Age-adjusted Rates Research Articles

Increased mortality among mothers involved in family court care proceedings compared with their peers in England

ObjectiveResearch has called for Family Courts (FC) and social care services involved in removing children from parental care to consider and address the health of the mother. ApproachWe linked England FC and healthcare data to compare the 10-year mortality risk and cause of death after a first live birth (FLB) for mothers who were involved or not in FC proceedings in England. Results3,072,946 mothers (15-39 years) with a FLB between 2007 and 2019 were followed for up to 10 years (median:8.7 years, IQR: 5.4-10), during which 33,759 were involved in FC. Ten-year cumulative mortality was higher among the FC mothers (1.7 vs 0.3%) and the age-adjusted mortality rate ratio was 7.8 (95%CI: 7.00-8.6). The majority of maternal deaths in both groups met criteria for avoidable death (FC 82.9% vs no-FC 66.8%). Injury was the leading cause of death (204/420; 48.5%) in mothers involved in FCs and cancer (2,823/6,208; 45.5%) in mothers in the no-FC group. Compared with no-FC mothers, more deaths were related to drug use (35.0% vs 6.0%), suicide (14.5% vs 8.4%) or alcohol (9.8% vs 3.5%). Among mothers involved in FCs, maternal mortality was higher in cases when children were placed into out-of-home care (1.65%, 463/28143), than when placed at home (0.94%, 53/5563) at first FC proceeding. Conclusions and ImplicationsAddressing high rates of avoidable mortality among mothers involved in FCs is important for children and parents and could be monitored using routinely linked healthcare, social care and family court data.

SP7.11 - Long term mortality risk factors for patients that underwent a Carotid surgery

Abstract Aims Carotid endarterectomy is the gold standard intervention to reduce carotid stenosis induced embolic cerebrovascular events. Current literature lacks long-term large sample analysis for post-carotid surgery mortality risks. The aim of this study was to determine long term all-cause mortality after carotid surgery. Method Single centre 10-year retrospective observational study of CEA mortality evaluating pre, intra and post-operative factors between 2010 and 2020. The data was manually extracted from the hospital’s database. Odds ratios and mortality rates were calculated and adjusted for age by adapting linear regression. Results 970 patients’ data were identified with an average follow up of 6.65 ±3.37 years for an average mortality rate of 31.9%. There was a non-significant (p>0.05) age adjusted odd of survival between gender (aOR 1.81 ±0.298) elective admission (aOR 0.932 ±0.321) and symptomatic patients (aOR 1.274 ±0.47). There was a significantly (p>0.05) decreased chance of survival for current smokers (aOR 0.433 ±0.54) and patients on ACE/ARB (aOR 0.516 ±0.091). On the other hand, single (aOR 2.934 ±0.531) and dual anti-platelet (aOR 4.964 ±0.286) showed a significant (p>0.05) protective effect. The 5-year age-adjusted death rate was elevated for all patients at 1.42. Conclusion The results highlight the smoking cessation, DAPT and appropriate prophylaxis remain important factors in increasing survival odds post carotid surgery. 30% mortality at 5 years is similar to those after Aortic interventions in these arteriopathic patients with extensive co morbidities.

Trends in patient characteristics and mortality among Medicare patients diagnosed with peripheral artery disease.

