Mortality In Poland Research Articles

How Sociodemographic Factors Impact the Utilization of Recommended Clinical Preventive Screening Services in Poland: A Nationwide Cross-Sectional Study.

Cardiovascular disease (CVD) and cancer are the most frequent causes of mortality in Poland. To date, no study in Poland has attempted to analyze the impact of sociodemographic factors on the utilization of all recommended preventive services for these diseases. To address this challenge, a nationwide cross-sectional study was conducted. One thousand adults aged 18 years or older were interviewed using computer-assisted telephone surveys conducted via random selection. A representative population was obtained in accordance with existing demographics per voivodeship in Poland. We assessed whether factors such as age, gender, body mass index (BMI), net income, household size, place of residence, and education impacted the odds ratio of utilizing recommended preventive services for CVD and cancer. We determined that elderly patients receive influenza vaccination, measure blood pressure, PSA concentration, glucose and lipid profiles, and undergo colonoscopy and mammography more often than younger counterparts. Men were more often influenza vaccinated (OR = 1.56, 95% CI: 1.07–2.27) than women, while women measured blood glucose more often than men (OR = 0.62, 95% CI: 0.42–0.93). Furthermore, net income < 2000 PLN, BMI < 24 kg/m2 and at least secondary education level were found to be crucial predictors of undergoing mammography (OR = 2.16; 95% CI: 1.26–3.72), cervical smear tests (OR = 1.99, 95% CI: 1.24–3.17), and lipid measurements (OR = 1.76, 95% CI: 1.07–2.91), respectively. Educating people and financial support seem to play a crucial role in implementing novel campaigns and preventive programs in Poland. Addressing each significant factor may be of paramount importance in improving the receipt of preventive services and warranting greater preventive care coverage in the Polish population.

Spatial convergence of mortality in Poland

AbstractAimThe aim is to observe whether there is a territorial similarity of changes in mortality due to selected causes in Poland in the years 2002–2017. Convergence models were used to verify the hypothesis that, since Poland's accession to the EU, the country has seen a spatial convergence of mortality due to major causes of death.Results and conclusionThe country's provinces have been homogenising in terms of death intensity levels evening out for the majority of examined groups of causes. This is indicated by the confirmed absolute beta-convergence for most variables, including the two major causes of death: I00–I99 and C00–D48. However, a confirmation of beta-convergence does not always apply to both a broader and a narrower group of causes. In turn, sigma-divergence of mortality due to most of the examined causes in Poland's provinces indicates increasing variation in the years 2002–2017, which means that the provinces were not becoming similar. Such findings indicate that the formulated hypothesis has not been confirmed.

Sex Differences in Alcohol Attributable Mortality in Poland, 2002-2018.

We study patterns and developments in sex differences in alcohol-attributable mortality (AAM) in Poland over the years 2002-2018. Sex gap and sex-specific mortality patterns according to age, educational level and urbanrural settlements are contrasted with findings for other developed countries. Premature AAM of the population 20-64 years old is quantified with age-standardized alcohol-attributable mortality rates (AASMR) by sex and selected characteristics. For the age pattern, we study the gender gap in alcohol-attributable crude death rates for 10-year age groups. Data comes from the World Health Organization database or directly from the Polish Central Statistical Office. In 2002, in Poland, men died 9-times more often than women from causes attributable to alcohol consumption. As a result of faster growth in AASMR among women, the relative sex gap halved between 2002 and 2018. However, this relative change was accompanied by an increase in the absolute gap, resulting from a larger increase in the total number of deaths attributed to alcohol consumption among men than women. Due to the substantially higher alcohol consumption and mortality among men, differences in AAM according to age, education and place of residence, and their changes over the study years, are much more pronounced for men than women. Polish men and women are characterized by similar patterns and developments of alcohol-attributable mortality in the study years. Different from that observed for other developed countries narrowing the sex gap, we observe in Poland perseverance of male elevated AAM. An important contribution of the study is the evidence that to understand differences between men and women in AAM and their developments, we need to study both relative and absolute sex gaps.

Mortality and Alcohol as Its Cause-Comparative Characteristics of the Two Neighboring Countries: Ukraine and Poland.

