. D.; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A.; Troeger, Christopher; VanderZanden, Amelia; Vollset, Stein Emil; Wanga, Valentine; Whiteford, Harvey A.; Wolock, Timothy; Zoeckler, Leo; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abera, Semaw Ferede; Abreu, Daisy M. X.; Abu-Raddad, Laith J.; Abyu, Gebre Yitayih; Achoki, Tom; Adelekan, Ademola Lukman; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C.; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N.; Akanda, All Shafqat; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Alabed, Samer; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M.; Alasfoor, Deena; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alexander, Lily T.; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amegah, Adeladza Kofi; Ameh, Emmanuel A.; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H.; Anderson, Benjamin; Anderson, Gregory M.; Antonio, Carl Abelardo T.; Aregay, Atsede Fantahun; Arnlov, Johan; Arsenijevic, Valentina S. Arsic; Al Artaman, Ali; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Arthur Avokpaho, Euripide Frinel G.; Awasthi, Ashish; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C.; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L.; Barnighausen, Till; Barregard, Lars; Barrero, Lope H.; Basu, Arindam; Basu, Sanjay; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Belay, Haileeyesus Adamu; Bell, Brent; Bell, Michelle L.; Bello, Aminu K.; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhalla, Ashish; Biadgilign, Sibhatu; Bikbov, Boris; Bin Abdulhak, Aref A.; Biroscak, Brian J.; Biryukov, Stan; Bjertness, Espen; Blore, Jed D.; Blosser, Christopher D.; Bohensky, Megan A.; Borschmann, Rohan; Bose, Dipan; Bourne, Rupert R. A.; Brainin, Michael; Brayne, Carol E. G.; Brazinova, Alexandra; Breitborde, Nicholas J. K.; Brenner, Hermann; Brewer, Jerry D.; Brown, Alexandria; Brown, Jonathan; Brugha, Traolach S.; Buckle, Geoffrey Colin; Butt, Zahid A.; Calabria, Bianca; Campos-Novato, Ismael Ricardo; Campuzano, Julio Cesar; Carapetis, Jonathan R.; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Castaneda-Oquela, Carlos A.; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cercy, Kelly; Cerda, Jorge; Chen, Wanqing; Chew, Adrienne; Chiang, Peggy Pei -Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Cirillo, Massimo; Cohen, Aaron J.; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M.; Cooper, Cyrus; Cooper, Leslie Trumbull; Cortinovis, Monica; Cowie, Benjamin C.; Crump, John A.; Damsere-Derry, James; Danawi, Hadi; Dandona, Rakhi; Daoud, Farah; Darby, Sarah C.; Dargan, Paul I.; das Neves, Jose; Davey, Gail; Davis, Adrian C.; Davitoiu, Dragos V.; de Castro, E. Filipa; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P.; Deribe, Kebede; Deribew, Amare; Dharmaratne, Samath D.; Dhillon, Preet K.; Diaz-Torne, Cesar; Ding, Eric L.; dos Santos, Kadine Priscila Bender; Dossou, Edem; Driscoll, Tim R.; Duan, Leilei; Dubey, Manisha; Bartholow, Bruce; Ellenbogen, Richard G.; Lycke, Christian; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Faghmous, Imad D. A.; Fahimi, Saman; Jose, Emerito; Farid, Talha A.; Sa Farinha, Carla Sofia e; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Feigin, Valery L.; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G.; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph R. A.; Flaxman, Abraham; Foigt, Nataliya; Fowkes, F. Gerry R.; Franca, Elisabeth Barboza; Franklin, Richard C.; Friedman, Joseph; Frostad, Joseph; Hirst, Thomas; Futran, Neal D.; Gall, Seana L.; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tsewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gessner, Bradford D.; Ghoshal, Aloke Gopal; Gibney, Katherine B.; Gillum, Richard F.; Gilmour, Stuart; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Giussani, Giorgia; Glaser, Elizabeth; Godwin, William W.; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gosselin, Richard A.; Gotay, Carolyn C.; Goto, Atsushi; Gouda, Hebe N.; Greaves, Felix; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A.; Hamadeh, Randah Ribhi; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J.; Hankey, Graeme J.; Hao, Yuantao; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Havmoeller, Rasmus; Heckbert, Susan R.; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hilderink, Henk B. M.; Hoek, Hans W.; Hogg, Robert S.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hotez, Peter J.; Hoy, Damian G.; Hsairi, Mohamed; Htet, Aung Soe; Than Htike, Maung Maung; Hu, Guoqing; Huang, Cheng; Huang, Hsiang; Huiart, Laetitia; Husseini, Abdullatif; Huybrechts, Inge; Huynh, Grace; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J.; Jacobs, Troy A.; Jacobsen, Kathryn H.; Jahanmehr, Nader; Jakovljevic, Mihajlo B.; James, Peter; Javanbakht, Mehdi; Jayaraman, Sudha P.; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jensen, Paul N.; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jonas, Jost B.; Joshi, Tushar Kant; Kabir, Zubair; Karnak, Ritul; Kan, Haidong; Kant, Surya; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Karletsos, Dimitris; Karthikeyan, Ganesan; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemmer, Laura; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A.; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Muthafer Khoja, Tawfik Ahmed; Kieling, Christian; Kim, Daniel; Kim, Yun Jin; Kissela, Brett M.; Kissoon, Niranjan; Knibbs, Luke D.; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A.; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Krog, Norun Hjertager; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A.; Kuipers, Ernst J.; Kulkarni, Veena S.; Kumar, G. Anil; Kwan, Gene F.; Lal, Aparna; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O.; Langan, Sinead M.; Lansingh, Van C.; Larsson, Anders; Laryea, Dennis Odai; Latif, Asma Abdul; Lawrynowicz, Alicia Elena Beatriz; Leigh, James; Levi, Miriam; Li, Yongmei; Lindsay, M. Patrice; Lipshultz, Steven E.; Liu, Patrick Y.; Liu, Shiwei; Liu, Yang; Lo, Loon-Tzian; Logroscino, Giancarlo; Lotufo, Paulo A.; Lucas, Robyn M.; Lunevicius, Raimundas; Lyons, Ronan A.; Ma, Stefan; Pedro Machado, Vasco Manuel; Mackay, Mark T.; MacLachlan, Jennifer H.; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Ayele Manamo, Wondimu Ayele; Mandisarisa, John; Mangalam, Srikanth; Mapoma, Chabila C.; Marcenes, Wagner; Margolis, David Joel; Martin, Gerard Robert; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J.; Massano, Joao; Matzopoulos, Richard; Mayosi, Bongani M.; McGarvey, Stephen Theodore; McGrath, John J.; Mckee, Martin; McMahon, Brian J.; Meaney, Peter A.; Mehari, Alem; Mehndiratta, Man Mohan; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J.; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R.; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N.; Abdulmuhsin Mohammad, Karzan; Mohammadi, Alireza; Mohammed, Shafiu; Mohan, Viswanathan; Mola, Glen Liddell D.; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montero, Pablo; Montico, Marcella; Montine, Thomas J.; Moradi-Lakeh, Maziar; Morawska, Lidia; Morgan, Katherine; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich; Satyanarayana Murthy, Gudlavalleti Venkata; Murthy, Srinivas; Musa, Kamarul Imran; Nachega, Jean B.; Nagel, Gabriele; Naidoo, Kovin S.; Naik, Nitish; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nejjari, Chakib; Neupane, Subas; Newton, Charles R.; Newton, John N.; Ng, Marie; Ngalesoni, Frida Namnyak; Ngirabega, Jean de Dieu; Quyen Le Nguyen, [Unknown; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nomura, Marika; Norheim, Ole F.; Norman, Paul E.; Norrving, Bo; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Ohkubo, Takayoshi; Ojelabi, Foluke Adetola; Olivares, Pedro R.; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Ozdemir, Raziye; Pa, Mahesh; Pandian, Jeyaraj D.; Pant, Puspa Raj; Papachristou, Christina; Park, Eun-Kee; Park, Jae-Hyun; Parry, Charles D.; Parsaeian, Mahboubeh; Caicedo, Angel J. Paternina; Patten, Scott B.; Patton, George C.; Paul, Vinod K.; Pearce, Neil; Pedro, Joao Mario; Stokic, Ljiljana Pejin; Pereira, David M.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B.; Pillay, Julian David; Plass, Dietrich; Platts-Mills, James A.; Polinder, Suzanne; Pope, C. Arden; Popova, Svetlana; Poulton, Richie G.; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qorbani, Mostafa; Quame-Amaglo, Justice; Quistberg, D. Alex; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajavi, Zhale; Rajsic, Sasa; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M.; Ranabhat, Chhabi L.; Rangaswamy, Thara; Rao, Puja; Rao, Sowmya R.; Refaat, Amany H.; Rehm, Jurgen; Reitsma, Marissa B.; Remuzzi, Giuseppe; Resnikofff, Serge; Ribeiro, Antonio L.; Ricci, Stefano; Blancas, Maria Jesus Rios; Roberts, Bayard; Roca, Anna; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Roy, Nawal K.; Ruhago, George Mugambage; Sagar, Rajesh; Saha, Sukanta; Sahathevan, Ramesh; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sanchez-Nino, Maria Dolores; Sanchez-Riera, Lidia; Santos, Itamar S.; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P.; Schmidt, Maria Ines; Schneider, Ione J. C.; Schottker, Ben; Schutte, Aletta E.; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shackelford, Katya A.; Shaddick, Gavin; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shen, Ziyan; Shepard, Donald S.; Sheth, Kevin N.; Shetty, Balakrishna P.; Shi, Peilin; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G.; Sigfusdottir, Inga Dora; Silberberg, Donald H.; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Silverberg, Jonathan I.; Simard, Edgar P.; Singh, Abhishek; Singh, Gitanjali M.; Singh, Jasvinder A.; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soneji, Samir; Soreide, Kjetil; Soriano, Joan B.; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Stein, Dan J.; Stein, Murray B.; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F.; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L.; Szoeke, Cassandra E. I.; Tabares-Seisdedos, Rafael; Tabb, Karen M.; Takahashi, Ken; Takala, Jukka S.; Talongwa, Roberto Tchio; Tandon, Nikhil; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R.; Ao, Braden J. Te; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Ten Have, Margreet; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tillmann, Taavi; Tirschwell, David L.; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Nx, Jeffrey Allen Towb; Traebert, Jefferson; Tran, Bach Xuan; Truelsen, Thomas; Trujillo, Ulises; Tura, Abera Kenay; Tuzcu, Emin Murat; Uchendu, Uche S.; Ukwaja, Kingsley N.; Undurraga, Eduardo A.; Uthman, Olalekan A.; Van Dingenen, Rita; Van Donkelaar, Aaron; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Vidavalur, Ramesh; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S.; Vlassov, Vasiliy Victorovich; Wagner, Joseph A.; Wagner, Gregory R.; Wallin, Mitchell T.; Wang, Linhong; Watkins, David A.; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Westerman, Ronny; White, Richard A.; Wijeratne, Tissa; Wilkinson, James D.; Williams, Hywel C.; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles D. A.; Won, Sungho; Wong, John Q.; Woolf, Anthony D.; Xavier, Denis; Xiao, Qingyang; Xu, Gelin; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yan, Lijing L.; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yirsaw, Biruck Desalegn; Yonemoto, Naohiro; Yonga, Gerald; Younis, Mustafa Z.; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zannad, Faiez; Zavala, Diego E.; Zeeb, Hajo; Zeleke, Berihun M.; Zhang, Hao; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.

    2016-01-01

    Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes

  10. Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Guo, Jing; Astrup, Arne; Lovegrove, Julie A; Gijsbers, Lieke; Givens, David I; Soedamah-Muthu, Sabita S

    2017-04-03

    With a growing number of prospective cohort studies, an updated dose-response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up to September 2016. Random-effect meta-analyses with summarised dose-response data were performed for total (high-fat/low-fat) dairy, milk, fermented dairy, cheese and yogurt. Non-linear associations were investigated using the spine models and heterogeneity by subgroup analyses. A total of 29 cohort studies were available for meta-analysis, with 938,465 participants and 93,158 mortality, 28,419 CHD and 25,416 CVD cases. No associations were found for total (high-fat/low-fat) dairy, and milk with the health outcomes of mortality, CHD or CVD. Inverse associations were found between total fermented dairy (included sour milk products, cheese or yogurt; per 20 g/day) with mortality (RR 0.98, 95% CI 0.97-0.99; I(2) = 94.4%) and CVD risk (RR 0.98, 95% CI 0.97-0.99; I(2) = 87.5%). Further analyses of individual fermented dairy of cheese and yogurt showed cheese to have a 2% lower risk of CVD (RR 0.98, 95% CI 0.95-1.00; I(2) = 82.6%) per 10 g/day, but not yogurt. All of these marginally inverse associations of totally fermented dairy and cheese were attenuated in sensitivity analyses by removing one large Swedish study. This meta-analysis combining data from 29 prospective cohort studies demonstrated neutral associations between dairy products and cardiovascular and all-cause mortality. For future studies it is important to investigate in more detail how dairy products can be replaced by other foods.

  11. Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen male study

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

    2010-01-01

    Objective: No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis. Method: We carried out a 30-year follow-up of the Copenhagen Male Study...... risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects....... of 5249 employed men aged 40-59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO2Max)] using the Åstrand cycling test and determined physical...

  12. Repeated measures of body mass index and C-reactive protein in relation to all-cause mortality and cardiovascular disease

    DEFF Research Database (Denmark)

    O'Doherty, Mark G; Jørgensen, Torben; Borglykke, Anders

    2014-01-01

    Obesity has been linked with elevated levels of C-reactive protein (CRP), and both have been associated with increased risk of mortality and cardiovascular disease (CVD). Previous studies have used a single 'baseline' measurement and such analyses cannot account for possible changes in these which...... body mass index (BMI) and CRP with all-cause mortality and CVD. Being overweight (≥25-obese (≥30-....79-0.94) and 0.80 (0.72-0.89). A similar relationship was found, but only for overweight in Glostrup, HR (95 % CI) 0.88 (0.76-1.02); and moderately obese in Tromsø, HR (95 % CI) 0.79 (0.62-1.01). Associations were not evident between repeated measures of BMI and CVD. Conversely, increasing CRP concentrations...

  13. Higher Diet Quality Is Associated with Decreased Risk of All-Cause, Cardiovascular Disease, and Cancer Mortality among Older Adults12

    Science.gov (United States)

    Reedy, Jill; Krebs-Smith, Susan M.; Miller, Paige E.; Liese, Angela D.; Kahle, Lisa L.; Park, Yikyung; Subar, Amy F.

    2014-01-01

    Increased attention in dietary research and guidance has been focused on dietary patterns, rather than on single nutrients or food groups, because dietary components are consumed in combination and correlated with one another. However, the collective body of research on the topic has been hampered by the lack of consistency in methods used. We examined the relationships between 4 indices—the Healthy Eating Index–2010 (HEI-2010), the Alternative Healthy Eating Index–2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)—and all-cause, cardiovascular disease (CVD), and cancer mortality in the NIH-AARP Diet and Health Study (n = 492,823). Data from a 124-item food-frequency questionnaire were used to calculate scores; adjusted HRs and 95% CIs were estimated. We documented 86,419 deaths, including 23,502 CVD- and 29,415 cancer-specific deaths, during 15 y of follow-up. Higher index scores were associated with a 12–28% decreased risk of all-cause, CVD, and cancer mortality. Specifically, comparing the highest with the lowest quintile scores, adjusted HRs for all-cause mortality for men were as follows: HEI-2010 HR: 0.78 (95% CI: 0.76, 0.80), AHEI-2010 HR: 0.76 (95% CI: 0.74, 0.78), aMED HR: 0.77 (95% CI: 0.75, 0.79), and DASH HR: 0.83 (95% CI: 0.80, 0.85); for women, these were HEI-2010 HR: 0.77 (95% CI: 0.74, 0.80), AHEI-2010 HR: 0.76 (95% CI: 0.74, 0.79), aMED HR: 0.76 (95% CI: 0.73, 0.79), and DASH HR: 0.78 (95% CI: 0.75, 0.81). Similarly, high adherence on each index was protective for CVD and cancer mortality examined separately. These findings indicate that multiple scores reflect core tenets of a healthy diet that may lower the risk of mortality outcomes, including federal guidance as operationalized in the HEI-2010, Harvard’s Healthy Eating Plate as captured in the AHEI-2010, a Mediterranean diet as adapted in an Americanized aMED, and the DASH Eating Plan as included in the DASH score. PMID

  14. Racial differences in breast cancer, cardiovascular disease, and all-cause mortality among women with ductal carcinoma in situ of the breast.

    Science.gov (United States)

    Berkman, Amy; F Cole, Bernard; Ades, Philips A; Dickey, Samantha; Higgins, Stephen T; Trentham-Dietz, Amy; Sprague, Brian L; Lakoski, Susan G

    2014-11-01

    Ductal carcinoma in situ (DCIS) of the breast represents 15-20% of new breast cancer diagnoses in the US annually. However, long-term competing risks of mortality, as well as racial differences in outcomes among US women with DCIS, are unknown. Case data from the years 1978-2010 were obtained using SEER*Stat software available through the National Cancer Institute from the 2010 SEER registries. Included were all women aged 40 and over with newly diagnosed DCIS. There were 67,514 women in the analysis, including 54,518 white women and 6,113 black women. A total of 12,173 deaths were observed over 607,287 person-years of follow-up. The 20-year cumulative incidence of all-cause death among women with DCIS was 39.6% (CI 38.9-40.3). The corresponding 20-year rates for breast cancer death and CVD death were 3.2% (CI 3.0-3.4) and 13.2% (CI 12.8-13.7), respectively. Black women with DCIS had a higher risk of death compared to white women, with these hazard ratios elevated throughout the entire study period. For example, between 1990 and 2010, black women had a higher risk of all-cause death (HR 3.06, CI 2.39-3.91), breast cancer death (HR 5.78, CI 3.16-10.57), and CVD death (HR 6.43, CI 3.61-11.45) compared to white women diagnosed between 50 and 59 years of age. The risk of all-cause and CVD death was greater than breast cancer death among women diagnosed with DCIS over 20 years. Black women had higher risks of dying from all-causes compared to white women. These differences persisted into the modern treatment era.

  15. Relation of blood pressure and all-cause mortality in 180,000 Japanese participants: pooled analysis of 13 cohort studies.

    Science.gov (United States)

    Murakami, Yoshitaka; Hozawa, Atsushi; Okamura, Tomonori; Ueshima, Hirotsugu

    2008-06-01

    Hypertension is a leading cause of death because of cardiovascular disease and predominantly affects total mortality. To reduce avoidable deaths from hypertension, we need to collect blood pressure data and assess their impact on total mortality. To examine this issue, a meta-analysis of 13 cohort studies was conducted in Japan. Poisson regression was used for estimating all-cause mortality rates and ratios. In the model, blood pressure data were treated as continuous (10-mm Hg increase) and categorical (every 10 mm Hg) according to recommendations of the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hypertension. Potential confounders included body mass index, smoking, drinking, and cohort. The impact of hypertension was measured by the population-attributable fraction. After excluding participants with cardiovascular disease history, 176 389 participants were examined in the analysis. Adjusted mortality rates became larger as the blood pressure increased, and these were more distinct in younger men and women. Hazard ratios also showed the same trends, and these trends were more apparent in younger men (hazard ratio [unit: 10-mm Hg increase] aged 40 to 49 years: systolic blood pressure 1.37 (range: 1.15 to 1.62); diastolic blood pressure 1.46 [range: 1.05 to 2.03]) than older ones (hazard ratio: aged 80 to 89 years: systolic blood pressure 1.09 [range: 1.05 to 1.13]and diastolic blood pressure 1.12 [range: 1.03 to 1.22]). Population-attributable fraction of hypertension was approximately 20% when the normal category was used as a reference level and was 10% when we included the prehypertension group in the reference level. In conclusion, high blood pressure raised the risk of total mortality, and this trend was higher in the younger Japanese population.

  16. Association between Insulin Monotherapy versus Insulin plus Metformin and the Risk of All-Cause Mortality and Other Serious Outcomes: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Sarah E Holden

    Full Text Available To determine if concomitant metformin reduced the risk of death, major adverse cardiac events (MACE, and cancer in people with type 2 diabetes treated with insulin.For this retrospective cohort study, people with type 2 diabetes who progressed to insulin with or without metformin from 2000 onwards were identified from the UK Clinical Practice Research Datalink (≈7% sample of the UK population. The risks of all-cause mortality, MACE and incident cancer were evaluated using multivariable Cox models comparing insulin monotherapy with insulin plus metformin. We accounted for insulin dose.12,020 subjects treated with insulin were identified, including 6,484 treated with monotherapy. There were 1,486 deaths, 579 MACE (excluding those with a history of large vessel disease, and 680 cancer events (excluding those in patients with a history of cancer. Corresponding event rates were 41.5 (95% CI 39.4-43.6 deaths, 20.8 (19.2-22.5 MACE, and 21.6 (20.0-23.3 cancer events per 1,000 person-years. The adjusted hazard ratios (aHRs for people prescribed insulin plus metformin versus insulin monotherapy were 0.60 (95% CI 0.52-0.68 for all-cause mortality, 0.75 (0.62-0.91 for MACE, and 0.96 (0.80-1.15 for cancer. For patients who were propensity-score matched, the corresponding aHRs for all-cause mortality and cancer were 0.62 (0.52-0.75 and 0.99 (0.78-1.26, respectively. For MACE, the aHR was 1.06 (0.75-1.49 prior to 1,275 days and 1.87 (1.22-2.86 after 1,275 days post-index.People with type 2 diabetes treated with insulin plus concomitant metformin had a reduced risk of death and MACE compared with people treated with insulin monotherapy. There was no statistically significant difference in the risk of cancer between people treated with insulin as monotherapy or in combination with metformin.

  17. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Peterson, Carrie Beth

    2015-01-01

    disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus......BACKGROUND: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries......, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were...

  18. A dose-response meta-analysis of the impact of body mass index on stroke and all-cause mortality in stroke patients: a paradox within a paradox.

    Science.gov (United States)

    Bagheri, M; Speakman, J R; Shabbidar, S; Kazemi, F; Djafarian, K

    2015-05-01

    The obesity paradox is often attributed to fat acting as a buffer to protect individuals in fragile metabolic states. If this was the case, one would predict that the reverse epidemiology would be apparent across all causes of mortality including that of the particular disease state. We performed a dose-response meta-analysis to assess the impact of body mass index (BMI) on all-cause and stroke-specific mortality among stroke patients. Data from relevant studies were identified by systematically searching PubMed, OVID and Scopus databases and were analysed using a random-effects dose-response model. Eight cohort studies on all-cause mortality (with 20,807 deaths of 95,651 stroke patients) and nine studies of mortality exclusively because of stroke (with 8,087 deaths of 28,6270 patients) were evaluated in the meta-analysis. Non-linear associations of BMI with all-cause mortality (P < 0.0001) and mortality by stroke (P = 0.05) were observed. Among overweight and obese stroke patients, the risk of all-cause mortality increased, while the risk of mortality by stroke declined, with an increase in BMI. Increasing BMI had opposite effects on all-cause mortality and stroke-specific mortality in stroke patients. Further investigations are needed to examine how mortality by stroke is influenced by a more accurate indicator of obesity than BMI.

  19. Artificial neural networks versus proportional hazards Cox models to predict 45-year all-cause mortality in the Italian Rural Areas of the Seven Countries Study

    Directory of Open Access Journals (Sweden)

    Puddu Paolo

    2012-07-01

    Full Text Available Abstract Background Projection pursuit regression, multilayer feed-forward networks, multivariate adaptive regression splines and trees (including survival trees have challenged classic multivariable models such as the multiple logistic function, the proportional hazards life table Cox model (Cox, the Poisson’s model, and the Weibull’s life table model to perform multivariable predictions. However, only artificial neural networks (NN have become popular in medical applications. Results We compared several Cox versus NN models in predicting 45-year all-cause mortality (45-ACM by 18 risk factors selected a priori: age; father life status; mother life status; family history of cardiovascular diseases; job-related physical activity; cigarette smoking; body mass index (linear and quadratic terms; arm circumference; mean blood pressure; heart rate; forced expiratory volume; serum cholesterol; corneal arcus; diagnoses of cardiovascular diseases, cancer and diabetes; minor ECG abnormalities at rest. Two Italian rural cohorts of the Seven Countries Study, made up of men aged 40 to 59 years, enrolled and first examined in 1960 in Italy. Cox models were estimated by: a forcing all factors; b a forward-; and c a backward-stepwise procedure. Observed cases of deaths and of survivors were computed in decile classes of estimated risk. Forced and stepwise NN were run and compared by C-statistics (ROC analysis with the Cox models. Out of 1591 men, 1447 died. Model global accuracies were extremely high by all methods (ROCs > 0.810 but there was no clear-cut superiority of any model to predict 45-ACM. The highest ROCs (> 0.838 were observed by NN. There were inter-model variations to select predictive covariates: whereas all models concurred to define the role of 10 covariates (mainly cardiovascular risk factors, family history, heart rate and minor ECG abnormalities were not contributors by Cox models but were so by forced NN. Forced expiratory volume and arm

  20. The Relationship of Alcoholism and Alcohol Consumption to All-Cause Mortality in Forty-One-Year Follow-up of the Swedish REBUS Sample

    DEFF Research Database (Denmark)

    Lundin, Andreas; Mortensen, Laust Hvas; Halldin, Jan

    2015-01-01

    OBJECTIVE: The purpose of this study was to examine the effects of alcoholism, alcohol consumption amount, and alcohol consumption pattern on mortality in a general population sample. METHOD: This study used a 1970 prospective population sample (double-phase random sample) of 2,300 individuals ages...... of the International Classification of Diseases (ICD-8). Information on the usual amount and frequency of alcohol consumption was collected at the psychiatric interview. Mortality up to year 2011 was assessed with Cox proportional hazard regression models. RESULTS: At baseline, there were 65 men and 21 women diagnosed...... with alcoholism. During followup, there were 873 deaths in the study population of 1,895. Alcoholism was associated with increased mortality rate. Former drinkers, but not never-drinkers, also had increased risk for mortality compared with moderate drinkers. We found no associations between heavy consumption...

  1. Body mass index and all-cause mortality in a large prospective cohort of white and black U.S. Adults.

    Directory of Open Access Journals (Sweden)

    Alpa V Patel

    Full Text Available Remaining controversies on the association between body mass index (BMI and mortality include the effects of smoking and prevalent disease on the association, whether overweight is associated with higher mortality rates, differences in associations by race and the optimal age at which BMI predicts mortality. To assess the relative risk (RR of mortality by BMI in Whites and Blacks among subgroups defined by smoking, prevalent disease, and age, 891,572 White and 38,119 Black men and women provided height, weight and other information when enrolled in the Cancer Prevention Study II in 1982. Over 28 years of follow-up, there were 434,400 deaths in Whites and 18,702 deaths in Blacks. Cox proportional-hazards regression was used to estimate multivariable-adjusted relative risks (RR and 95% confidence intervals (CI. Smoking and prevalent disease status significantly modified the BMI-mortality relationship in Whites and Blacks; higher BMI was most strongly associated with higher risk of mortality among never smokers without prevalent disease. All levels of overweight and obesity were associated with a statistically significantly higher risk of mortality compared to the reference category (BMI 22.5-24.9 kg/m2, except among Black women where risk was elevated but not statistically significant in the lower end of overweight. Although absolute mortality rates were higher in Blacks than Whites within each BMI category, relative risks (RRs were similar between race groups for both men and women (p-heterogeneity by race  = 0.20 for men and 0.23 for women. BMI was most strongly associated with mortality when reported before age 70 years. Results from this study demonstrate for the first time that the BMI-mortality relationship differs for men and women who smoke or have prevalent disease compared to healthy never-smokers. These findings further support recommendations for maintaining a BMI between 20-25 kg/m2 for optimal health and longevity.

  2. Body Mass Index and All-Cause Mortality in a Large Prospective Cohort of White and Black U.S. Adults

    Science.gov (United States)

    Patel, Alpa V.; Hildebrand, Janet S.; Gapstur, Susan M.

    2014-01-01

    Remaining controversies on the association between body mass index (BMI) and mortality include the effects of smoking and prevalent disease on the association, whether overweight is associated with higher mortality rates, differences in associations by race and the optimal age at which BMI predicts mortality. To assess the relative risk (RR) of mortality by BMI in Whites and Blacks among subgroups defined by smoking, prevalent disease, and age, 891,572 White and 38,119 Black men and women provided height, weight and other information when enrolled in the Cancer Prevention Study II in 1982. Over 28 years of follow-up, there were 434,400 deaths in Whites and 18,702 deaths in Blacks. Cox proportional-hazards regression was used to estimate multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI). Smoking and prevalent disease status significantly modified the BMI-mortality relationship in Whites and Blacks; higher BMI was most strongly associated with higher risk of mortality among never smokers without prevalent disease. All levels of overweight and obesity were associated with a statistically significantly higher risk of mortality compared to the reference category (BMI 22.5–24.9 kg/m2), except among Black women where risk was elevated but not statistically significant in the lower end of overweight. Although absolute mortality rates were higher in Blacks than Whites within each BMI category, relative risks (RRs) were similar between race groups for both men and women (p-heterogeneity by race  = 0.20 for men and 0.23 for women). BMI was most strongly associated with mortality when reported before age 70 years. Results from this study demonstrate for the first time that the BMI-mortality relationship differs for men and women who smoke or have prevalent disease compared to healthy never-smokers. These findings further support recommendations for maintaining a BMI between 20–25 kg/m2 for optimal health and longevity. PMID:25295620

  3. Differences between adiposity indicators for predicting all-cause mortality in a representative sample of United States non-elderly adults.

    Directory of Open Access Journals (Sweden)

    Henry S Kahn

    Full Text Available BACKGROUND: Adiposity predicts health outcomes, but this relationship could depend on population characteristics and adiposity indicator employed. In a representative sample of 11,437 US adults (National Health and Nutrition Examination Survey, 1988-1994, ages 18-64 we estimated associations with all-cause mortality for body mass index (BMI and four abdominal adiposity indicators (waist circumference [WC], waist-to-height ratio [WHtR], waist-to-hip ratio [WHR], and waist-to-thigh ratio [WTR]. In a fasting subsample we considered the lipid accumulation product (LAP; [WC enlargement*triglycerides]. METHODS AND FINDINGS: For each adiposity indicator we estimated linear and categorical mortality risks using sex-specific, proportional-hazards models adjusted for age, black ancestry, tobacco exposure, and socioeconomic position. There were 1,081 deaths through 2006. Using linear models we found little difference among indicators (adjusted hazard ratios [aHRs] per SD increase 1.2-1.4 for men, 1.3-1.5 for women. Using categorical models, men in adiposity midrange (quartiles 2+3; compared to quartile 1 were not at significantly increased risk (aHRs1.1, especially black men assessed by WTR (aHR 1.9 [1.4-2.6] and black women by LAP (aHR 2.2 [1.4-3.5]. Quartile 4 of WC or WHtR carried no significant risk for diabetic persons (aHRs 0.7-1.1, but elevated risks for those without diabetes (aHRs>1.5. For both sexes, quartile 4 of LAP carried increased risks for tobacco-exposed persons (aHRs>1.6 but not for non-exposed (aHRs<1.0. CONCLUSIONS: Predictions of mortality risk associated with top-quartile adiposity vary with the indicator used, sex, ancestry, and other characteristics. Interpretations of adiposity should consider how variation in the physiology and expandability of regional adipose-tissue depots impacts health.

  4. All-cause cancer mortality over 15 years in multi-ethnic Mauritius: the impact of diabetes and intermediate forms of glucose tolerance.

    Science.gov (United States)

    Harding, Jessica L; Soderberg, Stefan; Shaw, Jonathan E; Zimmet, Paul Z; Pauvaday, Vassen; Kowlessur, Sudhir; Tuomilehto, Jaakko; Alberti, K George M M; J Magliano, Dianna

    2012-11-15

    There are accumulating data describing the association between diabetes and cancer mortality from Westernised populations. There are no data describing the relationship between diabetes and cancer mortality in African or South Asian populations from developing countries. We explored the relationship of abnormal glucose tolerance and diabetes on cancer mortality risk in a large, multi-ethnic cohort from the developing nation of Mauritius. Population-based surveys were undertaken in 1987, 1992 and 1998. The 9559 participants comprised 66% of South Asian (Indian), 27% of African (Creole), and 7% of Chinese descent. Cox's proportional hazards model with time varying covariates was used to obtain hazard ratios (HRs) and 95% confidence intervals (95% CI) for risk of cancer mortality, after adjustment for confounding factors. In men, but not women, cancer mortality risk increased with rising 2h-PG levels with HR for the top versus bottom quintile of 2.77 (95%CI: 1.28 to 5.98). South Asian men with known diabetes had a significantly greater risk of cancer mortality than those with normal glucose tolerance (NGT) HR: 2.74 (95%CI: 1.00-7.56). Overall, impaired glucose tolerance was associated with an elevated risk of cancer mortality compared to NGT (HR: 1.47, 95% CI: 0.98-2.19), though this was not significant. We have shown that the association between abnormal glucose tolerance and cancer extends to those of African and South Asian descent. These results highlight the importance of understanding this relationship in a global context to direct future health policy given the rapid increase in type 2 diabetes, especially in developing nations.

  5. IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G D; Shipley, M J; Mortensen, L H;

    2008-01-01

    OBJECTIVE: To examine the role of potential mediating factors in explaining the IQ-mortality relation. DESIGN, SETTING AND PARTICIPANTS: A total of 4316 male former Vietnam-era US army personnel with IQ test results at entry into the service in late adolescence/early adulthood in the 1960/1970s (...

  6. Predictors of hospitalization for heart failure and of all-cause mortality after atrioventricular nodal ablation and right ventricular pacing for atrial fibrillation

    DEFF Research Database (Denmark)

    Björkenheim, Anna; Brandes, Axel; Andersson, Tommy;

    2014-01-01

    in patients who underwent AVJA because of AF and to determine predictors for HF and mortality. METHODS AND RESULTS: We retrospectively enrolled 162 consecutive patients, mean age 67 ± 9 years, 48% women, who underwent AVJA because of symptomatic AF refractory to pharmacological treatment (n = 117...

  7. All-cause mortality among people with serious mental illness (SMI, substance use disorders, and depressive disorders in southeast London: a cohort study

    Directory of Open Access Journals (Sweden)

    Lee William

    2010-09-01

    Full Text Available Abstract Background Higher mortality has been found for people with serious mental illness (SMI, including schizophrenia, schizoaffective disorders, and bipolar affective disorder at all age groups. Our aim was to characterize vulnerable groups for excess mortality among people with SMI, substance use disorders, depressive episode, and recurrent depressive disorder. Methods A case register was developed at the South London and Maudsley National Health Services Foundation Trust (NHS SLAM, accessing full electronic clinical records on over 150,000 mental health service users as a well-defined cohort since 2006. The Case Register Interactive Search (CRIS system enabled searching and retrieval of anonymised information since 2008. Deaths were identified by regular national tracing returns after 2006. Standardized mortality ratios (SMRs were calculated for the period 2007 to 2009 using SLAM records for this period and the expected number of deaths from age-specific mortality statistics for the England and Wales population in 2008. Data were stratified by gender, ethnicity, and specific mental disorders. Results A total of 31,719 cases, aged 15 years old or more, active between 2007-2009 and with mental disorders of interest prior to 2009 were detected in the SLAM case register. SMRs were 2.15 (95% CI: 1.95-2.36 for all SMI with genders combined, 1.89 (1.64-2.17 for women and 2.47 (2.17-2.80 for men. In addition, highest mortality risk was found for substance use disorders (SMR = 4.17; 95% CI: 3.75-4.64. Age- and gender-standardised mortality ratios by ethnic group revealed huge fluctuations, and SMRs for all disorders diminished in strength with age. The main limitation was the setting of secondary mental health care provider in SLAM. Conclusions Substantially higher mortality persists in people with serious mental illness, substance use disorders and depressive disorders. Furthermore, mortality risk differs substantially with age, diagnosis, gender

  8. Anemia as a risk factor for cardiovascular disease and all-cause mortality in diabetes: the impact of chronic kidney disease.