Peripheral artery disease (PAD) is a well-described risk factor for mortality, but few studies have examined secular trends in mortality over time for patients with PAD. We characterized trends in mortality in patients with PAD in recent years among Medicare patients. We used Medicare claims to identify patients with a new diagnosis code for PAD between January 1, 2006 and December 31, 2018 using International Classification of Diseases (ICD) diagnosis codes. The primary outcome of interest was the 1-year all-cause age-adjusted mortality rate. Our secondary outcome was the 5-year all-cause mortality rate. Multivariable regression was used to identify factors which predict mortality at 1 year. We identified 4,373,644 patients with a new diagnosis code for PAD during the study period. Between 2006 and 2018, 1-year all-cause age-adjusted mortality declined from 12.6% to 9.9% (p < 0.001). One-year crude all-cause mortality also declined from 14.6% to 9.5% (p < 0.001). Similar results were observed for 5-year age-adjusted mortality rates (40.9% to 35.2%, p < 0.001). Factors associated with increased risk of death at 1 year included age ⩾ 85 years (hazard ratio [HR] 3.030; 95% CI 3.008-3.053) and congestive heart failure (HR 1.86; 95% CI 1.85-1.88). Patients who were regularly dispensed statins, ace-inhibitors, beta-blockers, antithrombotic agents, and anticoagulants all had lower mortality (range OR 0.36; CI 0.35-0.37 for statins to OR 0.60; CI 0.59-0.61 for anticoagulants; all p < 0.001). Among US Medicare patients diagnosed with PAD between 2006 and 2019, 1-year age-adjusted mortality declined by 2.7%. This decline in mortality among PAD patients occurred in the context of a younger mean age of diagnosis of PAD and improved cardiovascular prevention therapy.

Social and Environmental Determinants of Health and Cardio-Kidney-Metabolic Syndrome–Related Mortality

It is not well understood if and how various social and environmental determinants of health (SEDoH) are associated with mortality rates related to cardio-kidney-metabolic syndrome (CKM) across the US. To study the magnitude of the association strength of SEDoH with CKM-related mortality at the county level across the US. This cross-sectional, retrospective, population-based study used aggregate county-level data from the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) data portal from 2010-2019. Data analysis occurred from September 2023 to January 2024. A total of 7 diverse SEDoH were chosen, including median annual household income, percentage of racial and ethnic minority residents per county, fine particulate air pollution (PM2.5) concentrations, high-school completion rate, primary health care access, food insecurity, and rurality rate. The primary outcome was county-level age-adjusted mortality rate (aaMR) attributable to CKM. The association of county-level CKM-related aaMR with the 7 SEDoH was analyzed using geographically weighted models and the model median coefficients for each covariate studied. Data from 3101 of 3243 counties (95.6%) were analyzed. There was substantial variation in SEDoH between states and counties. The overall pooled median (IQR) aaMR (2010-2019) in the US was 505.5 (441.3-578.9) per 100 000 residents. Most counties in the lower half of the US had rates much higher than the pooled median (eg, Southern US median [IQR] aaMR, 537.3 [466.0-615.9] per 100 000 residents). CKM-related mortality was positively associated with the food insecurity rate (median [IQR] β = 6.78 [2.78-11.56]) and PM2.5 concentrations (median [IQR] β = 5.52 [-11.06 to 19.70]), while it was negatively associated with median annual household income (median [IQR] β = -0.002 [-0.003 to -0.001]), rurality (median [IQR] β = -0.32 [-0.67 to 0.02]), high school completion rate (median [IQR] β = -1.89 [-4.54 to 0.10]), racial and ethnic minority rate (median [IQR] β = -0.66 [-1.85 to 0.89]), and primary health care access rate (median [IQR] β = -0.18 [-0.35 to 0.07]). In this cross-sectional study of county-level data across the US, there were substantial geographical differences in the magnitude of the association of SEDoH with CKM-related aaMR. These findings may provide guidance for deciding local health care policy.

Evolving Characteristics of Decedents With Hepatitis AListed as a Cause of Death, United States, 2011-2021.

Hepatitis A is a vaccine-preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person-to-person transmission have been widespread in the United States since 2016. We used public-use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A-listed deaths during non-outbreak (2011-2015) and outbreak (2017-2021) periods and assessed the median age at death among decedents with and without hepatitis A-listed deaths during the outbreak period. From the non-outbreak period to the outbreak period, hepatitis A-listed deaths more than doubled (from 369 to 801), while the hepatitis A-listed age-adjusted mortality rate increased 150% (p < 0.001). When compared with the non-outbreak period, hepatitis A-listed decedents during the outbreak period were more frequently male, aged 18-49 years, non-Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A-listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non-outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A-listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017-2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths.