This paper presents a comparative assessment of mortality in Poland and Ukraine, including due to alcohol consumption, by sex, place of residence, and age groups. Mortality from alcohol consumption is and remains one of the health problems of the state’s population. The aim of this study was to establish the difference in mortality, including due to alcohol consumption, in the two neighboring countries. The analysis was conducted in 2008 and 2018 according to statistical institutions in Poland and Ukraine. Data from the codes of the International Statistical Classification of Diseases of the 10th edition: F10, G31.2, G62.1, I42.6, K70, K86.0, and X45 were used to calculate mortality due to alcohol consumption. The share of mortality caused by alcohol consumption in Ukraine in 2008 was 3.52%, and 1.83% in 2018. At the same time, in Poland, there is an increase in this cause of death from 1.72% to 2.36%. Mortality caused by alcohol consumption is the main share of mortality in the section “Mental and behavioral disorders” in both Ukraine, at 73–74%, and Poland, at 82–92%. Changes in the mortality rate in the cities and villages of Ukraine and Poland showed different trends: Poland nated, a significant increase in mortality, while in Ukraine it has halved on average. Overall and alcohol mortality rates in both countries were higher among the male population. The analysis of mortality among people of working age showed that the highest proportion of deaths from alcohol consumption in both countries was among people aged 25–44. Despite the geographical proximity, and similarity of natural and climatic characteristics and population, mortality rates in each country reflect the difference in the medical and demographic situation, and the effectiveness of state social approaches to public health.

Decreasing Trends in Road Traffic Mortality in Poland: A Twenty-Year Analysis

The aim of the study was to assess mortality trends due to road traffic accidents in Poland between 1999 and 2018. The study material was a database including 7,582,319 death certificates of all inhabitants of Poland who died in the analyzed period (104,652 people died of transport accidents). Crude deaths rates (CDR), standardized death rates (SDR) and joinpoint models were used. Annual percentage change (APC) for each segment of broken lines and average annual percentage change (AAPC) for the whole study period were calculated. CDR decreased from 19.7 per 100,000 population in 1999 to 9.6 per 100,000 population in 2018; APC was −4.1% (p < 0.05) while SDR decreased from 20.9 to 10.9 per 100,000; APC was −4.1% (p < 0.05). Large differences in traffic accident-related mortality were observed between men and women. An analysis by gender and age shows that the decline in the number of deaths due to traffic accidents has been slowed down in the oldest age group, 65+, in both males and females. There is a need for in-depth analyses aimed at introducing effective preventive solutions in the field of road traffic safety in Poland. Legal regulations should particularly refer to the most endangered groups of road users.

Excess mortality in Poland during the COVID-19 pandemic in 2020

The outbreak of the COVID-19 pandemic began in China in November 2019, and spread to most countries around the world in the early 2020, causing a large increase in deaths. The aim of the study described in this paper is to estimate and analyse the geographical and temporal variations in excess mortality during the COVID-19 pandemic in 2020 in Poland and its regions. The study took into consideration variables such as sex, age and the stage of the pandemic in correlation with the reported number of COVID-19 deaths and the reported number of SARS-CoV-2 virus infections. The standard weekly mortality rate in Poland in 2020 was calculated using the method of time series analysis taking into account weekly seasonal fluctuations in the mortality rate throughout the year, indicated with data reported by registry offices and published by Statistics Poland. The obtained results showed that in 2020, there were approximately 71,000 deaths above the standard number in Poland, most of which, i.e. about 91%, were the deaths of people aged 60 and over. Out of them, only less than 30,000 deaths were reported as deaths caused by COVID-19, which was only about 41% of all excess deaths in this period. The number of excess deaths peaked in the 45th week of 2020, which was the time when the largest number of cases of COVID-19 infection were reported, and not when the largest number of deaths from COVID-19 occurred (which was three weeks later). However, it has not been established yet whether the reason for this situation was an imperfect way of determining the causes of deaths at the beginning of the pandemic, or the excessive burden hospitals were subjected to that caused the increase in deaths from other causes.

Impact of COVID-19 Pandemic on Total Mortality in Poland.