    Science.gov (United States)

    Vlagopoulos, Panagiotis T; Tighiouart, Hocine; Weiner, Daniel E; Griffith, John; Pettitt, Dan; Salem, Deeb N; Levey, Andrew S; Sarnak, Mark J

    2005-11-01

    Anemia is a potential nontraditional risk factor for cardiovascular disease (CVD). This study evaluated whether anemia is a risk factor for adverse outcomes in people with diabetes and whether the risk is modified by the presence of chronic kidney disease (CKD). Persons with diabetes from four community-based studies were pooled: Atherosclerosis Risk in Communities, Cardiovascular Health Study, Framingham Heart Study, and Framingham Offspring Study. Anemia was defined as a hematocrit death and each outcome separately. Cox regression analysis was used to study the effect of anemia on the risk for outcomes after adjustment for potential confounders. The study population included 3015 individuals: 30.4% were black, 51.6% were women, 8.1% had anemia, and 13.8% had CKD. Median follow-up was 8.6 yr. There were 1215 composite events, 600 MI/fatal CHD outcomes, 300 strokes, and 857 deaths. In a model with a CKD-anemia interaction term, anemia was associated with the following hazard ratios (95% confidence intervals) in patients with CKD: 1.70 (1.24 to 2.34) for the composite outcome, 1.64 (1.03 to 2.61) for MI/fatal CHD, 1.81 (0.99 to 3.29) for stroke, and 1.88 (1.33 to 2.66) for all-cause mortality. Anemia was not a risk factor for any outcome in those without CKD (P > 0.2 for all outcomes). In persons with diabetes, anemia is primarily a risk factor for adverse outcomes in those who also have CKD.

  9. Matrix-assisted laser desorption/ionisation (MALDI) TOF analysis identifies serum angiotensin II concentrations as a strong predictor of all-cause and breast cancer (BCa)-specific mortality following breast surgery.

    Science.gov (United States)

    Boccardo, Francesco; Rubagotti, Alessandra; Nuzzo, Pier Vitale; Argellati, Francesca; Savarino, Grazia; Romano, Paolo; Damonte, Gianluca; Rocco, Mattia; Profumo, Aldo

    2015-11-15

    MALDI-TOF MS was used to recognise serum peptidome profiles predictive of mortality in women affected by early BCa. Mortality was analysed based on signal profiling, and appropriate statistics were used. The results indicate that four signals were increased in deceased patients compared with living patients. Three of the four signals were individually associated with all-cause mortality, but only one having mass/charge ratio (m/z) 1,046.49 was associated with BCa-specific mortality and was the only peak to maintain an independent prognostic role after multivariate analysis. Two groups exhibiting different mortality probabilities were identified after clustering patients based on the expression of the four peptides, but m/z 1,046.49 was exclusively expressed in the cluster exhibiting the worst mortality outcome, thus confirming the crucial value of this peptide. The specific role of this peak was confirmed by competing risk analysis. MS findings were validated by ELISA analysis after demonstrating that m/z 1,046.49 structurally corresponded to Angiotensin II (ATII). In fact, mortality results obtained after arbitrarily dividing patients according to an ATII serum value of 255 pg/ml (which corresponds to the 66(th) percentile value) were approximately comparable to those previously demonstrated when the same patients were analysed according to the expression of signal m/z 1,046.49. Similarly, ATII levels were specifically correlated with BCa-related deaths after competing risk analysis. In conclusion, ATII levels were increased in women who exhibited worse mortality outcomes, reinforcing the evidence that this peptide potentially significantly affects the natural history of early BCa. Our findings also confirm that MALDI-TOF MS is an efficient screening tool to identify novel tumour markers and that MS findings can be rapidly validated through less complex techniques, such as ELISA.

  10. Incident comorbidities and all-cause mortality among 5-year survivors of Stage I and II breast cancer diagnosed at age 65 or older: a prospective-matched cohort study.

    Science.gov (United States)

    Jordan, Jennifer H; Thwin, Soe Soe; Lash, Timothy L; Buist, Diana S M; Field, Terry S; Haque, Reina; Pawloski, Pamala A; Petersen, Hans V; Prout, Marianne N; Quinn, Virginia P; Yood, Marianne Ulcickas; Silliman, Rebecca A; Geiger, Ann M

    2014-07-01

    Five-year breast cancer survivors, diagnosed after 65 years of age, may develop more incident comorbidities than similar populations free of cancer. We investigated whether older breast cancer survivors have a similar comorbidity burden 6-15 years after cancer diagnosis to matched women free of breast cancer at start of follow-up and whether incident comorbidities are associated with all-cause mortality. In this prospective cohort study, 1,361 older 5-year early-stage breast cancer survivors diagnosed between 1990 and 1994 and 1,361 age- and health system-matched women were followed for 10 years. Adjudicated medical record review captured prevalent and incident comorbidities during follow-up or until death as collected from the National Death Index. Older 5-year breast cancer survivors did not acquire incident comorbidities more often than matched women free of breast cancer in the subsequent 10 years [hazard ratio (HR) 1.0, 95 % confidence interval (95 % CI) 0.93, 1.1]. Adjusted for cohort membership, women with incident comorbidities had a higher mortality rate than those without incident comorbidities (HR 4.8, 95 % CI 4.1, 5.6). A breast cancer history continued to be a hazard for mortality 6-15 years after diagnosis (HR 1.3, 95 % CI 1.1, 1.4). We found that older breast cancer survivors who developed comorbidities had an increased all-cause mortality rate even after adjusting for age and prevalent comorbidity burden. Additionally, survivors acquire comorbidities at a rate similar to older women free of breast cancer. These results highlight the association between comorbidity burden and long-term mortality risk among older breast cancer survivors and their need for appropriate oncology and primary care follow-up.

  11. The interplay between physical activity at work and during leisure time--risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

    2009-01-01

    OBJECTIVE: Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. METHODS: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasi...... cardiovascular disease. In contrast, moderate and high levels of activity during leisure time seemed to be protective against IHD mortality among people with medium and high physical activity at work.......OBJECTIVE: Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. METHODS: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasian......, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. RESULTS: During the follow-up period, 591 men (11.9%) died from IHD. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high...

  12. The interplay between physical activity at work and during leisure time - risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men

    DEFF Research Database (Denmark)

    Holtermann, A.; Mortensen, O.S.; Burr, H.

    2009-01-01

    Objective our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. Methods We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caueasian...... cardiovascular disease. In contrast, moderate and high levels of activity during leisure time seemed to be protective against IHD mortality among people with medium and high physical activity at work Udgivelsesdato: 2009/11......Objective our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. Methods We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caueasian......, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. Results During the follow-up period, 591 men (11.9%) died from IIID. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high...

  13. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants.

    Science.gov (United States)

    Barylski, Marcin; Nikfar, Shekoufeh; Mikhailidis, Dimitri P; Toth, Peter P; Salari, Pooneh; Ray, Kausik K; Pencina, Michael J; Rizzo, Manfredi; Rysz, Jacek; Abdollahi, Mohammad; Nicholls, Stephen J; Banach, Maciej

    2013-06-01

    The available studies have reported the benefits of statins on all-cause and cardiovascular mortality in chronic kidney disease (CKD) patients. However studies in end-stage renal disease patients on dialysis yielded conflicting results. Therefore, we performed a meta-analysis and provide the most reliable trial data to date on the impact of statin therapy on cardiovascular events and death from all causes in CKD patients. Data from PubMed, Web of Science, Cochrane Library, and Scopus for the years 1966 to October 2012 were searched. The final meta-analysis included 11 randomized controlled trials involving 21,295 participants with CKD. Among them 6857 were on dialysis. The use of statins in subjects with non-dialysis-dependent CKD resulted in a marked reduction in death from all causes (relative risk [RR]: 0.66; 95% confidence interval [CI]: 0.55-0.79; pcauses (RR: 0.69; 95%CI: 0.55-0.68; p=0.0012), cardiovascular events (RR: 0.55; 95%CI: 0.4-0.75; p=0.0001) and stroke (RR: 0.66; 95%CI: 0.5-0.88; p=0.0022). The use of statins in dialysis-dependent CKD patients resulted in a non-significant effect on death from all causes (RR: 0.99; 95%CI: 0.88-1.11; p=0.85) and stroke (RR: 1.31; 95%CI: 0.9-1.89; p>0.05), but had the effect of reducing death from cardiac causes (RR: 0.79; 95%CI: 0.64-0.98; pCKD. According to the very limited data the obtained results suggest caution in expecting a reduction in cardiovascular events in patients on dialysis.

  14. The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980-2010

    OpenAIRE

    MARTÍNEZ, DAVID; Giráldez García, Carolina; Miqueleiz Autor, Estrella; Calle, María; Santos, Juana M.; Regidor, Enrique

    2015-01-01

    Background: An increase has been observed in differences in mortality between the richest and poorest areas of rich countries. This study assesses whether one of the proposed explanations, i.e., population change, might be responsible for this increase in Spain. Methods: Observational study based on average income, population change and mortality at provincial level. The premature mortality rate (ages 0-74 years) was estimated for all causes and for cancer, cardiovascular disease and external...

  15. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens

    DEFF Research Database (Denmark)

    Elming, H; Holm, E; Jun, L;

    1998-01-01

    , adjusted for age, gender, myocardial infarct, angina pectoris, diabetes mellitus, arterial hypertension, smoking habits, serum cholesterol level, and heart rate were 2.9 for the QT interval (95% confidence interval 1.1-7.8) and 4.4 for QT interval dispersion (95% confidence interval 1.0-19-1). Fatal......AIMS: To evaluate the prognostic value of the QT interval and QT interval dispersion in total and in cardiovascular mortality, as well as in cardiac morbidity, in a general population. METHODS AND RESULTS: The QT interval was measured in all leads from a standard 12-lead ECG in a random sample...

  16. Importance of light smoking and inhalation habits on risk of myocardial infarction and all cause mortality. A 22 year follow up of 12 149 men and women in The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Prescott, E; Scharling, H; Osler, M

    2002-01-01

    . After adjusting for major cardiovascular risk factors there was a dose-response relation between smoking with and without inhaling and both MI and all cause mortality. Among inhaling smokers significantly increased risks were found in women at a consumption of only 3-5 grams of tobacco per day...... with higher RR found in women than in men. The study emphasises the importance of recognising that even very limited tobacco consumption has detrimental health effects........30)). The RR associated with smoking were significantly higher in women than in men for both MI and all cause mortality. CONCLUSIONS: Smoking as little as 3-5 grams of tobacco per day or not inhaling the smoke was shown to carry a significantly increased risk of developing MI and of all cause mortality...

  17. Effect of Body Mass Index on All-cause Mortality and Incidence of Cardiovascular Diseases - Report for Meta-Analysis of Prospective Studies on Optimal Cut-off Points of Body Mass Index in Chinese Adults

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted allcause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in

  18. Higher plasma soluble Receptor for Advanced Glycation End Products (sRAGE) levels are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes: a 12-year follow-up study

    DEFF Research Database (Denmark)

    Nin, Johanna W M; Jorsal, Anders; Merces Ferreira, Isabel Maria;

    2010-01-01

    To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunct......To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal...... dysfunction, low-grade inflammation, arterial stiffness, and advanced glycation end products (AGEs)....

  19. Physical work demands and physical fitness in low social classes--30-year ischemic heart disease and all-cause mortality in the copenhagen male study

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann;

    2011-01-01

    Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness.......Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness....

  20. Influence of lifestyle aspects on the association of body size and shape with all-cause mortality in middle-aged men and women

    DEFF Research Database (Denmark)

    Bigaard, Janne; Christensen, Jane; Tjønneland, Anne;

    2010-01-01

    Waist circumference, BMI and hip circumference are differentially associated with mortality. We investigated the potential influence of selected lifestyle aspects such as smoking, alcohol intake, sports activity and education.......Waist circumference, BMI and hip circumference are differentially associated with mortality. We investigated the potential influence of selected lifestyle aspects such as smoking, alcohol intake, sports activity and education....

  1. Associations of objectively measured moderate-to-vigorous-intensity physical activity and sedentary time with all-cause mortality in a population of adults at high risk of type 2 diabetes mellitus.

    Science.gov (United States)

    Bakrania, Kishan; Edwardson, Charlotte L; Khunti, Kamlesh; Henson, Joseph; Stamatakis, Emmanuel; Hamer, Mark; Davies, Melanie J; Yates, Thomas

    2017-03-01

    The relationships of physical activity and sedentary time with all-cause mortality in those at high risk of type 2 diabetes mellitus (T2DM) are unexplored. To address this gap in knowledge, we examined the associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time with all-cause mortality in a population of adults at high risk of T2DM. In 2010-2011, 712 adults (Leicestershire, U.K.), identified as being at high risk of T2DM, consented to be followed up for mortality. MVPA and sedentary time were assessed by accelerometer; those with valid data (≥ 10 hours of wear-time/day with ≥ 4 days of data) were included. Cox proportional hazards regression models, adjusted for potential confounders, were used to investigate the independent associations of MVPA and sedentary time with all-cause mortality. 683 participants (250 females (36.6%)) were included and during a mean follow-up period of 5.7 years, 26 deaths were registered. Every 10% increase in MVPA time/day was associated with a 5% lower risk of all-cause mortality [Hazard Ratio (HR): 0.95 (95% Confidence Interval (95% CI): 0.91, 0.98); p = 0.004]; indicating that for the average adult in this cohort undertaking approximately 27.5 minutes of MVPA/day, this benefit would be associated with only 2.75 additional minutes of MVPA/day. Conversely, sedentary time showed no association with all-cause mortality [HR (every 10-minute increase in sedentary time/day): 0.99 (95% CI: 0.95, 1.03); p = 0.589]. These data support the importance of MVPA in adults at high risk of T2DM. The association between sedentary time and mortality in this population needs further investigation.

  2. Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

    Science.gov (United States)

    Ferri, Cleusa P.; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A. T.; Prince, Martin J.

    2012-01-01

    Background Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. Methods and Findings The vital status of 12,373 people aged 65 y and over was determined 3–5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89–0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Conclusions Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the

  3. Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Cleusa P Ferri

    2012-02-01

    Full Text Available BACKGROUND: Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. METHODS AND FINDINGS: The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98. Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. CONCLUSIONS: Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older

  4. All-cause mortality in treated HIV-infected adults with CD4 ≥500/mm3 compared with the general population

    DEFF Research Database (Denmark)

    Lewden, Charlotte; Bouteloup, Vincent; De Wit, Stéphane;

    2012-01-01

    Using data from a large European collaborative study, we aimed to identify the circumstances in which treated HIV-infected individuals will experience similar mortality rates to those of the general population....

  5. All-cause mortality and cardiovascular effects associated with the DPP-IV inhibitor sitagliptin compared with metformin, a retrospective cohort study on the Danish population

    DEFF Research Database (Denmark)

    Scheller, N M; Mogensen, U M; Andersson, Charlotte;

    2014-01-01

    AIM: We performed a retrospective cohort study, investigating the clinical outcomes including mortality and cardiovascular disease of sitagliptin compared with metformin monotherapies. METHODS: All patients receiving monotherapy with the dipeptidyl peptidase-IV inhibitors (DPP-IV) inhibitor sitag...

  6. Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Prescott, Eva; Holst, Claus; Grønbaek, Morten

    2003-01-01

    for biological, behavioural, and socioeconomic risk factors did not substantially affect the association for IHD but attenuated the association with all-cause mortality. CONCLUSIONS: Measures of fatigue and depression were common symptoms in this population sample and convey increased risk of IHD and of all-cause......BACKGROUND: Vital exhaustion, a psychological measure characterized by fatigue and depressive symptoms, has been suggested to be an independent risk factor for ischaemic heart disease (IHD) but the generality of the phenomenon remains in question. The aim of this study is to describe prevalence...... of these symptoms in a community sample and determine whether they prospectively predict increased risk of IHD and all-cause mortality in men and women. METHODS: The study base was 4084 men and 5479 women aged 20-98 free of IHD examined in 1991-1993 in the Copenhagen City Heart Study. Events were ascertained...

  7. Predictive Validity of the American College of Cardiology/American Heart Association Pooled Cohort Equations in Predicting All-Cause and Cardiovascular Disease-Specific Mortality in a National Prospective Cohort Study of Adults in the United States.

    Science.gov (United States)

    Loprinzi, Paul D; Addoh, Ovuokerie

    2016-06-01

    The predictive validity of the Pooled Cohort risk (PCR) equations for cardiovascular disease (CVD)-specific and all-cause mortality among a national sample of US adults has yet to be evaluated, which was this study's purpose. Data from the 1999-2010 National Health and Nutrition Examination Survey were used, with participants followed up through December 31, 2011, to ascertain mortality status via the National Death Index probabilistic algorithm. The analyzed sample included 11,171 CVD-free adults (40-79 years of age). The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined from the PCR equations. For the entire sample encompassing 849,202 person-months, we found an incidence rate of 1.00 (95% CI, 0.93-1.07) all-cause deaths per 1000 person-months and an incidence rate of 0.15 (95% CI, 0.12-0.17) CVD-specific deaths per 1000 person-months. The unweighted median follow-up duration was 72 months. For nearly all analyses (unadjusted and adjusted models with ASCVD expressed as a continuous variable as well as dichotomized at 7.5% and 20%), the ASCVD risk score was significantly associated with all-cause and CVD-specific mortality (Pequations was associated with all-cause and CVD-specific mortality among those free of CVD at baseline. In this American adult sample, the PCR equations provide evidence of predictive validity.

  8. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Naghavi, Mohsen; Wang, Haidong; Lozano, Rafael; Davis, Adrian; Liang, Xiaofeng; Zhou, Maigeng; Vollset, Stein Emil; Ozgoren, Ayse Abbasoglu; Abdalla, Safa; Abd-Allah, Foad; Aziz, Muna I. Abdel; Abera, Semaw Ferede; Aboyans, Victor; Abraham, Biju; Abraham, Jerry P.; Abuabara, Katrina E.; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Achoki, Tom; Adelekan, Ademola; Ademi, Zanfi Na; Adofo, Koranteng; Adou, Arsene Kouablan; Adsuar, Jose C.; Aernlov, Johan; Agardh, Emilie Elisabet; Akena, Dickens; Al Khabouri, Mazin J.; Alasfoor, Deena; Albittar, Mohammed; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Mohammed K.; Ali, Raghib; Alla, Francois; Al Lami, Faris; Allebeck, Peter; AlMazroa, Mohammad A.; Salman, Rustam Al-Shahi; Alsharif, Ubai; Alvarez, Elena; Alviz-Guzman, Nelson; Amankwaa, Adansi A.; Amare, Azmeraw T.; Ameli, Omid; Amini, Hassan; Ammar, Walid; Anderson, H. Ross; Anderson, Benjamin O.; Antonio, Carl Abelardo T.; Anwari, Palwasha; Apfel, Henry; Cunningham, Solveig Argeseanu; Arsenijevic, Valentina S. Arsic; Al Artaman, Ali; Asad, Majed Masoud; Asghar, Rana J.; Assadi, Reza; Atkins, Lydia S.; Atkinson, Charles; Badawi, Alaa; Bahit, Maria C.; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Banerjee, Amitava; Barber, Ryan M.; Barker-Collo, Suzanne L.; Barquera, Simon; Barregard, Lars; Barrero, Lope H.; Barrientos-Gutierrez, Tonatiuh; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed Omar; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bekele, Tolesa; Bell, Michelle L.; Benjet, Corina; Bennett, Derrick A.; Bensenor, Isabela M.; Benzian, Habib; Bertozzi-Villa, Amelia; Beyene, Tariku Jibat; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A.; Bikbov, Boris; Bin Abdulhak, Aref; Biryukov, Stan; Blore, Jed D.; Blyth, Fiona M.; Bohensky, Megan A.; Borges, Guilherme; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R.; Boyers, Lindsay N.; Brainin, Michael; Brauer, Michael; Brayne, Carol E. G.; Brazinova, Alexandra; Breitborde, Nicholas; Brenner, Hermann; Briggs, Adam D. M.; Brown, Jonathan C.; Brugha, Traolach S.; Buckle, Geoffrey C.; Bui, Linh Ngoc; Bukhman, Gene; Burch, Michael; Nonato, Ismael Ricardo Campos; Carabin, Helesne; Cardenas, Rosario; Carapetis, Jonathan; Carpenter, David O.; Caso, Valeria; Castaneda-Orjuela, Carlos A.; Castro, Ruben Estanislao; Catala-Lopez, Ferrn; Cavalleri, Fiorella; Chang, Jung-Chen; Charlson, Fiona C.; Che, Xuan; Chen, Honglei; Chen, Yingyao; Chen, Jian Sheng; Chen, Zhengming; Chiang, Peggy Pei-Chia; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christensen, Hanne; Christophi, Costas A.; Chuang, Ting-Wu; Chugh, Sumeet S.; Cirillo, Massimo; Coates, Matthew M.; Coffeng, Luc Edgar; Coggeshall, Megan S.; Cohen, Aaron; Colistro, Valentina; Colquhoun, Samantha M.; Colomar, Mercedes; Cooper, Leslie Trumbull; Cooper, Cyrus; Coppola, Luis M.; Cortinovis, Monica; Courville, Karen; Cowie, Benjamin C.; Criqui, Michael H.; Crump, John A.; Cuevas-Nasu, Lucia; Leite, Iuri da Costa; Dabhadkar, Kaustubh C.; Dandona, Lalit; Dandona, Rakhi; Dansereau, Emily; Dargan, Paul I.; Dayama, Anand; De la Cruz-Gongora, Vanessa; de la Vega, Shelley F.; De Leo, Diego; Degenhardt, Louisa; del Pozo-Cruz, Borja; Dellavalle, Robert P.; Deribe, Kebede; Jarlais, Don C. Des; Dessalegn, Muluken; deVeber, Gabrielle A.; Dharmaratne, Samath D.; Dherani, Mukesh; Diaz-Ortega, Jose-Luis; Diaz-Torne, Cesar; Dicker, Daniel; Ding, Eric L.; Dokova, Klara; Dorsey, E. Ray; Driscoll, Tim R.; Duan, Leilei; Duber, Herbert C.; Durrani, Adnan M.; Ebel, Beth E.; Edmond, Karen M.; Ellenbogen, Richard G.; Elshrek, Yousef; Ermakov, Sergey Petrovich; Erskine, Holly E.; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fuerst, Thomas; Fahimi, Saman; Fahrion, Anna S.; Faraon, Emerito Jose A.; Farzadfar, Farshad; Fay, Derek F. J.; Feigl, Andrea B.; Feigin, Valery L.; Felicio, Manuela Mendonca; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G.; Ferrari, Alize J.; Fleming, Thomas D.; Foigt, Nataliya; Foreman, Kyle; Forouzanfar, Mohammad H.; Fowkes, F. Gerry R.; Fra Paleo, Urbano; Franklin, Richard C.; Futran, Neal D.; Gaffikin, Lynne; Gambashidze, Ketevan; Gankpe, Fortune Gbetoho; Garcia-Guerra, Francisco Armando; Garcia, Ana Cristina; Geleijnse, Johanna M.; Gessner, Bradford D.; Gibney, Katherine B.; Gillum, Richard F.; Gilmour, Stuart; Abdelmageem, Ibrahim; Ginawi, Mohamed; Giroud, Maurice; Glaser, Elizabeth L.; Goenka, Shifalika; Dantes, Hector Gomez; Gona, Philimon; Gonzalez-Medina, Diego; Guinovart, Caterina; Gupta, Rahul; Gupta, Rajeev; Gosselin, Richard A.; Gotay, Carolyn C.; Goto, Atsushi; Gowda, Hube N.; Graetz, Nicholas; Greenwell, K. Fern; Gugnani, Harish Chander; Gunnell, David; Gutierrez, Reyna A.; Haagsma, Juanita; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A.; Hamadeh, Randah Ribhi; Hamavid, Hannah; Hammami, Mouhanad; Hancock, Jamie; Hankey, Graeme J.; Hansen, Gillian M.; Harb, Hilda L.; Harewood, Heather; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Roderick J.; Hay, Simon I.; Hedayati, Mohammad T.; Pi, Ileana B. Heredia; Heuton, Kyle R.; Heydarpour, Pouria; Higashi, Hideki; Hijar, Martha; Hoek, Hans W.; Hoffman, Howard J.; Hornberger, John C.; Hosgood, H. Dean; Hossain, Mazeda; Hotez, Peter J.; Hoy, Damian G.; Hsairi, Mohamed; Hu, Guoqing; Huang, John J.; Huffman, Mark D.; Hughes, Andrew J.; Husseini, Abdullatif; Huynh, Chantal; Iannarone, Marissa; Iburg, Kim M.; Idrisov, Bulat T.; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H.; Jassal, Simerjot; Jayaraman, Sudha P.; Jensen, Paul N.; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jonas, Jost B.; Joseph, Jonathan; Juel, Knud; Kabagambe, Edmond Kato; Kan, Haidong; Karch, Andre; Karimkhani, Chante; Karthikeyan, Ganesan; Kassebaum, Nicholas; Kaul, Anil; Kawakami, Norito; Kazanjan, Konstantin; Kazi, Dhruv S.; Kemp, Andrew H.; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Khader, Yousef Saleh; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz Ahmed; Khan, Gulfaraz; Khang, Young-Ho; Kieling, Christian; Kinfu, Yohannes; Kinge, Jonas M.; Kim, Daniel; Kim, Sungroul; Kivipelto, Miia; Knibbs, Luke; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kosen, Sowarta; Kotagal, Meera; Kravchenko, Michael A.; Krishnaswami, Sanjay; Krueger, Hans; Defo, Barthelemy Kuate; Kuipers, Ernst J.; Bicer, Burcu Kucuk; Kulkarni, Chanda; Kulkarni, Veena S.; Kumar, Kaushalendra; Kumar, Ravi B.; Kwan, Gene F.; Kyu, Hmwe; Lai, Taavi; Balaji, Arjun Lakshmana; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C.; Larson, Heidi J.; Larsson, Anders; Lavados, Pablo M.; Lawrynowicz, Alicia E. B.; Leasher, Janet L.; Lee, Jong-Tae; Leigh, James; Leinsalu, Mall; Leung, Ricky; Levitz, Carly; Li, Bin; Li, Yichong; Li, Yongmei; Liddell, Chelsea; Lim, Stephen S.; de Lima, Graca Maria Ferreira; Lind, Maggie L.; Lipshultz, Steven E.; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K.; Lofgren, Katherine T.; Logroscino, Giancarlo; London, Stephanie J.; Lortet-Tieulent, Joannie; Lotufo, Paulo A.; Lucas, Robyn M.; Lunevicius, Raimundas; Lyons, Ronan Anthony; Ma, Stefan; Machado, Vasco Manuel Pedro; MacIntyre, Michael F.; Mackay, Mark T.; MacLachlan, Jennifer H.; Magis-Rodriguez, Carlos; Mahdi, Abbas A.; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher Chabila; Marape, Marape; Marcenes, Wagner; Margono, Christopher; Marks, Guy B.; Marzan, Melvin Barrientos; Masci, Joseph R.; Mashal, Mohammad Taufi Q.; Masiye, Felix; Mason-Jones, Amanda J.; Matzopolous, Richard; Mayosi, Bongani M.; Mazorodze, Tasara T.; McGrath, John J.; Mckay, Abigail C.; Mckee, Martin; McLain, Abigail; Meaney, Peter A.; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Melaku, Yohannes Adama; Meltzer, Michele; Memish, Ziad A.; Mendoza, Walter; Mensah, George A.; Meretoja, Atte; Mhimbira, Francis A.; Miller, Ted R.; Mills, Edward J.; Misganaw, Awoke; Mishra, Santosh K.; Mock, Charles N.; Moffitt, Terrie E.; Ibrahim, Norlinah Mohamed; Mohammad, Karzan Abdulmuhsin; Mokdad, Ali H.; Mola, Glen Liddell; Monasta, Lorenzo; Monis, Jonathan de la Cruz; Hernandez, Julio C. Montaez; Montico, Marcella; Montine, Thomas J.; Mooney, Meghan D.; Moore, Ami R.; Moradi-Lakeh, Maziar; Moran, Andrew E.; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister Nyaora; Moyer, Madeline L.; Mozaffarian, Dariush; Mueller, Ulrich O.; Mukaigawara, Mitsuru; Mullany, Erin C.; Murray, Joseph; Mustapha, Adetoun; Naghavi, Paria; Naheed, Aliya; Naidoo, Kovin S.; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K. M. Venkat; Nash, Denis; Nasher, Jamal; Nejjari, Chakib; Nelson, Robert G.; Neuhouser, Marian; Neupane, Sudan Prasad; Newcomb, Polly A.; Newman, Lori; Newton, Charles R.; Ng, Marie; Ngalesoni, Frida Namnyak; Nguyen, Grant; Nhung Thi Trang Nguyen, [Unknown; Nisar, Muhammad Imran; Nolte, Sandra; Norheim, Ole F.; Norman, Rosana E.; Norrving, Bo; Nyakarahuka, Luke; Odell, Shaun; O'Donnell, Martin; Ohkubo, Takayoshi; Ohno, Summer Lockett; Olusanya, Bolajoko O.; Omer, Saad B.; Opio, John Nelson; Orisakwe, Orish Ebere; Ortblad, Katrina F.; Ortiz, Alberto; Otayza, Maria Lourdes K.; Pain, Amanda W.; Pandian, Jeyaraj D.; Panelo, Carlo Irwin; Panniyammakal, Jeemon; Papachristou, Christina; Paternina Caicedo, Angel J.; Patten, Scott B.; Patton, George C.; Paul, Vinod K.; Pavlin, Boris; Pearce, Neil; Pellegrini, Carlos A.; Pereira, David M.; Peresson, Sophie C.; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando P.; Perico, Norberto; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B.; Petzold, Max; Phillips, Bryan K.; Phillips, David E.; Phillips, Michael R.; Plass, Dietrich; Piel, Frederic Bernard; Poenaru, Dan; Polinder, Suzanne; Popova, Svetlana; Poulton, Richie G.; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qato, Dima; Quezada, Amado D.; Quistberg, D. Alex; Rabito, Felicia; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad U. R.; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M.; Refaat, Amany; Remuzzi, Giuseppe; Ribeiro, Antonio L.; Ricci, Stefano; Riccio, Patricia M.; Richardson, Lee; Richardus, Jan Hendrik; Roberts, Bayard; Roberts, D. Allen; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Ronfani, Luca; Room, Robin; Roth, Gregory A.; Rothenbacher, Dietrich; Rothstein, David H.; Rowley, Jane Tf; Roy, Nobhojit; Ruhago, George M.; Rushton, Lesley; Sambandam, Sankar; Soreide, Kjetil; Saeedi, Mohammad Yahya; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Sahle, Berhe Weldearegawi; Salomon, Joshua A.; Salvo, Deborah; Samonte, Genesis May J.; Sampson, Uchechukwu; Sanabria, Juan Ramon; Sandar, Logan; Santos, Itamar S.; Satpathy, Maheswar; Sawhney, Monika; Saylan, Mete; Scarborough, Peter; Schoettker, Ben; Schmidt, Juergen C.; Schneider, Ione J. C.; Schumacher, Austin E.; Schwebel, David C.; Scott, James G.; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shackelford, Katya; Shaheen, Amira; Shahraz, Saeid; Shakh-Nazarova, Marina; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shepard, Donald S.; Shibuya, Kenji; Shinohara, Yukito; Shishani, Kawkab; Shiue, Ivy; Shivakoti, Rupak; Shrime, Mark G.; Sigfusdottir, Inga Dora; Silberberg, Donald H.; Silva, Andrea P.; Simard, Edgar P.; Sindi, Shireen; Singh, Jasvinder A.; Singh, Lavanya; Sioson, Edgar; Skirbekk, Vegard; Sliwa, Karen; So, Samuel; Soljak, Michael; Soneji, Samir; Soshnikov, Sergey S.; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stanaway, Jeff Rey D.; Stathopoulou, Vasiliki Kalliopi; Steenland, Kyle; Stein, Claudia; Steiner, Caitlyn; Stevens, Antony; Stoeckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F.; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L.; Tabb, Karen M.; Takahashi, Ken; Talongwa, Roberto Tchio; Tan, Feng; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Ao, Braden Te; Teixeira, Carolina Maria; Templin, Tara; Tenkorang, Eric Yeboah; Terkawi, Abdullah Sulieman; Thomas, Bernadette A.; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tillmann, Taavi; Tirschwell, David L.; Tleyjeh, Imad M.; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeffrey A.; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X.; Truelsen, Thomas; Trujillo, Ulises; Trillini, Matias; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, E. Murat; Ubeda, Clotilde; Uchendu, Uche S.; Ukwaja, Kingsley N.; Undurraga, Eduardo A.; Vallely, Andrew J.; van de Vijver, Steven; van Gool, Coen H.; Varakin, Yuri Y.; Vasankari, Tommi J.; Vasconcelos, Ana Maria Nogales; Vavilala, Monica S.; Venketasubramanian, N.; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S.; Vlassov, Vasiliy Victorovich; Wagner, Gregory R.; Waller, Stephen G.; Wang, JianLi; Wang, Linhong; Wang, XiaoRong; Wang, Yanping; Warouw, Tati Suryati; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Wenzhi, Wang; Werdecker, Andrea; Wessells, K. Ryan R.; Westerman, Ronny; Whiteford, Harvey A.; Wilkinson, James D.; Williams, Thomas Neil; Woldeyohannes, Solomon Meseret; Wolfe, Charles D. A.; Wolock, Timothy M.; Woolf, Anthony D.; Wong, John Q.; Wright, Jonathan L.; Wulf, Sarah; Wurtz, Brittany; Xu, Gelin; Yang, Yang C.; Yano, Yuichiro; Yatsuya, Hiroshi; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa; Yu, Chuanhua; Jin, Kim Yun; Zaki, Maysaa El Sayed; Zamakhshary, Mohammed Fouad; Zeeb, Hajo; Zhang, Yong; Zhao, Yong; Zheng, Yingfeng; Zhu, Jun; Zhu, Shankuan; Zonies, David; Zou, Xiao Nong; Zunt, Joseph R.; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.

    2015-01-01

    Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries betwe

  9. Determinants of longevity and all-cause mortality among middle-aged men. Role of 48 personal characteristics in 40-year follow-up of Italian Rural Areas in the Seven Countries Study.

    NARCIS (Netherlands)

    Menotti, A.; Lanti, M.; Maiani, G.; Kromhout, D.

    2006-01-01

    Background and aims: Forty-year all-cause mortality and its association with entry risk factor levels are reported for men enrolled in the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases. Methods: Forty-eight potential risk factors were measured in 1712 men aged 40-59 at

  10. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC)

    DEFF Research Database (Denmark)

    Ekelund, Ulf; Ward, Heather; Norat, Teresa

    2015-01-01

    Background: The higher risk of death resulting from excess adiposity may be attenuated by physical activity (PA). However, the theoretical number of deaths reduced by eliminating physical inactivity compared with overall and abdominal obesity remains unclear. Objective: We examined whether overall......, and adjusted for sex, education, smoking, and alcohol intake. Center-specific PAF associated with inactivity, body mass index (BMI; in kg/m2) (>30), and WC (≥102 cm for men, ≥88 cm for women) were calculated and combined in random-effects meta-analysis. Life-tables analyses were used to estimate gains in life...... of BMI and WC. Avoiding all inactivity would theoretically reduce all-cause mortality by 7.35% (95% CI: 5.88%, 8.83%). Corresponding estimates for avoiding obesity (BMI >30) were 3.66% (95% CI: 2.30%, 5.01%). The estimates for avoiding high WC were similar to those for physical inactivity. Conclusion...