Global forecasting of chronic kidney disease mortality rates and numbers with the generalized additive model

BackgroundChronic kidney disease (CKD) is an important public health problem worldwide; therefore, forecasting CKD mortality rates and death numbers globally is vital for planning CKD prevention programs. This study aimed to characterize the temporal trends in CKD mortality at the international level from 1990 to 2019 and predict CKD mortality rates and numbers until 2030.MethodsData were obtained from the Global Burden of Disease 2019 Study. A joinpoint regression model was used to estimate the average annual percentage change in CKD mortality rates and numbers. Finally, we used a generalized additive model to predict CKD mortality through 2030.ResultsThe number of CKD-related deaths worldwide increased from 591.80 thousand in 1990 to 1425.67 thousand in 2019. The CKD age-adjusted mortality rate increased from 15.95 per 100,000 people to 18.35 per 100,000 people during the same period. Between 2020 and 2030, the number of CKD deaths is forecasted to increase further to 1812.85 thousand by 2030. The CKD age-adjusted mortality rate is expected to decrease slightly to 17.76 per 100,000 people (95% credible interval (CrI): 13.84 to 21.68). Globally, it is predicted that in the next decade, the CKD mortality rate will decrease in men, women, all subgroups of disease etiology except glomerulonephritis, people younger than 40 years old, and all groupings of countries based on the sociodemographic index (SDI) except high-middle-SDI countries.ConclusionsThe CKD mortality rate is predicted to decrease in the next decade. However, more attention should be given to people with glomerulonephritis, people over 40 years old, and people in high- to middle-income countries because the mortality rate due to CKD in these subgroups is expected to increase until 2030.

Abstract P326: Measuring Health Equity Gaps for a Blood Pressure Control Quality Improvement Program: Results from Cook County Health

Background: High blood pressure (BP) affects nearly half of U.S. adult population and was responsible for 13.0 deaths per 100,000 in 2022, with significant differences in age-adjusted mortality rates by sex, race, and ethnicity. Previous research has also highlighted that lower BP control rates are more prominent in Hispanic and Non-Hispanic Black patients, and well as those 60 years or older. This study assesses the role of the AMA MAP™ Hypertension quality improvement (QI) program to improve potential inequities in blood pressure control at a large public health care institution. Methods: 18,252 patients diagnosed with hypertension were identified at Cook County Health. BP values were obtained for patients in the 2 -years prior to implementation of the QI program (July 2019 to June 2021) compared to BP in the 2-years after implementation (July 2021 to July 2023). A multivariable logistic regression model of BP control status, paired t-tests, and ANCOVA analyses, stratified by race, ethnicity, sex, and age are conducted to assess SBP and measure the gaps by demographic characteristics. Results: Prior to the QI program, BP control (&lt;140/&lt;90) was significantly less for Black as compared to White patients (OR 0.82 [0.74-0.92]). The racial difference remained after the program, although it was slightly diminished (OR 0.86 [0.76 – 0.97]). Patients who were older were less likely to have controlled BP prior to the program, but these differences were no longer evident following the QI program. The QI program led to a decline in SBP in all demographic groups, including between ethnicity as shown in Figure 1 (Hispanic: -5.74 [CI:6.19- -5.29] vs Non-Hispanic -4.92 [-5.21- -4.63]), White (-5.96 [CI: -6.45- -5.47]) and Black (-4.80 [CI: -5.11- -4.49]) patients, and by age as shown in Figure 2 between 45-64 years ( -5.79 [CI: -6.12- -5.46] and 65-85 years (-4.31 [CI: -4.68- -3.94]). Conclusion: The results indicate an overall improvement in BP control and SBP, however, gaps persisted in SBP across ethnicity, race, and certain age groups. Quality improvement coaching and dashboards may support clinical care teams in addressing inequities in patient BP control.