Background: According to published data the number of deaths attributed to COVID-19 is underestimated between 30 and 80%. Aim: The aim of this study is to assess the impact of COVID-19 on total mortality of Poland and the Silesian voivodship. Methods: Secondary epidemiological data on COVID-19 deaths were obtained from the Ministry of Health registry and data on total mortality were gathered from the National Statistical Office and Registry Office in Poland. Three scenarios were used to estimated COVID-19 deaths: real number + an extra 30%, 60%, and 70% excess total deaths. Results: In 2020, there were 73,254, 64,584, and 67,677 excess deaths in comparison to 2017–2019, respectively. For the Silesian voivodship, it was 8339, 7946, and 8701, respectively. The total mean increase in deaths was 16% for the whole country and the Silesian voivodship. The simulation for 30% extra COVID-19 deaths gave COVID-19 mortality equal to 12.5%; n = 50,708 deaths, for extra 60%; 17.9% n = 72,866 and for extra 70%; 19.7% n = 80,251 for Poland; and 11.9% (n = 6072), 17.2% (n = 8740), 24.2% (n = 12,297), respectively, for the Silesian voivodship. Conclusions: The participation of COVID-19 in total deaths should not exceed 20% for Poland and 24% for the Silesian voivodship in 2020.

COMPARATIVE ANALYSIS OF THE MAIN SOCIAL HEALTH DETERMINANTS OF LIFE EXPECTANCY AND INFANT MORTALITY IN UKRAINE AND POLAND

The aim: To analyze the data of social health determinants - life expectancy of population and infant mortality in neighboring countries: Ukraine and Poland in cut-away of territory habitation. Materials and methods: The statistical materials of the Ukrainian and Polish information sources were used in this work: SI "The center of medical statistics of the Ministry of Health of Ukraine", The state statistics service of Ukraine, The central statistical management of Poland (Główny Urząd Statystyczny). Methods of system approach, bibliosemantic, statistical, analytical were used for analysis. Results: In both countries, Poland and Ukraine, the general dynamics as to the growth of an average life expectancy (ALE) among men and women was observed during 28 years of surveillance, and in both countries it was revealed that the ALE indices in women were much higher than in men. Within the last five years, there is a considerable tendency of decrease in the infant death rate in Ukraine, while in Poland this index is particularly invariable. This may be due to the fact that the level of infant mortality in Poland is half the level in Ukraine; moreover, this correlation is approximate within the last five years of observation. A significant place in the structure of all the causes of infant mortalityin 2019 is occupied by the ХVІ chapter in accordance with ICD-10 "Certain conditions originating in the perinatal period" - 54.39 % in Ukraine and 53.05 % in Poland, the last - "Diseases of the Urogenital system" (chapter ХІV) - 0 % and 0.7 %, correspondingly. Conclusions: With a view of an incessant improvement of a high-quality information which is registered when the statistical data are formed, it is necessary to promote a broad intersector cooperation inside the countries and international collaboration between the countries.

Assessment of Pain, Acceptance of Illness, Adaptation to Life, and Strategies of Coping With the Disease, in Patients With Bladder Cancer.

Bladder cancer is one of the most common cancers and causes of mortality in Poland, significantly reducing the quality of life. The objective of the study was to evaluate the strategy of coping with the disease in patients suffering from bladder cancer. Four psychometric tests were used: the beliefs about pain control questionnaire (BPCQ), the pain coping strategies questionnaire (CSQ), acceptance of illness scale (AIS), and mental adjustment to cancer (Mini-Mac) test. Patients suffering from bladder cancer assign the greatest role in controlling pain to the influence of physicians. The most frequently chosen strategy for coping with the disease was declaring coping. The average level of acceptance of the disease among patients was mean=27.25. The most often indicated manner of coping was fighting spirit. Patients with bladder cancer are characterized by a constructive attitude towards the disease.