  11. Correlation between T lymphocyte subsets in peripheral blood lymphocytes and 2-year all-cause mortality in an apparently healthy elderly Chinese cohort

    Institute of Scientific and Technical Information of China (English)

    WANG Yu-hong; ZHANG Jing-yu; QIAO Fang-fang; ZHU Jing; YIN Feng; HAN Hui

    2012-01-01

    Background Few data have been acquired on the predictive value of age-related T-lymphocyte subsets among older individuals.The present study has determined the distribution of T-cell phenotypes and their correlation to 2-year mortality in a cohort of Chinese male seniors.Methods A total of 101 asymptomatic elderly individuals with laboratory homeostasis were enrolled at baseline.Three age subgroups were categorized as young (65-74 years old),middle (75-84 years old ),and old (≥85 years) for age-related comparison.T-cell subsets in peripheral blood were measured by multi-colored flow cytometry.Results At baseline,there was a mild negative correlation by age for total lymphocytes and CD3+ T-cells.The frequency of CD28 and CD95 demonstrated a "curved" rather than linear tendency by age.At 2-year follow-up,little change of T-cell distribution was found among those who remained alive (as survivors) comparing the data at baseline to the 2-year time point.Immune risk phenotypes were distinctly demonstrated between survivors and non-survivors.Conclusions Since few studies have studied on the distribution of T-lymphocyte subsets in an elderly Chinese population,our results have not only provided reference values of T-subsets for aged Chinese men,but confirmed the immune risk phenotypes among elderly Chinese.The inappropriate age-dependent trajectory of CD28-/CD8+ and CD95-/CD8+ by age,which suggested 85 might be an inflexion point of age during T-cell ageing,warrants further exploration of the underlying mechanisms of T-cell ageing.

  12. Numerous Brugada syndrome-associated genetic variants have no effect on J-point elevation, syncope susceptibility, malignant cardiac arrhythmia, and all-cause mortality

    DEFF Research Database (Denmark)

    Ghouse, Jonas; Have, Christian T; Skov, Morten W;

    2016-01-01

    PURPOSE: We investigated whether Brugada syndrome (BrS)-associated variants identified in the general population have an effect on J-point elevation as well as whether carriers of BrS variants were more prone to experience syncope and malignant ventricular arrhythmia and had increased mortality....../620; noncarriers 9/5,524; P = 0.24), or overall mortality (hazard ratio 0.93, 95% CI 0.63-1.4). CONCLUSIONS: Our data indicate that a significant number of BrS-associated variants are not the monogenic cause of BrS.Genet Med advance online publication 06 October 2016Genetics in Medicine (2016); doi:10.1038/gim...

  13. Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy

    DEFF Research Database (Denmark)

    Jorsal, A.; Tarnow, L.; Frystyk, J.;

    2008-01-01

    Adiponectin levels are increased in patients with type I diabetes especially in the presence of microangiopathy. Here we determined the predictive value of serum adiponectin levels and 8 adiponectin gene polymorphisms for mortality, cardiovascular events and end-stage renal disease in type I...... predicted end stage renal disease in a covariate-adjusted analysis. Two of eight gene polymorphisms, found in the 878 patients, were associated with increased serum adiponectin levels but none of the polymorphisms were associated with a renal or cardiovascular outcome. These studies show that high serum...... adiponectin levels predict mortality and progression to end stage renal disease in type I diabetic patients Udgivelsesdato: 2008/9...

  14. Cortisol, estrogens and risk of ischaemic heart disease, cancer and all-cause mortality in postmenopausal women: a prospective cohort study

    DEFF Research Database (Denmark)

    2010-01-01

    Chronic stress may affect morbidity and mortality through neuroendocrine changes, and the ratio of cortisol to sex steroid hormones has been suggested as a biomarker of stress. We aim to address a relation between the ratio of cortisol to estrogens (C/E) and risk of ischaemic heart disease (IHD...

  15. Fluid Intelligence Is Independently Associated with All-Cause Mortality over 17 Years in an Elderly Community Sample: An Investigation of Potential Mechanisms

    Science.gov (United States)

    Batterham, Philip J.; Christensen, Helen; Mackinnon, Andrew J.

    2009-01-01

    The long-term relationship between lower intelligence and mortality risk in later life is well established, even when controlling for a range of health and sociodemographic measures. However, there is some evidence for differential effects in various domains of cognitive performance. Specifically, tests of fluid intelligence may have a stronger…

  16. Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes

    DEFF Research Database (Denmark)

    Skriver, Mette Vinther; Sandbæk, Annelli; Kristensen, Jette Kolding;

    2015-01-01

    OBJECTIVE: We assessed the relationship of mortality with glycated hemoglobin (HbA1c) variability and with absolute change in HbA1c. DESIGN: A population-based prospective observational study with a median follow-up time of 6 years. METHODS: Based on a validated algorithm, 11 205 Danish individuals...

  17. Bringing the individual back to small-area variation studies: a multilevel analysis of all-cause mortality in Andalusia, Spain.

    Science.gov (United States)

    Merlo, Juan; Viciana-Fernández, Francisco J; Ramiro-Fariñas, Diego

    2012-10-01

    We performed a multilevel analysis (including individuals, households, census tracts, municipalities and provinces) on a 10% sample (N=230,978) from the Longitudinal Database of the Andalusian Population (LDAP). We aimed to investigate place effects on 8-year individual mortality risk. Moreover, besides calculating association (yielding odds ratios, ORs) between area socio-economic circumstances and individual risk, we wanted to estimate variance and clustering using the variance partition coefficient (VPC). We explicitly proclaim the relevance of considering general contextual effects (i.e. the degree to which the context, as a whole, affects individual variance in mortality risk) under at least two circumstances. The first of these concerns the interpretation of specific contextual effects (i.e. the association between a particular area characteristic and individual risk) obtained from multilevel regression analyses. The second involves the interpretation of geographical variance obtained from classic ecological spatial analyses. The so-called "ecological fallacy" apart, the lack of individual-level information renders geographical variance unrelated to the total individual variation and, therefore, difficult to interpret. Finally, we stress the importance of considering the familial household in multilevel analyses. We observed an association between percentage of people with a low educational level in the census tract and individual mortality risk (OR, highest v. lowest quintile=1.14; 95% confidence interval, CI 1.08-1.20). However, only a minor proportion of the total individual variance in the probability of dying was at the municipality (M) and census tract (CT) levels (VPC(M)=0.2% and VPC(CT)=0.3%). Conversely, the household (H) level appeared much more relevant (VPC(H)=18.6%) than the administrative geographical areas. Without considering general contextual effects, both multilevel analyses of specific contextual effects and ecological studies of small

  18. All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment

    DEFF Research Database (Denmark)

    Jennum, Poul; Tønnesen, Philip; Ibsen, Rikke;

    2015-01-01

    BACKGROUND: More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women. METHODS: We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA......, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P

  19. Does oral polio vaccine have non-specific effects on all-cause mortality? Natural experiments within a randomised controlled trial of early measles vaccine

    Science.gov (United States)

    Aaby, Peter; Andersen, Andreas; Martins, Cesário L; Fisker, Ane B; Rodrigues, Amabelia; Whittle, Hilton C; Benn, Christine S

    2016-01-01

    Background BCG and measles vaccine (MV) may have beneficial non-specific effects (NSEs). If an unplanned intervention with a vaccine (a natural experiment) modifies the estimated effect in a randomised controlled trial (RCT), this suggests NSEs. We used this approach to test NSEs of triple oral polio vaccine (OPV). Methods During an RCT of 2 doses of MV at 4.5 and 9 months versus 1 dose of MV at 9 months of age, we experienced 2 natural experiments with OPV. We assessed whether these OPV experiments modified the effect of 2-dose MV in the MV trial. Setting MV RCT conducted in urban Guinea-Bissau 2003–2009. Interventions Natural experiments with OPV due to missing vaccine and the implementation of OPV campaigns. Main outcome measure Changes in the mortality rate ratio (MRR) for 2-dose MV versus 1-dose MV. Results First, the MRR (2-dose/1-dose MV) overall was 0.70 (0.52 to 0.94), but the MRR was 1.04 (0.53 to 2.04) when OPV at birth (OPV0) was not given, suggesting that early priming with OPV was important for the effect of 2-dose MV. The effect of OPV0 depended on age of administration; the MRR (2-dose/1-dose MV) was 0.45 (0.29 to 0.71) for children receiving OPV0 in the first week of life, but 3.63 (0.87 to 15.2) for those receiving OPV0 after the first month of life (p=0.007, test of no interaction). Second, campaign-OPV may have reduced the difference between the randomisation groups since the MRR (2-dose/1-dose MV) was 0.60 (0.42 to 0.85) for children who had not received campaign-OPV before RCT-enrolment versus 0.72 (0.23 to 2.31) and 1.42 (0.70 to 2.90) for children who had received 1 or 2 doses of campaign-OPV-before-enrolment, respectively. Conclusions Bissau had no polio infection during this trial, so OPV0 and campaign-OPV may have NSEs since they modified the effect of 2-dose MV in an RCT. Different interventions may interact to a much larger effect than usually assumed. PMID:28011813

  20. Predictive value of microalbuminuria on cardiovascular and all-cause mortality%微量白蛋白尿对心血管疾病死亡及全因死亡风险的预测价值

    Institute of Scientific and Technical Information of China (English)

    李妍妍; 陆菊明; 王淑玉; 卢艳慧; 宋瑛; 刘力生; 田慧; 潘长玉

    2011-01-01

    Objective To analyze the effect of microalbuminuria on predicting cardiovascular disease mortality and total mortality risk in 2181 subjects.Methods These subjects came from Beijing epidemiological data in the moderate-elderly population in June 2004.After 4 years follow up, the death of various reasons were observed of death of four-year period for various reasons in May 2008.In according to the albumin creatinine ratio (ACR) value, all subjects were divided into normal albuminuria group (NAU group), microalbuminuria group (MIAU group) and macroalbuminuria group (MAAU in according to the ACR).The various causes of death were analyzed, and the baseline clinical characteristics and metabolic markers were compared between the death group and survival group.In the follow-up, Cox regression model was used.After adjusted for age, DM history, history of hypertension, dyslipidemia and other potential risk factors, the relationship between ACR levels and cardiovascular- or all-cause mortality was analyzed.Results Totally 77 subjects died during the 4 years follow up.The all-cause mortality was 8.7/1000 person-year in total population.The CVD and malignant tumor were the main causes of death.Compared with the survival population,the proportion of MIAU, MAAU, and DM were significantly higher in the death population ( 18.2% vs 8.7% ,9.1% vs 1.6%, 50.6% vs 25.8%, P < 0.01 ).The all-cause mortality was 6.8‰,20.6‰ and 58.8 ‰ in NAU, MIAU, MAAU population respectively.In the NAU population, malignant tumor was the leading cause of death, followed by cardiovascular disease.While in MIAU and MAAU population, cardiovascular disease was the primary cause of death.After age, blood glucose, hypertension,dyslipidemia and other factors were adjusted, compared with the NAU, the risk of death of cardiovascular disease was increased by 1.72 times and the all-cause death increased by 1.01 times in MIAU group, risk of death of cardiovascular disease increased by 3.87 times and of all-cause

  1. Optimal Dietary and Plasma Magnesium Statuses Depend on Dietary Quality for a Reduction in the Risk of All-Cause Mortality in Older Adults.

    Science.gov (United States)

    Huang, Yi-Chen; Wahlqvist, Mark L; Kao, Mei-Ding; Wang, Jui-Lien; Lee, Meei-Shyuan

    2015-07-13

    The association between dietary or plasma magnesium (Mg) with diabetes incidence and with mortality in free-living elderly was investigated. A total of 1400 participants from the Taiwanese Nutrition Survey, aged ≥ 65 years, and diabetes-free from the 1999-2000 were assessed. The dietary intake and plasma Mg concentration were obtained through 24h dietary recall and health examination at baseline. Participants were classified by quartiles (Q) of dietary Mg or by the plasma Mg normal range (0.75-0.95 mmol/L). Dietary diversity score (DDS, range 1-6) represented the dietary quality. During 8 and 10 years, 231 incident diabetes cases and 475 deaths were identified. Cox's proportional-hazards regression was used to evaluate the association between Mg and health outcomes. The hazard ratios (95% confidence interval) for death in Q2 and Q3 of Mg intakes with DDS > 4 were 0.57 (0.44-0.74) and 0.59 (0.39-0.88), respectively, compared with the lowest intake and DDS ≤ 4 participants. Participants with normal and high plasma Mg in conjunction with high DDS had relative risks of 0.58 (0.37-0.89) and 0.46 (0.25-0.85) in mortality compared with low plasma Mg and lower DDS. Optimal dietary Mg intake and plasma Mg depend on dietary quality to reduce the mortality risk in older adults.

  2. Optimal Dietary and Plasma Magnesium Statuses Depend on Dietary Quality for a Reduction in the Risk of All-Cause Mortality in Older Adults

    Directory of Open Access Journals (Sweden)

    Yi-Chen Huang

    2015-07-01

    Full Text Available The association between dietary or plasma magnesium (Mg with diabetes incidence and with mortality in free-living elderly was investigated. A total of 1400 participants from the Taiwanese Nutrition Survey, aged ≥ 65 years, and diabetes-free from the 1999–2000 were assessed. The dietary intake and plasma Mg concentration were obtained through 24h dietary recall and health examination at baseline. Participants were classified by quartiles (Q of dietary Mg or by the plasma Mg normal range (0.75–0.95 mmol/L. Dietary diversity score (DDS, range 1–6 represented the dietary quality. During 8 and 10 years, 231 incident diabetes cases and 475 deaths were identified. Cox’s proportional-hazards regression was used to evaluate the association between Mg and health outcomes. The hazard ratios (95% confidence interval for death in Q2 and Q3 of Mg intakes with DDS > 4 were 0.57 (0.44–0.74 and 0.59 (0.39–0.88, respectively, compared with the lowest intake and DDS ≤ 4 participants. Participants with normal and high plasma Mg in conjunction with high DDS had relative risks of 0.58 (0.37–0.89 and 0.46 (0.25–0.85 in mortality compared with low plasma Mg and lower DDS. Optimal dietary Mg intake and plasma Mg depend on dietary quality to reduce the mortality risk in older adults.

  3. Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study

    Directory of Open Access Journals (Sweden)

    Azizi Fereidoun

    2010-09-01

    Full Text Available Abstract Background The body mass index (BMI is the most commonly used marker for evaluating obesity related risks, however, central obesity measures have been proposed to be more informative. Lipid accumulation product (LAP is an alternative continuous index of lipid accumulation. We sought in this study to assess if LAP can outperform BMI, waist-to-height-ratio (WHtR, or waist-to-hip-ratio (WHpR in predicting incident cardiovascular disease (CVD or all-cause mortality. Results Among participants of Tehran Lipid and Glucose Study, 6,751 participants (2,964 men, aged ≥ 30 years, were followed for a median of 8.6 years. We observed 274 deaths (men: 168 and 447 CVD events (men: 257. Levels of common CVD risk factors significantly increased across LAP quartiles. Mortality rates did not differ by LAP quartiles. Among participants free of CVD at baseline [6331 (2,741 men], CVD incident rates per 1000 person increased in a stepwise fashion with increasing LAP quartile values in both men (from 6.9 to 17.0 and women (from 1.3 to 13.0, (Ps Among women, a 1-SD increment in log-LAP conferred a 41% increased risk for CVD (HR 1.41, 95% CIs 1.02-1.96. Among men, however, LAP was not observed to be independently associated with increased risk of CVD; except in a sub-group of men assigned to the lifestyle modification interventions, where, LAP predicted CVD risk. After adjustment with CVD risk factors LAP turned to be inversely associated with risk of all-cause mortality (HR, men 0.74, 95% CIs 0.61-0.90; women, 0.94 95% CIs 0.74-1.20. Among women, magnitude of increased risk of CVD due to LAP was not different from those of anthropometric measures. Among men, however, WHpR was observed to be more strongly associated with increased risk of CVD than was LAP. Among neither men nor women were the predictive performances (discrimination, calibration, goodness-of-fit of the LAP better than those of different anthropometric measures were. Conclusions If LAP is to be

  4. Evaluation of placental growth factor and soluble Fms-like tyrosine kinase 1 as predictors of all-cause and cardiovascular mortality in patients with Type 1 diabetes with and without diabetic nephropathy

    DEFF Research Database (Denmark)

    Theilade, S; Lajer, Maria Stenkil; Jorsal, Anders;

    2012-01-01

    Placental growth factor is a vascular endothelial growth factor involved in angiogenesis, vascular inflammation and plaque formation. Soluble Fms-like tyrosine kinase 1 is a decoy receptor for placental growth factor, reducing its activity. The aim of this study is to evaluate the predictive valu...... of placental growth factor and soluble Fms-like tyrosine kinase 1 in relation to all-cause and cardiovascular mortality and decline in kidney function in Type 1 diabetes....

  5. Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality

    DEFF Research Database (Denmark)

    Kobylecki, Camilla J; Afzal, Shoaib; Davey Smith, George;

    2015-01-01

    in the sodium-dependent vitamin C transporter 1 in 97,203 white individuals of whom 10,123 subjects had ischemic heart disease, and 8477 subjects died. We measured plasma vitamin C in 3512 individuals and included dietary information on 83,256 individuals. RESULTS: The SLC23A1 rs33972313 G allele was associated...

  6. Change of Serum BNP Between Admission and Discharge After Acute Decompensated Heart Failure Is a Better Predictor of 6-Month All-Cause Mortality Than the Single BNP Value Determined at Admission

    Science.gov (United States)

    De Vecchis, Renato; Ariano, Carmelina; Giandomenico, Giuseppe; Di Maio, Marco; Baldi, Cesare

    2016-01-01

    Background B-type natriuretic peptide (BNP) is regarded as a reliable predictor of outcome in patients with acute decompensated heart failure (ADHF). However, according to some scholars, a single isolated measurement of serum BNP at the time of hospital admission would not be sufficient to provide reliable prognostic information. Methods A retrospective study was carried out on patients hospitalized for ADHF, who had then undergone follow-up of at least 6 months, in order to see if there was any difference in midterm mortality among patients with rising BNP at discharge as compared to those with decreasing BNP at discharge. Medical records had to be carefully examined to divide the case records into two groups, the former characterized by an increase in BNP during hospitalization, and the latter showing a decrease in BNP from the time of admission to the time of discharge. Results Ultimately, 177 patients were enrolled in a retrospective study. Among them, 53 patients (29.94%) had increased BNPs at the time of discharge relative to admission, whereas 124 (70.06%) exhibited decreases in serum BNP during their hospital stay. The group with patients who exhibited BNP increases at the time of discharge had higher degree of congestion evident in the higher frequency of persistent jugular venous distention (odds ratio: 3.72; P = 0.0001) and persistent orthopnea at discharge (odds ratio: 2.93; P = 0.0016). Moreover, patients with increased BNP at the time of discharge had a lower reduction in inferior vena cava maximum diameter (1.58 ± 2.2 mm vs. 6.32 ± 1.82 mm; P = 0.001 (one-way ANOVA)). In contrast, there was no significant difference in weight loss when patients with increased BNP at discharge were compared to those with no such increase. A total of 14 patients (7.9%) died during the 6-month follow-up period. Cox proportional hazard analysis revealed that BNP increase at the time of discharge was an independent predictor of 6-month all-cause mortality after

  7. INVESTIGATION OF EFFECT OF METABOLIC SYNDROME ON HEMODIALYSIS PATIENTS' CARDIOVASCULAR MORTALITY AND ALL-CAUSE MORTALITY%代谢综合征对血液透析患者的心血管病死亡和全因死亡的影响

    Institute of Scientific and Technical Information of China (English)

    解倩; 张爱华; 朱宁; 范敏华

    2012-01-01

    [目的]观察代谢综合征对血液透析患者心血管死亡和全因死亡的影响.[方法]收集了某院血透中心维持性血液透析患者共157例,观察36~42个月.对患者临床和实验室基本资料进行收集,记录死亡时间和原因.并对患者的体成分和营养状况进行评估.[结果]根据IDF代谢综合征定义,患者被分为代谢综合征(MS)组和无代谢综合征(non-MS)组.两组患者的心血管死亡和全因死亡差异无统计学意义(P>0.05).MS组患者营养状况好于non-MS组(SGA评分,卡方检验,P=000).白蛋白<37 g/l和年龄>66岁是导致患者全因死亡率增加的独立危险因素(COX回归分析).[结论]IDF代谢综合征未增加患者的心血管死亡和全因死亡风险,白蛋白水平下降和老年是导致患者全因死亡率增加的独立危险因素.%[Objective] To investigate the influence of metabolic syndrome on hemodialysts patients' caediovascular mortality and all-cause mortality. [Methods] 157 patients were recruited in this cohort. The cohort was followed for 36-42 months. The tune points and causes of mortality were documented. The definition of metabolic syndrome used was IDF criteria 2006. Nutrition statuses were assessed by subject global assessment (SGA) and laboratory parameters. [Results] Patients were divided into two groups by IDF criteria, as metabolic syndrome and non-metabolic syndrome groups. No significant difference were found in all-cause mortality and cardiovascular mortality (x2 test, P > 0.05). There were more patients with normal nutrition (SGA) in MS group (x2 test, P = 0.000). COX multivariale analysis on mortality risk showed that independent mortality risk factors were older than 66 years and serum albumin levels below 37 g/L. [Conclusion] Metabolic syndrome does not increase the risk of cardiovascular mortality and all-cause mortality in hemodialysis patients. The independent risk factors of all-cause mortality are low albumin levels

  8. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2016-01-01

    also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality...

  9. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC)

    DEFF Research Database (Denmark)

    Ekelund, Ulf; Ward, Heather; Norat, Teresa;

    2015-01-01

    and abdominal adiposity modified the association between PA and all-cause mortality and estimated the population attributable fraction (PAF) and the years of life gained for these exposures. Design: This was a cohort study in 334,161 European men and women. The mean follow-up time was 12.4 y, corresponding to 4......, and adjusted for sex, education, smoking, and alcohol intake. Center-specific PAF associated with inactivity, body mass index (BMI; in kg/m2) (>30), and WC (≥102 cm for men, ≥88 cm for women) were calculated and combined in random-effects meta-analysis. Life-tables analyses were used to estimate gains in life...

  10. Metabolic and Lifestyle Predictors of Ischemic Heart Disease and All-Cause Mortality Among Normal Weight, Overweight, and Obese Men: A 16-Year Follow-up in the Copenhagen Male Study

    DEFF Research Database (Denmark)

    Suadicani, P.; Hein, H.O.; Eyben, F.E. von

    2009-01-01

    Aim: The aim of this study was to identify metabolic and lifestyle risk factors for ischemic heart disease (IHD) and all-cause mortality (ACM) among normal weight, overweight, and obese men. Methods: This was a 16-year follow up of 2982 men 53 to 75 years without overt cardiovascular disease...... gradually from the normal weight (BMI 20.0-25.0) to higher BMI groups. With respect to IHD, compared to normal weight men, obese men (BMI = 30.0) had an age-adjusted hazard ratio (HR) (95% CI) of 1.67(1.04-2.68); adjusted for potential confounders HR was 0.99 (0.59-1.66); corresponding estimates for ACM...

  11. Exclusive breastfeeding, diarrhoeal morbidity and all-cause mortality in infants of HIV-infected and HIV uninfected mothers: an intervention cohort study in KwaZulu Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Nigel C Rollins

    Full Text Available INTRODUCTION: Antiretroviral drug interventions significantly reduce the risk of HIV transmission to infants through breastfeeding. We report diarrhoea prevalence and all-cause mortality at 12 months of age according to infant feeding practices, among infants born to HIV-infected and uninfected mothers in South Africa. METHODS: A non-randomised intervention cohort study that followed both HIV-infected and HIV-uninfected mothers and their infants until 18 months of age. Mothers were supported in their infant feeding choice. Detailed morbidity and vital status data were collected over the first year. At the time, only single dose nevirapine was available to prevent mother-to-child transmission of HIV. RESULTS: Among 2,589 infants, detailed feeding data and vital status were available for 1,082 HIV-exposed infants and 1,155 HIV non-exposed infants. Among exclusively breastfed (EBF infants there were 9.4 diarrhoeal days per 1,000 child days (95%CI. 9.12-9.82 while among infants who were never breastfed there were 15.6 diarrhoeal days per 1,000 child days (95%CI. 14.62-16.59. Exclusive breastfeeding was associated with fewer acute, persistent and total diarrhoeal events than mixed or no breastfeeding in both HIV-exposed infants and also infants of HIV uninfected mothers. In an adjusted cox regression analysis, the risk of death among all infants by 12 months of age was significantly greater in those who were never breastfed (aHR 3.5, p<0.001 or mixed fed (aHR 2.65, p<0.001 compared with those who were EBF. In separate multivariable analyses, infants who were EBF for shorter durations had an increased risk of death compared to those EBF for 5-6 months [aHR 2.18 (95% CI, 1.56-3.01; p<0.001]. DISCUSSION: In the context of antiretroviral drugs being scaled-up to eliminate new HIV infections among children, there is strong justification for financial and human resource investment to promote and support exclusive breastfeeding to improve HIV-free survival

  12. Prognostic Contribution of Exercise Capacity, Heart Rate Recovery, Chronotropic Incompetence, and Myocardial Perfusion Single-Photon Emission Computerized Tomography in the Prediction of Cardiac Death and All-Cause Mortality.

    Science.gov (United States)

    Arbit, Boris; Azarbal, Babak; Hayes, Sean W; Gransar, Heidi; Germano, Guido; Friedman, John D; Thomson, Louise; Berman, Daniel S

    2015-12-01

    Chronotropic incompetence, measured by the percentage (%) of heart rate (HR) reserve achieved (%HR reserve), abnormal HR recovery, reduced exercise capacity (EC), and myocardial perfusion single-photon emission computerized tomography (SPECT MPS) abnormalities are known predictors of all-cause mortality (ACM) and cardiac death (CD). The aim of this study was to determine if EC, %HR reserve, and HR recovery add incremental value to MPS in the prediction of ACM and CD. A total of 11,218 patients without valvular disease and not on β blockers underwent symptom-limited exercise MPS. %HR reserve was (peak HR - rest HR)/(220 - age - rest HR) × 100, with %HR reserve recovery was peak HR - recovery HR. An HR recovery recovery, χ(2) = 18.45; diabetes, χ(2) = 17.75; and previous coronary artery disease, χ(2) = 11.85 (p ≤0.0006). The independent predictors of CD were SSS, χ(2) = 54.25; EC, χ(2) = 49.34; age, χ(2) = 46.45; abnormal electrocardiogram at rest, χ(2) = 30.60; previous coronary artery disease, χ(2) = 20.69; Duke treadmill score, χ(2) = 19.50; %HR reserve, χ(2) = 11.43; diabetes, χ(2) = 10.23 (all p ≤0.0014); and HR recovery, χ(2) = 5.30 (p = 0.0214). The exercise variables showed increases in Harrell's C static and net improvement reclassification, with EC showing the strongest incremental improvement in predicting ACM and CD (respective C-index 76.5% and 83.3% and net reclassification index 0.3201 and 0.4996). In conclusion, EC, %HR reserve, and HR recovery are independent predictors of ACM and CD and add incremental prognostic value to extent and severity of MPS.

  13. Risk assessment of mortality for all-cause, ischemic heart disease, cardiopulmonary disease, and lung cancer due to the operation of the world's largest coal-fired power plant

    Science.gov (United States)

    Kuo, Pei-Hsuan; Tsuang, Ben-Jei; Chen, Chien-Jen; Hu, Suh-Woan; Chiang, Chun-Ju; Tsai, Jeng-Lin; Tang, Mei-Ling; Chen, Guan-Jie; Ku, Kai-Chen

    2014-10-01

    Based on recent understanding of PM2.5 health-related problems from fossil-fueled power plants emission inventories collected in Taiwan, we have determined the loss of life expectancy (LLE) and the lifetime (75-year) risks for PM2.5 health-related mortalities as attributed to the operation of the world's largest coal-fired power plant; the Taichung Power Plant (TCP), with an installed nominal electrical capacity of 5780 MW in 2013. Five plausible scenarios (combinations of emission controls, fuel switch, and relocation) and two risk factors were considered. It is estimated that the lifetime (75-y) risk for all-cause mortality was 0.3%-0.6% for males and 0.2%-0.4% for females, and LLE at 84 days in 1997 for the 23 million residents of Taiwan. The risk has been reduced to one-fourth at 0.05%-0.10% for males and 0.03%-0.06% for females, and LLE at 15 days in 2007, which was mainly attributed to the installation of desulfurization and de-NOx equipment. Moreover, additional improvements can be expected if we can relocate the power plant to a downwind site on Taiwan, and convert the fuel source from coal to natural gas. The risk can be significantly reduced further to one-fiftieth at 0.001%-0.002% for males and 0.001% for females, and LLE at 0.3 days. Nonetheless, it is still an order higher than the commonly accepted elevated-cancer risk at 0.0001% (10-6), indicating that the PM2.5 health-related risk for operating such a world-class power plant is not negligible. In addition, this study finds that a better-chosen site (involving moving the plant to the leeward side of Taiwan) can reduce the risk significantly as opposed to solely transitioning the fuel source to natural gas. Note that the fuel cost of using natural gas (0.11 USD/kWh in 2013) in Taiwan is about twice the price of using coal fuel (0.05 USD/kWh in 2013).

  14. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with Beta-carotene, vitamin a, and vitamin e singly or in different combinations on all-cause mortality

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Nikolova, Dimitrinka; Gluud, Christian

    2013-01-01

    Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias.......Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias....

  15. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm?

    Directory of Open Access Journals (Sweden)

    Goran Bjelakovic

    Full Text Available BACKGROUND AND AIMS: Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias. METHODS: The present study is based on our 2012 Cochrane systematic review analyzing beneficial and harmful effects of antioxidant supplements in adults. Using random-effects meta-analyses, meta-regression analyses, and trial sequential analyses, we examined the association between beta-carotene, vitamin A, and vitamin E, and mortality according to their daily doses and doses below and above the recommended daily allowances (RDA. RESULTS: We included 53 randomized trials with low risk of bias (241,883 participants, aged 18 to 103 years, 44.6% women assessing beta-carotene, vitamin A, and vitamin E. Meta-regression analysis showed that the dose of vitamin A was significantly positively associated with all-cause mortality. Beta-carotene in a dose above 9.6 mg significantly increased mortality (relative risk (RR 1.06, 95% confidence interval (CI 1.02 to 1.09, I(2 = 13%. Vitamin A in a dose above the RDA (> 800 µg did not significantly influence mortality (RR 1.08, 95% CI 0.98 to 1.19, I(2 = 53%. Vitamin E in a dose above the RDA (> 15 mg significantly increased mortality (RR 1.03, 95% CI 1.00 to 1.05, I(2 = 0%. Doses below the RDAs did not affect mortality, but data were sparse. CONCLUSIONS: Beta-carotene and vitamin E in doses higher than the RDA seem to significantly increase mortality, whereas we lack information on vitamin A. Dose of vitamin A was significantly associated with increased mortality in meta-regression. We lack information on doses below the RDA. BACKGROUND: All essential compounds to stay healthy cannot be synthesized in our body. Therefore, these compounds must be taken through our diet or obtained in other ways [1]. Oxidative stress has been

  16. B-type natriuretic peptide is a long-term predictor of all-cause mortality, whereas high-sensitive C-reactive protein predicts recurrent short-term troponin T positive cardiac events in chest pain patients: a prognostic study

    Directory of Open Access Journals (Sweden)

    Staines Harry

    2008-11-01

    Full Text Available Abstract Background Few studies have addressed whether the combined use of B-type natriuretic peptide (BNP and high-sensitive C-reactive protein (hsCRP improves risk stratification for mortality and cardiovascular events in a population with chest pain and suspected acute coronary syndromes (ACS. Therefore, we wanted to assess the incremental prognostic value of these biomarkers with respect to long-term all-cause mortality and recurrent troponin T (TnT positive cardiac events in 871 patients admitted to the emergency department. Methods Blood samples were obtained immediately following admission. Results After a follow-up period of 24 months, 129 patients had died. The BNP levels were significantly higher among patients dying than in long-term survivors (401 (145–736 versus 75 (29–235 pq/mL [median, 25 and 75% percentiles], p = 0.000. In a multivariable Cox regression model for death within 2 years, the hazard ratio (HR for BNP in the highest quartile (Q4 was 5.13 (95% confidence interval (CI, 1.97–13.38 compared to the lowest quartile (Q1 and was associated with all-cause mortality above and beyond age, congestive heart failure and the index diagnosis ST-segment elevation myocardial infarction. HsCRP rendered no prognostic information for all-cause mortality. However, within 30 days, the adjusted HR for patients with recurrent TnT cardiac positive events hsCRP in Q4 was 14.79 (95% CI, 1.89–115.63 compared with Q1 and was associated with recurrent ischemic events above and beyond age, hypercholesterolemia and TnT values at admission. Conclusion BNP may act as a clinically useful biomarker when obtained at admission in an unselected patient population following hospitalization with chest pain and potential ACS, and may provide complementary prognostic information to established risk determinants at long-term follow-up. Our data do not support the hypothesis that the additional assessment of hsCRP will lead to better risk stratification

  17. Regional variations in mortality rates of pancreatic cancer in China:Results from 1990-1992 national mortality survey

    Institute of Scientific and Technical Information of China (English)

    Ke-Xin Chen; Peizhong Peter Wang; Si-Wei Zhang; Lian-Di Li; Feng-Zhu Lu; Xi-Shan Hao

    2003-01-01

    AIM: To examine the regional variations in mortality rates of pancreatic cancer in China.METHODS: Aggregated mortality data of pancreatic cancer were extracted from the 1990-1992 national death of all causes and its mortality survey in China. Age specific and standardized mortality rates were calculated at both national and provincial levels with selected characteristics including sex and residence status.RESULTS: Mortality of pancreatic cancer ranked the ninth and accounted for 1.38 percent of the total malignancy deaths. The crude and age standardized mortality rates of pancreatic cancer in China in the period of 1990-1992 were 1.48/100 000 and 1.30/100 000, respectively. Substantial regional variations in mortality rates across China were observed with adjusted mortality rates ranging from 0.43/100 000 to 3.70/100 000 with an extremal value of 8.7.Urban residents had significant higher pancreatic mortality than rural residents.CONCLUSION: The findings of this study show different mortality rates of this disease and highlight the importance of further investigation on factors, which might contribute to the observed epidemiological patterns.

  18. HbA1c levels in non-diabetic older adults - No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies

    OpenAIRE

    Schöttker, Ben; Rathmann, W.; Herder, C.; Thorand, B; Wilsgaard, T; Njølstad, I.; Siganos, G; Mathiesen, E.B.; Saum, K.U.; Peasey, A; Feskens, E.; Boffetta, P.; Trichopoulou, A; Kuulasmaa, K; Kee, F.

    2016-01-01

    Background: To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. Methods: The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial infarction or stroke) were assessed in non-diabetic subjects ≥50 years from six population-based cohort studies from Europe and the USA and meta-analyzed. Very low, low, intermediate and increas...

  19. HbA1c levels in non-diabetic older adults – No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies

    OpenAIRE

    Schöttker, Ben; Rathmann, Wolfgang; Herder, Christian; Thorand, Barbara; Wilsgaard, Tom; Njølstad, Inger; Siganos, Galatios; Mathiesen, Ellisiv B.; Saum, Kai-Uwe; Peasey, Anne; Edith J. M. Feskens; Boffetta, Paolo; Trichopoulou, Antonia; Kuulasmaa, Kari; Kee, Frank

    2016-01-01

    Source: doi: 10.1186/s12916-016-0570-1 Background:To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. Methods: The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial infarction or stroke) were assessed in non-diabetic subjects ≥50 years from six population-based cohort studies from Europe and the USA and m...