Heart Failure Mortality in Chronic Kidney Disease: The Fatal Crossover

Real-world mortality data regarding heart failure in patients with comorbid chronic kidney disease remains limited, especially following the advent of advanced heart failure therapies. Using the CDC WONDER database, we included patients ≥ 25 years old who died primarily from heart failure (2011-2020) with comorbid chronic kidney disease. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals. We determined the trends over time by estimating the annual percent change (APC) using the Joinpoint regression program. There were 82,454 heart failure deaths with comorbid chronic kidney disease. The AAMR increased from 2.34 (95% CI, 2.28- 2.41) in 2011 to 4.79 (95% CI, 4.71- 4.88) in 2020. During the study period, Heart failure deaths among patients with comorbid chronic kidney disease increased by 149.0% compared to 59.9% in those without. Men had higher AAMR than women (3.92 [95% CI, 3.88- 3.96] vs. 2.96 [95% CI, 2.93- 2.99]). African American patients had the highest AAMR (5.85 [95% CI, 5.75- 5.96]). The Midwest region had the highest AAMR (3.83 [95% CI, 3.78- 3.89]). The AAMR was higher in the rural areas than in the urban regions (3.77 [95% CI, 3.71- 3.83] vs. 3.23 [95% CI, 3.20- 3.25]). Most patients died in hospices or nursing homes (29,000, 35.2%). Our study showed a significant increase in heart failure AAMR in patients with comorbid chronic kidney disease in recent eras. Further effort is needed to optimize cardioprotective agents for this population and to address demographic discrepancies at the policy level.

All-cause mortality due to conduction abnormalities in the United States: Sex, racial, and geographic variations from 1999 to 2022

BackgroundMortality related to conduction abnormalities in the United States (US) population is not well documented. Population-based stratification approaches can improve public health policies and targeted strategies. ObjectiveThe purpose of this study was to evaluate all-cause mortality related to conduction abnormalities in the US population MethodsThe Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to calculate the age-adjusted mortality rate (AAMR) per 100,000 individuals older than 35 years related to conduction abnormalities between 1999 and 2022. ResultsA total of 207,861 deaths were attributed to conduction abnormalities throughout the study period ,with 56,186 of these deaths occurring between 2020 and 2022. All-cause mortality related to conduction abnormalities has increased during the past decade with an exponential growth in 2020–2021 (coronavirus disease 2019 era; annual percent change of 16.6% per year). Although the mortality rates decreased in 2022, they remained elevated compared to 2019–2020. Throughout the past 2 decades, males consistently exhibited higher mortality rates than females, with the rate in 2022 being 1.5 times higher (AAMR 11.4 vs 7.0 per 100,000). Non-Hispanic Black patients experienced a significantly higher mortality rate compared to non-Hispanic White individuals in the study period (AAMR 13.7 vs 8.6 per 100,000 in 2022). In the past 2 decades, mortality has been persistently higher in rural and small- to medium-sized metropolitan areas than in large metropolitan urban areas. ConclusionMortality rates related to conduction abnormalities have increased over the past decade, and persistent disparities have been observed. These data suggest that continued innovative outreach approaches and engagement with underrepresented populations remain essential.