Remote Monitoring Reduces Mortality and Hospitalizations Among COVID-19 Patients. Data from the Polish Nationwide Program

Background: Early diagnosis of progressive respiratory failure and immediate hospitalization are essential components of providing care for SARS-CoV-2 patients. This is a huge challenge due to the insidious nature of COVID-19, hence it is necessary to implement system solutions to facilitate this process. Already in Autumn 2020, in light of the growing second wave of the COVID-19 pandemic and the associated increase in mortality in Poland, the Ministry of Health launched a national remote monitoring program (Home Medical Care – HMC) for COVID-19 outpatients.Methods: The analysis of data obtained from the first six and half months of the national HMC program was conducted to evaluate its effectiveness in terms of its effects on COVID-19-related mortality and hospitalizations. HMC covered patients with confirmed SARS-CoV-2 infection, who were older than 18 years. Only unvaccinated patients were included in the analysis for this publication to eliminate the effect of being vaccinated on the parameters studied. The effectiveness of the HMC program against COVID-19 was calculated based on COVID-19-related mortality and hospitalization rates in population included in the program compared with the rates in the population outside the program, considering individual age groups (18–44, 45–54, 55–64, 65–74, 75–84 and +85 years).A total of 551 463 unvaccinated patients were involved in the HMC program and they were divided into two groups: active patients (group A) who sent at least one result of pulse oximetry measurement to the system (n = 86 036; 15·6%) and passive patients (group B) who did not send any results (n = 465 427; 84·4%). Group C consists of unvaccinated patients outside the HMC program, who were diagnosed with SARS-CoV-2 since December 2020 (n = 1 104 367). The median age of active population included in the HMC program was 60 years (IQR 55-65), 65 years (IQR 60-72) for passive population and 40 years (IQR 32-49) for the population outside the HMC program.Findings: A total of 1 655 830 SARS-CoV-2 infections, 132 396 hospitalizations and 43 081 deaths due to COVID-19 were analyzed from 5 November 2020 to 19 May 2021 among the unvaccinated population in Poland. Mortality was lower in active population compared to passive and outside the HMC program populations (1·12% vs. 2·97% and 3·66%, respectively), where a relative risk of COVID-19-related death was 2·69 (95% CI: 2·48-2·92) for passive population and 3·32 (95% CI: 3·07-3·60) for the population outside the HMC program. Importantly, the hospitalization rate was also lower in active population compared to passive and outside the HMC program populations (5·16% vs. 10·23% and 12·24%, respectively), where the relative risk of COVID-19-related hospitalization was 2·06 (95% CI: 1·98-2·14) for passive population and 2·57 (95% CI: 2·47-2·67) for the population outside the HMC program.Interpretation: The remote home monitoring of patients with confirmed SARS-CoV-2 infection has a high efficacy in reduction of mortality and hospitalizations, and it should be in common use as a valuable tool that counteracts the effects of the COVID-19 pandemic.Funding: Ministry of Health in PolandDeclaration of Interest: The authors declare no conflict of interest.Ethical Approval: Ethical approval was not sought for the present study because it did not directly involve human participants. This study was completed in accordance with the Helsinki Declarationas revised in 2013

Investigating multi-cause mortality in Poland

Progress in life expectancy and the growing number of people living to old age intensify the phenomenon of multi-morbidity, defined as the coexistence of several chronic diseases. By exploiting all the medical information in death certificates, the multiple causes of death (MCoD) approach serves to investigate complex pathological processes that lead eventually to death. This is the first MCoD analysis for Poland and its objective is twofold: to examine the quality of information on contributing causes of death, in particular in the regional dimension, and to assess the scale of multi-morbidity involving conditions that are becoming more and more frequent in ageing populations. The analysis is carried out for all deaths that took place in Poland in 2013. The results show that medical doctors issuing death certificates often define contributing causes of death, but a large part of this information includes unknown or ill-defined conditions. Several conditions favour the certification of well-defined contributing causes: when death occurs in hospital, or is due to underlying causes other than cardiovascular, the number of contributing conditions is higher. Important regional differences are observed in this regard. The analysis highlights the importance of diseases that are rarely certified as the underlying causes, but often contribute to mortal conditions, such as diseases of the blood and the blood-forming organs, diseases of the skin and subcutaneous tissue, diseases of the genitourinary system or mental and behavioural disorders.