  20. Abdominal obesity in Japanese-Brazilians: which measure is best for predicting all-cause and cardiovascular mortality? Obesidade abdominal em nipo-brasileiros: que medida antropométrica tem maior capacidade de predizer a mortalidade geral e por doenças cardiovasculares?

    Directory of Open Access Journals (Sweden)

    Marselle Rodrigues Bevilacqua

    2011-10-01

    Full Text Available This study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in Japanese-Brazilians. The study followed 1,581 subjects for 14 years. Socio-demographic, lifestyle, metabolic, and anthropometric data were collected. The dependent variable was vital status (alive or dead at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. The mortality rate was estimated, and Poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. The mortality rate was 10.68/thousand person-years. Male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. The results indicate that prevalence of abdominal obesity was high among Japanese-Brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality in this group.O objetivo foi verificar qual medida antropométrica de obesidade abdominal melhor prediz mortalidade geral e por doenças cardiovasculares entre nipo-brasileiros. Foram seguidos, por 14 anos, 1.581 sujeitos. Coletaram-se dados sociodemográficos, de estilo de vida, metab��licos e antropométricos. Considerou-se vivo ou óbito ao final do estudo como variável dependente e a presença de obesidade abdominal por diferentes medidas na linha de base como variável independente. Estimou-se o coeficiente de mortalidade e se usou o modelo de Poisson para obtenção das razões entre eles e a obesidade abdominal, ajustados simultaneamente às demais variáveis. O coeficiente de mortalidade foi de 10,68/mil pessoas-ano. O gênero masculino, a idade > 60 anos e ter hipertensão arterial foram fatores de risco independentes para mortalidade. Os resultados indicaram que entre nipo-brasileiros a prevalência de obesidade abdominal foi

  1. Relationship between body mass index and all-cause mortality in hemodialysis patients: a meta-analysis%尿毒症血液透析患者体重指数与全因死亡率相关性的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王嘉琳; 周益; 袁伟杰

    2012-01-01

    目的 采用荟萃分析的方法探讨不同水平BMI对血液透析患者全因死亡率的影响.方法 以“hemodialysis/haemodialysis”和“obese/body mass index/overweight"和“mortality/survival/reverse epidemiology/obesity paradox”为关键词,检索1966-2012年PubMed、Embase、ScienceDirect、Wiley、Scopus和Ovid数据库的临床研究文献.2位评价者独立评价每个研究的质量并且对其提取数据.结果 4个观察性研究共计81 423例患者纳入本研究,入选研究没有异质性(I2=0%,P=0.45).与BMI非升高组相比,BMI升高组(BMI≥25 kg/m2)有较低水平的全因死亡率( OR 0.67,95% CI0.65 ~0.68).校正相关风险因素后的研究结果仍显示高水平BMI能较好地改善血液透析患者生存率(校正后HR0.94,95% CI0.92 ~0.96).结论 血液透析患者BMI水平与全因死亡率呈负相关,提示高水平BMI对血液透析患者具有保护作用,血流动力学状态、细胞因子和神经内分泌因子的变化以及营养状态等因素可能是其保护作用的潜在机制,但还需多中心随机对照研究的进一步证实.%Objective To explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. Methods Eligible studies assessing the effects of BMI ranges on all-cause mortality (published from 1966 to 2012 ) were searched, using "hemodialysis/haemodialysis" and "obese/body mass index/overweight" and " mortality/surwival/reverse epidemiology/obesity paradox" in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.Results With no significant heterogeneity ( I2 =0

  2. Valor preditivo da frequência cardíaca em repouso do teste ergométrico na mortalidade Valor predictivo de la frecuencia cardíaca en reposo del test ergométrico en la mortalidad Predictive value of resting heart rate for cardiovascular and all-cause mortality

    Directory of Open Access Journals (Sweden)

    Jaqueline Eilert Fagundes

    2010-12-01

    , de enero de 1995 a junio de 2007. Fueron analizados 7.055 pacientes, siendo 1.645 (23,3% del grupo caso (óbitos y 5.410 (76,7% del grupo control (vivos. Fue calculado el punto de corte de la FCR para mortalidad, a través de la curva ROC y realizado el análisis multivariado para las variables seleccionadas. Los desenlaces fueron mortalidad CV y general. RESULTADOS: La incidencia de mortalidad CV fue de 674 casos (9,5%; la FCR > 78 lpm fue el punto de corte. Después de ajustado para las variables seleccionadas, el odds ratio (OR para FCR > 78 lpm fue de 3,5 (IC 95% = 2,9 - 4,2 para mortalidad CV y 3,6 (IC 95% = 3,2 - 4,0 para mortalidad general. CONCLUSIÓN: La FCR > 78 lpm es un predictor independiente de mortalidad cardiovascular y general.BACKGROUND: Resting heart rate (which ranges from 60 to 80 bpm is one of the simplest cardiovascular parameters, and has been considered as a predictor of cardiovascular and all-cause mortality. OBJECTIVE: To determine the predictive value of resting heart rate (RHR before exercise stress testing (ET for cardiovascular (CV and all-cause mortality. METHODS: This was a case-control study using data from the database of the Exercise Testing Laboratory of a cardiac hospital and the death records of the Health Department of a city located in the South of Brazil from January 1995 to June 2007. A total of 7,055 patients were studied; 1,645 (23.3% in the case group (deceased and 5,410 (76.7% in the control group (alive. The cut-off value of RHR for mortality was derived from the ROC curve, and a multivariate analysis was performed for the selected variables. The study's outcome measures were cardiovascular and all-cause mortality. RESULTS: Six hundred and seventy-four patients died of cardiovascular diseases (9.5%; the cut-off value was RHR > 78 bpm. After adjusting for selected variables, the odds ratio (OR of RHR > 78 bpm was 3.5 (95% CI 2.9 to 4.2 for CV mortality and 3.6 (95% CI 3.2 to 4.0 for all-cause mortality. CONCLUSION

  3. Concentration response functions for ultrafine particles and all-cause mortality and hospital admissions: results of a European expert panel elicitation.

    NARCIS (Netherlands)

    Hoek, G.; Boogaard, H.; Knol, A.B.; de Hartog, J.J.; Slottje, P.; Ayres, J.G.; Borm, P.; Brunekreef, B.; Donaldson, K.; Forastiere, F.; Holgate, S.; Kreyling, W.G.; Nemery, B.; Pekkanen, J.; Stone, V.; Wichmann, H.E.; van der Sluijs, J.P.

    2010-01-01

    Toxicological studies have provided evidence of the toxicity of ultrafine particles (UFP), but epidemiological evidence for health effects of ultrafines is limited. No quantitative summary currently exists of concentration-response functions for ultrafine particles that can be used in health impact

  4. Glycemic Control And All-Cause Mortality In Older Diabetics%老年2型糖尿病患者的血糖控制水平对其病死率的影响

    Institute of Scientific and Technical Information of China (English)

    颜轶隽; 王颖; 高佳

    2015-01-01

    【目的】探讨血糖不同控制水平对老年2型糖尿病(T2DM)患者心血管事件及病死率的影响。【方法】收集老年 T2DM 患者628例,根据糖化血红蛋白(HbA1c)水平,将患者分成三组:HbA1c0.05).[Conclusion]Strict glycemic control increases mortality in older diabet-ics.And glycemic control should be based on individual difference in elders with T2DM.

  5. Why do thin people have elevated all-cause mortality? Evidence on confounding and reverse causality in the association of adiposity and COPD from the British Women's Heart and Health Study.

    Science.gov (United States)

    Dale, Caroline; Nüesch, Eveline; Prieto-Merino, David; Choi, Minkyoung; Amuzu, Antoinette; Ebrahim, Shah; Casas, Juan P; Davey-Smith, George

    2015-01-01

    Low adiposity has been linked to elevated mortality from several causes including respiratory disease. However, this could arise from confounding or reverse causality. We explore the association between two measures of adiposity (BMI and WHR) with COPD in the British Women's Heart and Health Study including a detailed assessment of the potential for confounding and reverse causality for each adiposity measure. Low BMI was found to be associated with increased COPD risk while low WHR was not (OR = 2.2; 95% CI 1.3-3.1 versus OR = 1.2; 95% CI 0.7-1.6). Potential confounding variables (e.g. smoking) and markers of ill-health (e.g. unintentional weight loss) were found to be higher in low BMI but not in low WHR. Women with low BMI have a detrimental profile across a broad range of health markers compared to women with low WHR, and women with low WHR do not appear to have an elevated COPD risk, lending support to the hypothesis that WHR is a less confounded measure of adiposity than BMI. Low adiposity does not in itself appear to increase the risk of respiratory disease, and the apparent adverse consequences of low BMI may be due to reverse causation and confounding.

  6. Why do thin people have elevated all-cause mortality? Evidence on confounding and reverse causality in the association of adiposity and COPD from the British Women's Heart and Health Study.

    Directory of Open Access Journals (Sweden)

    Caroline Dale

    Full Text Available Low adiposity has been linked to elevated mortality from several causes including respiratory disease. However, this could arise from confounding or reverse causality. We explore the association between two measures of adiposity (BMI and WHR with COPD in the British Women's Heart and Health Study including a detailed assessment of the potential for confounding and reverse causality for each adiposity measure. Low BMI was found to be associated with increased COPD risk while low WHR was not (OR = 2.2; 95% CI 1.3-3.1 versus OR = 1.2; 95% CI 0.7-1.6. Potential confounding variables (e.g. smoking and markers of ill-health (e.g. unintentional weight loss were found to be higher in low BMI but not in low WHR. Women with low BMI have a detrimental profile across a broad range of health markers compared to women with low WHR, and women with low WHR do not appear to have an elevated COPD risk, lending support to the hypothesis that WHR is a less confounded measure of adiposity than BMI. Low adiposity does not in itself appear to increase the risk of respiratory disease, and the apparent adverse consequences of low BMI may be due to reverse causation and confounding.

  7. Change in body size and mortality: results from the Melbourne collaborative cohort study.

    Directory of Open Access Journals (Sweden)

    Amalia Karahalios

    Full Text Available BACKGROUND: The association between change in weight or body mass index, and mortality is widely reported, however, both measures fail to account for fat distribution. Change in waist circumference, a measure of central adiposity, in relation to mortality has not been studied extensively. METHODS: We investigated the association between mortality and changes in directly measured waist circumference, hips circumference and weight from baseline (1990-1994 to wave 2 (2003-2007 in a prospective cohort study of people aged 40-69 years at baseline. Cox regression, with age as the time metric and follow-up starting at wave 2, adjusted for confounding variables, was used to estimate hazard ratios (HRs and 95% confidence intervals (CIs for change in body size in relation to mortality from all causes, cardiovascular disease and cancer. RESULTS: There were 1465 deaths (109 cancer, 242 cardiovascular disease identified during an average 7.7 years of follow-up from 21 298 participants. Compared to minimal increase in body size, loss of waist circumference (HR: 1.26; 95% CI: 1.09-1.47, weight (1.80; 1.54-2.11, or hips circumference (1.35; 1.15-1.57 were associated with an increased risk of all-cause mortality, particularly for older adults. Weight loss was associated with cardiovascular disease mortality (2.40; 1.57-3.65 but change in body size was not associated with obesity-related cancer mortality. CONCLUSION: This study confirms the association between weight loss and increased mortality from all-causes for older adults. Based on evidence from observational cohort studies, weight stability may be the recommended option for most adults, especially older adults.

  8. Subjective memory complaints in primary care patients and death from all causes: a four-year follow-up

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Waldemar, Gunhild; Waldorff, Frans Boch

    2013-01-01

    -related quality of life were collected at the enrolment primary care consultation. Dates of death from all causes occurring during the four-year follow-up were retrieved from the national databases. Cox proportional hazard regression models on time to death (censored after four years) were used to examine......OBJECTIVE: To investigate the prognostic value of subjective memory complaints for all-cause mortality in order to determine whether elderly persons with subjective memory complaints may be regarded as a group of vulnerable patients who need close follow-up. DESIGN: Prospective cohort study...... the influence of subjective memory complaints on all-cause mortality. RESULTS: 88 patients died during the four-year follow-up. The association between subjective memory complaints and mortality had a statistically not significant hazard ratio (HR) of 0.91, adjusting for known confounders. Statistically...

  9. Association between anemia and 3-year all-cause mortality among oldest old people in longevity ;areas in China%中国长寿地区高龄老年人贫血及其3年死亡风险关系的研究

    Institute of Scientific and Technical Information of China (English)

    吕跃斌; 殷召雪; 罗杰斯; 施小明; 曾毅

    2015-01-01

    目的:探讨中国长寿地区80岁以上老年人贫血及其3年死亡风险的关系。方法2009年6月中国老年健康影响因素跟踪调查(CLHLS)项目在中国7个长寿地区选取929名80岁以上老年人进行问卷调查、身体测量和血生化检测,于2012年8月随访生存结局。采用Cox比例风险模型分析贫血和不同Hb水平对死亡风险的影响。结果929名老年人贫血患病率为49.6%,贫血主要类型为正常细胞性贫血。经3年随访共计447人死亡,死亡率为49.8%,其中贫血组为56.0%,高于非贫血组的43.3%(P<0.01)。校正混杂因素后,贫血组3年死亡风险高于非贫血组25%(HR=1.25,95%CI:1.03~1.52),除正常细胞性贫血与老年人死亡风险的无关外,大细胞性贫血、单纯小细胞性贫血和小细胞低色素性贫血与老年人的高死亡风险相关联,高龄老年人不同类型贫血的死亡风险存在性别差异。与低Hb水平者相比,高Hb水平者死亡风险较低(HR=0.87,95%CI:0.77~0.99),且女性更显著。结论贫血或低Hb水平与中国长寿地区高龄老年人较高的死亡风险相关联。%Objective To explore the association between anemia and 3-year all-cause mortality among the oldest old people in longevity areas in China. Methods In August 2012, questionnaire survey,health examination and blood test were conducted among 929 old people aged≥80 years in 7 longevity areas in China,who were included in Chinese Longitudinal Healthy Longevity Survey(CLHLS)2009. Cox regression model was used to evaluate the association between anemia or different hemoglobin levels and mortality. Results Among the 929 subjects,the prevalence of anemia was 49.6%,the main form of anemia was normocytic anemia. During the three year follow-up period,a total of 447 subjects died,the overall mortality was 49.8%(56.0%in subjects with anemia and 43.3% in subjects without anemia). Compared with the subjects

  10. Mortality in Central Java: results from the indonesian mortality registration system strengthening project

    Directory of Open Access Journals (Sweden)

    Irianto Joko

    2010-12-01

    Full Text Available Abstract Background Mortality statistics from death registration systems are essential for health policy and development. Indonesia has recently mandated compulsory death registration across the entire country in December 2006. This article describes the methods and results from activities to ascertain causes of registered deaths in two pilot registration areas in Central Java during 2006-2007. The methods involved several steps, starting with adaptation of international standards for reporting causes of registered deaths for implementation in two sites, Surakarta (urban and Pekalongan (rural. Causes for hospital deaths were certified by attending physicians. Verbal autopsies were used for home deaths. Underlying causes were coded using ICD-10. Completeness of registration was assessed in a sample of villages and urban wards by triangulating data from the health sector, the civil registration system, and an independent household survey. Finally, summary mortality indicators and cause of death rankings were developed for each site. Findings A total of 10,038 deaths were registered in the two sites during 2006-2007; yielding annual crude death rates of 5.9 to 6.8 per 1000. Data completeness was higher in rural areas (72.5% as compared to urban areas (52%. Adjusted life expectancies at birth were higher for both males and females in the urban population as compared to the rural population. Stroke, ischaemic heart disease and chronic respiratory disease are prominent causes in both populations. Other important causes are diabetes and cancer in urban areas; and tuberculosis and diarrhoeal diseases in rural areas. Conclusions Non-communicable diseases cause a significant proportion of premature mortality in Central Java. Implementing cause of death reporting in conjunction with death registration appears feasible in Indonesia. Better collaboration between health and registration sectors is required to improve data quality. These are the first local

  11. Calprotectin--a marker of mortality in COPD? Results from a prospective cohort study.

    Science.gov (United States)

    Holmgaard, Dennis B; Mygind, Lone H; Titlestad, Ingrid; Madsen, Hanne; Pedersen, Svend Stenvang; Mortensen, Ole H; Pedersen, Court

    2013-10-01

    Calprotectin comprises more than 45% of the cytosolic content of neutrophil granulocytes. Because pathogenesis, disease activity and disease progression in COPD are believed to be partly dependent of neutrophil driven inflammation we decided to investigate whether plasma level of calprotectin (p-calprotectin) was associated with all-cause mortality in patients with COPD. We measured p-calprotectin in blood samples from 460 patients with moderate to very severe COPD in stable phase. Patients were stratified into three groups according to p-calprotectin level. Outcome measure was all-cause mortality. Analyses were adjusted for factors known to influence mortality using a Cox regression analysis. We found a time dependent correlation between p-calprotectin levels and mortality during the first 5 years of follow-up. Increasing levels of p-calprotectin were associated with concomitant increases in mortality from HR 1.56 (CI 95%: 1.03 -2.38) at calprotectin between 100 -200 ng/ml to HR 2.02 (CI 95%: 1.27-3.19) at calprotectin >200 ng/ml. P-calprotectin could be a useful marker of all-cause mortality in patients suffering from moderate to very severe COPD.

  12. Rheumatoid Arthritis and Mortality Among Women During 36 Years of Prospective Follow-Up: Results From the Nurses’ Health Study

    Science.gov (United States)

    SPARKS, JEFFREY A.; CHANG, SHUN-CHIAO; LIAO, KATHERINE P.; LU, BING; FINE, ALEXANDER R.; SOLOMON, DANIEL H.; COSTENBADER, KAREN H.; KARLSON, ELIZABETH W.

    2016-01-01

    Objective To evaluate rheumatoid arthritis (RA) and mortality risk among women followed prospectively in the Nurses’ Health Study (NHS). Methods We analyzed 119,209 women in the NHS who reported no connective tissue disease at enrollment in 1976. Comorbidity and lifestyle data were collected through biennial questionnaires. Incident RA cases were validated by medical records review. Cause of death was determined by death certificate and medical records review. Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality for women with RA compared to those without RA. Results We validated 964 incident RA cases and identified 28,808 deaths during 36 years of prospective follow-up. Of 307 deaths among women with RA, 80 (26%) were from cancer, 70 (23%) were from CVD, and 44 (14%) were from respiratory causes. Women with RA had increased total mortality (HR 1.40, 95% CI 1.25–1.57) compared to those without RA, independent of mortality risk factors, including smoking. RA was associated with significantly increased respiratory disease mortality (HR 2.06, 95% CI 1.51–2.80) and cardiovascular disease mortality (HR 1.45, 95% CI 1.14–1.83), but not cancer mortality (HR 0.93, 95% CI 0.74–1.15). For women with seropositive RA, respiratory disease mortality was nearly 3-fold higher than among non-RA women (HR 2.67, 95% CI 1.89–3.77). Conclusion Women with RA had significantly increased mortality compared to those without RA. Respiratory disease and cardiovascular disease mortality were both significantly elevated for women with RA. The nearly 3-fold increased relative risk of respiratory disease mortality was observed only for those with seropositive RA. PMID:26473946

  13. The relationship of walking intensity to total and cause-specific mortality. Results from the National Walkers' Health Study.

    Directory of Open Access Journals (Sweden)

    Paul T Williams

    Full Text Available PURPOSE: Test whether: 1 walking intensity predicts mortality when adjusted for walking energy expenditure, and 2 slow walking pace (≥24-minute mile identifies subjects at substantially elevated risk for mortality. METHODS: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. RESULTS: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10(-5, cardiovascular diseases (2.4% increase, P=0.001, 637 deaths, ischemic heart disease (2.8% increase, P=0.003, 336 deaths, heart failure (6.5% increase, P=0.001, 36 deaths, hypertensive heart disease (6.2% increase, P=0.01, 31 deaths, diabetes (6.3% increase, P=0.004, 32 deaths, and dementia (6.6% increase, P=0.0004, 44 deaths. Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001, cardiovascular diseases (43.9% increased risk, P=0.03, and dementia (5.0-fold increased risk, P=0.0002 even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET-hours per week. CONCLUSIONS: The risk for mortality: 1 decreases in association with walking intensity, and 2 increases substantially in association for walking pace ≥24 minute mile (equivalent to <400 m during a six-minute walk test even among subjects who exercise regularly.

  14. Determinants of infant and child mortality in Zimbabwe: Results of multivariate hazard analysis

    Directory of Open Access Journals (Sweden)

    Joshua Kembo

    2009-10-01

    Full Text Available This study addresses important issues in infant and child mortality in Zimbabwe. The objective of the paper is to determine the impact of maternal, socioeconomic and sanitation variables on infant and child mortality. Results show that births of order 6+ with a short preceding interval had the highest risk of infant mortality. The infant mortality risk associated with multiple births was 2.08 times higher relative to singleton births (p<0.001. Socioeconomic variables did not have a distinct impact on infant mortality. Determinants of child mortality were different in relative importance from those of infant mortality. This study supports health policy initiatives to stimulate use of family planning methods to increase birth spacing. These and other results are expected to assist policy makers and programme managers in the child health sector to formulate appropriate strategies to improve the situation of children under 5 in Zimbabwe.

  15. Alcohol and mortality. Results from the EPOZ (Epidemiologic Study of Cardiovascular Risk Indicators) follow-up study

    NARCIS (Netherlands)

    K.M. Berberian; C.M. van Duijn (Cock); A.W. Hoes (Arno); H.A. Valkenburg (Hans); A. Hofman (Albert)

    1994-01-01

    textabstractTo investigate the association of alcohol intake with mortality from all causes, cardiovascular disease (CVD), cancer and other causes (e.g., accidents, violence, suicide), we performed an analysis of data obtained in a prospective follow-up study conducted in the Netherlands since 1977.

  16. Smallpox vaccination and all-cause infectious disease hospitalization

    DEFF Research Database (Denmark)

    Sørup, Signe; Villumsen, Marie; Ravn, Henrik

    2011-01-01

    There is growing evidence from observational studies and randomized trials in low-income countries that vaccinations have non-specific effects. Administration of live vaccines reduces overall child morbidity and mortality, presumably due to protection against non-targeted infections. In Denmark......, the live vaccine against smallpox was phased out in the 1970s due to the eradication of smallpox. We used the phasing-out period to investigate the effect of smallpox vaccination on the risk of hospitalization for infections....

  17. Changes of body mass index in relation to mortality: results of a cohort of 42,099 adults.

    Directory of Open Access Journals (Sweden)

    Jochen Klenk

    Full Text Available BACKGROUND: High Body-Mass-Index (BMI is associated with increased all-cause mortality, but little is known about the effect of short- and long-term BMI change on mortality. The aim of the study was to determine how long-term weight change affects mortality. METHODS AND FINDINGS: Within a population-based prospective cohort of 42,099 Austrian men and women (mean age 43 years with at least three BMI measurements we investigated the relationship of BMI at baseline and two subsequent BMI change intervals of five years each with all-cause mortality using Cox proportional Hazard models. During median follow-up of 12 years 4,119 deaths were identified. The lowest mortalities were found in persons with normal weight or overweight at baseline and stable BMI over 10 years. Weight gain (≥0.10 kg/m(2/year during the first five years was associated with increased mortality in overweight and obese people. For weight gain during both time intervals mortality risk remained significantly increased only in overweight (Hazard Ratio (HR: 1.39 (95% confidence interval: 1.01; 1.92 and obese women (1.85 (95% confidence interval: 1.18; 2.89. Weight loss (< -0.10 kg/m(2/year increased all-cause mortality in men and women consistently. BMI change over time assessed using accepted World Health Organisation BMI categories showed no increased mortality risk for people who remained in the normal or overweight category for all three measurements. In contrast, HRs for stable obese men and women were 1.57 (95% CI: 1.31; 1.87 and 1.46 (95% CI: 1.25; 1.71 respectively. CONCLUSION: Our findings highlight the importance of weight stability and obesity avoidance in prevention strategy.

  18. Joint associations of alcohol consumption and physical activity with all-cause and cardiovascular mortality.

    NARCIS (Netherlands)

    Soedamah-Muthu, S.S.; Neve, De M.; Shelton, N.J.; Tielemans, S.M.A.J.; Stamatakis, E.

    2013-01-01

    Individual associations of alcohol consumption and physical activity with cardiovascular disease are relatively established, but the joint associations are not clear. Therefore, the aim of this study was to examine prospectively the joint associations between alcohol consumption and physical activit

  19. Risk of Major Adverse Cardiovascular Events and All-Cause Mortality in Patients With Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Gislason, Gunnar H; Hansen, Peter R

    2016-01-01

    IMPORTANCE: Hidradenitis suppurativa (HS) is a common inflammatory skin disease. The disease has been associated with cardiovascular (CV) risk factors, but the risk of CV disease in patients with HS is unknown. OBJECTIVE: To investigate CV risk in patients with HS. DESIGN, SETTING, AND PARTICIPAN...

  20. Increased all-cause mortality with psychotropic medication in Parkinson's disease and controls

    DEFF Research Database (Denmark)

    Frandsen, Rune; Baandrup, Lone; Kjellberg, Jakob;

    2014-01-01

    of psychotropic medication in PD patients and controls. Hazard ratios were as follows for the medication types: selective serotonin reuptake inhibitors or serotonin-noradrenalin reuptake inhibitors, PD HR = 1.19, 95% CI = 1.04-1.36; Control HR = 1.77, 95% CI = 1.64-1.91; benzodiazepines, PD HR = 1.17, 95% CI = 0...

  1. Subclinical and Overt Thyroid Dysfunction and Risk of All-Cause Mortality and Cardiovascular Events

    DEFF Research Database (Denmark)

    Selmer, Christian; Olesen, Jonas Bjerring; Hansen, Morten Lock

    2014-01-01

    cardiovascular events (MACEs), and cause-specific events in subjects with overt and subclinical thyroid dysfunction. DESIGN: This was a retrospective cohort study. SETTING AND PARTICIPANTS: Participants in the study were subjects who underwent thyroid blood tests, without prior thyroid disease, consulting...

  2. Hyponatremia, all-cause mortality, and risk of cancer diagnoses in the primary care setting

    DEFF Research Database (Denmark)

    Selmer, Christian; Madsen, Jesper Clausager; Torp-Pedersen, Christian

    2016-01-01

    : Retrospective cohort study on subjects who underwent blood tests, consulting their general practitioner 2000-2012 in Copenhagen, Denmark. Reference range for sodium was 135-145mmol/L, and mild, moderate, and severe hyponatremia were defined as 130-135, 125-129, and

  3. Nutrient-rich foods, cardiovascular diseases and all-cause mortality: the Rotterdam study

    NARCIS (Netherlands)

    Streppel, M.T.; Sluik, D.; Yperen, van J.; Geelen, A.; Hofman, A.; Franco, O.H.; Witteman, J.C.M.; Feskens, E.J.M.

    2014-01-01

    Background/Objectives: The nutrient-rich food (NRF) index assesses nutrient quality of individual food items by ranking them according to their nutrient composition. The index reflects the nutrient density of the overall diet. We examined the associations between the NRF9.3 index—a score on the basi

  4. Intensity versus duration of cycling, impact on all-cause and coronary heart disease mortality

    DEFF Research Database (Denmark)

    Schnohr, Peter; Marott, Jacob L; Jensen, Jan S

    2012-01-01

    Background: Current recommendations prescribe that every adult should accumulate 30¿minutes or more of moderate physical activity in leisure time, preferably every day of the week. The optimal intensity, duration, and frequency still have to be established. The aim of this study was to examine....... The difference in expected lifetime in relation to intensity of cycling was calculated. Men with fast intensity cycling survived 5.3 years longer, and men with average intensity 2.9 years longer than men with slow cycling intensity. For women the figures were 3.9 and 2.2 years longer, respectively. Conclusion...

  5. Short term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities : Results from time series data from the APHEA project

    NARCIS (Netherlands)

    Katsouyanni, K; Touloumi, G; Spix, C; Schwartz, J; Balducci, F; Medina, S; Rossi, G; Wojtyniak, B; Sunyer, J; Bacharova, L; Schouten, JP; Ponka, A; Anderson, HR

    1997-01-01

    Objectives: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide. . Design: Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particu

  6. Mortality risk in a historical cohort of nuclear power plant workers in Germany: results from a second follow-up.

    Science.gov (United States)

    Merzenich, Hiltrud; Hammer, Gaël P; Tröltzsch, Katrin; Ruecker, Kai; Buncke, Johanna; Fehringer, Franz; Blettner, Maria

    2014-05-01

    Possible health effects of low and protracted doses of ionizing radiation are relevant for persons who are exposed to an occupational context like nuclear industry workers. A historical cohort study was therefore conducted to examine mortality risks following occupational radiation exposure among 4,844 German nuclear power plant workers. This cohort included workers from ten nuclear power plants with an observational period from 1991 until 1997. The results of an enlarged cohort with 8,972 workers from all 17 nuclear power plants in West Germany are now available. During the extended follow-up period from 1991 to 2008, a total of 310 deaths among men were observed. The standardized mortality ratio (SMR) from all causes of deaths was estimated at 0.50 [95 % confidence interval (CI) 0.45-0.56]. A total of 126 deaths due to cancer occurred (SMR = 0.65; 95 % CI 0.51-0.82) and seven deaths due to leukemia (SMR = 1.23; 95 % CI 0.42-2.84). Overall, a reduced mortality compared to the general population of West Germany was observed indicating a healthy worker effect. In the dose-response analysis, no statistically significant risk due to ionizing radiation was seen. The hazard ratio (HR/mSv) for leukemia excluding chronic lymphocytic leukemia was estimated at 1.004 (95 % CI 0.997-1.011). In conclusion, the cohort is small and made up of young workers, most of whom were still employed at the end of the observational period in 2008. Results of the external analysis are difficult to interpret as influenced by a healthy worker effect. In the internal analysis, no excess of risk due to radiation was detected.

  7. Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014–2015 in Monrovia Results from a Mobile Phone Survey

    Science.gov (United States)

    Kuehne, Anna; Lynch, Emily; Marshall, Esaie; Tiffany, Amanda; Alley, Ian; Bawo, Luke; Massaquoi, Moses; Lodesani, Claudia; Le Vaillant, Philippe; Porten, Klaudia; Gignoux, Etienne

    2016-01-01

    Between March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF) conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR) of 0.33/10,000 persons/day (95%CI:0.25–0.43) and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03–0.11). During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277). Of the sick household members, 43% (122/276) did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak detection

  8. Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey.

    Science.gov (United States)

    Kuehne, Anna; Lynch, Emily; Marshall, Esaie; Tiffany, Amanda; Alley, Ian; Bawo, Luke; Massaquoi, Moses; Lodesani, Claudia; Le Vaillant, Philippe; Porten, Klaudia; Gignoux, Etienne

    2016-08-01

    Between March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF) conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR) of 0.33/10,000 persons/day (95%CI:0.25-0.43) and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03-0.11). During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277). Of the sick household members, 43% (122/276) did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak detection and

  9. How stand productivity results from size- and competition-dependent growth and mortality.

    Directory of Open Access Journals (Sweden)

    John P Caspersen

    Full Text Available BACKGROUND: A better understanding of the relationship between stand structure and productivity is required for the development of: a scalable models that can accurately predict growth and yield dynamics for the world's forests; and b stand management regimes that maximize wood and/or timber yield, while maintaining structural and species diversity. METHODS: We develop a cohort-based canopy competition model ("CAIN", parameterized with inventory data from Ontario, Canada, to examine the relationship between stand structure and productivity. Tree growth, mortality and recruitment are quantified as functions of diameter and asymmetric competition, using a competition index (CAI(h defined as the total projected area of tree crowns at a given tree's mid-crown height. Stand growth, mortality, and yield are simulated for inventoried stands, and also for hypothetical stands differing in total volume and tree size distribution. RESULTS: For a given diameter, tree growth decreases as CAI(h increases, whereas the probability of mortality increases. For a given CAI(h, diameter growth exhibits a humped pattern with respect to diameter, whereas mortality exhibits a U-shaped pattern reflecting senescence of large trees. For a fixed size distribution, stand growth increases asymptotically with total density, whereas mortality increases monotonically. Thus, net productivity peaks at an intermediate volume of 100-150 m(3/ha, and approaches zero at 250 m(3/ha. However, for a fixed stand volume, mortality due to senescence decreases if the proportion of large trees decreases as overall density increases. This size-related reduction in mortality offsets the density-related increase in mortality, resulting in a 40% increase in yield. CONCLUSIONS: Size-related variation in growth and mortality exerts a profound influence on the relationship between stand structure and productivity. Dense stands dominated by small trees yield more wood than stands dominated by fewer

  10. Vascular Disease and Risk Stratification for Ischemic Stroke and All-Cause Death in Heart Failure Patients without Diagnosed Atrial Fibrillation: A Nationwide Cohort Study

    Science.gov (United States)

    Melgaard, Line; Gorst-Rasmussen, Anders; Rasmussen, Lars Hvilsted; Lip, Gregory Y. H.; Larsen, Torben Bjerregaard

    2016-01-01

    Background Stroke and mortality risk among heart failure patients previously diagnosed with different manifestations of vascular disease is poorly described. We conducted an observational study to evaluate the stroke and mortality risk among heart failure patients without diagnosed atrial fibrillation and with peripheral artery disease (PAD) or prior myocardial infarction (MI). Methods Population-based cohort study of patients diagnosed with incident heart failure during 2000–2012 and without atrial fibrillation, identified by record linkage between nationwide registries in Denmark. Hazard rate ratios of ischemic stroke and all-cause death after 1 year of follow-up were used to compare patients with either: a PAD diagnosis; a prior MI diagnosis; or no vascular disease. Results 39,357 heart failure patients were included. When compared to heart failure patients with no vascular disease, PAD was associated with a higher 1-year rate of ischemic stroke (adjusted hazard rate ratio [HR]: 1.34, 95% confidence interval [CI]: 1.08–1.65) and all-cause death (adjusted HR: 1.47, 95% CI: 1.35–1.59), whereas prior MI was not (adjusted HR: 1.00, 95% CI: 0.86–1.15 and 0.94, 95% CI: 0.89–1.00, for ischemic stroke and all-cause death, respectively). When comparing patients with PAD to patients with prior MI, PAD was associated with a higher rate of both outcomes. Conclusions Among incident heart failure patients without diagnosed atrial fibrillation, a previous diagnosis of PAD was associated with a significantly higher rate of the ischemic stroke and all-cause death compared to patients with no vascular disease or prior MI. Prevention strategies may be particularly relevant among HF patients with PAD. PMID:27015524

  11. Vascular Disease and Risk Stratification for Ischemic Stroke and All-Cause Death in Heart Failure Patients without Diagnosed Atrial Fibrillation

    DEFF Research Database (Denmark)

    Melgaard, Line; Gorst-Rasmussen, Anders; Rasmussen, Lars Hvilsted;

    2016-01-01

    BACKGROUND: Stroke and mortality risk among heart failure patients previously diagnosed with different manifestations of vascular disease is poorly described. We conducted an observational study to evaluate the stroke and mortality risk among heart failure patients without diagnosed atrial...... fibrillation and with peripheral artery disease (PAD) or prior myocardial infarction (MI). METHODS: Population-based cohort study of patients diagnosed with incident heart failure during 2000-2012 and without atrial fibrillation, identified by record linkage between nationwide registries in Denmark. Hazard...... rate ratios of ischemic stroke and all-cause death after 1 year of follow-up were used to compare patients with either: a PAD diagnosis; a prior MI diagnosis; or no vascular disease. RESULTS: 39,357 heart failure patients were included. When compared to heart failure patients with no vascular disease...