Post-COVID changes and disparities in cardiovascular mortality rates in the United States

IntroductionThe COVID-19 pandemic disrupted healthcare delivery and increased cardiovascular morbidity and mortality. This study assesses whether cardiovascular mortality rates in the US have recovered post-pandemic and examines the equity of this recovery across different populations. MethodsWe analyzed data from the CDC WONDER database, covering US residents’ mortality from 2018–2023. We focused on cardiovascular diseases, categorized by ischemic heart disease (IHD), heart failure (HF), hypertensive diseases (HTN), and cerebrovascular disease. Age-adjusted mortality rates were calculated for three periods: pre-COVID (2018–2019), during COVID (2020–2021), and post-COVID (2022–2023), stratified by demographic and geographic variables. ResultsCardiovascular age-adjusted mortality rates increased by 5.9% during the pandemic but decreased by 3.4% post-pandemic, resulting in a net increase of 2.4% compared to pre-COVID levels. When compared to pre COVID age-adjusted mortality rates, post COVID IHD mortality age-adjusted mortality rates decreased by 5.0%, while cerebrovascular and HTN age-adjusted mortality rates increased by 5.9% and 28.5%, respectively. Men and younger populations showed higher increases in cardiovascular Age-adjusted mortality rates. Geographic disparities were notable, with significant reductions in cardiovascular mortality in the Northeast and increases in states like Arizona and Oregon. ConclusionThe COVID-19 pandemic led to a surge in cardiovascular mortality, with partial recovery post-pandemic. Significant differences in mortality changes highlight the need for targeted healthcare interventions to address inequities across demographic and geographic groups.

Lung cancer mortality trends and disparities: A cross-sectional analysis 1999–2020

BackgroundLung cancer remains a leading cause of morbidity and mortality in the United States. Given the importance of epidemiological insight on lung cancer outcomes as the foundation for targeted interventions, we aimed to examine lung cancer death trends in the United States in the recent 22-year period, exploring demographic disparities and yearly mortality shifts. MethodsMortality information was obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database from the years 1999–2020. Demographic information included age, sex, race or ethnicity, and area of residence. We performed log-linear regression models to assess temporal mortality shifts and calculated average annual percentage change (AAPC) and compared age-adjusted mortality rates (AAMR) across demographic subpopulations. ResultsA total of 3,380,830 lung cancer deaths were identified. The AAMR decreased from 55.4 in 1999-31.8 in 2020 (p<0.001). Males (AAMR 57.6) and non-Hispanic (NH) (AAMR 47.5) populations were disproportionately impacted compared to females (AAMR 36.0) and Hispanic (AAMR 19.1) populations, respectively. NH Black populations had the highest AAMR (48.5) despite an overall reduction in lung cancer deaths (AAPC −3.3 %) over the study period. Although non-metropolitan regions were affected by higher mortality rates, the annual decrease in mortality among metropolitan regions (AAPC −2.8 %, p<0.001) was greater compared to non-metropolitan regions (AAPC −1.7 %, p<0.001). Individuals living in the Western US (AAPC −3.4 %, p<0.001) experienced the greatest decline in lung cancer mortality compared to other US census regions. ConclusionsOur findings revealed lung cancer mortality inequalities in the US. By contextualizing these mortality shifts, we provide a larger framework of data-driven initiatives for societal and health policy changes for improving access to care, minimizing healthcare inequalities, and improving outcomes.

Hypertension status and its risk factors in highlanders living in Ganzi Tibetan Plateau: a cross-sectional study

BackgroundThe updated status of hypertension and its risk factors are poorly evaluated in Tibetan highland areas. We initiated a large-scale cross-sectional survey to provide updated status of hypertension and its risk factors (especially salt intake) in the Ganzi Tibetan Plateau, China.MethodsStratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents from 4 counties in the Ganzi Tibetan area. The whole survey population was used to present the epidemiology and risk factors of hypertension. The participants with blood and urine biochemistry data were used to analyze the relationship between salt intake parameters and hypertension.ResultsStratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents. The overall prevalence rate of hypertension was 33.5% (the age-adjusted prevalence rate was 28.9%). A total of 50.9% of the hypertensive patients knew their conditions; 30.1% of them received antihypertensive treatment; and 11.2% of them had their blood pressure controlled. Age, male sex, living altitude ≥ 3500 m, overweight and abdominal obesity were positively correlated with hypertension. In addition, the adjusted odds ratio (OR) for hypertension was 1.33 (95% CI: 1.01–1.74) for drinking tea with salt, and 1.51 (95% CI: 1.32–1.72) for per SD increase in the estimation of 24-hour urinary sodium excretion (e24hUSE). Furthermore, per 100mmol/day increase in e24hUSE was associated with elevation of blood pressure (+ 10.16, 95% CI: 8.45–11.87 mmHg for SBP; +3.83, 95% CI: 2.74–4.93 mmHg for DBP) in this population.ConclusionsOur survey suggests a heavy disease burden of hypertension in the Ganzi Tibetan Plateau. Age, male sex, altitude of residence ≥ 3500 m, overweight, abdominal obesity, and excessive salt intake (shown as drinking tea with adding salt and a higher level of e24hUSE) all increased the risk of hypertension in this highland area.