Contribution of avoidable causes of death to premature mortality in Poland and selected European countries

Our study, availing the new, agreed by the OECD and Eurostat, lists of preventable and treatable causes of death, seeks to quantify the contribution of avoidable causes to premature mortality and its dynamics in Poland and Central European countries – Czechia, Hungary, Lithuania and Slovenia, in comparison with Sweden serving as a benchmark country in 1999–2017. We calculated age standardised death rates for the broad groups of avoidable causes and more specific ones, which comprised preventable and treatable cancer and diseases of the circulatory system (DCS), preventable injuries and alcohol-related diseases. Deaths from not avoidable causes were also analysed. The analysis of time trends in the death rates and calculation of the Average Annual Percent Change (AAPC) for the overall trend were performed with joint-point models. The contribution of changes in mortality from avoidable causes to increase life expectancy during 1999–2017 and contribution of the difference in mortality from these causes to the difference in life expectancy between five countries and Sweden were based on the decomposition of temporary life expectancy between birth and age 75 [e(0-75)]. For the calculation of life expectancy, we used the classic Chiang method and the decomposition of life expectancy by the death causes and age was conducted with the Arriaga method. The AAPC of death rates from avoidable causes in 1999–2017 was similar in all the countries but Lithuania, where the decline started later. The decline in the death rates from not avoidable causes is much slower than the rates from avoidable causes. Mortality from treatable causes was decreasing faster than from preventable causes in most populations. In 1999–2017, the average rate of mortality decline for preventable cancer was greater among men than among women, while for treatable cancer the sex-related differences were much smaller and in favour of women. As for preventable and treatable death from DCS, their decrease was faster among women than men in all the countries but Sweden. Improvements in mortality from causes that could be avoided through prevention or treatment made substantial positive contributions to the overall change in life expectancy in all the countries. The differences in temporary life expectancy e(0-75) between the analysed Central European countries and Sweden were much smaller in 2017 than in 1999, due to the reduction of the gap in mortality from avoidable causes. Our results show that among men, and to a lesser extent among women, mortality from preventable causes contributes more than mortality from causes that can be effectively treated to shorter life expectancy in the countries of Central Europe than in Sweden.&#x0D; This indicates that in reducing the health gap between the inhabitants of Central Europe and Western Europe, the healthcare system should consider disease prevention even to a greater extent than just treating them.

10year trends in hospitalization rates due to heart failure and related in-hospital mortality in Poland (2010-2019).

AimsHeart failure (HF) remains a major public health challenge worldwide. Contemporary epidemiological data on HF hospitalization rates and related in‐hospital mortality are scarce also in Poland. The aim of the study was to determine the trends in hospitalization rates due to HF and related in‐hospital mortality in Poland in the recent decade.Methods and resultsData on HF hospitalizations and in‐hospital mortality in patients aged >17 years in Poland between 2010 and 2019 were obtained from the central database of the Polish National Health Fund. Hospitalizations with either primary or secondary diagnosis of HF were identified using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes (I50, I42, J81 with extensions, and R57.0). There were 4 259 698 HF hospitalizations and 608 577 in‐hospital deaths (14% in‐hospital mortality) reported during 2010–2019 in Poland. During this period, there was a steady increase in the number of HF hospitalizations per 1000 inhabitants in subsequent years, being more pronounced in men than in women (in 2019: 16 and 13 HF hospitalizations per 1000 inhabitants in men and women, respectively). The relative risk of HF hospitalization was higher in men than in women, and this gender‐related difference steadily increased from 9% in 2010 to 25% in 2019. During 2010–2019, there was an increase in the number of HF hospitalizations per 1000 inhabitants in subsequent age groups, with a trend being more pronounced in men than in women (129 and 99 HF hospitalizations per 1000 inhabitants in men and women aged ≥80 years, respectively). During this period, there was a slight increase in in‐hospital mortality during HF hospitalization in subsequent years, being more pronounced in women than in men (in 2019: 16% and 14% of in‐hospital mortality in women and men, respectively). The relative risk of in‐hospital mortality during HF hospitalization was higher in women than in men, and this gender‐related difference steadily increased from 8% in 2010 to 18% in 2019. During this period, in‐hospital mortality during HF hospitalization was ~12% for women and men aged 18–29 years, whereas the highest values of in‐hospital mortality reached ~19% for patients aged ≥80 years.ConclusionsWe have observed steady growing trends in HF hospitalization rates and related in‐hospital mortality in Poland over the last decade. Both age and gender have differentiated the reported epidemiological patterns.