  12. New findings for maternal mortality age patterns: aggregated results for 38 countries.

    Directory of Open Access Journals (Sweden)

    Ann K Blanc

    Full Text Available BACKGROUND: With recent results showing a global decline in overall maternal mortality during the last two decades and with the target date for achieving the Millennium Development Goals only four years away, the question of how to continue or even accelerate the decline has become more pressing. By knowing where the risk is highest as well as where the numbers of deaths are greatest, it may be possible to re-direct resources and fine-tune strategies for greater effectiveness in efforts to reduce maternal mortality. METHODS: We aggregate data from 38 Demographic and Health Surveys that included a maternal mortality module and were conducted in 2000 or later to produce maternal mortality ratios, rates, and numbers of deaths by five year age groups, separately by residence, region, and overall mortality level. FINDINGS: The age pattern of maternal mortality is broadly similar across regions, type of place of residence, and overall level of maternal mortality. A "J" shaped curve, with markedly higher risk after age 30, is evident in all groups. We find that the excess risk among adolescents is of a much lower magnitude than is generally assumed. The oldest age groups appear to be especially resistant to change. We also find evidence of extremely elevated risk among older mothers in countries with high levels of HIV prevalence. CONCLUSIONS: The largest number of deaths occurs in the age groups from 20-34, largely because those are the ages at which women are most likely to give birth so efforts directed at this group would most effectively reduce the number of deaths. Yet equity considerations suggest that efforts also be directed toward those most at risk, i.e., older women and adolescents. Because women are at risk each time they become pregnant, fulfilling the substantial unmet need for contraception is a cross-cutting strategy that can address both effectiveness and equity concerns.

  13. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H. Bas; Jakobsen, Marianne U.; Egeberg, Rikke; Tjonneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M.; Boeing, Heiner; Li, Kuanrong; Kaaks, Rudolf; Khaw, Kay-Tee; Wareham, Nicholas J.; Crowe, Francesca L.; Key, Timothy J.; Naska, Androniki; Trichopoulou, Antonia; Trichopoulos, Dimitirios; Leenders, Max; Peeters, Petra H. M.; Engeset, Dagrun; Parr, Christine L.; Skeie, Guri; Jakszyn, Paula; Sanchez, Maria-Jose; Huerta, Jose M.; Luisa Redondo, M.; Barricarte, Aurelio; Amiano, Pilar; Drake, Isabel; Sonestedt, Emily; Hallmans, Goran; Johansson, Ingegerd; Fedirko, Veronika; Romieux, Isabelle; Ferrari, Pietro; Norat, Teresa; Vergnaud, Anne C.; Riboli, Elio; Linseisen, Jakob

    2013-01-01

    Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption wit

  14. Depression and risk of mortality in people with diabetes mellitus

    DEFF Research Database (Denmark)

    van Dooren, Fleur E P; Nefs, Giesje; Schram, Miranda T

    2013-01-01

    OBJECTIVE: To examine the association between depression and all-cause and cardiovascular mortality in people with diabetes by systematically reviewing the literature and carrying out a meta-analysis of relevant longitudinal studies. RESEARCH DESIGN AND METHODS: PUBMED and PSYCINFO were searched...... for articles assessing mortality risk associated with depression in diabetes up until August 16, 2012. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria, which were pooled in an overall all-cause mortality estimate, and five...... in a cardiovascular mortality estimate. After adjustment for demographic variables and micro- and macrovascular complications, depression was associated with an increased risk of all-cause mortality (HR = 1.46, 95% CI = 1.29-1.66), and cardiovascular mortality (HR = 1.39, 95% CI = 1.11-1.73). Heterogeneity across...

  15. Foot complications and mortality: results from Translating Research Into Action for Diabetes (TRIAD)

    Science.gov (United States)

    McEwen, Laura N.; Ylitalo, Kelly R.; Munson, Michael; Herman, William H.; Wrobel, James S.

    2016-01-01

    Background Our objective was to study the impact of foot complications on 10 year mortality independent of other demographic and biological risk factors in a racially and socioeconomically diverse managed care population with access to high-quality medical care. Methods We studied 6,992 patients with diabetes in Translating Research Into Action for Diabetes (TRIAD), a prospective observational study of diabetes care in managed care. Foot complications were assessed using administrative claims data. The National Death Index was searched for deaths over 10 years of followup (2000–2009). Results Charcot neuroosteoarthropathy (CN) and diabetic foot ulcer with debridement (DFU) were associated with an increased risk of mortality; however, the associations were not significant in fully adjusted models. Lower extremity amputation (LEA) was associated with an increased risk of mortality in both unadjusted (HR 3.21, 95% CI 2.50–4.12) and fully adjusted models (HR 1.84, 95% CI 1.28–2.63). When we examined the associations between LEA and mortality stratified by sex and race, risk was increased in men (HR 1.96, 95% CI 1.25–3.07), Hispanics (HR 5.17, 95% CI 1.48–18.01), and Whites (HR 2.18, 95% CI 1.37–3.47). In sensitivity analyses, minor LEA tended to increase the risk of mortality (HR 1.48, 95% CI 0.92–2.40) and major LEA was associated with a significantly higher risk of death at 10 years (HR 1.89, 95% CI 1.18–3.01). Conclusions In this managed care population with access to high-quality medical care, LEA remained a robust independent predictor of mortality. The association was strongest in men and differed by race. PMID:26895355

  16. Mortality and morbidity during and after Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: results by sex.

    Science.gov (United States)

    Oparil, Suzanne; Davis, Barry R; Cushman, William C; Ford, Charles E; Furberg, Curt D; Habib, Gabriel B; Haywood, L Julian; Margolis, Karen; Probstfield, Jeffrey L; Whelton, Paul K; Wright, Jackson T

    2013-05-01

    To determine whether an angiotensin-converting enzyme inhibitor (lisinopril) or calcium channel blocker (amlodipine) is superior to a diuretic (chlorthalidone) in reducing cardiovascular disease incidence in sex subgroups, we carried out a prespecified subgroup analysis of 15 638 women and 17 719 men in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Total follow-up (active treatment + passive surveillance using national administrative databases to ascertain deaths and hospitalizations) was 8 to 13 years. The primary outcome was fatal coronary heart disease or nonfatal myocardial infarction. Secondary outcomes included all-cause mortality, stroke, combined cardiovascular disease (coronary heart disease death, nonfatal myocardial infarction, stroke, angina, coronary revascularization, heart failure [HF], or peripheral vascular disease), and end-stage renal disease. In-trial rates of HF, stroke, and combined cardiovascular disease were significantly higher for lisinopril compared with chlorthalidone, and rates of HF were significantly higher for amlodipine compared with chlorthalidone in both men and women. There were no significant treatment sex interactions. These findings did not persist through the extension period with the exception of the HF result for amlodipine versus chlorthalidone, which did not differ significantly by sex. For both women and men, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary coronary heart disease outcome or any other cardiovascular disease outcome, and chlorthalidone-based treatment resulted in the lowest risk of HF. Neither lisinopril nor amlodipine is superior to chlorthalidone for initial treatment of hypertension in either women or men. Clinical Trial Registration- clinicaltrials.gov; Identifier: NCT00000542.

  17. Outbreak of Hepatitis E in Urban Bangladesh Resulting in Maternal and Perinatal Mortality

    Science.gov (United States)

    Gurley, Emily S.; Hossain, M. Jahangir; Paul, Repon C.; Sazzad, Hossain M. S.; Islam, M. Saiful; Parveen, Shahana; Faruque, Labib I.; Husain, Mushtuq; Ara, Khorshed; Jahan, Yasmin; Rahman, Mahmudur; Luby, Stephen P.

    2014-01-01

    Background. Hepatitis E virus (HEV) causes outbreaks of jaundice associated with maternal mortality. Four deaths among pregnant women with jaundice occurred in an urban community near Dhaka, Bangladesh, in late 2008 and were reported to authorities in January 2009. We investigated the etiology and risk factors for jaundice and death. Methods. Field workers identified suspected cases, defined as acute onset of yellow eyes or skin, through house-to-house visits. A subset of persons with suspected HEV was tested for immunoglobulin M (IgM) antibodies to HEV to confirm infection. We used logistic regression analysis to identify risk factors for HEV disease and for death. We estimated the increased risk of perinatal mortality associated with jaundice during pregnancy. Results. We identified 4751 suspected HEV cases during August 2008–January 2009, including 17 deaths. IgM antibodies to HEV were identified in 56 of 73 (77%) case-patients tested who were neighbors of the case-patients who died. HEV disease was significantly associated with drinking municipally supplied water. Death among persons with HEV disease was significantly associated with being female and taking paracetamol (acetaminophen). Among women who were pregnant, miscarriage and perinatal mortality was 2.7 times higher (95% confidence interval, 1.2–6.1) in pregnancies complicated by jaundice. Conclusions. This outbreak of HEV was likely caused by sewage contamination of the municipal water system. Longer-term efforts to improve access to safe water and license HEV vaccines are needed. However, securing resources and support for intervention will rely on convincing data about the endemic burden of HEV disease, particularly its role in maternal and perinatal mortality. PMID:24855146

  18. A Retrospective Study of the Clinical Burden of Hospitalized All-Cause and Pneumococcal Pneumonia in Canada

    Directory of Open Access Journals (Sweden)

    Shelly A. McNeil

    2016-01-01

    Full Text Available Background. Routine vaccination against Streptococcus pneumoniae is recommended in Canada for infants, the elderly, and individuals with chronic comorbidity. National incidence and burden of all-cause and pneumococcal pneumonia in Canada (excluding Quebec were assessed. Methods. Incidence, length of stay, and case-fatality rates of hospitalized all-cause and pneumococcal pneumonia were determined for 2004–2010 using ICD-10 discharge data from the Canadian Institutes for Health Information Discharge Abstract Database. Population-at-risk data were obtained from the Statistics Canada census. Temporal changes in pneumococcal and all-cause pneumonia rates in adults ≥65 years were analyzed by logistic regression. Results. Hospitalization for all-cause pneumonia was highest in children 70 years and declined significantly from 1766/100,000 to 1537/100,000 per year in individuals aged ≥65 years (P<0.001. Overall hospitalization for pneumococcal pneumonia also declined from 6.40/100,000 to 5.08/100,000 per year. Case-fatality rates were stable (11.6% to 12.3%. Elderly individuals had longer length of stay and higher case-fatality rates than younger groups. Conclusions. All-cause and pneumococcal pneumonia hospitalization rates declined between 2004 and 2010 in Canada (excluding Quebec. Direct and indirect effects from pediatric pneumococcal immunization may partly explain some of this decline. Nevertheless, the burden of disease from pneumonia remains high.

  19. A Case of Cerebral Sinus Venous Thrombosis Resulting in Mortality in Severe Preeclamptic Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Hatice Ender Soydinc

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a rarely encountered condition during pregnancy. A 21-year-old pregnant woman with labour pains was hospitalized in our clinic. Diagnosis of severe preeclampsia was made based on her clinical and laboratory findings. She suffered from convulsive episodes during postpartum period which lead to initiation of treatment for eclampsia. However neurological and radiological examinations were performed after emergence of additional neurological symptoms disclosed the diagnosis of CVST. In this paper, we aimed to present a case with CVST which diagnosis was confused with eclampsia and resulting in maternal mortality.

  20. Perceived stress and cause-specific mortality among men and women: results from a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage S; Schnohr, Peter

    2008-01-01

    was most pronounced for deaths due to respiratory diseases (high vs. low stress: HR = 1.79, 95% CI: 1.10, 2.91), external causes (HR = 3.07, 95% CI: 1.65, 5.71), and suicide (HR = 5.91, 95% CI: 2.47, 14.16). High stress was related to a 2.59 (95% CI: 1.20, 5.61) higher risk of ischemic heart disease......The authors assessed the effect of psychological stress on total and cause-specific mortality among men and women. In 1981-1983, the 12,128 Danish participants in the Copenhagen City Heart Study were asked two questions on stress intensity and frequency and were followed in a nationwide registry...... until 2004, with stress and mortality (p = 0.02). After adjustments, men with high stress versus low stress had higher all-cause mortality (hazard ratio (HR) = 1.32, 95% confidence interval (CI): 1.15, 1.52). This finding...

  1. Increasing asthma mortality in Denmark 1969-88 not a result of a changed coding practice

    DEFF Research Database (Denmark)

    Juel, K; Pedersen, P A

    1992-01-01

    We have studied asthma mortality in Denmark from 1969 to 1988. Age standardized mortality rates calculated in three age groups, 10-34, 35-59, and greater than or equal to 60 years, disclosed similar trends. Increasing mortality from asthma in the mid-1970s to 1988 was seen in all three age groups...

  2. Human amyloidogenic light chain proteins result in cardiac dysfunction, cell death, and early mortality in zebrafish

    Science.gov (United States)

    Mishra, Shikha; Guan, Jian; Plovie, Eva; Seldin, David C.; Connors, Lawreen H.; Merlini, Giampaolo; Falk, Rodney H.; MacRae, Calum A.

    2013-01-01

    Systemic amyloid light-chain (AL) amyloidosis is associated with rapidly progressive and fatal cardiomyopathy resulting from the direct cardiotoxic effects of circulating AL light chain (AL-LC) proteins and the indirect effects of AL fibril tissue infiltration. Cardiac amyloidosis is resistant to standard heart failure therapies, and, to date, there are limited treatment options for these patients. The mechanisms underlying the development of cardiac amyloidosis and AL-LC cardiotoxicity are largely unknown, and their study has been limited by the lack of a suitable in vivo model system. Here, we establish an in vivo zebrafish model of human AL-LC-induced cardiotoxicity. AL-LC isolated from AL cardiomyopathy patients or control nonamyloidogenic LC protein isolated from multiple myeloma patients (Con-LC) was directly injected into the circulation of zebrafish at 48 h postfertilization. AL-LC injection resulted in impaired cardiac function, pericardial edema, and increased cell death relative to Con-LC, culminating in compromised survival with 100% mortality within 2 wk, independent of AL fibril deposition. Prior work has implicated noncanonical p38 MAPK activation in the pathogenesis of AL-LC-induced cardiotoxicity, and p38 MAPK inhibition via SB-203580 rescued AL-LC-induced cardiac dysfunction and cell death and attenuated mortality in zebrafish. This in vivo zebrafish model of AL-LC cardiotoxicity demonstrates that antagonism of p38 MAPK within the AL-LC cardiotoxic signaling response may serve to improve cardiac function and mortality in AL cardiomyopathy. Furthermore, this in vivo model system will allow for further study of the molecular underpinnings of AL cardiotoxicity and identification of novel therapeutic strategies. PMID:23624626

  3. Changes to dryland rainfall result in rapid moss mortality and altered soil fertility

    Science.gov (United States)

    Reed, Sasha C.; Coe, Kirsten K.; Sparks, Jed P.; Housman, David C.; Zelikova, Tamara J.; Belnap, Jayne

    2012-01-01

    Arid and semi-arid ecosystems cover ~40% of Earth’s terrestrial surface, but we know little about how climate change will affect these widespread landscapes. Like many drylands, the Colorado Plateau in southwestern United States is predicted to experience elevated temperatures and alterations to the timing and amount of annual precipitation. We used a factorial warming and supplemental rainfall experiment on the Colorado Plateau to show that altered precipitation resulted in pronounced mortality of the widespread moss Syntrichia caninervis. Increased frequency of 1.2 mm summer rainfall events reduced moss cover from ~25% of total surface cover to soil fertility. Mosses are important members in many dryland ecosystems and the community changes observed here reveal how subtle modifications to climate can affect ecosystem structure and function on unexpectedly short timescales. Moreover, mortality resulted from increased precipitation through smaller, more frequent events, underscoring the importance of precipitation event size and timing, and highlighting our inadequate understanding of relationships between climate and ecosystem function in drylands.

  4. Influenza associated mortality in the subtropics and tropics: results from three Asian cities.

    Science.gov (United States)

    Yang, Lin; Ma, Stefan; Chen, Ping Yan; He, Jian Feng; Chan, King Pan; Chow, Angela; Ou, Chun Quan; Deng, Ai Ping; Hedley, Anthony J; Wong, Chit Ming; Peiris, J S Malik

    2011-11-01

    Influenza has been well documented to significantly contribute to winter increase of mortality in the temperate countries, but its severity in the subtropics and tropics was not recognized until recently and geographical variations of disease burden in these regions remain poorly understood. In this study, we applied a standardized modeling strategy to the mortality and virology data from three Asian cities: subtropical Guangzhou and Hong Kong, and tropical Singapore, to estimate the disease burden of influenza in these cities. We found that influenza was associated with 10.6, 13.4 and 8.3 deaths per 100,000 population in Guangzhou, Hong Kong and Singapore, respectively. The annual rates of excess deaths in the elders were estimated highest in Guangzhou and lowest in Singapore. The excess death rate attributable to A/H1N1 subtype was found slightly higher than the rates attributable to A/H3N2 during the study period of 2004-2006 based on the data from Hong Kong and Guangzhou. Our study revealed a geographical variation in the disease burden of influenza in these subtropical and tropical cities. These results highlight a need to explore the determinants for severity of seasonal influenza.

  5. Comparison of predictive modeling approaches for 30-day all-cause non-elective readmission risk

    Directory of Open Access Journals (Sweden)

    Liping Tong

    2016-02-01

    Full Text Available Abstract Background This paper explores the importance of electronic medical records (EMR for predicting 30-day all-cause non-elective readmission risk of patients and presents a comparison of prediction performance of commonly used methods. Methods The data are extracted from eight Advocate Health Care hospitals. Index admissions are excluded from the cohort if they are observation, inpatient admissions for psychiatry, skilled nursing, hospice, rehabilitation, maternal and newborn visits, or if the patient expires during the index admission. Data are randomly and repeatedly divided into fitting and validating sets for cross validations. Approaches including LACE, STEPWISE logistic, LASSO logistic, and AdaBoost, are compared with sample sizes varying from 2,500 to 80,000. Results Our results confirm that LACE has moderate discrimination power with the area under receiver operating characteristic curve (AUC around 0.65-0.66, which can be improved to 0.73-0.74 when additional variables from EMR are considered. These variables include Inpatient in the last six months, Number of emergency room visits or inpatients in the last year, Braden score, Polypharmacy, Employment status, Discharge disposition, Albumin level, and medical condition variables such as Leukemia, Malignancy, Renal failure with hemodialysis, History of alcohol substance abuse, Dementia and Trauma. When sample size is small (≤5000, LASSO is the best; when sample size is large (≥20,000, the predictive performance is similar. The STEPWISE method has a slightly lower AUC (0.734 comparing to LASSO (0.737 and AdaBoost (0.737. More than one half of the selected predictors can be false positives when using a single method and a single division of fitting/validating data. Conclusions True predictors can be identified by repeatedly dividing data into fitting/validating subsets and referring the final model based on summarizing results. LASSO is a better alternative to the STEPWISE

  6. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women

    DEFF Research Database (Denmark)

    Ekelund, Ulf; Ward, Heather A; Norat, Teresa;

    2015-01-01

    realización de varios tipos de tareas. En este respecto, el artículo argumentará que hay un grano de verdad en las muy categóricas opiniones de Lees e Itkonen, por lo menos en lo que se refiere a la lexicografía especializada, pues dentro de esta disciplina ya no se trata de luchar contra los molinos de...

  7. Combined effects of weight loss and physical activity on all-cause mortality of overweight men and women

    DEFF Research Database (Denmark)

    Østergaard, J N; Grønbaek, M; Schnohr, Peter

    2010-01-01

    To estimate the excess deaths associated with weight loss in combination with leisure time physical activity among overweight or obese people.......To estimate the excess deaths associated with weight loss in combination with leisure time physical activity among overweight or obese people....

  8. Is the adiposity-associated FTO gene variant related to all-cause mortality independent of adiposity?

    DEFF Research Database (Denmark)

    Zimmermann, E; Ängquist, L H; Mirza, S S

    2015-01-01

    -up. Linear regression showed that the minor allele of the FTO SNP was associated with greater BMI (n = 169,551; 0.32 kg m(-2) ; 95% CI 0.28-0.32, P 17 kg m(-2) ; 0.13-0.22, P = 1.0 × 10(-13) ). Cox proportional...

  9. Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen elderly study

    NARCIS (Netherlands)

    Milder, I.E.J.; Feskens, E.J.M.; Arts, I.C.W.; Bueno-de Mesquita, H.B.; Hollman, P.C.H.; Kromhout, D.

    2006-01-01

    Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks. OBJECTIVE: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol, and mataire

  10. Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen Elderly Study.

    NARCIS (Netherlands)

    Milder, Ivon E J; Feskens, Edith J M; Arts, Ilja C W; Bueno-de-Mesquita, H Bas; Hollman, Peter C H; Kromhout, Daan

    2006-01-01

    BACKGROUND: Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks. OBJECTIVE: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol,

  11. High serum YKL-40 level in a cohort of octogenarians is associated with increased risk of all-cause mortality

    DEFF Research Database (Denmark)

    Johansen, J. S.; Pedersen, Agnes Nadelmann; Schroll, M.;

    2007-01-01

    = 151) and serum YKL-40 in 18-30-year-olds (n = 89). Fifty-one of the octogenarians died during the 6-year follow-up. Serum YKL-40 in octogenarians was higher compared to the level in young people (median 116 versus 31 microg/l, P elderly women...... (Spearman's rho = 0.30, P = 0.009) and men (rho = 0.25, P = 0.003), but only with serum TNF-alpha (rho = 0.23, P = 0.05) and C-reactive protein (CRP) (rho = 0.57, P elderly women. In addition, high serum level of YKL-40 was associated with a low CD4 : CD8 cell ratio. Univariate analysis...

  12. The inflammatory biomarker YKL-40 as a new prognostic marker for all-cause mortality in patients with heart failure

    DEFF Research Database (Denmark)

    Harutyunyan, Marina; Christiansen, Michael; Johansen, Julia S;

    2011-01-01

    BACKGROUND: Despite progress in management of patients with heart failure (HF) these patients still have a poor prognosis. We tested the hypothesis whether the inflammatory biomarker YKL-40 alone or in combination with high-sensitivity C-reactive protein (hs-CRP) and/or N-terminal-pro-B natriuretic...... YKL-40 II to IV quartiles, respectively following multivariable adjustment for cardiovascular risk factors (age, left ventricular ejection fraction, gender, history of heart failure, ischemic heart disease, chronic pulmonary disease, diabetes mellitus, stroke, hypertension, NT-proBNP, hs...

  13. Effects of Happiness on All-Cause Mortality During 15 Years of Follow-Up: The Arnhem Elderly Study

    NARCIS (Netherlands)

    Koopmans, T.A.; Geleijnse, J.M.; Zitman, F.G.; Giltay, E.J.

    2010-01-01

    Positive psychological characteristics may be beneficial for physical health. However, prospective data on the effects of happiness on survival is scarce. In a population-based cohort study, the Arnhem Elderly Study, happiness was measured by two items, being: "I have many moments of happiness" and

  14. Failure to prescribe pneumocystis prophylaxis is associated with increased mortality, even in the cART era: results from the Treat Asia HIV observational database

    Directory of Open Access Journals (Sweden)

    Lim Poh-Lian

    2012-01-01

    Full Text Available Abstract Background Pneumocystis jiroveci pneumonia (PCP prophylaxis is recommended for patients with CD4 counts of less than 200 cells/mm3. This study examines the proportion of patients in the TREAT Asia HIV Observational Database (TAHOD receiving PCP prophylaxis, and its effect on PCP and mortality. Methods TAHOD patients with prospective follow up had data extracted for prophylaxis using co-trimoxazole, dapsone or pentamidine. The proportion of patients on prophylaxis was calculated for each calendar year since 2003 among patients with CD4 counts of less than 200 cells/mm3. The effect of prophylaxis on PCP and survival were assessed using random-effect Poisson regression models. Results There were a total of 4050 patients on prospective follow up, and 90% of them were receiving combination antiretroviral therapy. Of those with CD4 counts of less than 200 cells/mm3, 58% to 72% in any given year received PCP prophylaxis, predominantly co-trimoxazole. During follow up, 62 patients developed PCP (0.5 per 100 person-years and 169 died from all causes (1.36/100 person-years. After stratifying by site and adjusting for age, CD4 count, CDC stage and antiretroviral treatment, those without prophylaxis had no higher risk of PCP, but had a significantly higher risk of death (incident rate ratio 10.8, p 3, lowering mortality rates from 33.5 to 6.3 per 100 person-years. Conclusions Approximately two-thirds of TAHOD patients with CD4 counts of less than 200 cells/mm3 received PCP prophylaxis. Patients without prophylaxis had significantly higher mortality, even in the era of combination ART. Although PCP may be under-diagnosed, these data suggest that prophylaxis is associated with important survival benefits.

  15. Brain-Derived Neurotrophic Factor Predicts Mortality Risk in Older Women

    DEFF Research Database (Denmark)

    Krabbe, K.S.; Mortensen, E.L.; Avlund, K.

    2009-01-01

    OBJECTIVES To test the hypothesis that low circulating brain-derived neurotrophic factor (BDNF), a secretory member of the neurotrophin family that has a protective role in neurodegeneration and stress responses and a regulatory role in metabolism, predicts risk of all-cause mortality in 85-year...... was measured in plasma and serum. The Danish National Register of Patients was used to collect data on morbidity. The primary outcome in Cox regression analyses was all-cause mortality. RESULTS Women with low plasma BDNF (lowest tertile) had greater all-cause mortality risk than women with high plasma BDNF......-grade inflammation. No association was found between plasma BDNF and mortality in men, and serum BDNF did not influence mortality in either sex. CONCLUSION Low plasma BDNF is a novel, independent, and robust biomarker of mortality risk in old women. BDNF may be a central factor in the network of multimorbidity...

  16. Discontinuation of antiplatelet treatment and risk of recurrent stroke and all-cause death

    DEFF Research Database (Denmark)

    Ostergaard, Kamilla; Pottegård, Anton; Hallas, Jesper;

    2014-01-01

    use and followed them up for stroke recurrence, or all-cause death. Person-time was classified by antiplatelet drug use into current use, recent use (≤150 days after last use), and non-use (>150 days after last use). Lipid-lowering drug (LLD) use was classified by the same rules. We used Cox...... proportional hazard models to calculate the adjusted hazard ratio (HR) and corresponding 95% confidence intervals (CIs) for the risk of recurrent stroke or death associated with discontinuation of antiplatelet or LLD drugs. RESULTS: Among 4,670 stroke patients followed up for up a median of 1.5 years, 237...... experienced a second stroke and 600 died. Compared with current antiplatelet drug use, both recent use (1.3 (0.8-2.0)), and non-use (1.3 (0.8-1.9)) were associated with increased recurrent stroke risk. The corresponding HRs of death were 1.9 (1.4-2.5) for recent and 1.8 (1.4-2.3) for non-use of antiplatelet...

  17. Excess mortality attributable to chronic kidney disease. Results from the PIRP project.

    Science.gov (United States)

    Gibertoni, Dino; Mandreoli, Marcora; Rucci, Paola; Fantini, Maria Pia; Rigotti, Angelo; Scarpioni, Roberto; Santoro, Antonio

    2016-10-01

    Although chronic kidney disease (CKD) has a high mortality rate, the estimation of CKD mortality burden in the general population may be challenging because CKD is not always listed as a cause of death in mortality registries. To overcome this limitation, relative survival was used to estimate the excess mortality attributable to CKD as compared to the general population using data of patients registered in the Prevenzione Insufficienza Renale Progressiva (PIRP) registry since 2005 and were followed up until 2013. Relative survival was the ratio of survival observed in CKD patients to the expected survival of the general population. Multivariate parametric survival analysis was used to identify factors predicting excess mortality. The relative survival of CKD patients at 9 years was 0.708. Survival was significantly lower in CKD patients with cardiovascular comorbidities, proteinuria, diabetes, anemia and high phosphate levels and in advanced CKD stages, males, older patients and those who underwent dialysis. Relative survival is a viable method to determine mortality attributable to CKD. Study limitations are that patients are representative only of CKD patients followed by nephrologists and that our follow-up duration may be relatively short as a model for mortality.

  18. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Vahtera, Jussi; Westerlund, Hugo

    2011-01-01

    Poor sleep is an increasing problem in modern society, but most previous studies on the association between sleep and mortality rates have addressed only duration, not quality, of sleep. The authors prospectively examined the effects of sleep disturbances on mortality rates and on important risk ...... factors for mortality, such as body mass index, hypertension, and diabetes. A total of 16,989 participants in the GAZEL cohort study were asked validated questions on sleep disturbances in 1990 and were followed up until 2009, with...

  19. Indications, Results and Mortality of Pulmonary Artery Banding Procedure: a Brief Review and Five- year Experiences

    Directory of Open Access Journals (Sweden)

    Hamid Hoseinikhah

    2016-05-01

    Full Text Available Background Pulmonary artery banding (PAB is a technique of palliative surgical therapy used by congenital heart surgeons as a staged approach to operative correction of congenital heart defects. Materials and Methods We report 5- year experiences from January 2011 to January 2016 of Imam Reza Hospital center (a tertiary referral hospital in Mashhad city, North East of Iran that consist of 50 patients with congenital heart disease with left to right shunt that pulmonary artery banding procedure was performed for them were studied. Results Age of patients (n=50 was 1to 9 months (mean=4.6 + 1.3. In this study, the most common disease that need to PAB procedure was Ventricular septal defect (VSD with twenty-eight patients (56%. Mean of extubation time (hour was 10.4 + 0.8 and mean of hospital stay (day was 13.3 + 2.4 respectively. Conclusion Although the number of pulmonary artery banding palliation surgery was decreased, but in selected group of congenital heart disease, this palliation to reduce over circulation of Pulmonary system, can use successfully with acceptable results and low mortality. We suggest pulmonary artery banding palliative surgery in these selected patients.

  20. APP knockout mice experience acute mortality as the result of ischemia.

    Directory of Open Access Journals (Sweden)

    Maya A Koike

    Full Text Available The incidence of Alzheimer's disease increases in people who have had an ischemic episode. Furthermore, APP expression is increased following ischemic or hypoxic conditions, as is the production of the Aβ peptide. To address the question of why APP and Aβ are increased in hypoxic and ischemic conditions we induced an ischemic episode in APP knockout mice (APP-/- and BACE1 knockout mice (BACE-/-. We find that both APP-/- and BACE-/- mice have a dramatically increased risk of mortality as a result of cerebral ischemia. Furthermore, APP knockout mice have reduced cerebral blood flow in response to hypoxia, while wild-type mice maintain or increase cerebral blood flow to the same conditions. The transcription factor, serum response factor (SRF, and calcium-binding molecule, calsequestrin, both involved in vascular regulation, are significantly altered in the brains of APP-/- mice compared to wild type controls. These results show that APP regulates cerebral blood flow in response to hypoxia, and that it, and its cleavage fragments, are crucial for rapid adaptation to ischemic conditions.

  1. Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Sejling, A. S.; Schouwenberg, B.; Færch, Louise H

    2016-01-01

    of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort). Results: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either...... cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence...

  2. Prognostic Value of Obesity on Both Overall Mortality and Cardiovascular Disease in the General Population

    Science.gov (United States)

    Ponce-Garcia, Isabel; Simarro-Rueda, Marta; Carbayo-Herencia, Julio Antonio; Divisón-Garrote, Juan Antonio; Artigao-Ródenas, Luis Miguel; Botella-Romero, Francisco; Palazón-Bru, Antonio; Martínez-St. John, Damian Robert James; Gil-Guillén, Vicente Francisco

    2015-01-01

    Background Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain. Materials and Methods This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥30 kg/m2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model. Results The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80–113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124–163). A BMI ≥35 kg/m2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11–3.42) in comparison to non-obese subjects (BMI <30 kg/m2). For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥35 kg/m2 had a hazard ratio of 1.84 (95% CI: 1.15–2.93) compared to non-obese subjects. Conclusions A BMI ≥35 kg/m2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality. PMID:25992570

  3. Development of a New Technique to Assess Susceptibility to Predation Resulting from Sublethal Stresses (Indirect Mortality)

    Energy Technology Data Exchange (ETDEWEB)

    Cada, G.F.

    2003-08-25

    Fish that pass through a hydroelectric turbine may not be killed directly, but may nonetheless experience sublethal stresses that will increase their susceptibility to predators (indirect mortality). There is a need to develop reliable tests for indirect mortality so that the full consequences of passage through turbines (and other routes around a hydroelectric dam) can be assessed. We evaluated a new technique for assessing indirect mortality, based on a behavioral response to a startling stimulus (akin to perceiving an approaching predator). We compare this technique to the standard predator preference test. The behavioral response is a rapid movement commonly referred to as a startle response, escape response, or C-shape, based on the characteristic body position assumed by the fish. When viewed from above, a startled fish bends into a C-shape, then springs back and swims away in a direction different from its original orientation. This predator avoidance (escape) behavior can be compromised by sublethal stresses that temporarily stun or disorient the fish. We subjected striped shiners and fathead minnows to varying intensities of either turbulence (10-, 20- or 30-min) or 2-min exposures to a fish anesthetic (100 or 200 mg/L of tricaine methanesulfonate), and evaluated their subsequent behavior. Individual fish were given a startle stimulus and filmed with a high-speed video camera. Each fish was startled and filmed twice before being stressed, and then at 1-, 5-, 15-, and 30-min post-exposure. The resulting image files were analyzed for a variety of behavioral measures including: presence of a response, time to first reaction, duration of reaction, time to formation of maximum C-shape, time to completion of C-shape, and completeness of C-shape. The most immediate measure of potential changes in fish behavior was whether stressed fish exhibited a startle response. For striped shiners, the number of fish not responding to the stimulus was significantly different

  4. Case management does not decrease mortality of patients with myocardial infarction or unstable angina: Evidence from a systematic review

    Directory of Open Access Journals (Sweden)

    Li-Juan Yi

    2016-06-01

    Conclusion: Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care. Additional, prospective RCTs of high quality and large scale are warranted to verify these results.

  5. Determinant Effects of Average Fasting Plasma Glucose on Mortality in Diabetic End-Stage Renal Disease Patients on Maintenance Hemodialysis

    Directory of Open Access Journals (Sweden)

    Yi-Chun Lin

    2017-01-01

    Discussion: Our results suggest that the average FPG levels are useful predictors of all-cause mortality in dialysis patients. In addition, an increasing trend in average FPG levels indicates poor survival.

  6. Tempo-Spatial Variations of Ambient Ozone-Mortality Associations in the USA: Results from the NMMAPS Data

    Science.gov (United States)

    Liu, Tao; Zeng, Weilin; Lin, Hualiang; Rutherford, Shannon; Xiao, Jianpeng; Li, Xing; Li, Zhihao; Qian, Zhengmin; Feng, Baixiang; Ma, Wenjun

    2016-01-01

    Although the health effects of ambient ozone have been widely assessed, their tempo-spatial variations remain unclear. We selected 20 communities (ten each from southern and northern USA) based on the US National Morbidity, Mortality, and Air Pollution Study (NMMAPS) dataset. A generalized linear model (GLM) was used to estimate the season-specific association between each 10 ppb (lag0-2 day average) increment in daily 8 h maximum ozone concentration and mortality in every community. The results showed that in the southern communities, a 10 ppb increment in ozone was linked to an increment of mortality of −0.07%, −0.17%, 0.40% and 0.27% in spring, summer, autumn and winter, respectively. For the northern communities, the excess risks (ERs) were 0.74%, 1.21%, 0.52% and −0.65% in the spring, summer, autumn and winter seasons, respectively. City-specific ozone-related mortality effects were positively related with latitude, but negatively related with seasonal average temperature in the spring, summer and autumn seasons. However, a reverse relationship was found in the winter. We concluded that there were different seasonal patterns of ozone effects on mortality between southern and northern US communities. Latitude and seasonal average temperature were identified as modifiers of the ambient ozone-related mortality risks. PMID:27571094

  7. Tempo-Spatial Variations of Ambient Ozone-Mortality Associations in the USA: Results from the NMMAPS Data.

    Science.gov (United States)

    Liu, Tao; Zeng, Weilin; Lin, Hualiang; Rutherford, Shannon; Xiao, Jianpeng; Li, Xing; Li, Zhihao; Qian, Zhengmin; Feng, Baixiang; Ma, Wenjun

    2016-01-01

    Although the health effects of ambient ozone have been widely assessed, their tempo-spatial variations remain unclear. We selected 20 communities (ten each from southern and northern USA) based on the US National Morbidity, Mortality, and Air Pollution Study (NMMAPS) dataset. A generalized linear model (GLM) was used to estimate the season-specific association between each 10 ppb (lag0-2 day average) increment in daily 8 h maximum ozone concentration and mortality in every community. The results showed that in the southern communities, a 10 ppb increment in ozone was linked to an increment of mortality of -0.07%, -0.17%, 0.40% and 0.27% in spring, summer, autumn and winter, respectively. For the northern communities, the excess risks (ERs) were 0.74%, 1.21%, 0.52% and -0.65% in the spring, summer, autumn and winter seasons, respectively. City-specific ozone-related mortality effects were positively related with latitude, but negatively related with seasonal average temperature in the spring, summer and autumn seasons. However, a reverse relationship was found in the winter. We concluded that there were different seasonal patterns of ozone effects on mortality between southern and northern US communities. Latitude and seasonal average temperature were identified as modifiers of the ambient ozone-related mortality risks.