Trends in pancreatic cancer mortality in the United States 1999-2020: a CDC database population-based study.

Pancreatic cancer is a significant public health concern and a leading cause of cancer-related deaths worldwide. This study aimed to investigate pancreatic cancer mortality trends and disparities in the United States (US) from 1999 to 2020. Data were obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research database. Mortality rates were age-adjusted and standardized to the year 2000 US population. Joinpoint regression was used to analyze temporal trends in age-adjusted mortality rates (AAMRs) by sociodemographic and geographic variables. Between 1999 and 2020, pancreatic cancer led to a total of 810,628 deaths in the US, an average mortality of nearly 39,000 deaths per year. The AAMR slightly increased from 10.6 in 1999 to 11.1 in 2020, with an associated annual percent change (APC) of 0.2. Mortality rates were highest among individuals aged 65 and older. Black individuals experienced the highest overall pancreatic cancer-related AAMR at 13.8. Despite this, Black individuals experienced a decreasing mortality trend over time (APC -0.2) while White individuals experienced an increasing trend in mortality (APC 0.4). Additionally, individuals residing in rural areas experienced steeper rates of mortality increase than those living in urban areas (APC 0.6 for rural vs -0.2 for urban). White individuals in urban and rural populations experienced an increase in mortality, while Black individuals in urban environments experienced a decrease in mortality, and Black individuals in rural environments experienced stable mortality trends. Mortality from pancreatic cancer continues to increase in the US, with racial and regional disparities identified in minorities and rural-dwelling individuals. These disparate findings highlight the importance of ongoing efforts to understand and address pancreatic cancer treatment and outcomes disparities in the US, and future studies should further investigate the underlying etiologies of these disparities and potential for novel therapies to reduce the mortality.

Temporal trends in Parkinson's disease among older adults in the United States from 1999 to 2020: Retrospective analysis from CDC WONDER database

This retrospective study assessed the mortality trends related to Parkinson's Disease (PD) between 1999 and 2020. We assessed individuals aged 65 years and older and a total of 831,793 deaths were identified. Of these total number of deaths, place of death was accessible for 830,176 cases. Majority of the deaths occurred in nursing homes of long-term care facilities (367,633), followed by at home (212,886), medical facilities (165,450), other locations (44,506), and hospice (39,701). Analysis of age-adjusted mortality rates (AAMR) revealed an overall rise from 1999 to 2020, 88.9 to 119.6 per 100,000 population. AAMR showed an initial decline between 1999 and 2013, followed by a slight increase between 2013 and 2018 and then a significant rise from 2018 to 2020. Gender-based analysis showed a constantly higher AAMR for older men compared to older women. Variations in AAMR based on race and ethnicity revealed that Non-Hispanic White population had the highest AAMRs. Geographic disparities among states showed that Nebraska, Vermont, Minnesota, Utah, and Idaho had a significantly higher AAMR than Hawaii, Florida, Nevada. New York, and District of Columbia. Midwest region had a consistently higher AAMR followed by West, South, and Northeast. Additionally, nonmetropolitan areas had a higher AAMR than metropolitan areas. These findings offer valuable insights into mortality patterns related to PD among the elderly, highlighting the significance of incorporating demographic and geographic variables into public health planning and interventions.