Tuberculosis in Poland in 2018.

To evaluate the main features of tuberculosis (TB) epidemiology in 2018 in Poland and to compare with the situation in the EU/EEA countries. Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2018, data from National Institute of Public Health- National Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from the report " European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2020- 2018 data. Stockholm: European Centre for Disease Prevention and Control, 2020". In 2018, 5487 TB cases were reported in Poland. The incidence rate was 14.3 cases per 100000, with large variability between voivodeships from 7.3 to 23.4 per 100 000. The mean annual decrease of TB incidence in 2014- 2018 was 3.8%. In 2018, 4852 cases were newly diagnosed with no history of previous treatment i.e. 12.6 per 100 000. 635 cases i.e. 1.7 per 100 000 - 11.6% of all registered subjects were previously treated for tuberculosis. In 2018, the number of all pulmonary tuberculosis cases was 5224 i.e. 13.7 per 100000. Pulmonary cases represented 95.2% of all TB cases. In 2018, 243 extrapulmonary TB cases were found i.e. 0.6 per 100 000. In the whole country there were 52 pediatric cases of tuberculosis. TB in children represented 0.9% of all cases notified in Poland in 2018. The incidence rates of tuberculosis were growing along with the age group from 0.9 per 100 000 among children to 24.7 per 100 000 among subjects in the age group 45-64 years (the highest incidence rate). In 2018, the incidence rate in the age group ≥65 years was 21.3 per 100 000. The TB incidence among men i.e. 21.0 per 100 000 was 2.6 times higher than among women i.e. 8.0 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 55 to 59 years - 44.9 vs. 9.8 and in age group 60- 64 years - 43.7 vs. 10.2. The TB incidence in rural population was lower than in urban, respectively 13.4 per 100 000 and 14.9 per 100 000. The number of all registered culture positive TB cases was 4075. Pulmonary tuberculosis was bacteriologically confirmed in 3935 subjects. Cases confirmed by culture represented 74.3% of all TB cases and 75.3% of all pulmonary TB cases. The number of smear-positive pulmonary TB cases reported in 2018 was 2324 i.e. 6.1 per 100 000 accounting for 44.3% of all pulmonary TB cases and 59.1% of pulmonary TB cases confirmed by culture. In all patients with tuberculosis in Poland in 2018 there were 48 cases with MDR-TB (among them 14 foreigners) and 83 patients with resistance to isoniazid only, representing respectively 1.3% and 2.2% of cases with known DST results (DSTs were available in 90.7% of all culture-confirmed TB cases). In 2018, there were 97 patients of foreign origin among all cases of tuberculosis in Poland. TB was AIDS-indicative disease in 14 subjects with HIV co-infection. There were 490 deaths due to tuberculosis reported in 2017 - 1.3 per 100 000; 468 people died from pulmonary and 22 from extrapulmonary tuberculosis. Mortality among males - 2.1 per 100 000 - was 3.6 X higher than among females - 0.5. 40.2% of all TB deaths were cases 65 years old and older - 3.1 per 100 000. In 2017, there was no death from tuberculosis in children and no deaths in adolescents. In 2017, tuberculosis represented 0.1% of total mortality in Poland and 25.4% of mortality from infectious and parasitic diseases. In 2018, the incidence of tuberculosis in Poland was lower than in 2017. Despite a continuous decline it is still higher than the average in the EU/EEA countries. The highest incidence rates were observed in older age groups. The participation of pediatric cases is smaller than average in the EU/EEA countries. The incidence in males was more than 2 times higher than in females. The impact of migration on the characteristics of tuberculosis in Poland is not substantial. In Poland, MDR-TB is less common than the average in the EU/EEA countries.