  8. Impact of loneliness and depression on mortality : results from the Longitudinal Ageing Study Amsterdam

    NARCIS (Netherlands)

    Holwerda, Tjalling J; van Tilburg, Theo G; Deeg, Dorly J H; Schutter, Natasja; Van, Rien; Dekker, Jack; Stek, Max L; Beekman, Aartjan T F; Schoevers, Robert A

    2016-01-01

    BACKGROUND: Loneliness is highly prevalent among older people, has serious health consequences and is an important predictor of mortality. Loneliness and depression may unfavourably interact with each other over time but data on this topic are scarce. AIMS: To determine whether loneliness is associa

  9. Clinically Diagnosed Insomnia and Risk of All-Cause and Diagnosis-Specific Disability Pension: A Nationwide Cohort Study

    Directory of Open Access Journals (Sweden)

    Catarina Jansson

    2013-01-01

    Full Text Available Background. Insomnia and disability pension are major health problems, but few population-based studies have examined the association between insomnia and risk of disability pension. Methods. We conducted a prospective nationwide cohort study based on Swedish population-based registers including all 5,028,922 individuals living in Sweden on December 31, 2004/2005, aged 17–64 years, and not on disability or old age pension. Those having at least one admission/specialist visit with a diagnosis of disorders of initiating and maintaining sleep (insomnias (ICD-10: G47.0 during 2000/2001–2005 were compared to those with no such inpatient/outpatient care. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2010. Incidence rate ratios (IRRs and 95% confidence intervals (CIs were estimated by Cox regression. Results. In models adjusted for prior sickness absence, sociodemographic factors, and inpatient/specialized outpatient care, associations between insomnia and increased risks of all-cause disability pension (IRR 1.35, 95% CI 1.09–1.67 and disability pension due to mental diagnoses (IRR 1.86, 95% CI 1.38–2.50 were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of disability pension due to cancer, circulatory, or musculoskeletal diagnoses were observed. Conclusion. Insomnia seems to be positively associated with all-cause disability pension and disability pension due to mental diagnoses.

  10. Measuring adult mortality using sibling survival: a new analytical method and new results for 44 countries, 1974-2006.

    Directory of Open Access Journals (Sweden)

    Ziad Obermeyer

    2010-04-01

    summary measure (45q(15-the probability of a 15-y old dying before his or her 60th birthday-for 44 countries with DHS sibling survival data. Our findings suggest that levels of adult mortality prevailing in many developing countries are substantially higher than previously suggested by other analyses of sibling history data. Generally, our estimates show the risk of adult death between ages 15 and 60 y to be about 20%-35% for females and 25%-45% for males in sub-Saharan African populations largely unaffected by HIV. In countries of Southern Africa, where the HIV epidemic has been most pronounced, as many as eight out of ten men alive at age 15 y will be dead by age 60, as will six out of ten women. Adult mortality levels in populations of Asia and Latin America are generally lower than in Africa, particularly for women. The exceptions are Haiti and Cambodia, where mortality risks are comparable to many countries in Africa. In all other countries with data, the probability of dying between ages 15 and 60 y was typically around 10% for women and 20% for men, not much higher than the levels prevailing in several more developed countries. CONCLUSIONS: Our results represent an expansion of direct knowledge of levels and trends in adult mortality in the developing world. The CSS method provides grounds for renewed optimism in collecting sibling survival data. We suggest that all nationally representative survey programs with adequate sample size ought to implement this critical module for tracking adult mortality in order to more reliably understand the levels and patterns of adult mortality, and how they are changing. Please see later in the article for the Editors' Summary.

  11. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study.

    Science.gov (United States)

    Rod, Naja Hulvej; Vahtera, Jussi; Westerlund, Hugo; Kivimaki, Mika; Zins, Marie; Goldberg, Marcel; Lange, Theis

    2011-02-01

    Poor sleep is an increasing problem in modern society, but most previous studies on the association between sleep and mortality rates have addressed only duration, not quality, of sleep. The authors prospectively examined the effects of sleep disturbances on mortality rates and on important risk factors for mortality, such as body mass index, hypertension, and diabetes. A total of 16,989 participants in the GAZEL cohort study were asked validated questions on sleep disturbances in 1990 and were followed up until 2009, with <1% loss to follow-up. Body mass index, hypertension, and diabetes were measured annually through self-reporting. During follow-up, a total of 1,045 men and women died. Sleep disturbances were associated with a higher overall mortality risk in men (P = 0.005) but not in women (P = 0.33). This effect was most pronounced for men <45 years of age (≥3 symptoms vs. none: hazard ratio = 2.03, 95% confidence interval: 1.24, 3.33). There were no clear associations between sleep disturbances and cardiovascular mortality rates, although men and women with sleep disturbances were more likely to develop hypertension and diabetes (P < 0.001). Compared with people with no sleep disturbances, men who reported ≥3 types of sleep disturbance had an almost 5 times' higher risk of committing suicide (hazard ratio = 4.99, 95% confidence interval: 1.59, 15.7). Future strategies to prevent premature deaths may benefit from assessment of sleep disturbances, especially in younger individuals.

  12. Mortality Risk Among Heart Failure Patients With Depression

    DEFF Research Database (Denmark)

    Adelborg, Kasper; Schmidt, Morten; Sundbøll, Jens;

    2016-01-01

    included 9636 patients with and 194 887 patients without a diagnosis of depression. Compared with patients without a history of depression, those with depression had higher 1-year (36% versus 33%) and 5-year (68% versus 63%) mortality risks. Overall, the adjusted mortality rate ratio was 1.03 (95% CI 1......BACKGROUND: The prevalence of depression is 4- to 5-fold higher in heart failure patients than in the general population. We examined the influence of depression on all-cause mortality in patients with heart failure. METHODS AND RESULTS: Using Danish medical registries, this nationwide population......-based cohort study included all patients with a first-time hospitalization for heart failure (1995-2014). All-cause mortality risks and 19-year mortality rate ratios were estimated based on Cox regression analysis, adjusting for age, sex, time period, comorbidity, and socioeconomic status. The analysis...

  13. Mortality Risk Among Heart Failure Patients With Depression

    DEFF Research Database (Denmark)

    Adelborg, Kasper; Schmidt, Morten; Sundbøll, Jens

    2016-01-01

    BACKGROUND: The prevalence of depression is 4- to 5-fold higher in heart failure patients than in the general population. We examined the influence of depression on all-cause mortality in patients with heart failure. METHODS AND RESULTS: Using Danish medical registries, this nationwide population......-based cohort study included all patients with a first-time hospitalization for heart failure (1995-2014). All-cause mortality risks and 19-year mortality rate ratios were estimated based on Cox regression analysis, adjusting for age, sex, time period, comorbidity, and socioeconomic status. The analysis...... included 9636 patients with and 194 887 patients without a diagnosis of depression. Compared with patients without a history of depression, those with depression had higher 1-year (36% versus 33%) and 5-year (68% versus 63%) mortality risks. Overall, the adjusted mortality rate ratio was 1.03 (95% CI 1...

  14. Mortality and use of psychotropic medication in patients with stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Baandrup, Lone; Iversen, Helle K;

    2016-01-01

    with a diagnosis of stroke and either no drug use or preindex use of psychotropic medication (n=49 968) and compared with control subjects (n=86 100) matched on age, gender, marital status and community location. PRIMARY OUTCOME MEASURE: All-cause mortality. RESULTS: All-cause mortality was higher in patients......OBJECTIVES: The study sought to describe whether psychotropic medication may have long-term side effects in patients with stroke compared with controls. SETTING: Use of national register data from healthcare services were identified from the Danish National Patient Registry in Denmark. Information...... about psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics. OBJECTIVES: We aimed to evaluate all-cause mortality in relation to the use of benzodiazepines, antidepressants and antipsychotics in patients with stroke and matched controls. PARTICIPANTS: Patients...

  15. Continuing the search for a fundamental law of mortality

    Energy Technology Data Exchange (ETDEWEB)

    Carnes, B.A.; Grahn, D. [Argonne National Lab., IL (United States); Olshansky, S.J. [Univ. of Chicago, IL (United States)

    1997-08-01

    For 170 years, scientists have attempted to explain why consistent temporal patterns of death are observed among individuals within populations. Historical efforts to identify a {open_quotes}law of mortality{close_quotes} from these patterns ended in 1935 when it was declared that such a law did not exist. These empirical tests for a law of mortality were constructed using mortality curves based on all causes of death. We predicted that patterns of mortality consistent with the historical concept of a law would be revealed if mortality curves for species were constructed using only senescent causes of death. Using data on senescent mortality for laboratory animals and humans, we demonstrate that patterns of mortality overlap when compared on a biologically comparable time scale. These results are consistent with the existence of a law of mortality following sexual maturity as asserted by Benjamin Gompertz and Raymond Pearl. The societal, medical, and research implications of such a law are discussed.

  16. Continuing the search for a fundamental law of mortality

    Energy Technology Data Exchange (ETDEWEB)

    Carnes, B.A.; Grahn, D. [Argonne National Lab., IL (United States); Olshansky, S.J. [Chicago Univ., IL (United States)

    1996-03-01

    for 170 years, scientists have attempted to explain why consistent temporal patterns of death are observed among individuals within populations. Historical efforts to identify a `law of mortality` from these patterns ended in 1935 when it was declared that such a law did not exist. These empirical tests for a law of mortality were constructed using mortality curves based on all causes of death. We predicted patterns of mortality consistent with the historical concept of a law would be revealed if mortality curves for species were constructed using only senescent causes of death. Using data on senescent mortality for laboratory animals and humans, we demonstrate patterns of mortality overlap when compared on a biologically comparable time scale. The results are consistent with the existence of a law of mortality following sexual maturity. The societal, medical, and research implications of such a law are discussed.

  17. Occupational mortality

    DEFF Research Database (Denmark)

    Lynge, Elsebeth

    2011-01-01

    INTRODUCTION: This paper aims to present the methods and main results from the Danish occupational mortality studies, and to set the Danish studies into the international context of occupational mortality studies. RESEARCH TOPICS: The first Danish occupational mortality study from 1970...

  18. Mortality of centrarchid fishes in the Potomac drainage: Survey results and overview of potential contributing factors

    Science.gov (United States)

    Blazer, Vicki; Iwanowicz, Luke R.; Starliper, Clifford E.; Zaugg, Steven D.; Burkhardt, Mark R.; Barbash, P.; Hedrick, J.D.; Reeser, S.J.; Mullican, J.E.; Kelble, J.

    2010-01-01

    Skin lesions and spring mortality events of smallmouth bass Micropterus dolomieu and selected other species were first noted in the South Branch of the Potomac River in 2002. Since that year morbidity and mortality have also been observed in the Shenandoah and Monocacy rivers. Despite much research, no single pathogen, parasite, or chemical cause for the lesions and mortality has been identified. Numerous parasites, most commonly trematode metacercariae and myxozoans; the bacterial pathogens Aeromonas hydrophila, Aeromonas salmonicida, and Flavobacterium columnare; and largemouth bass virus have all been observed. None have been consistently isolated or observed at all sites, however, nor has any consistent microscopic pathology of the lesions been observed. A variety of histological changes associated with exposure to environmental contaminants or stressors, including intersex (testicular oocytes), high numbers of macrophage aggregates, oxidative damage, gill lesions, and epidermal papillomas, were observed. The findings indicate that selected sensitive species may be stressed by multiple factors and constantly close to the threshold between a sustainable (healthy) and nonsustainable (unhealthy) condition. Fish health is often used as an indicator of aquatic ecosystem health, and these findings raise concerns about environmental degradation within the Potomac River drainage. Unfortunately, while much information has been gained from the studies conducted to date, due to the multiple state jurisdictions involved, competing interests, and other issues, there has been no coordinated approach to identifying and mitigating the stressors. This synthesis emphasizes the need for multiyear, interdisciplinary, integrative research to identify the underlying stressors and possible management actions to enhance ecosystem health.

  19. Afoxolaner against fleas: immediate efficacy and resultant mortality after short exposure on dogs.

    Science.gov (United States)

    Beugnet, Frédéric; deVos, Christa; Liebenberg, Julian; Halos, Lénaïg; Fourie, Josephus

    2014-01-01

    The speed of efficacy of afoxolaner (NexGard) against Ctenocephalides felis fleas was evaluated in two studies. Study A assessed the efficacy against existing fleas whereas study B assessed the efficacy against new infesting fleas. In study A, 12 dogs were allocated to the untreated group and 20 dogs to the treated group. All dogs were infested by 100 fleas each at Day -1, treated at Day 0 and flea combed at 2 h or at 6 h post treatment. In study B, 6 dogs were allocated to the untreated group and 10 to the treated group. They were infested with 100 fleas each on Days 2, 7, 14, 21 and 28. Fleas were removed and counted at 6 h post-infestation. Immediate and persistent efficacies were evaluated by counting fleas on the dogs. To evaluate induced mortality after exposure on dogs, fleas collected alive were placed in an insectarium for 24 h and assessed for viability. The immediate efficacy on dogs was significant at 6 h with 100%. The induced death of the fleas collected live from dogs 2 h after exposure was 99.7%. Concerning new infesting fleas, the observed efficacy at 6 h and the induced mortality were significantly different (p 97% at Day 2 and Day 8 and > 90% at Day 14. The induced mortality after 6 h of exposure on dogs varied between 73.3% and 100% for the whole study.

  20. Active social participation and mortality risk among older people in Japan: results from a nationally representative sample.

    Science.gov (United States)

    Minagawa, Yuka; Saito, Yasuhiko

    2015-07-01

    A large literature suggests that active social participation contributes to the well-being of older people. Japan provides a compelling context to test this hypothesis due to its rapidly growing elderly population and the phenomenal health of the population. Using the Nihon University Japanese Longitudinal Study of Aging, this study examines how social participation, measured by group membership, is related to the risk of overall mortality among Japanese elders aged 65 and older. Results from Cox proportional hazards models show that group affiliation confers advantages against mortality risk, even after controlling for sociodemographic characteristics, physical health measures, and family relationship variables. In particular, activities geared more toward self-development, such as postretirement employment and lifelong learning, are strongly associated with lower levels of mortality. Findings suggest that continued social participation at advanced ages produces positive health consequences, highlighting the importance of active aging in achieving successful aging in the Japanese context.

  1. Análisis de la mortalidad en ciudades: resultados en Valencia y Alicante Mortality surveillance in cities: results in Valencia and Alicante [Spain

    Directory of Open Access Journals (Sweden)

    Andreu Nolasco

    2004-02-01

    selected specific causes in Valencia and Alicante, to establish internal inequalities by districts, and to evaluate changes in the magnitude of these inequalities over time. Methods: Deaths among residents of Valencia and Alicante in the periods 1990-1992 and 1996-1998 were assigned to residential municipal districts. Comparisons between the periods studied and between cities were carried out using the relative risk derived from a Poisson regression model. A comparative mortality figure was calculated using the 17 largest groups of the 9th International Classification of Diseases. Rates adjusted by the direct method, standardized mortality ratio, potential years of life lost (PYLL ratio and life expectancy at birth were calculated by districts in each study period. Results: The risks of death from all causes decreased between the first and second periods in both men and women in both cities. Life expectancy significantly increased in both cities for men and in Valencia for women. The city of Valencia had the greatest risk of death in both periods. Some causes of death increased (groups 5 and 6, mental and nervous system disorders and sensory organ diseases. By districts, there was greater variability in Valencia than in Alicante, especially in districts 1 and 11 in Valencia, which showed a high risk of death. Conclusions: The process of internal mortality surveillance by districts is reproducible. In the city of Valencia there were inequalities in mortality that were maintained over time. The city of Alicante showed less internal variability in its mortality indicators.

  2. Afoxolaner against fleas: immediate efficacy and resultant mortality after short exposure on dogs

    Directory of Open Access Journals (Sweden)

    Beugnet Frédéric

    2014-01-01

    Full Text Available The speed of efficacy of afoxolaner (NexGard® against Ctenocephalides felis fleas was evaluated in two studies. Study A assessed the efficacy against existing fleas whereas study B assessed the efficacy against new infesting fleas. In study A, 12 dogs were allocated to the untreated group and 20 dogs to the treated group. All dogs were infested by 100 fleas each at Day −1, treated at Day 0 and flea combed at 2 h or at 6 h post treatment. In study B, 6 dogs were allocated to the untreated group and 10 to the treated group. They were infested with 100 fleas each on Days 2, 7, 14, 21 and 28. Fleas were removed and counted at 6 h post-infestation. Immediate and persistent efficacies were evaluated by counting fleas on the dogs. To evaluate induced mortality after exposure on dogs, fleas collected alive were placed in an insectarium for 24 h and assessed for viability. The immediate efficacy on dogs was significant at 6 h with 100%. The induced death of the fleas collected live from dogs 2 h after exposure was 99.7%. Concerning new infesting fleas, the observed efficacy at 6 h and the induced mortality were significantly different (p  97% at Day 2 and Day 8 and > 90% at Day 14. The induced mortality after 6 h of exposure on dogs varied between 73.3% and 100% for the whole study.

  3. The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project

    Directory of Open Access Journals (Sweden)

    Bisanti Luigi

    2010-07-01

    Full Text Available Abstract Background The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity. Methods Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated. Results The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality than in North Continental (+ 12.4% cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. Conclusions Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.

  4. Stressful social relations and mortality

    DEFF Research Database (Denmark)

    Lund, Rikke; Christensen, Ulla; Nilsson, Charlotte Juul

    2014-01-01

    BACKGROUND: Few studies have examined the relationship between stressful social relations in private life and all-cause mortality. OBJECTIVE: To evaluate the association between stressful social relations (with partner, children, other family, friends and neighbours, respectively) and all......-cause mortality in a large population-based study of middle-aged men and women. Further, to investigate the possible modification of this association by labour force participation and gender. METHODS: We used baseline data (2000) from The Danish Longitudinal Study on Work, Unemployment and Health, including 9875...... men and women aged 36-52 years, linked to the Danish Cause of Death Registry for information on all-cause mortality until 31 December 2011. Associations between stressful social relations with partner, children, other family, friends and neighbours, respectively, and all-cause mortality were examined...

  5. The relationship between physical activity level and selected cardiovascular risk factors and mortality of males ≥ 50 years in Poland – The results of follow-up of participants of National Multicenter Health Survey WOBASZ

    Directory of Open Access Journals (Sweden)

    Janusz Śmigielski

    2016-08-01

    Full Text Available Objectives: The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. Material and Methods: Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50–80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia, Poland (2003–2005 was linked with male mortality in 2004–2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. Results: Among males aged 50–59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60–69 years and 70–80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70–80 years (unlike in the 50–59 years age group, the protective effect of large settlements and provincial capitals as a place of residence was noted. Conclusions: Occupational physical activity significantly reduced cardiovascular mortality in men aged 50–69 years, while for leisure-time activity the positive effect was observed in age group 60–69 years and 70–80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50–69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.

  6. Occupational physical activity and mortality among Danish workers

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Burr, Hermann; Hansen, Jørgen V;

    2012-01-01

    PURPOSE: The relationship between occupational physical activity (OPA) and mortality has mainly been studied among males and shows conflicting results. This study examines this relationship in a cohort of both male and female workers. METHODS: OPA was determined by 4 self-reported questions...... in a representative sample of 5,839 Danish workers aged 18-59 years at baseline. A 19-year follow-up on mortality was assessed by linkage with the national death registry. Gender-stratified Cox regression models were used to determine the effect of high OPA on all-cause mortality while controlling for age, BMI.......79, CI: 1.19-2.70), but not among female workers (HR: 0.99, CI: 0.65-1.49) compared with workers in the lowest quartile of OPA. Among females, indications of a u-shaped relationship between occupational physical activity and all-cause mortality were found. CONCLUSIONS: The findings indicate that high...

  7. Part 1. Short-term effects of air pollution on mortality: results from a time-series analysis in Chennai, India.

    Science.gov (United States)

    Balakrishnan, Kalpana; Ganguli, Bhaswati; Ghosh, Santu; Sankar, S; Thanasekaraan, Vijaylakshmi; Rayudu, V N; Caussy, Harry

    2011-03-01

    This report describes the results of a time-series analysis of the effect of short-term exposure to particulate matter with an aerodynamic diameter Public Health and Air Pollution in Asia (PAPA) initiative. The study involved integration and analysis of retrospective data for the years 2002 through 2004. The data were obtained from relevant government agencies in charge of routine data collection. Data on meteorologic confounders (including temperature, relative humidity, and dew point) were available on all days of the study period. Data on mortality were also available on all days, but information on cause-of-death (including accidental deaths) could not be reliably ascertained. Hence, only all-cause daily mortality was used as the major outcome for the time-series analyses. Data on PM10, nitrogen dioxide (NO2), and sulfur dioxide (SO2) were limited to a much smaller number of days, but spanned the full study period. Data limitations resulting from low sensitivity of gaseous pollutant measurements led to using only PM10 in the main analysis. Of the eight operational ambient air quality monitor (AQM) stations in the city, seven met the selection criteria set forth in the common protocol developed for the three PAPA studies in India. In addition, all raw data used in the analysis were subjected to additional quality assurance (QA) and quality control (QC) criteria to ensure the validity of the measurements. Two salient features of the PM10 data set in Chennai were a high percentage of missing readings and a low correlation among daily data recorded by the AQMs. The latter resulted partly because each AQM had a small footprint (approximate area over which the air pollutant measurements recorded in the AQM are considered valid), and partly because of differences in source profiles among the 10 zones within the city. The zones were defined by the Chennai Corporation based on population density. Alternative exposure series were developed to control for these data

  8. Resistance of oat to‘take-all'causing fungus (Gaeumannomyces graminis var. tritici)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Evaluation with the pot assay at seedling stage in greenhouse showed that oat (Avena sativa) was highly resistant to take-all disease to which, however, wheat (Triticum aestivum) was extremely susceptible. The oat roots were shown to be inhibitory to the invasion and spread of take-all causing fungus G. graminis var. tritici by the following criteria: ( i ) less infection sites were observed (about 1/7 of those in wheat); (ii) the ectotrophic growth of G. graminis var.tritici on oat roots was much slower than that on those of wheat, and the runner hyphae appeared as kidney- or fork-shaped hyphopodia on the surface of oat roots which could not be discerned on that of wheat roots; (iii) the period from inoculation to penetration into the epidermis of oat roots was about 2.9 times as long as that of wheat; (iv) the infection hyphae were hindered substantially when it was about to penetrate into the epidermis of oat roots with the mycelium deformed; and ( v ) the cortical layer of oat roots was revealed to be unsuitable for the G. graminis var. tritici infestation as some lysed hyphae were found therein, and the spread of hyphae from the first layer of cortex to the pericycie needed 108 h, about 1.8 times as long as it did on wheat roots.

  9. Incidence, morbidity, mortality, and prevalence of diabetes in Denmark, 2000–2011: results from the Diabetes Impact Study 2013

    Science.gov (United States)

    Green, Anders; Sortsø, Camilla; Jensen, Peter Bjødstrup; Emneus, Martha

    2015-01-01

    Purpose As part of the Danish Diabetes Impact Study 2013, we present trends in the incidence, morbidity, mortality, and prevalence of diabetes in Denmark for the period 2000 through 2011. Patients and methods The Danish National Diabetes Register was established in 2006 and is assumed to cover all patients with diabetes, alive as of the end of 1996, and all subsequent new cases. The present study is based on the content of the register as of July 3, 2013 (n=497,232 patients). Using the personal identification code assigned to all Danish inhabitants, all available supplementary information from the Danish National Patient Register and the Danish Civil Registration Service was used to define the date of diagnosis of diabetes and the first date of experiencing complications (grouped according to impact and severity). Results During the period of 2000 to 2011, the incidence rate of diabetes increased approximately 5% annually. During the same period, decreasing trends were observed for both the rates of progression in complications and of the complication-specific mortality. During the same period, the prevalence of diabetes doubled. Conclusion The increasing prevalence of diabetes in Denmark is driven by increasing incidence combined with decreasing morbidity and mortality in the population of patients with diabetes. These mechanisms will be explored further as part of the Diabetes Impact Study 2013, together with investigations into the socioeconomic and health economic aspects of diabetes. PMID:26604822

  10. Global Inequalities in Youth Mortality, 2007-2012

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2015-03-01

    Full Text Available Objectives: There is limited cross-national research on youth mortality. We examined age- and gender variations in all-cause mortality among youth aged 15-34 years across 52 countries. Methods: Using the 2014 WHO mortality database, mortality rates for all countries were computed for the latest available year between 2007 and 2012. Rates, rate ratios, and ordinary least squares (OLS and Poisson regression were used to analyze international variation in mortality. Results: Mortality rates among youth aged 15-34 years varied from a low of 28.4 deaths per 100,000 population for Hong Kong to a high of 250.6 for Russia and 619.1 for South Africa. For men aged 15-34, Singapore and Hong Kong had the lowest mortality rates (≈40 per 100,000, compared with South Africa and Russia with rates of 589.7 and 383.3, respectively. Global patterns in mortality among women were similar. Youth aged 15-24 in South Africa had 14 times higher mortality and those in the Philippines, Mexico, Russia, Colombia, and Brazil had 5-7 times higher mortality than those in Hong Kong. Youth aged 25-34 in Russia and South Africa had, respectively, 10 and 29 times higher mortality than their counterparts in Hong Kong. United States (US had the 12th highest mortality rate among youth aged 15-24 and the 13th highest rate among youth aged 25-34. Overall, the US youth had 2-3 times higher rates of mortality than their counterparts in many industrialized countries including Hong Kong, Singapore, Netherlands, Switzerland, Germany, Norway, and Sweden. Income inequality, unemployment rate, and human development explained 50-66% of the global variance in youth mortality. Compared to the countries with low unemployment and income inequality and high human development levels, countries with high unemployment and income inequality and low human development had, respectively, 343%, 213%, and 205% higher risks of youth mortality. Conclusions and Global Health Implications: Marked international

  11. Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study.

    Science.gov (United States)

    Bonaccio, Marialaura; Di Castelnuovo, Augusto; De Curtis, Amalia; Costanzo, Simona; Bracone, Francesca; Persichillo, Mariarosaria; Donati, Maria Benedetta; de Gaetano, Giovanni; Iacoviello, Licia

    2015-09-14

    Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4·3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (≤2 times/month) was inversely associated with mortality (multivariable HR=0·68; 95 % CI 0·54, 0·87). At intake ≥8 times/month, a greater protection was observed (HR=0·53; 0·32, 0·90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0·64; 95 % CI 0·44, 0·94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship.

  12. Life satisfaction and mortality in elderly people: The Kangwha Cohort Study

    Directory of Open Access Journals (Sweden)

    Kimm Heejin

    2012-01-01

    Full Text Available Abstract Background As well as biomedical risk factors, psychological factors have been reported to be related to mortality rate. The purpose of this study was to examine the relationship between life satisfaction and mortality in elderly people through an 11.8-year follow-up study of a prospective cohort. Methods Among 3,600 participants of the Kangwha Cohort Study who survived in 1994, 1,939 respondents of the Life Satisfaction Index (LSI-A questionnaire were included (men, 821; women, 1118. The mortality risk for the period up to December 2005 was measured using the Cox Proportional Hazard Model. Results When the relationship between LSI and mortality was evaluated in men, the unsatisfied group with lower LSI scores showed a significantly higher risk of all-cause mortality (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.11-1.83 than the satisfied group with higher LSI scores. In women, the unsatisfied group showed a significantly higher risk of all-cause mortality (HR, 1.51; 95% CI, 1.18-1.92 and cardiovascular mortality (HR, 2.23; 95% CI, 1.30-3.85 than the satisfied group. Conclusion We found that elderly people with a lower LSI score, regardless of gender, were at risk of increased mortality from all causes, and low LSI score was also associated with cardiovascular mortality.

  13. Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Søgaard, Karen;

    2012-01-01

    Prospective 30-year follow-up. Setting The Copenhagen Male Study. Participants 5249 gainfully employed men aged 40-59 years; 311 men with cardiovascular disease/diabetes were excluded. Primary and secondary outcome measures IHD and all-cause mortality. Results 579 men (11.8%) died due to IHD and 2628 (53...... physical work demands (HR: 0.48, 95% CI 0.24 to 0.96), a moderate/high level of leisure-time physical activity was associated with reduced risk of IHD mortality only among men with moderate and high physical work demands. High systolic blood pressure and smoking were risk factors in all groups. Similar......, but less pronounced differences in risk factors for all-cause mortality between groups were found. Conclusions The risk factors for IHD and all-cause mortality, low physical fitness and low leisure-time physical activity are not identical for men with different physical work demands. Preventive initiatives...

  14. Postoperative mortality after cancer surgery in octogenarians and nonagenarians: results from a series of 5,390 patients

    Directory of Open Access Journals (Sweden)

    Meijer Willem S

    2005-11-01

    Full Text Available Abstract Background To support decisions about surgical treatment of elderly patients with cancer, population-based estimates of postoperative mortality (POM rates are required. Methods Electronic records from the Rotterdam Cancer Registry were retrieved for octogenarians and nonagenarians who underwent resection in the period 1987–2000. POM was defined as death within 30 days of resection and both elective and emergency operations were included. Results In a series of 5.390 operated patients aged 80 years and older, POM rates were 0.5% for breast cancer, 1.7% for endometrial cancer and 4.2% for renal cancer. For patients with colorectal cancer, POM increased from 8% for the age group 80–84 to 13% for those 85–89 to 20% in nonagenarians. For stomach cancer, the respective figures were 11%, 20% and 44%. Conclusion These results show that resections can be performed at acceptable risk in selected elderly patients with cancer.

  15. An examination of black/white differences in the rate of age-related mortality increase

    Directory of Open Access Journals (Sweden)

    Andrew Fenelon

    2013-09-01

    Full Text Available BACKGROUND The rate of mortality increase with age among adults is typically used as a measure of the rate of functional decline associated with aging or senescence. While black and white populations differ in the level of mortality, mortality also rises less rapidly with age for blacks than for whites, leading to the well-known black/white mortality "crossover". OBJECTIVE This paper investigates black/white differences in the rate of mortality increase with age for major causes of death in order to examine the factors responsible for the black/white crossover. METHODS The analysis considers two explanations for the crossover: selective survival and age misreporting. Mortality is modeled using a Gompertz model for 11 causes of death from ages 50-84 among blacks and whites by sex. RESULTS Mortality increases more rapidly with age for whites than for blacks for nearly all causes of death considered. The all-cause mortality rate of mortality increase is nearly two percentage points higher for whites. The analysis finds evidence for both selective survival and age misreporting, although age misreporting is a more prominent explanation among women. CONCLUSIONS The black/white mortality crossover reflects large differences in the rate of age-related mortality increase. Instead of reflecting the impact of specific causes of death, this pattern exists across many disparate disease conditions, indicating the need for a broad explanation.

  16. Mortality among Norwegian doctors 1960-2000

    Directory of Open Access Journals (Sweden)

    Hem Erlend

    2011-03-01

    Full Text Available Abstract Background To study the mortality pattern of Norwegian doctors, people in human service occupations, other graduates and the general population during the period 1960-2000 by decade, gender and age. The total number of deaths in the study population was 1 583 559. Methods Census data from 1960, 1970, 1980 and 1990 relating to education were linked to data on 14 main causes of death from Statistics Norway, followed up for two five-year periods after census, and analyzed as stratified incidence-rate data. Mortality rate ratios were computed as combined Mantel-Haenzel estimates for each sex, adjusting for both age and period when appropriate. Results The doctors had a lower mortality rate than the general population for all causes of death except suicide. The mortality rate ratios for other graduates and human service occupations were 0.7-0.8 compared with the general population. However, doctors have a higher mortality than other graduates. The lowest estimates of mortality for doctors were for endocrine, nutritional and metabolic diseases, diseases in the urogenital tract or genitalia, digestive diseases and sudden death, for which the numbers were nearly half of those for the general population. The differences in mortality between doctors and the general population increased during the periods. Conclusions Between 1960 and 2000 mortality for doctors converged towards the mortality for other university graduates and for people in human service occupations. However, there was a parallel increase in the gap between these groups and the rest of the population. The slightly higher mortality for doctors compared with mortality for other university graduates may be explained by the higher suicide rate for doctors.