Temporal Trends in Race and Sex Differences in Cardiac Arrest Mortality in the USA, 1999–2020

BackgroundCardiac arrest (CA) affects over 600,000 patients in the USA annually. Despite large-scale public health and educational initiatives, survival rates are lower in certain racial and socioeconomic groups. MethodsA county-level cross-sectional longitudinal study using death data of patients aged 15 years or more from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2020. CAs were identified using the International Classification of Diseases, tenth revision, clinical modification codes. ResultsThe CA-related deaths between 1999 and 2020 were 7,710,211 in the entire USA. The annual CA related age-adjusted mortality rates (CA-MR) declined through 2019 (132.9 to 89.7 per 100,000 residents), followed by an increase in 2020 (104.5 per 100,000). White patients constituted 82 % of all deaths and 51 % were female. The overall CA-MR during the study period was 104.48 per 100,000 persons. The CA-MR was higher for men as compared with women (123.5 vs. 89.7 per 100,000) and higher for Black as compared with White adults (154.4 vs. 99.1 per 100,000). ConclusionsCA-MR in the overall population has declined, followed by an increase in 2020, which is likely the impact of the COVID-19 pandemic. There were also significant racial and sex differences in mortality rates.

Identify Primary Risk Variables Influencing the Recurrence of Cervical Cancer in Patients, Using Non-Parametric Methods at Tikur Anbessa Specialized Hospital

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: This study aimed to identify the primary risk variables influencing the recurrence of cervical cancer in patients, at Tikur Anbessa Specialized Hospital. Cervical cancer deaths in Ethiopia reached 4,595, or 0.76% of total deaths. The age-adjusted death rate is 18.51 per 100,000 of the population in Ethiopia. &amp;lt;i&amp;gt;Method&amp;lt;/i&amp;gt;: Among patients with cervical cancer, an institution-based retrospective follow-up research was conducted from January 2015 to March 2017 at TASH and is under follow-up. Out of a population of cervical cancer patients who were taking treatment in the hospital during that period, data on 420 patients is included in this study. Non-parametric methods, such as log-rank tests and the Kaplan-Meier method, were used to compare the rate of recurrence among the different explanatory variable categories. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: After the medical cards of women were reviewed among those patients with cervical cancer, 170 (40.5%) were recurrent, and the remaining 250 (59.5%) were censored. Out of the total patients, 6.2% were at stage I, 32.6% were at stage II, 51.7% were at stage III, and 9.5% were at stage IV. The recurrence proportions of stage I, stage II, stage III, and stage IV patients were 5.88%, 27.05%, 52.35%, and 14.705%, respectively. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Finally, the findings of this study implied that age, smoking cigarettes, stage of disease, initial treatment patients took, types of treatment patients took, and place were major factors related to the recurrence time of cervical cancer patients.

The Trends in Atrial Fibrillation-Related Mortality before, during, and after the COVID-19 Pandemic Peak in the United States.

Background: During the first months of the COVID-19 outbreak, an increase was observed in atrial fibrillation (AF)-related mortality in the United States (U.S). We aimed to investigate AF-related mortality trends in the U.S. before, during, and after the COVID-19 pandemic peak, stratified by sociodemographic factors. Methods: using the Wide-Ranging Online Data for Epidemiologic Research database of the Centers for Disease Control and Prevention, we compared the AF-related age-adjusted mortality rate (AAMR) among different subgroups in the two years preceding, during, and following the pandemic peak (2018-2019, 2020-2021, 2022-2023). Result: By analyzing a total of 1,267,758 AF-related death cases, a significant increase of 24.8% was observed in AF-related mortality during the pandemic outbreak, followed by a modest significant decrease of 1.4% during the decline phase of the pandemic. The most prominent increase in AF-related mortality was observed among males, among individuals younger than 65 years, and among individuals of African American and Hispanic descent, while males, African American individuals, and multiracial individuals experienced a non-statistically significant decrease in AF-related mortality during the pandemic decline period. Conclusions: Our findings suggest that in future healthcare crises, targeted healthcare policies and interventions to identify AF, given its impact on patients' outcomes, should be developed while addressing disparities among different patient populations.