Short-term association of air pollution and health in Poland. Results from multi-city study

Abstract Background Although time-series studies of the impact of air pollution on mortality are numerous in the literature there is noticeable lack of the results from multi-city studies in Poland. The aim of our analysis is to fill this gap and give estimates based on the most actual data. Methods A multi-city ecological time series analysis was carried out. A database contained a daily number of deaths from all causes (excluding external), by sex and age groups (below 65, 65 and more), PM10 and PM2.5 levels as well as meteorological conditions in 3 agglomerations and 19 big cities in Poland. The analysis was performed using generalized additive models. The distributed lag model method was used to investigate the mortality displacement phenomenon. Results Two versions of time-series analysis considering the level of air pollution from the current and previous day (acute effect) as well as from the past 30 days (allowing for mortality displacement) in the total population as well as in sub-populations determined by sex and age-group were done in each localization. The pooled effect estimate was calculated based on estimates obtained in each city. The value of the relative risk of death from all causes associated with an increase of air pollution with PM10 and PM2.5 was equal to (respectively) 1.005 (1.003-1.006) and 1.004 (1.002-1.005) for acute effect and 1.016 (1.011-1.021) and 1.021 (1.015-1.026) for delayed pollution effect. Higher relative risks were obtained for females and in the older age group. Conclusions A statistically significant short-term effect of air pollution with both PM10 and PM2.5 on mortality was found. The relative risks for PM2.5 were higher than for PM10. Population of females and people aged 65 years and above were more at risk. Key messages The existence of the short-term effect of dust air pollution on mortality in Poland has been confirmed. The air pollution effect modification by sex and age was found.

Zmiana liczby zgonów i trwania życia w latach 2016–2018. Przyczynek do analizy zgonów w Polsce

Since the 1990s, life expectancy at birth in Poland has increased by over three months on average each year for both sexes. However, in recent years there has been a decrease in life expectancy, and the number of deaths increased by 6% for men and 8% for women between 2016 and 2018.&#x0D; The aim of this study is to identify the subpopulations most sensitive to the recent changes in mortality in Poland. The increase in deaths is described with regard to changes in age distribution of the population and age at death contributing to life expectancy changes in recent years is analysed. The findings serve as a basis for making references to theoretical knowledge and proposals for future research directions as well as recommendations for public statistics and social policy.&#x0D; The increase in the number of deaths is a new phenomenon that cannot be accounted for by the size differences between the cohorts born between the two world wars and during the Second World War or the ageing of the baby-boom generations. The greatest contributors to the decreasing life expectancy are deaths at older age. This and the fast growing population aged 85 years and more indicate a need to devote more research attention to analysing mortality in the oldest age groups. It is also emphasised that the elderly are potentially the most prone to various threats associated with an excessive number of deaths, including inadequate health care funding.

Ocena poziomu wiedzy żywieniowej za pomocą kwestionariusza komPAN pacjentów po ostrym zespole wieńcowym hospitalizowanych na oddziale kardiologii inwazyjnej. Doniesienie wstępne

Introduction. Cardiovascular diseases are the major cause of mortality in Poland. Thus, both primary and secondary prevention should include lifestyle modification, including proper nutrition. The aim of the study was to examine dietary habits and nutritional beliefs for the purpose of evaluating the nutrition knowledge of cardiac patients after an acute coronary syndrome [ACS; non-ST-segment myocardial infarction (NSTEMI) and ST-segment myocardial infarction (STEMI)] undergoing invasive treatment. Material and methods. The study included 100 patients, including 35 women and 65 men aged 53.43 ± 10.11 years [mean ± standard deviation (SD)], admitted urgently due to ACS to the 2nd Department of Cardiology. The study used part C of the questionnaire: “Nutrition Beliefs” that consisted of 25 statements assessing nutrition knowledge. For each correct answer (“True” or “False”), 1 point was assigned, and for an incorrect answer or “Hard to say”, 0 points were assigned. Then, the points were added up. Results. It was found that only 20.8% (N = 21) of subjects followed dietary recommendations as advised by a physician. The majority of respondents were diagnosed with an excessive body mass: obesity in 35.4% (N = 35) of subjects, and overweight in 38.4% (N = 38) of subjects. Nutritional self-assessment was reported to be at a good level in 71.3% of patients (N = 72). However, the actual nutrition knowledge was found to be at a good level in only 6.9% (N = 7) of subjects. Conclusion . Patient nutrition knowledge as assessed using the komPAN questionnaire was found to be mostly at a satisfactory level, despite high self-assessment res ults provided by the respondents. There is a great need for regular nutrition education.