  17. Impact of vitamin A supplementation on infant and childhood mortality

    Directory of Open Access Journals (Sweden)

    Black Robert E

    2011-04-01

    Full Text Available Abstract Introduction Vitamin A is important for the integrity and regeneration of respiratory and gastrointestinal epithelia and is involved in regulating human immune function. It has been shown previously that vitamin A has a preventive effect on all-cause and disease specific mortality in children under five. The purpose of this paper was to get a point estimate of efficacy of vitamin A supplementation in reducing cause specific mortality by using Child Health Epidemiology Reference Group (CHERG guidelines. Methods A literature search was done on PubMed, Cochrane Library and WHO regional data bases using various free and Mesh terms for vitamin A and mortality. Data were abstracted into standardized forms and quality of studies was assessed according to standardized guidelines. Pooled estimates were generated for preventive effect of vitamin A supplementation on all-cause and disease specific mortality of diarrhea, measles, pneumonia, meningitis and sepsis. We did a subgroup analysis for vitamin A supplementation in neonates, infants 1-6 months and children aged 6-59 months. In this paper we have focused on estimation of efficacy of vitamin A supplementation in children 6-59 months of age. Results for neonatal vitamin A supplementation have been presented, however no recommendations are made as more evidence on it would be available soon. Results There were 21 studies evaluating preventive effect of vitamin A supplementation in community settings which reported all-cause mortality. Twelve of these also reported cause specific mortality for diarrhea and pneumonia and six reported measles specific mortality. Combined results from six studies showed that neonatal vitamin A supplementation reduced all-cause mortality by 12 % [Relative risk (RR 0.88; 95 % confidence interval (CI 0.79-0.98]. There was no effect of vitamin A supplementation in reducing all-cause mortality in infants 1-6 months of age [RR 1.05; 95 % CI 0.88-1.26]. Pooled results for

  18. Mortality trends among Alaska Native people: successes and challenges

    Directory of Open Access Journals (Sweden)

    Peter Holck

    2013-08-01

    Full Text Available Background . Current mortality rates are essential for monitoring, understanding and developing policy for a population's health. Disease-specific Alaska Native mortality rates have been undergoing change. Objective . This article reports recent mortality data (2004–2008 for Alaska Native/American Indian (AN/AI people, comparing mortality rates to US white rates and examines changes in mortality patterns since 1980. Design . We used death record data from the state of Alaska, Department of Vital Statistics and SEER*Stat software from the National Cancer Institute to calculate age-adjusted mortality rates. Results . Annual age-adjusted mortality from all-causes for AN/AI persons during the period 2004–2008 was 33% higher than the rate for US whites (RR=1.33, 95% CI 1.29–1.38. Mortality rates were higher among AN/AI males than AN/AI females (1212/100,000 vs. 886/100,000. Cancer remained the leading cause of death among AN/AI people, as it has in recent previous periods, with an age-adjusted rate of 226/100,000, yielding a rate ratio (RR of 1.24 compared to US whites (95% CI 1.14–1.33. Statistically significant higher mortality compared to US white mortality rates was observed for nine of the ten leading causes of AN/AI mortality (cancer, unintentional injury, suicide, alcohol abuse, chronic obstructive pulmonary disease [COPD], cerebrovascular disease, chronic liver disease, pneumonia/influenza, homicide. Mortality rates were significantly lower among AN/AI people compared to US whites for heart disease (RR=0.82, the second leading cause of death. Among leading causes of death for AN/AI people, the greatest disparities in mortality rates with US whites were observed in unintentional injuries (RR=2.45 and suicide (RR=3.53. All-cause AN/AI mortality has declined 16% since 1980–1983, compared to a 21% decline over a similar period among US whites. Conclusion . Mortality rates and trends are essential to understanding the health of a

  19. High-Dose Conformal Radiotherapy Reduces Prostate Cancer-Specific Mortality: Results of a Meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Viani, Gustavo Arruda, E-mail: gusviani@gmail.com [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Godoi Bernardes da Silva, Lucas; Stefano, Eduardo Jose [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil)

    2012-08-01

    Purpose: To determine in a meta-analysis whether prostate cancer-specific mortality (PCSM), biochemical or clinical failure (BCF), and overall mortality (OM) in men with localized prostate cancer treated with conformal high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT). Methods and Materials: The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing conformal HDRT with CDRT for localized prostate cancer. Results: Five randomized, controlled trials (2508 patients) that met the study criteria were identified. Pooled results from these randomized, controlled trials showed a significant reduction in the incidence of PCSM and BCF rates at 5 years in patients treated with HDRT (p = 0.04 and p < 0.0001, respectively), with an absolute risk reduction (ARR) of PCSM and BCF at 5 years of 1.7% and 12.6%, respectively. Two trials evaluated PCSM with 10 years of follow up. The pooled results from these trials showed a statistical benefit for HDRT in terms of PCSM (p = 0.03). In the subgroup analysis, trials that used androgen deprivation therapy (ADT) showed an ARR for BCF of 12.9% (number needed to treat = 7.7, p < 0.00001), whereas trials without ADT had an ARR of 13.6% (number needed to treat = 7, p < 0.00001). There was no difference in the OM rate at 5 and 10 years (p = 0.99 and p = 0.11, respectively) between the groups receiving HDRT and CDRT. Conclusions: This meta-analysis is the first study to show that HDRT is superior to CDRT in preventing disease progression and prostate cancer-specific death in trials that used conformational technique to increase the total dose. Despite the limitations of our study in evaluating the role of ADT and HDRT, our data show no benefit for HDRT arms in terms of BCF in trials with or without ADT.

  20. Postoperative mortality after cancer surgery in octogenarians and nonagenarians: results from a series of 5,390 patients.

    NARCIS (Netherlands)

    R.A. Damhuis (Ronald); C.J. Meurs (Claudia); W.S. Meijer (Willem)

    2005-01-01

    textabstractBACKGROUND: To support decisions about surgical treatment of elderly patients with cancer, population-based estimates of postoperative mortality (POM) rates are required. METHODS: Electronic records from the Rotterdam Cancer Registry were retrieved for octogenarians and nonagenarians who

  1. Vitamin D status and cause-specific mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta;

    2012-01-01

    Vitamin D deficiency is associated with an increased risk of all-cause mortality in observational studies. The specific causes of death underlying this association lack clarity. We investigated the association between vitamin D status and cause-specific mortality.......Vitamin D deficiency is associated with an increased risk of all-cause mortality in observational studies. The specific causes of death underlying this association lack clarity. We investigated the association between vitamin D status and cause-specific mortality....

  2. Analysis of Environmental Issues Related to Small-Scale Hydroelectric Development IV: Fish Mortality Resulting From Turbine Passage

    Energy Technology Data Exchange (ETDEWEB)

    Turbak, Susan C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reichle, Donna R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Shriner, Carole R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    1981-01-01

    The purpose of this report is to provide summary information for use by potential developers and regulators of small-scale hydroelectric projects (defined as existing dams that can be retrofitted to a total site capacity of ≤30 MW), where turbine-related mortality of fish is a potential issue affecting site-specific development. Mitigation techniques for turbine-related mortality are not covered in this report.

  3. Digoxin Use and Lower 30-day All-cause Readmission for Medicare Beneficiaries Hospitalized for Heart Failure

    NARCIS (Netherlands)

    Ahmed, Ali; Bourge, Robert C.; Fonarow, Gregg C.; Patel, Kanan; Morgan, Charity J.; Fleg, Jerome L.; Aban, Inmaculada B.; Love, Thomas E.; Yancy, Clyde W.; Deedwania, Prakash; van Veldhuisen, Dirk J.; Filippatos, Gerasimos S.; Anker, Stefan D.; Allman, Richard M.

    2014-01-01

    BACKGROUND: Heart failure is the leading cause for hospital readmission, the reduction of which is a priority under the Affordable Care Act. Digoxin reduces 30-day all-cause hospital admission in chronic systolic heart failure. Whether digoxin is effective in reducing readmission after hospitalizati

  4. Mineral and bone disorders, morbidity and mortality in end-stage renal failure patients on chronic dialysis

    Science.gov (United States)

    MOLDOVAN, DIANA; RUSU, CRINA; KACSO, INA MARIA; POTRA, ALINA; PATIU, IOAN MIHAI; GHERMAN-CAPRIOARA, MIRELA

    2016-01-01

    Background and aim In spite of numerous interventions, the control of mineral disturbances remains poor in end-stage renal failure (ESRF) patients. Chronic kidney disease - mineral and bone disorders (CKD-MBD) represent an important cause of mortality and morbidity. The aim of this study is to analyze the relationship between mineral and bone disorders (MBD) and their components impact on all-cause mortality and cardiovascular (CDV) mortality and morbidity in chronic dialysis patients. Methods This prospective study was carried out in a cohort of 92 randomly selected patients with ESRF treated with hemodialysis (HD) and peritoneal dialysis (PD). The data regarding demographic and clinical characteristics were recorded, including vascular disease (coronary, cerebral, peripheral). The follow-up lasted 40 months and the final evaluation included the number and causes of deaths, CDV events and disease. Serum Ca, P, ALP, iPTH, albumin, cholesterol, urea and creatinine levels were measured. The plain radiographic films of hands and pelvis evaluated all bone abnormalities suggestive of renal osteodystrophy (ROD) and peripheral vascular calcification (VC). Results All-cause annual mortality represented 9.25% in HD and 9.09% in PD patients. The CDV mortality represented almost 44% in HD patients and 66% in PD patients from all deaths. There was a high prevalence of CDV diseases and events. High and low serum P levels were associated with a worse survival rate. Hypercalcaemia was associated with high risk for CDV events in HD patients. In PD patients, the relationship between increased ALP levels and all-cause mortality was significant. Other mineral markers were not predictive of the outcome in the studied patients. In the HD patients the severity of VC was associated with all-cause and CDV mortality, and with CDV events. Male gender, hypercholesterolemia, decreased URR, albumin and creatinine were identified as risk factors for all-cause mortality. The diabetics had higher

  5. Risk factors for mortality during the 2002 landslides in Chuuk, Federated States of Micronesia.

    Science.gov (United States)

    Sanchez, Carlos; Lee, Tze-San; Young, Stacy; Batts, Dahna; Benjamin, Jefferson; Malilay, Josephine

    2009-10-01

    This study examines health effects resulting from landslides in Chuuk during Tropical Storm Chata'an in July 2002, and suggests strategies to prevent future mortality. In August 2002, we conducted a cross-sectional survey to identify risk factors for mortality during landslides, which included 52 survivors and 40 surrogates for 43 decedents to identify risk factors for death. Findings suggest that 1) females had a higher mortality rate from this event than males, and 2) children aged 5-14 years had a 10-fold increase in mortality when compared with annual mortality rates from all causes. Awareness of landslides occurring elsewhere and knowledge of natural warning signs were significantly associated with lower risks of death; being outside during landslides was not associated with reduced mortality. In Chuuk, improving communication systems during tropical storms and increasing knowledge of natural warnings can reduce the risk for mortality during landslides.

  6. Risk of Mortality (Including Sudden Cardiac Death and Major Cardiovascular Events in Atypical and Typical Antipsychotic Users: A Study with the General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Tarita Murray-Thomas

    2013-01-01

    Full Text Available Objective. Antipsychotics have been associated with increased cardiac events including mortality. This study assessed cardiac events including mortality among antipsychotic users relative to nonusers. Methods. The General Practice Research Database (GPRD was used to identify antipsychotic users, matched general population controls, and psychiatric diseased nonusers. Outcomes included cardiac mortality, sudden cardiac death (SCD, all-cause mortality (excluding suicide, coronary heart disease (CHD, and ventricular arrhythmias (VA. Sensitivity analyses were conducted for age, dose, duration, antipsychotic type, and psychiatric disease. Results. 183,392 antipsychotic users (115,491 typical and 67,901 atypical, 544,726 general population controls, and 193,920 psychiatric nonusers were identified. Nonusers with schizophrenia, dementia, or bipolar disorder had increased risks of all-cause mortality compared to general population controls, while nonusers with major depression had comparable risks. Relative to psychiatric nonusers, the adjusted relative ratios (aRR of all-cause mortality in antipsychotic users was 1.75 (95% CI: 1.64–1.87; cardiac mortality 1.72 (95% CI: 1.42–2.07; SCD primary definition 5.76 (95% CI: 2.90–11.45; SCD secondary definition 2.15 (95% CI: 1.64–2.81; CHD 1.16 (95% CI: 0.94–1.44; and VA 1.16 (95% CI: 1.02–1.31. aRRs of the various outcomes were lower for atypical versus typical antipsychotics (all-cause mortality 0.83 (95% CI: 0.80–0.85; cardiac mortality 0.89 (95% CI: 0.82–0.97; and SCD secondary definition 0.76 (95% CI: 0.55–1.04. Conclusions. Antipsychotic users had an increased risk of cardiac mortality, all-cause mortality, and SCD compared to a psychiatric nonuser cohort.

  7. Vitamin D levels and mortality in type 2 diabetes

    DEFF Research Database (Denmark)

    Joergensen, Christel; Gall, Mari-Anne; Schmedes, Anne;

    2010-01-01

    To evaluate vitamin D as a predictor of all-cause and cardiovascular mortality and risk of progression to micro- or macroalbuminuria in type 2 diabetic patients.......To evaluate vitamin D as a predictor of all-cause and cardiovascular mortality and risk of progression to micro- or macroalbuminuria in type 2 diabetic patients....

  8. Hyperphosphatemia Is an Independent Risk Factor for Mortality in Critically Ill Patients: Results from a Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Dominik G Haider

    Full Text Available Phosphate imbalances or disorders have a high risk of morbidity and mortality in patients with chronic kidney disease. It is unknown if this finding extends to mortality in patients presenting at an emergency room with or without normal kidney function.This cross sectional analysis included all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland. A multivariable cox regression model was applied to assess the association between phosphate levels and in-hospital mortality up to 28 days.22,239 subjects were screened for the study. Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died. In univariate analysis, phosphate levels were associated with mortality, age, diuretic therapy and kidney function (all p0.05.Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

  9. Birthweight and mortality in adulthood: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Risnes, Kari R; Vatten, Lars J; Baker, Jennifer L;

    2011-01-01

    results. METHODS: The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for conducting and reporting meta-analysis of observational studies were followed. We retrieved 22 studies that assessed the association between birthweight and adult mortality from all causes, CVD or cancer...

  10. Analysis of environmental issues related to small-scale hydroelectric development IV: fish mortality resulting from turbine passage

    Energy Technology Data Exchange (ETDEWEB)

    Turbak, S. C.; Reichle, D. R.; Shriner, C. R.

    1981-01-01

    This document presents a state-of-the-art review of literature concerning turbine-related fish mortality. The review discusses conventional and, to a lesser degree, pumped-storage (reversible) hydroelectric facilities. Much of the research on conventional facilities discussed in this report deals with studies performed in the Pacific Northwest and covers both prototype and model studies. Research conducted on Kaplan and Francis turbines during the 1950s and 1960s has been extensively reviewed and is discussed. Very little work on turbine-related fish mortality has been undertaken with newer turbine designs developed for more modern small-scale hydropower facilities; however, one study on a bulb unit (Kaplan runner) has recently been released. In discussing turbine-related fish mortality at pumped-storage facilities, much of the literature relates to the Ludington Pumped Storage Power Plant. As such, it is used as the principal facility in discussing research concerning pumped storage.

  11. Wire marking results in a small but significant reduction in avian mortality at power lines: a BACI designed study.

    Directory of Open Access Journals (Sweden)

    Rafael Barrientos

    Full Text Available BACKGROUND: Collision with electric power lines is a conservation problem for many bird species. Although the implementation of flight diverters is rapidly increasing, few well-designed studies supporting the effectiveness of this costly conservation measure have been published. METHODOLOGY/PRINCIPAL FINDINGS: We provide information on the largest worldwide marking experiment to date, including carcass searches at 35 (15 experimental, 20 control power lines totalling 72.5 km, at both transmission (220 kV and distribution (15 kV-45 kV lines. We found carcasses of 45 species, 19 of conservation concern. Numbers of carcasses found were corrected to account for carcass losses due to removal by scavengers or being overlooked by researchers, resulting in an estimated collision rate of 8.2 collisions per km per month. We observed a small (9.6% but significant decrease in the number of casualties after line marking compared to before line marking in experimental lines. This was not observed in control lines. We found no influence of either marker size (large vs. small spirals, sample of distribution lines only or power line type (transmission vs. distribution, sample of large spirals only on the collision rate when we analyzed all species together. However, great bustard mortality was slightly lower when lines were marked with large spirals and in transmission lines after marking. CONCLUSIONS: Our results confirm the overall effectiveness of wire marking as a way to reduce, but not eliminate, bird collisions with power lines. If raw field data are not corrected by carcass losses due to scavengers and missed observations, findings may be biased. The high cost of this conservation measure suggests a need for more studies to improve its application, including wire marking with non-visual devices. Our findings suggest that different species may respond differently to marking, implying that species-specific patterns should be explored, at least for species

  12. Mortality Associated with Night and Weekend Admissions to ICU with On-Site Intensivist Coverage: Results of a Nine-Year Cohort Study (2006-2014)

    Science.gov (United States)

    Brunot, Vincent; Landreau, Liliane; Corne, Philippe; Platon, Laura; Besnard, Noémie; Buzançais, Aurèle; Daubin, Delphine; Serre, Jean Emmanuel; Molinari, Nicolas; Klouche, Kada

    2016-01-01

    Background The association between mortality and time of admission to ICU has been extensively studied but remains controversial. We revaluate the impact of time of admission on ICU mortality by retrospectively investigating a recent (2006–2014) and large ICU cohort with on-site intensivist coverage. Patients and Methods All adults (≥ 18 years) admitted to a tertiary care medical ICU were included in the study. Patients' characteristics, medical management, and mortality were prospectively collected. Patients were classified according to their admission time: week working days on- and off-hours, and weekends. ICU mortality was the primary outcome and adjusted Hazard-ratios (HR) of death were analysed by multivariate Cox model. Results 2,428 patients were included: age 62±18 years; male: 1,515 (62%); and median SAPSII score: 38 (27–52). Overall ICU mortality rate was 13.7%. Admissions to ICU occurred during open-hours in 680 cases (28%), during night-time working days in 1,099 cases (45%) and during weekends in 649 cases (27%). Baseline characteristics of patients were similar between groups except that patients admitted during the second part of night (00:00 to 07:59) have a significantly higher SAPS II score than others. ICU mortality was comparable between patients admitted during different time periods but was significantly higher for those admitted during the second part of the night. Multivariate analysis showed however that admission during weeknights and weekends was not associated with an increased ICU mortality as compared with open-hours admissions. Conclusion Time of admission, especially weeknight and weekend (off-hour admissions), did not influence the prognosis of ICU patients. The higher illness severity of patients admitted during the second part of the night (00:00–07:59) may explain the observed increased mortality. PMID:28033395

  13. Mortality in members of HIV-1 serodiscordant couples in Africa and implications for antiretroviral therapy initiation: Results of analyses from a multicenter randomized trial

    Directory of Open Access Journals (Sweden)

    de Bruyn Guy

    2012-10-01

    Full Text Available Abstract Background The risk of HIV-1 related mortality is strongly related to CD4 count. Guidance on optimal timing for initiation of antiretroviral therapy (ART is still evolving, but the contribution of HIV-1 infection to excess mortality at CD4 cell counts above thresholds for HIV-1 treatment has not been fully described, especially in resource-poor settings. To compare mortality among HIV-1 infected and uninfected members of HIV-1 serodiscordant couples followed for up to 24 months, we conducted a secondary data analysis examining mortality among HIV-1 serodiscordant couples participating in a multicenter, randomized controlled trial at 14 sites in seven sub-Saharan African countries. Methods Predictors of death were examined using Cox regression and excess mortality by CD4 count and plasma HIV-1 RNA was computed using Poisson regression for correlated data. Results Among 3295 HIV serodiscordant couples, we observed 109 deaths from any cause (74 deaths among HIV-1 infected and 25 among HIV-1 uninfected persons. Among HIV-1 infected persons, the risk of death increased with lower CD4 count and higher plasma viral levels. HIV-1 infected persons had excess mortality due to medical causes of 15.2 deaths/1000 person years at CD4 counts of 250 – 349 cells/μl and 8.9 deaths at CD4 counts of 350 – 499 cells/μl. Above a CD4 count of 500 cells/μl, mortality was comparable among HIV-1 infected and uninfected persons. Conclusions Among African serodiscordant couples, there is a high rate of mortality attributable to HIV-1 infection at CD4 counts above the current threshold (200 – 350 cells/μl for ART initiation in many African countries. These data indicate that earlier initiation of treatment is likely to provide clinical benefit if further expansion of ART access can be achieved. Trial Registration Clinicaltrials.gov (NCT00194519

  14. Influence of Social Engagement on Mortality in Korea: Analysis of the Korean Longitudinal Study of Aging (2006-2012).

    Science.gov (United States)

    Kim, Jae-Hyun; Lee, Sang Gyu; Kim, Tae-Hyun; Choi, Young; Lee, Yunhwan; Park, Eun-Cheol

    2016-07-01

    The objective of this study was to investigate the impact of social engagement and patterns of change in social engagement over time on mortality in a large population, aged 45 years or older. Data from the Korean Longitudinal Study of Aging from 2006 and 2012 were assessed using longitudinal data analysis. We included 8,234 research subjects at baseline (2006). The primary analysis was based on Cox proportional hazards models to examine our hypothesis. The hazard ratio of all-cause mortality for the lowest level of social engagement was 1.841-times higher (P engagement. Subgroup analysis results by gender showed a similar trend. A six-class linear solution fit the data best, and class 1 (the lowest level of social engagement class, 7.6% of the sample) was significantly related to the highest mortality (HR: 4.780, P engagement and changes in social engagement on all-cause mortality in current practice, which are important for all-cause mortality risk. Therefore, protection from all-cause mortality may depend on avoidance of constant low-levels of social engagement.

  15. Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality. A longitudinal study of Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, M; Andersen, Anne-Marie Nybo; Due, P;

    2003-01-01

    OBJECTIVE: To examine the relation between socioeconomic position in early life and mortality in young adulthood, taking birth weight and childhood cognitive function into account. DESIGN: A longitudinal study with record linkage to the Civil Registration System and Cause of Death Registry...... with all cause mortality. The association between father's social class and mortality attenuated (HR(working class)1.30 (1.08 to 1.56); HR(unknown class)1.81 (1.30 to 2.52)) after control for birth weight and cognitive function. Mortality from cardiovascular diseases and violent deaths was also...... characteristics had been traced manually in 1965. This population was followed up from April 1968 to January 2002 for information on mortality. MAIN OUTCOME MEASURES: Mortality from all causes, cardiovascular diseases, and violent deaths. RESULTS: Men whose fathers were working class or of unknown social class...

  16. Tree Mortality Undercuts Ability of Tree-Planting Programs to Provide Benefits: Results of a Three-City Study

    Directory of Open Access Journals (Sweden)

    Sarah Widney

    2016-03-01

    Full Text Available Trees provide numerous benefits for urban residents, including reduced energy usage, improved air quality, stormwater management, carbon sequestration, and increased property values. Quantifying these benefits can help justify the costs of planting trees. In this paper, we use i-Tree Streets to quantify the benefits of street trees planted by nonprofits in three U.S. cities (Detroit, Michigan; Indianapolis, Indiana, and Philadelphia, Pennsylvania from 2009 to 2011. We also use both measured and modeled survival and growth rates to “grow” the tree populations 5 and 10 years into the future to project the future benefits of the trees under different survival and growth scenarios. The 4059 re-inventoried trees (2864 of which are living currently provide almost $40,000 (USD in estimated annual benefits ($9–$20/tree depending on the city, the majority (75% of which are increased property values. The trees can be expected to provide increasing annual benefits during the 10 years after planting if the annual survival rate is higher than the 93% annual survival measured during the establishment period. However, our projections show that with continued 93% or lower annual survival, the increase in annual benefits from tree growth will not be able to make up for the loss of benefits as trees die. This means that estimated total annual benefits from a cohort of planted trees will decrease between the 5-year projection and the 10-year projection. The results of this study indicate that without early intervention to ensure survival of planted street trees, tree mortality may be significantly undercutting the ability of tree-planting programs to provide benefits to neighborhood residents.

  17. Obesity and mortality among older Thais: a four year follow up study

    Directory of Open Access Journals (Sweden)

    Prasartkul Pramote

    2010-10-01

    Full Text Available Abstract Background To assess the association of body mass index with mortality in a population-based setting of older people in Thailand. Methods Baseline data from the National Health Examination Survey III (NHES III conducted in 2004 was linked to death records from vital registration for 2004-2007. Complete information regarding body mass index (BMI (n = 15997 and mortality data were separately analysed by sex. The Cox Proportional Hazard Model was used to test the association between BMI and all-cause mortality controlling for demographic, socioeconomic, and health risk factors. Results During a mean follow-up time of 3.8 years (60545.8 person-years, a total of 1575 older persons, (936 men and 639 women had died. A U-shaped and reverse J-shaped of association between BMI and all-cause mortality were observed in men and women, respectively. However there was no significant increased risk in the higher BMI categories. Compared to those with BMI 18.5-22.9 kg/m2, the adjusted hazard ratios (HR of all-cause mortality for those with BMI Conclusions The results of this study support the obesity paradox phenomenon in older Thai people, especially in women. Improvement in quality of mortality data and further investigation to confirm such association are needed in this population.

  18. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality

    NARCIS (Netherlands)

    Roest, Annelieke M.; Thombs, Brett D.; Grace, Sherry L.; Stewart, Donna E.; Abbey, Susan E.; de Jonge, Peter

    2011-01-01

    Background: Symptom dimensions of post myocardial infarction (MI) depression may be differently related to prognosis. Somatic/affective symptoms appear to be associated with a worse cardiac outcome than cognitive/affective symptoms. We examined the relationship between depressive symptom dimensions

  19. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2015-01-01

    disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus...

  20. Upper gastrointestinal bleeding as a risk factor for dialysis and all-cause mortality: a cohort study of chronic kidney disease patients in Taiwan

    OpenAIRE

    Liang, Chih-Chia; Chou, Che-Yi; Chang, Chiz-Tzung; Wang, I-Kuan; Huang, Chiu-Ching

    2016-01-01

    Objective Impaired renal function is associated with higher risk of upper gastrointestinal bleeding (UGIB) in patients with chronic kidney disease and not on dialysis (CKD-ND). It is unclear if UGIB increases risk of chronic dialysis. The aim of the study was to investigate risk of chronic dialysis in CKD-ND patients with UGIB. Setting All CKD-ND stage 3–5 patients of a CKD programme in one hospital between 2003 and 2009 were enrolled and prospectively followed until September 2012. Primary a...

  1. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig;

    2013-01-01

    This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%....

  2. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2015-01-01

    , and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey......, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were...

  3. Relation of Serum Adiponectin Levels to Number of Traditional Atherosclerotic Risk Factors and All-Cause Mortality and Major Adverse Cardiovascular Events (from the Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Lindberg, Soren; Mogelvang, Rasmus; Pedersen, Sune H;

    2013-01-01

    Adiponectin exerts anti-inflammatory and antiatherogenic effects and appears to protect against arteriosclerosis. Accordingly, an association between low concentrations of plasma adiponectin and cardiovascular (CV) disease has been demonstrated in several studies. In contrast, elevated plasma...... or nonfatal myocardial infarction or ischemic stroke (n = 502). High adiponectin was inversely associated with an increasing number of traditional CV risk factors (p...

  4. Effect size estimates of lifestyle and dietary changes on all-cause mortality in coronary artery disease patients. A systematic review

    NARCIS (Netherlands)

    Iestra, J.A.; Kromhout, D.; Schouw, van der Y.T.; Grobbee, D.E.; Boshuizen, H.C.; Staveren, van W.A.

    2005-01-01

    Background¿Guidelines for lifestyle and dietary modification in patients with coronary artery disease (CAD) are mainly supported by evidence from general population studies. CAD patients, however, differ from the general population in age (older) and treatment with preventive drugs. This review seek

  5. The relationship between N-terminal prosomatostatin, all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus (ZODIAC-35)

    NARCIS (Netherlands)

    van Dijk, Peter R.; Landman, Gijs W. D.; van Essen, Larissa; Struck, Joachim; Groenier, Klaas H.; Bilo, Henk J. G.; Bakker, Stephan J. L.; Kleefstra, Nanne

    2015-01-01

    Background: The hormone somatostatin inhibits growth hormone release from the pituitary gland and is theoretically linked to diabetes and diabetes related complications. This study aimed to investigate the relationship between levels of the stable somatostatin precursor, N-terminal prosomatostatin (

  6. Prognostic value of vitamin D level for all-cause mortality, and association with inflammatory markers, in HIV-infected persons

    DEFF Research Database (Denmark)

    Shepherd, Leah; Souberbielle, Jean-Claude; Bastard, Jean-Philippe

    2014-01-01

    BACKGROUND: Low 25-hydroxyvitamin D (25(OH)D) has been associated with inflammation, human immunodeficiency virus (HIV) disease progression, and death. We aimed to identify the prognostic value of 25(OH)D for AIDS, non-AIDS-defining events and death, and its association with immunological......-positive persons. Effectiveness of vitamin D supplementation on inflammation and patient outcomes should be investigated....

  7. Lifestyle Changes in Young Adulthood and Middle Age and Risk of Cardiovascular Disease and All-Cause Mortality : The Doetinchem Cohort Study

    NARCIS (Netherlands)

    Hulsegge, Gerben; Looman, Moniek; Smit, Henriëtte A; Daviglus, Martha L; van der Schouw, Yvonne T; Verschuren, W M Monique

    2016-01-01

    BACKGROUND: The associations between overall lifestyle profile and cardiovascular disease (CVD) and death have been mainly investigated in cross-sectional studies. The full benefits of a healthy lifestyle may therefore be underestimated, and the magnitude of benefits associated with changes in lifes

  8. Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO)

    NARCIS (Netherlands)

    Berg, K.S. van den; Marijnissen, R.M.; Brink, R.H. van den; Naarding, P.; Comijs, H.C.; Oude Voshaar, R.C.

    2016-01-01

    OBJECTIVE: To study the effect of vitamin D levels on depression course and remission status after two years, as well as attrition and mortality, in an older cohort. METHODS: This study was part of the Netherlands Study on Depression in Older persons (NESDO), a prospective cohort study. 367 depresse

  9. The American Cancer Society challenge goal to reduce US cancer mortality by 50% between 1990 and 2015: Results and reflections.

    Science.gov (United States)

    Byers, Tim; Wender, Richard C; Jemal, Ahmedin; Baskies, Arnold M; Ward, Elizabeth E; Brawley, Otis W

    2016-09-01

    In 1996, the Board of Directors of the American Cancer Society (ACS) challenged the United States to reduce what looked to be possible peak cancer mortality in 1990 by 50% by the year 2015. This analysis examines the trends in cancer mortality across this 25-year challenge period from 1990 to 2015. In 2015, cancer death rates were 26% lower than in 1990 (32% lower among men and 22% lower among women). The 50% reduction goal was more fully met for the cancer sites for which there was enactment of effective approaches for prevention, early detection, and/or treatment. Among men, mortality rates dropped for lung cancer by 45%, for colorectal cancer by 47%, and for prostate cancer by 53%. Among women, mortality rates dropped for lung cancer by 8%, for colorectal cancer by 44%, and for breast cancer by 39%. Declines in the death rates of all other cancer sites were substantially smaller (13% among men and 17% among women). The major factors that accounted for these favorable trends were progress in tobacco control and improvements in early detection and treatment. As we embark on new national cancer goals, this recent past experience should teach us that curing the cancer problem will require 2 sets of actions: making new discoveries in cancer therapeutics and more completely applying those discoveries in cancer prevention we have already made. CA Cancer J Clin 2016;66:359-369. © 2016 American Cancer Society.

  10. Sex Differences in Stroke Incidence, Prevalence, Mortality and DALYs: Results from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Barker-Collo, Suzanne L.; Bennett, Derrick A.; Krishnamurthi, Rita; Parmar, Priya; Feigin, Valery L; Naghavi, Mohsen; Forouzanfar, Mohammad H.; Johnson, Catherine; Nguyen, Grant; Mensah, George A.; Vos, Theo; Murray, Christopher; Roth, Gregory A.; Abd-Allah, Foad; Abera, Semaw Ferede; Akinyemi, Rufus, O.; Bahit, Cecilia; Banerjee, Amitava; Basu, Sanjay; Brainin, Michael; Bornstein, Natan M.; Caso, Valeria; Catalá-López, Ferrán; Chowdhury, Rajiv; Christensen, Hanne; Colomar, Merceded; Davis, Stephen; deVeber, Gabrielle; Dharmaratne, Samath D.; Donnan, Geoffrey; Dorairaj, Prabhakaran; Dokova, Klara; Endres, Matthias; Fernandes, Jefferson G; Geleijnse, J. Marianne; Gillum, Richard F.; Giroud, Maurice; Guohong, Jiang; Hamadeh, Randah R.; Hankey, Graeme J.; Jeemon, Panniyammakal; Jin, Kim Yun; Jonas, Jost B.; Kalkonde, Yogesh; Kengne, Andre P; Kim, Daniel; Kissela, Brett M.; Kokubo, Yoshihiro; Lavados, Pablo; Lindsay, Patrice; Lotufo, Paulo A; Mackay, Mark T.; Malekzadeh, Reza; Mehndiratta, Man Mohan; Nand, Devina; Norrving, Bo; Pandian, Jeyaraj Durai; Perkins, Harry; Pourmalek, Farshad; Ricci, Stefano; Riccio, Patricia M.; Rojas-Rueda, David; Roy, Nobhojit; Sacco, Ralph, L.; Sahathevan, Ramesh; Sheth, Kevin N.; Shiue, Ivy; Sposato, Luciano A.; Tanne, David; Thrift, Amanda; Thurston, George; Tirschwell, David; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy; Westerman, Ronny; Wolfe, Charles

    2015-01-01

    Background Accurate information on stroke burden in men and women are important for evidence-based health care planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time. Methods Stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and healthy years lost due to disability (YLDs) were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence, and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UI) were computed. Findings In 2013 global ischaemic stroke (IS) and haemorrhagic stroke (HS) incidence (per 100 000) in men (IS 132.77 [95% UI, 125.34-142.77]; HS 64.89 [95% UI 59.82-68.85]) exceeded those of women (IS 98.85 [95%UI, 92.11 - 106.62]; HS 45.48 [95% UI, 42.43-48.53]). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 [95% UI, 137.87-157-66]; 1990 female IS incidence 113.31 [95%UI, 103.52 – 123.40]), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 = 65.31 [95% UI, 61.63 – 69.0], 2013 = 64.89[95% UI, 59.82-68.85]), but was significant for females (1990= 64.892 [95% UI, 59.82-68.85], 2013= 45.48 [95% UI, 42.427-48.53]). The number of DALYs related to IS

  11. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department

    DEFF Research Database (Denmark)

    Mrgan, Monija; Rytter, Dorte; Brabrand, Mikkel

    2014-01-01

    the relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality. METHODS: We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data...... descriptively. Difference between continuous data was analysed using Wilcoxon Rank Sum Test and categorical data using χ(2) test. The primary endpoint was 1-day all-cause mortality. RESULTS: 3046 patients were enrolled and CRT was measured on 1935. In univariate analyses, we found increasing all-cause 1-day...

  12. Testosterone Therapy and Mortality Risk

    Science.gov (United States)

    Eisenberg, Michael L.; Li, Shufeng; Herder, Danielle; Lamb, Dolores J.; Lipshultz, Larry I.

    2014-01-01

    INTRODUCTION Recent data suggests and increased risk of cardiovascular events and mortality in men on testosterone therapy (TT). To date there are no long term, prospective studies to determine safety. In such cases, retrospective observational studies can be helpful. We examined our patient database to determine if TT altered a man’s risk of all cause mortality. METHODS We queried our hormone database for all men with a serum testosterone level and then examined charts to determine testosterone status. In all, 509 men had charts available for review. We linked our patient records to the National Death Index to determine morality. RESULTS Of the 509 men who met inclusion criteria, 284 were on testosterone therapy and 225 did not use testosterone. Age (mean 54 years) and follow up time (mean 10 years) were similar for both groups. In all, 19 men died—10 (4.4%) of the men not on TT and 9 (3.2%) of the men on TT. After adjusting for age and year of evaluation, there was no significant difference in the risk of death based on TT (HR 1.0, 95% CI 0.39 – 2.57, p=1.0). CONCLUSIONS There appears to be no change in mortality risk overall for men utilizing long-term testosterone therapy. PMID:25078049

  13. BMI, weight stability and mortality among adults without clinical co-morbidities: a 22-year mortality follow-up in the finnish twin cohort

    DEFF Research Database (Denmark)

    Korkeila, Maarit; Rissanen, Aila; Sørensen, Thorkild I A

    2009-01-01

    with mortality were estimated by Cox proportional hazards model for all individuals and conditional logistic regression analysis for pairwise analyses. RESULTS: Mortality increased with increasing BMI for all causes and coronary heart disease (CHD) in men, and there were no associations for all natural causes......, cerebrovascular disease, and violent deaths. After adjustment for multiple co-variates and changes in co-variates between 1975 and 1981, BMI was associated with CHD mortality in all men (hazard ratio (HR) = 1.22, 95% CI 1.06-1.41) and in men with stable weight between 1975 and 1981 (HR = 1.26, 95% CI 1...

  14. Median age at death as an indicator of premature mortality

    OpenAIRE

    Jannerfeldt, Eric; Hörte, Lars-Gunnar

    1988-01-01

    The median age at death from certain diseases was calculated for each year for 1969-85 and compared with that at death from all causes. The results indicated the impact of these diseases in terms of premature mortality and changes over time. Cancer was a more important cause of premature mortality among women than among men. For cancer of the cervix the median age at death increased appreciably whereas for cancer of the lung in women it slightly decreased. The median age at death is easy to c...