Geo-demographic trends in nontraumatic subarachnoid hemorrhage-related mortality among older adults in the United States, 1999-2020.

Nontraumatic subarachnoid hemorrhage (ntSAH) often results from a ruptured aneurysm and correlates with significant morbidity and mortality, particularly among the older population. Despite its impact, limited comprehensive studies evaluate the longitudinal trends in ntSAH-related mortality in older adults in the United States (US). The authors conducted a retrospective analysis using the CDC WONDER database from 1999 to 2020, analyzing Multiple Cause-of-Death Public Use death certificates to identify ntSAH as a contributing factor in the death of adults aged 65 years and older. We calculated age-adjusted mortality rates (AAMR) and annual percent change (APC) to examine trends across demographic variables such as sex, race/ethnicity, urbanization, and states/census region. A total of 78,260 ntSAH-related deaths (AAMR 8.50 per 100,000 individuals) occurred among older adults in the US from 1999 to 2020. The overall AAMR for ntSAH decreased from 9.98 in 1999 to 8.67 in 2020 with an APC of -0.7% [95% CI (-1.0, -0.3)]. However, the authors observed a noticeable rise from 2013 to 2020 with an APC of 1.7% [95% CI (0.8, 2.6)]. Sex, racial, and regional disparities were evident with higher mortality rates for ages 85 or greater (crude mortality rate 16.6), women (AAMR 9.55), non-Hispanic Asian or Pacific Islander (AAMR 12.5), and micropolitan areas (AAMR 8.99), and Western US (AAMR 8.65). Mortality from ntSAH increases with age, affects women disproportionately, and occurs more often in an inpatient setting. These findings necessitate targeted, multi-dimensional health policies and clinical interventions. Specialties beyond neurosurgery can utilize this data for improved risk stratification and early treatment. Policymakers should focus on equitable resource allocation and community-level interventions to mitigate these trends effectively.

Mortality in the United States - Provisional Data, 2023.

Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data. In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups. Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614). Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality.

Comparing SEER and NCDB: a case study using colorectal cancer.

Nationwide datasets are frequently used to examine cancer trends and outcomes in the U.S. Understanding the strengths and limitations of the commonly used Surveillance, Epidemiology, and End Results (SEER) Program and the National Cancer Database (NCDB) is important when designing studies and interpreting results. We used colorectal cancer (CRC) as a case study to compare information available. We identified 575,128 (SEER) and 1,578,046 (NCDB) adults diagnosed with CRC between 2004 and 2021. The distribution of age, tumor location, stage, and treatment did not meaningfully differ between SEER and NCDB. SEER represents racially and ethnically diverse populations, including a higher proportion of Hispanic (11.7% vs 5.8%) and Asian/Pacific Islander (8.6% vs 3.3%) persons. SEER includes more information on area-level characteristics, such as county-level measures of poverty, unemployment, and migration and census tract-level measures of socioeconomic status. Age-adjusted incidence, mortality rates, and cause-specific survival are only available in SEER, facilitating detailed analyses of racial, ethnic, and socioeconomic differences in cancer incidence and mortality. NCDB provides information on tumor characteristics and treatment not available in SEER, including microsatellite instability, KRAS mutation, palliative treatment, unplanned readmissions, and 30-day mortality after surgery, facilitating analyses of treatment effectiveness and outcomes. Five-year overall survival was similar in SEER (55.6%) vs NCDB (57.5%).