Trends in breast cancer incidence and mortality, clinical diagnosis and treatment in the light of the contemporary demographic changes in Germany and Poland, 2006–2016

Introduction: Trends in cancer incidence and mortality are determined by contemporary demographic processes. Breast cancer in women is a particular threat. In Germany, the chances of survival after the diagnosis of cancer are among the highest in Europe. The understanding of the latest trends in breast cancer incidence and mortality in Germany and the presentation of the latest screening options, treatment and prevention methods can be used to improve the control of breast cancer in the future. Aim: The aim of the research was to present trends in cancer incidence and mortality, with particular emphasis on breast cancer in women in Germany and Poland on the background of contemporary demographic changes relating to the process of population ageing in 2006–2016. The clinical diagnostic process, the treatment of breast cancer and potential risk factors and prevention methods were described. Material and methods: In the publication the basic statistical indicators have been applied: absolute numbers, percentages, crude rates, age-standardized rates, and demographic aging index. Results and discussion: The cancer mortality in Poland was much higher than in Germany, which is associated with the low five-year survival rate of cancer patients in Poland. The breast cancer was characterized by the highest dynamics in incidence growth with a persistent mortality level. Conclusions: Over the last two decades, breast cancer outcomes of patients have improved significantly due to highly individualized breast cancer therapies and the development of breast cancer treatment options such as immunotherapy, hormone receptor-based therapy and HER2 status-based therapy. The main risk factors are age, hormonal situation and inherited risk genes.

Nadumieralność z powodu chorób układu krążenia jako czynnik depopulacyjny Łodzi i regionu

Choroby układu krążenia (ChUK) stanowią najczęstszą przyczynę zgonów zarówno w Polsce, jak i na terenie UE. Natężenie zgonów z powodu ChUK w województwie łódzkim należy do jednego z najwyższych w Polsce. Celem autora niniejszej pracy było porównanie poziomu umieralności z powodu ChUK w Łodzi i w regionie z poziomem ogólnokrajowym przy zniwelowaniu czynnika demograficznego. Wyniki przeprowadzonych analiz wskazały, że województwo łódzkie charakteryzuje się nadumieralnością z powodu ChUK, sięgającą średniorocznie blisko 1000 osób, przy tym wskazana niekorzystna sytuacja utrzymuje się już od kilkunastu lat.

Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction.

Background: The efficacy of interventions in ST-segment elevation myocardial infarction (STEMI) assessed by a decrease in inpatient mortality in Poland is very high. However, a rise in mortality rate is recorded within 3 years of the discharge from the intervention centre. In order to reduce out-of-hospital mortality, the treatment should be continued with cardiac rehabilitation after hospitalization. The aim of this retrospective study was to evaluate the effect of cardiac rehabilitation on exercise capacity increase patients with STEMI with regard to their age, gender, Body Mass Index (BMI), ejection fraction (EF), concomitant diabetes and nicotine dependence. The effectiveness of cardiac rehabilitation was assessed by exercise ECG (electrocardiogram) stress test or the 6-min walk test, prior to and after cardiac rehabilitation completion. Methods: The study group included 100 randomly selected patients undergoing cardiac rehabilitation after STEMI, aged 40–75 years, with BMI ≤ 40 kg/m2, with controlled arterial hypertension, without anemia and any pulmonary comorbidities. Results: The study patients’ exercise capacity was observed to have increased significantly (+1 metabolic equivalent (MET) in exercise ECG stress test and +75.4 m in the 6-min walk test) regardless of their gender, age, BMI and nicotine dependence. Conclusions: This study proved that every patient with STEMI could benefit from cardiac rehabilitation. Nicotine-dependents, males, patients aged ≤55 and those with reduced EF (<50%) were found to have benefitted most substantially.