  15. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  16. Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Fleur E P van Dooren

    Full Text Available OBJECTIVE: To examine the association between depression and all-cause and cardiovascular mortality in people with diabetes by systematically reviewing the literature and carrying out a meta-analysis of relevant longitudinal studies. RESEARCH DESIGN AND METHODS: PUBMED and PSYCINFO were searched for articles assessing mortality risk associated with depression in diabetes up until August 16, 2012. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria, which were pooled in an overall all-cause mortality estimate, and five in a cardiovascular mortality estimate. After adjustment for demographic variables and micro- and macrovascular complications, depression was associated with an increased risk of all-cause mortality (HR = 1.46, 95% CI = 1.29-1.66, and cardiovascular mortality (HR = 1.39, 95% CI = 1.11-1.73. Heterogeneity across studies was high for all-cause mortality and relatively low for cardiovascular mortality, with an I-squared of respectively 78.6% and 39.6%. Subgroup analyses showed that the association between depression and mortality not significantly change when excluding three articles presenting odds ratios, yet this decreased heterogeneity substantially (HR = 1.49, 95% CI = 1.39-1.61, I-squared = 15.1%. A comparison between type 1 and type 2 diabetes could not be undertaken, as only one study reported on type 1 diabetes specifically. CONCLUSIONS: Depression is associated with an almost 1.5-fold increased risk of mortality in people with diabetes. Research should focus on both cardiovascular and non-cardiovascular causes of death associated with depression, and determine the underlying behavioral and physiological mechanisms that may explain this association.

  17. Mature Turkey Breeder Hens Exposed to Pandemic Influenza H1N1: Resultant Effects on Morbidity, Mortality, and Fecundity.

    Science.gov (United States)

    Evans, Robert; Bommineni, Yugendar; Falk, Jonathan; Blackway, Adam; Young, Brent; Isenhart, Connie

    2015-03-01

    During the artificial insemination process, turkey breeder hens may become infected with influenza virus acquired from humans. The virus has been shown, through experimental infection, to localize in the reproductive tract, with limited dissemination in other tissues. A limited number of hens were used during these studies, and the overall flock morbidity, mortality, and fecundity were not able to be determined. The current case follows the progression of clinical signs in a flock of commercial breeder hens from onset of egg production losses in one house through the subsequent drops in four remaining houses. Each house contained approximately 3000 hens and followed a sequential loss of shell quality, reduced numbers of eggs, and fertility, while mild clinical signs were observed and mortality was slightly increased in a house with concurrent fowl cholera (Pasturella multocida) infection.

  18. Mortality and survival of lung cancer in Denmark: Results from the Danish Lung Cancer Group 2000-2012

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Rasmussen, Torben Riis; Green, Anders

    2016-01-01

    Background In the 1990s outcomes in Danish lung cancer patients were poor compared with the other Nordic countries. The five-year survival was only about 5%, only 10% of patients were operated on and less than 60% received active surgical or oncologic treatment. This paper describes trends in mor...... on cancer-specific mortality relative to the total general population may be misleading when interpreted in the context of outcomes and quality of care....

  19. Breastfeeding and the risk for diarrhea morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Victora Cesar

    2011-04-01

    Full Text Available Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52 and to any breastfeeding among children aged 6-23 months (RR: 2.18. Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.

  20. Mortality patterns following downsizing at Pan American World Airways.

    Science.gov (United States)

    Steenland, Kyle; Pinkerton, Lynne E

    2008-01-01

    There are only a small number of studies on the health effects of involuntary unemployment (e.g., downsizing), and results are contradictory. The authors studied the mortality through 2002 of 13,370 Pan American World Airways employees who were born before 1940 and whose records were available after the company's bankruptcy in 1991. The cohort was divided into those who left work voluntarily (55%), involuntarily (39%), and because of illness (6%). The mean year of first employment was 1963, the mean year of last employment was 1987, and the mean age at leaving the company was 55 years. Of those who left involuntarily, 56% left at the time of bankruptcy in December 1991 or later. Twenty-two percent of the cohort died during follow-up, which began at the time of leaving the company. Standardized mortality ratios relative to the US population for all causes for those who left voluntarily, involuntarily, and because of illness were 0.72 (95% confidence interval (CI): 0.69, 0.76), 0.69 (95% CI: 0.65, 0.74), and 2.40 (95% CI: 2.22, 2.60), respectively. Ischemic heart disease mortality showed a similar pattern. Internal analyses comparing involuntary to voluntary leavers after adjusting for age, race, sex, calendar time, and education yielded all-cause and ischemic heart disease rate ratios of 0.96 (95% CI: 0.87, 1.07) and 1.11 (95% CI: 0.93, 1.35), respectively. Subanalyses of those who left involuntarily at age >/=60 years, or those who left involuntarily at the time of bankruptcy, did not indicate any excess mortality (all-cause standardized mortality ratios = 0.69 and 0.64, respectively). These data do not indicate that mortality among those who left involuntarily was higher than for those who left voluntarily. Both groups showed a strong healthy worker effect.

  1. High female mortality resulting in herd collapse in free-ranging domesticated reindeer (Rangifer tarandus tarandus in Sweden.

    Directory of Open Access Journals (Sweden)

    Birgitta Åhman

    Full Text Available Reindeer herding in Sweden is a form of pastoralism practised by the indigenous Sámi population. The economy is mainly based on meat production. Herd size is generally regulated by harvest in order not to overuse grazing ranges and keep a productive herd. Nonetheless, herd growth and room for harvest is currently small in many areas. Negative herd growth and low harvest rate were observed in one of two herds in a reindeer herding community in Central Sweden. The herds (A and B used the same ranges from April until the autumn gathering in October-December, but were separated on different ranges over winter. Analyses of capture-recapture for 723 adult female reindeer over five years (2007-2012 revealed high annual losses (7.1% and 18.4%, for herd A and B respectively. A continuing decline in the total reindeer number in herd B demonstrated an inability to maintain the herd size in spite of a very small harvest. An estimated breakpoint for when herd size cannot be kept stable confirmed that the observed female mortality rate in herd B represented a state of herd collapse. Lower calving success in herd B compared to A indicated differences in winter foraging conditions. However, we found only minor differences in animal body condition between the herds in autumn. We found no evidence that a lower autumn body mass generally increased the risk for a female of dying from one autumn to the next. We conclude that the prime driver of the on-going collapse of herd B is not high animal density or poor body condition. Accidents or disease seem unlikely as major causes of mortality. Predation, primarily by lynx and wolverine, appears to be the most plausible reason for the high female mortality and state of collapse in the studied reindeer herding community.

  2. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

    Science.gov (United States)

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

    2016-03-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh.

  3. Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality--results from a 10-year prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Dennis Back Holmgaard

    Full Text Available BACKGROUND: Recent studies have found vitamin D (25-OHD deficiency and insufficiency to be common among patients with COPD. Serum level of 25-OHD seems to correlate to pulmonary function, COPD disease staging, and increased susceptibility to respiratory infections. We wanted to investigate whether vitamin D deficiency or insufficiency was associated with mortality rate in patients suffering from advanced COPD. METHODS: 25-OHD serum levels were measured in 462 patients suffering from moderate to very severe COPD. Patients were stratified into three groups according to serum levels of 25-OHD. Outcome measure was mortality in a 10 year follow-up period. Kaplan-Meier curves (KM were plotted and mortality hazard ratios (HR were calculated using Cox Proportional Hazard regression (Cox PH. RESULTS: Serum 25-OHD deficiency and insufficiency were prevalent. We were unable to demonstrate any association between baseline serum levels of 25-OHD and mortality rate. We found an association between mortality and age [HR 1.05 (CI 95%: 1.03-1.06], Charlson score [HR 1.49 (CI 95%: 1.06-2.09], increasing neutrophil count [HR 1.05 (CI 95%: 1.02-1.09], severe [HR 1.41 (CI 95%: 1.06-1.86]/very severe COPD [HR 2.19 (CI 95%: 1.58-3.02] and a smoking history of more than 40 pack years [HR 1.27 (CI 95%: 1.02-1.70]. CONCLUSIONS: Serum level of 25-OHD does not seem to be associated with mortality rate, suggesting no or only a minor role of 25-OHD in disease progression in patients with moderate to very severe COPD.

  4. Cancer risk and mortality after kidney transplantation

    DEFF Research Database (Denmark)

    Engberg, Henriette; Wehberg, Sonja; Bistrup, Claus;

    2016-01-01

    to examine whether post-transplant cancer and all-cause mortality differed between Danish renal transplantation centres using standard immunosuppressive protocols including steroids (Centres 2, 3, 4) or a steroid-free protocol (Centre 1). The Danish Nephrology Registry, the Danish Civil Registration System......BACKGROUND: Kidney recipients receive immunosuppression to prevent graft rejection, and long-term outcomes such as post-transplant cancer and mortality may vary according to the different protocols of immunosuppression. METHODS: A national register-based historical cohort study was conducted......, the Danish National Cancer Registry and the Danish National Patient Register were used. A historical cohort of 1450 kidney recipients transplanted in 1995-2005 was followed up with respect to post-transplant cancer and death until 31 December 2011. RESULTS: Compared with Center 1 the adjusted post...

  5. Mortality profile across our Intensive Care Units: A 5-year database report from a Singapore restructured hospital.

    Science.gov (United States)

    Siddiqui, Shahla

    2015-12-01

    Intensive care remains an area of high acuity and high mortality across the globe. With a rapidly aging population, the disease burden requiring intensive care is growing. The cost of critical care also is rising with new technology becoming available rapidly. We present the all-cause mortality results of 5 years database established in a restructured, large public hospital in Singapore, looking at all three types of Intensive Care Units present in our hospital. These include medical, surgical, and coronary care units.

  6. Early infection during burn-induced inflammatory response results in increased mortality and p38-mediated neutrophil dysfunction.

    Science.gov (United States)

    Adediran, Samuel G; Dauplaise, Derrick J; Kasten, Kevin R; Tschöp, Johannes; Dattilo, Jonathan; Goetzman, Holly S; England, Lisa G; Cave, Cindy M; Robinson, Chad T; Caldwell, Charles C

    2010-09-01

    Following burn injury, the host is susceptible to bacterial infections normally cleared by healthy patients. We hypothesized that during the systemic immune response that follows scald injury, the host's altered immune status increases infection susceptibility. Using a murine model of scald injury under inhaled anesthesia followed by intraperitoneal infection, we observed increased neutrophil numbers and function at postburn day (PBD) 1 compared with sham-burned and PBD4 mice. Further, increased mortality, bacteremia, and serum IL-6 were observed in PBD1 mice after Pseudomonas aeruginosa (PA) infection compared with sham-burned and PBD4 mice infected with PA. To examine these disparate responses, we investigated neutrophils isolated at 5 and 24 h following PA infection from PBD1 and sham-burned mice. Five hours after infection, there was no significant difference in number of recruited neutrophils; however, neutrophils from injured mice had decreased activation, active-p38, and oxidative burst compared with sham-burned mice. In direct contrast, 24 h after infection, we observed increased numbers, active-p38, and oxidative burst of neutrophils from PBD1 mice. Finally, we demonstrated that in neutrophils isolated from PBD1 mice, the observed increase in oxidative burst was p38 dependent. Altogether, neutrophil activation and function from thermally injured mice are initially delayed and later exacerbated by a p38-dependent mechanism. This mechanism is likely key to the observed increase in bacterial load and mortality of PBD1 mice infected with PA.

  7. Endovascular Aneurysm Repair: Is Imaging Surveillance Robust, and Does It Influence Long-term Mortality?

    Energy Technology Data Exchange (ETDEWEB)

    Waduud, Mohammed Abdul, E-mail: m.a.waduud@doctors.org.uk [Glasgow Royal Infirmary, Department of Surgery (United Kingdom); Choong, Wen Ling, E-mail: wenlingchoong@nhs.net [Aberdeen Royal Infirmary, NHS Grampian, Department of Surgery (United Kingdom); Ritchie, Moira, E-mail: moirasim9@gmail.com; Williams, Claire, E-mail: c.williams.3@research.gla.ac.uk [University of Glasgow, Institute of Health and Wellbeing Glasgow (United Kingdom); Yadavali, Reddi, E-mail: reddi.yadavali@nhs.net [Aberdeen Royal Infirmary, NHS Grampian, Department of Radiology (United Kingdom); Lim, Shueh, E-mail: s.lim.06@aberdeen.ac.uk [Royal Infirmary of Edinburgh, NHS Lothian, Department of Radiology (United Kingdom); Buchanan, Fraser, E-mail: f.buchanan.11@aberdeen.ac.uk [University of Aberdeen, The School of Medicine and Dentistry (United Kingdom); Bhat, Raj, E-mail: raj.bhat@nhs.net [Ninewells Hospital, NHS Tayside, Department of Radiology (United Kingdom); Ramanathan, Krishnappan, E-mail: k.ramanathan@dundee.ac.uk [University of Dundee, School of Medicine (United Kingdom); Ingram, Susan, E-mail: susan.ingram@luht.scot.nhs.uk; Cormack, Laura, E-mail: lgcormack@googlemail.com [Royal Infirmary of Edinburgh, NHS Lothian, Department of Radiology (United Kingdom); Moss, Jonathan G., E-mail: jon.moss@ggc.scot.nhs.uk [Gartnavel General Hospital, Department of Radiology (United Kingdom)

    2015-02-15

    PurposeEndovascular aneurysm repair (EVAR) is the dominant treatment strategy for abdominal aortic aneurysms. However, as a result of uncertainty regarding long-term durability, an ongoing imaging surveillance program is required. The aim of the study was to assess EVAR surveillance in Scotland and its effect on all-cause and aneurysm-related mortality.MethodsA retrospective analysis of all EVAR procedures carried out in the four main Scottish vascular units. The primary outcome measure was the implementation of post-EVAR imaging surveillance across Scotland. Patients were identified locally and then categorized as having complete, incomplete, or no surveillance. Secondary outcome measures were all-cause mortality and aneurysm-related mortality. Cause of death was obtained from death certificates.ResultsData were available for 569 patients from the years 2001 to 2012. All centers had data for a minimum of 5 contiguous years. Surveillance ranged from 1.66 to 4.55 years (median 3.03 years). Overall, 53 % had complete imaging surveillance, 43 % incomplete, and 4 % none. For the whole cohort, all-cause 5-year mortality was 33.5 % (95 % confidence interval 28.0–38.6) and aneurysm-related mortality was 4.5 % (.8–7.3). All-cause mortality in patients with complete, incomplete, and no imaging was 49.9 % (39.2–58.6), 19.1 % (12.6–25.2), and 47.2 % (17.7–66.2), respectively. Aneurysm-related mortality was 3.7 % (1.8–7.4), 4.4 % (2.2–8.9), and 9.5 % (2.5–33.0), respectively. All-cause mortality was significantly higher in patients with complete compared to incomplete imaging surveillance (p < 0.001). No significant differences were observed in aneurysm-related mortality (p = 0.2).ConclusionOnly half of EVAR patients underwent complete long-term imaging surveillance. However, incomplete imaging could not be linked to any increase in mortality. Further work is required to establish the role and deliverability of EVAR imaging surveillance.

  8. Early life origins of all-cause and cause-specific disability pension: findings from the Helsinki Birth Cohort Study.

    Directory of Open Access Journals (Sweden)

    Mikaela B von Bondorff

    Full Text Available There is some evidence linking sub-optimal prenatal development to an increased risk of disability pension (DP. Our aim was to investigate whether body size at birth was associated with transitioning into all-cause and cause-specific DP during the adult work career.10 682 people born in 1934-44 belonging to the Helsinki Birth Cohort Study had data on birth weight extracted from birth records, and on time, type and reason of retirement between 1971 and 2011 extracted from the Finnish Centre for Pensions.Altogether 21.3% transitioned into DP during the 40-year follow-up, mainly due to mental disorders, musculoskeletal disorders and cardiovascular disease. Average age of transitioning into DP was 51.3 (SD 8.4 for men and 52.2 (SD 7.6 for women. Cohort members who did not transition into DP retired 10 years later on average. Among men, higher birth weight was associated with a lower hazard of transitioning into DP, adjusted hazard ratio (HR being 0.94 (95% confidence interval [CI] 0.88-0.99 for 1 SD increase in birth weight. For DP due to mental disorders the adjusted HR was 0.90, 95% CI 0.81, 0.99. A similar but non-significant trend was found for DP due to cardiovascular disease. Among women there were no associations between body size at birth and all-cause DP (p for interaction gender*birth weight on DP p = 0.007.Among men disability pension, particularly due to mental disorders, may have its origins in prenatal development. Given that those who retire due to mental health problems are relatively young, the loss to the workforce is substantial.

  9. Effect of grandparent's and parent's socioeconomic position on mortality among Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, Merete; Andersen, Anne-Marie Nybo; Lund, Rikke;

    2005-01-01

    BACKGROUND: The adverse effect on health of poor social circumstances might accumulate not only over the lifespan of the individual but also across generations. This study examines the effect of parent's and grandparent's socioeconomic position on all-cause mortality of their adult offspring....... METHODS: 2890 males born in the metropolitan area of Copenhagen, Denmark in 1953, whose mothers were interviewed for information on family social background in 1968, were followed from 1968 to 2002 for information on vital status by record linkage to the Civil Registration System. The data were analysed...... using Cox regression models. RESULTS: All-cause mortality from age 15 to 49 years increased 25% [95% confidence interval (CI) 13-39%] for each number of parents or grandparents from working or unknown occupational social class. Offspring mortality decreased with the number of ancestors with a secondary...

  10. Mortality as a key driver of the spatial distribution of aboveground biomass in Amazonian forest: results from a dynamic vegetation model

    Directory of Open Access Journals (Sweden)

    N. Delbart

    2010-10-01

    Full Text Available Dynamic Vegetation Models (DVMs simulate energy, water and carbon fluxes between the ecosystem and the atmosphere, between the vegetation and the soil, and between plant organs. They also estimate the potential biomass of a forest in equilibrium having grown under a given climate and atmospheric CO2 level. In this study, we evaluate the Above Ground Woody Biomass (AGWB and the above ground woody Net Primary Productivity (NPPAGW simulated by the DVM ORCHIDEE across Amazonian forests, by comparing the simulation results to a large set of ground measurements (220 sites for biomass, 104 sites for NPPAGW. We found that the NPPAGW is on average overestimated by 63%. We also found that the fraction of biomass that is lost through mortality is 85% too high. These model biases nearly compensate each other to give an average simulated AGWB close to the ground measurement average. Nevertheless, the simulated AGWB spatial distribution differs significantly from the observations. Then, we analyse the discrepancies in biomass with regards to discrepancies in NPPAGW and those in the rate of mortality. When we correct for the error in NPPAGW, the errors on the spatial variations in AGWB are exacerbated, showing clearly that a large part of the misrepresentation of biomass comes from a wrong modelling of mortality processes.

    Previous studies showed that Amazonian forests with high productivity have a higher mortality rate than forests with lower productivity. We introduce this relationship, which results in strongly improved modelling of biomass and of its spatial variations. We discuss the possibility of modifying the mortality modelling in ORCHIDEE, and the opportunity to improve forest productivity modelling through the integration of biomass measurements, in particular from remote sensing.

  11. Mortality as a key driver of the spatial distribution of aboveground biomass in Amazonian forests: results from a Dynamic Vegetation Model

    Directory of Open Access Journals (Sweden)

    N. Delbart

    2010-04-01

    Full Text Available Dynamic Vegetation Models (DVMs simulate energy, water and carbon fluxes between the ecosystem and the atmosphere, between the vegetation and the soil, and between plant organs. They also estimate the potential biomass of a forest in equilibrium having grown under a given climate and atmospheric CO2 level. In this study, we evaluate the above ground woody biomass (AGWB and the above ground woody Net Primary Productivity (NPPAGW simulated by the DVM ORCHIDEE across Amazonian forests, by comparing the simulation results to a large set of ground measurements (220 sites for biomass, 104 sites for NPPAGW. We found that the NPPAGW is on average overestimated by 63%. We also found that the fraction of biomass that is lost through mortality is 85% too high. These model biases nearly compensate each other to give an average simulated AGWB close to the ground measurement average. Nevertheless, the simulated AGWB spatial distribution differs significantly from the observations. Then, we analyse the discrepancies in biomass with regards to discrepancies in NPPAGW and those in the rate of mortality. When we correct for the error in NPPAGW, the errors on the spatial variations in AGWB are exacerbated, showing clearly that a large part of the misrepresentation of biomass comes from a wrong modelling of mortality processes.

    Previous studies showed that Amazonian forests with high productivity have a higher mortality rate than forests with lower productivity. We introduce this relationship, which results in strongly improved modelling of biomass and of its spatial variations. We discuss the possibility of modifying the mortality modelling in ORCHIDEE, and the opportunity to improve forest productivity modelling through the integration of biomass measurements, in particular from remote sensing.

  12. The predisposition, infection, response and organ failure (Piro sepsis classification system: results of hospital mortality using a novel concept and methodological approach.

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    Cristina Granja

    Full Text Available INTRODUCTION: PIRO is a conceptual classification system in which a number of demographic, clinical, biological and laboratory variables are used to stratify patients with sepsis in categories with different outcomes, including mortality rates. OBJECTIVES: To identify variables to be included in each component of PIRO aiming to improve the hospital mortality prediction. METHODS: Patients were selected from the Portuguese ICU-admitted community-acquired sepsis study (SACiUCI. Variables concerning the R and O component included repeated measurements along the first five days in ICU stay. The trends of these variables were summarized as the initial value at day 1 (D1 and the slope of the tendency during the five days, using a linear mixed model. Logistic regression models were built to assess the best set of covariates that predicted hospital mortality. RESULTS: A total of 891 patients (age 60±17 years, 64% men, 38% hospital mortality were studied. Factors significantly associated with mortality for P component were gender, age, chronic liver failure, chronic renal failure and metastatic cancer; for I component were positive blood cultures, guideline concordant antibiotic therapy and health-care associated sepsis; for R component were C-reactive protein slope, D1 heart rate, heart rate slope, D1 neutrophils and neutrophils slope; for O component were D1 serum lactate, serum lactate slope, D1 SOFA and SOFA slope. The relative weight of each component of PIRO was calculated. The combination of these four results into a single-value predictor of hospital mortality presented an AUC-ROC 0.84 (IC(95%:0.81-0.87 and a test of goodness-of-fit (Hosmer and Lemeshow of p = 0.368. CONCLUSIONS: We identified specific variables associated with each of the four components of PIRO, including biomarkers and a dynamic view of the patient daily clinical course. This novel approach to PIRO concept and overall score can be a better predictor of mortality for

  13. Influence of social support on cognitive change and mortality in old age: results from the prospective multicentre cohort study AgeCoDe

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    Eisele Marion

    2012-03-01

    Full Text Available Abstract Background Social support has been suggested to positively influence cognition and mortality in old age. However, this suggestion has been questioned due to inconsistent operationalisations of social support among studies and the small number of longitudinal studies available. This study aims to investigate the influence of perceived social support, understood as the emotional component of social support, on cognition and mortality in old age as part of a prospective longitudinal multicentre study in Germany. Methods A national subsample of 2,367 primary care patients was assessed twice over an observation period of 18 months regarding the influence of social support on cognitive function and mortality. Perceived social support was assessed using the 14-item version of the FSozU, which is a standardised and validated questionnaire of social support. Cognition was tested by the neuropsychological test battery of the Structured Interview for the Diagnosis of Dementia (SIDAM. The influence of perceived support on cognitive change was analysed by multivariate ANCOVA; mortality was analysed by multivariate logistic and cox regression. Results Sample cognitive change (N = 1,869: Mean age was 82.4 years (SD 3.3 at the beginning of the observation period, 65.9% were female, mean cognition was 49 (SD 4.4 in the SIDAM. Over the observation period cognitive function declined in 47.2% by a mean of 3.4 points. Sample mortality (N = 2,367: Mean age was 82.5 years (SD 3.4, 65.7% were female and 185 patients died during the observation period. Perceived social support showed no longitudinal association with cognitive change (F = 2.235; p = 0.135 and mortality (p = 0.332; CI 0.829-1.743. Conclusions Perceived social support did not influence cognition and mortality over an 18 months observation period. However, previous studies using different operationalisations of social support and longer observation periods indicate that such an influence may exist

  14. Association between serum interleukin-6 concentrations and mortality in older adults: the Rancho Bernardo study.

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    Jeffrey K Lee

    Full Text Available BACKGROUND: Interleukin-6 (IL-6 may have a protective role in acute liver disease but a detrimental effect in chronic liver disease. It is unknown whether IL-6 is associated with risk of liver-related mortality in humans. AIMS: To determine if IL-6 is associated with an increased risk of all-cause, cardiovascular disease (CVD, cancer, and liver-related mortality. METHODS: A prospective cohort study included 1843 participants who attended a research visit in 1984-87. Multiple covariates were ascertained including serum IL-6. Multivariable-adjusted Cox proportional hazards regression analyses were used to examine the association between serum IL-6 as a continuous (log transformed variable with all-cause, CVD, cancer, and liver-related mortality. Patients with prevalent CVD, cancer and liver disease were excluded for cause-specific mortality. RESULTS: The mean (± standard deviation age and body-mass-index (BMI of participants was 68 (± 10.6 years and 25 (± 3.7 Kg/m(2, respectively. During the 25,802 person-years of follow-up, the cumulative all-cause, CVD, cancer, and liver-related mortality were 53.1% (N = 978, 25.5%, 11.3%, and 1.3%, respectively. The median (± IQR length of follow-up was 15.3 ± 10.6 years. In multivariable analyses, adjusted for age, sex, alcohol, BMI, diabetes, hypertension, total cholesterol, HDL, and smoking, one-SD increment in log-transformed serum IL-6 was associated with increased risk of all-cause, CVD, cancer, and liver-related mortality, with hazard ratios of 1.48 (95% CI, 1.33-1.64, 1.38 (95% CI, 1.16-1.65, 1.35 (95% CI, 1.02-1.79, and 1.88 (95% CI, 0.97-3.67, respectively. CRP adjustment attenuated the effects but the association between IL-6 and all-cause and CVD mortality remained statistically significant, independent of CRP levels. CONCLUSIONS: In community-dwelling older adults, serum IL-6 is associated with all-cause, CVD, cancer, and liver-related mortality.

  15. Prospective comorbidity-matched study of Parkinson's disease and risk of mortality among women

    Science.gov (United States)

    Winter, Anke C; Rist, Pamela M; Buring, Julie E; Kurth, Tobias

    2016-01-01

    Background Individuals with Parkinson's disease (PD) may have an increased risk of overall mortality compared to the general population. Women may have lower mortality rates from PD than men; however, studies among women on the effect of PD on mortality have been limited and may not have adequately controlled for confounding by comorbidities. Methods We conducted a matched cohort study among participants in the Women's Health Study. 396 incident PD cases were identified through self-report. Each PD case was matched by age to a comparator who was alive and had the same modified Charlson comorbidity score as the PD case. The PD cases and matched comparators were followed for all-cause mortality. Cox proportional hazards models adjusted for age at the index date, smoking, alcohol consumption, exercise and body mass index were used to determine the association between PD and mortality. Results During a median of 6.2 years of follow-up, 72 women died (47 PD cases and 25 comparators). The multivariable-adjusted HR for mortality was 2.60 (95% CI 1.56 to 4.32). Conclusions PD was associated with more than a twofold increased risk of all-cause mortality among women. Results are similar to those observed among men. PMID:27670518

  16. Occupational exposure to asbestos is associated with increased mortality in men recruited for a population-based study in Germany

    Directory of Open Access Journals (Sweden)

    Katja Repp

    2015-10-01

    Full Text Available Objectives: Occupational exposure to asbestos is associated with increased mortality which, however, has not been thoroughly validated in a general population. We have aimed at exploring whether this association may be confirmed within a population-based setting after adjustment for confounders. Furthermore, the impact of tobacco consumption on the association between occupational exposure to asbestos and mortality is assessed. Material and Methods: We used data from 2072 (224 exposed male participants of the Study of Health in Pomerania. Information on exposure to asbestos is based on a selfreport. Median follow-up time was 11.3 years. All-cause mortality and cause-specific mortality of exposed and non-exposed men were compared using mortality rate ratios, Kaplan-Meier analyses and multivariable Cox regression. Results: During the follow-up, 52 (23.2% exposed and 320 (17.3% non-exposed participants deceased. Exposed subjects had increased hazard ratios (HR for all-cause mortality (HR=1.48, 95% CI: 1.1–2, benign lung disease mortality (HR=3, 95% CI: 1.18– 7.62 and stomach cancer mortality (HR=4.59, 95% CI: 1.53–13.76. The duration of exposure (per 10 years was associated with all-cause (HR=1.21, 95% CI: 1.07–1.36 and benign lung disease mortality (HR=1.68, 95% CI: 1.26–2.22. Smokers occupationally exposed to asbestos had the highest risk for all-cause (HR=3.70, 95% CI: 2.19–6.27 and cancer mortality (HR=4.56, 95% CI: 1.99–10.48 as compared to non-asbestos exposed non-smokers. Conclusions: Our results confirm associations of occupational exposure to asbestos with all-cause, benign lung disease, and stomach cancer mortality and underline the impact of joint effects of asbestos and smoking on mortality.

  17. Effect of chronic kidney diseases on mortality among digoxin users treated for non-valvular atrial fibrillation

    DEFF Research Database (Denmark)

    Sessa, Maurizio; Mascolo, Annamaria; Andersen, Mikkel Porsborg;

    2016-01-01

    , 1997 to December 31, 2012 were identified in Danish nationwide administrative registries. Cox proportional hazard model was used to compare the adjusted risk of all-causes and cardiovascular mortality among patients with and without chronic kidney disease and among patients with different chronic......PURPOSE: This study investigated the impact of chronic kidney disease on all-causes and cardiovascular mortality in patients with atrial fibrillation treated with digoxin. METHODS: All patients with non-valvular atrial fibrillation and/or atrial flutter as hospitalization diagnosis from January 1...... kidney disease stages within 180 days and 2 years from the first digoxin prescription. RESULTS: We identified 37,981 patients receiving digoxin; 1884 patients had the diagnosis of chronic kidney disease. Cox regression analysis showed no statistically significant differences in all-causes (Hazard Ratio...

  18. Impaired fasting glucose and body mass index as determinants of mortality in ALLHAT: is the obesity paradox real?

    Science.gov (United States)

    Shah, Ravi V; Abbasi, Siddique A; Yamal, José-Miguel; Davis, Barry R; Barzilay, Joshua; Einhorn, Paula T; Goldfine, Alison B; Goldfine, Allison

    2014-06-01

    Emerging literature suggests that obesity may be "protective" against mortality and cardiovascular outcomes, while dysglycemia may worsen outcomes regardless of obesity. The authors measured the association of weight, smoking, and glycemia with mortality in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Among 5423 ALLHAT participants without established diabetes or cardiovascular disease, 3980 (73%) had normal fasting glucose and 1443 (27%) had impaired fasting glucose (IFG) levels at study entry. After a median of 4.9 years follow-up, 554 (10%) had died (37% cardiovascular). IFG was associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.02-1.50), while obesity was associated with lower all-cause mortality (adjusted HR, 0.76; 95% CI, 0.60-0.96). However, after excluding underweight individuals (body mass index [BMI] obesity nor IFG was associated with all-cause mortality [corrected]. Although obesity appeared protective against mortality, this association was not significant in never-smokers or after exclusion of BMI obesity paradox may result from confounding by a sicker, underweight referent population and smoking.

  19. Impact of diabetes mellitus on pneumonia mortality in a senior population:results from the NHANES III follow-up study

    Institute of Scientific and Technical Information of China (English)

    Jian Liu

    2013-01-01

    Objective To examine whether diabetes mellitus increases the risk of pneumonia mortality among seniors in the U.S. general popula-tion. Methods&Results The NHANES III follow-up study data were used. After excluding individuals from other minorities, being hos-pitalized with pneumonia in the previous year at baseline, or death of pneumonia during the first year of follow-up, a total of 3,707 subjects aged 65 years or older (1,794 men and 1,913 women) who had no missing information on variables for the analysis were included. Approxi-mately 16% of seniors at baseline were diabetics, which was defined as either having been diagnosed by a physician, currently taking pills/insulin lowering blood glucose, or HbA1c higher than 6.4%. During an average 11 years of follow-up, a total of 98 deaths due to pneu-monia were recorded (ICD-10:J12-J18). Cox-regression models were used to estimate the risk association between pneumonia mortality and diabetes mellitus. After adjustment for the covariates at baseline, the hazard ratios of pneumonia death were 1.30 (95%CI:0.64-2.70) for pre-diabetics and 2.28 (95%CI:1.18-4.39) for diabetics, respectively. Among those covariates, only age (HR (95%CI);1.16 (1.13-1.20)), gender as female (0.35 (0.22-0.61)) and physical fitness measured as having no problem walking 1+mile during the previous month (0.38 (0.20-0.67)) reached statistical significance. Conclusions The results suggest that diabetes mellitus is a strong risk predictor of pneumonia mortality and the evaluation of physical fitness may also be useful in the risk prediction of pneumonia mortality for seniors.

  20. Excess Mortality in Patients with Severe Mental Disorders in 1996-2010 in Finland.

    Science.gov (United States)

    Lumme, Sonja; Pirkola, Sami; Manderbacka, Kristiina; Keskimäki, Ilmo

    2016-01-01

    Unselected population-based nationwide studies on the excess mortality of individuals with severe mental disorders are scarce with regard to several important causes of death. Using comprehensive register data, we set out to examine excess mortality and its trends among patients with severe mental disorders compared to the total population. Patients aged 25-74 and hospitalised with severe mental disorders in 1990-2010 in Finland were identified using the national hospital discharge register and linked individually to population register data on mortality and demographics. We studied mortality in the period 1996-2010 among patients with psychotic disorders, psychoactive substance use disorders, and mood disorders by several causes of death. In addition to all-cause mortality, we examined mortality amenable to health care interventions, ischaemic heart disease mortality, disease mortality, and alcohol-related mortality. Patients with severe mental disorders had a clearly higher mortality rate than the total population throughout the study period regardless of cause of death, with the exception of alcohol-related mortality among male patients with psychotic disorders without comorbidity with substance use disorders. The all-cause mortality rate ratio of patients with psychotic disorders compared to the total population was 3.48 (95% confidence interval 2.98-4.06) among men and 3.75 (95% CI 3.08-4.55) among women in the period 2008-10. The corresponding rate ratio of patients with psychoactive substance use disorders was 5.33 (95% CI 4.87-5.82) among men and 7.54 (95% CI 6.30-9.03) among women. Overall, the mortality of the total population and patients with severe mental disorders decreased between 1996 and 2010. However, the mortality rate ratio of patients with psychotic disorders and patients with psychoactive substance use disorders compared to the total population increased in general during the study period. Exceptions were alcohol-related mortality among

  1. An actuarial approach to comparing early stage and late stage lung cancer mortality and survival.

    Science.gov (United States)

    Goldberg, Sara W; Mulshine, James L; Hagstrom, Dale; Pyenson, Bruce S

    2010-02-01

    Comparing the mortality characteristics of different cohorts is an essential process in the life insurance industry. Pseudodisease, lead-time bias, and length bias, which are critical to determining the value of cancer screening, have close analogues in life insurance company management, including the temporal impact of underwriting. Ratios of all-cause mortality rates for cancer cohorts relative to standard population mortality rates can provide insights into early stage and late stage mortality differences, differences by age, sex, race, and histology, and allow modeling of biases associated with early stage detection or screening protocols. The Surveillance, Epidemiology and End Results (SEER) data set has characteristics that allow efficient application of actuarial techniques. We show the mortality burden associated with treated early stage lung cancer and that identifying all lung cancers at early stage could reduce US lung cancer deaths by over 70,000 per year.

  2. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women: A Prospective Cohort Study.

    Science.gov (United States)

    Neergaard, Jesper Skov; Dragsbæk, Katrine; Hansen, Henrik Bo; Henriksen, Kim; Christiansen, Claus; Karsdal, Morten Asser

    2016-03-01

    Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32-2.34]) and impaired fasting glucose levels. A dose-response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05-1.49] and 1.45 [1.03-2.06] for impaired (5.6-6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62-0.89]) and physical activity at least once weekly (HR = 0.77 [0.61-0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population.

  3. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study.

    Science.gov (United States)

    de Groot, Lisette C P M G; Verheijden, Marieke W; de Henauw, Stefaan; Schroll, Marianne; van Staveren, Wija A

    2004-12-01

    This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at base