Mortality In Switzerland Research Articles

No association between vitamin/dietary supplements and total or cardiovascular mortality in switzerland: A 10-year prospective study

No association between vitamin/dietary supplements and total or cardiovascular mortality in switzerland: A 10-year prospective study

Nationwide projections of heat- and cold-related mortality impacts under various climate change and population development scenarios in Switzerland

Climate change and progressive population development (i.e., ageing and changes in population size) are altering the temporal patterns of temperature-related mortality in Switzerland. However, limited evidence exists on how current trends in heat- and cold-related mortality would evolve in future decades under composite scenarios of global warming and population development. Moreover, the contribution of these drivers to future mortality impacts is not well-understood. Therefore, we aimed to project heat- and cold-related mortality in Switzerland under various combinations of emission and population development scenarios and to disentangle the contribution of each of these two drivers using high-resolution mortality and temperature data. We combined age-specific (<75 and ⩾75 years) temperature-mortality associations in each district in Switzerland (1990–2010), estimated through a two-stage time series analysis, with 2 km downscaled CMIP5 temperature data and population and mortality rate projections under two scenarios: RCP4.5/SSP2 and RCP8.5/SSP5. We derived heat and cold-related mortality for different warming targets (1.5 °C, 2.0 °C and 3.0 °C) using different emission and population development scenarios and compared this to the baseline period (1990–2010). Heat-related mortality is projected to increase from 312 (116; 510) in the 1990–2010 period to 1274 (537; 2284) annual deaths under 2.0 °C of warming (RCP4.5/SSP2) and to 1871 (791; 3284) under 3.0 °C of warming (RCP8.5/SSP5). Cold-related mortality will substantially increase from 4069 (1898; 6016) to 6558 (3223; 9589) annual deaths under 2.0 °C (RCP4.5/SSP2) and to 5997 (2951; 8759) under 3.0 °C (RCP8.5/SSP5). Moreover, while the increase in cold-related mortality is solely driven by population development, for heat, both components (i.e., changes in climate and population) have a similar contribution of around 50% to the projected heat-related mortality trends. In conclusion, our findings suggest that both heat- and cold-related mortality will substantially increase under all scenarios of climate change and population development in Switzerland. Population development will lead to an increase in cold-related mortality despite the decrease in cold temperature under warmer scenarios. Whereas the combination of the progressive warming of the climate and population development will substantially increase and exacerbate the total temperature-related mortality burden in Switzerland.

Overcrowded housing during adolescence and future risk of premature mortality: a 28-year follow-up of 556,191 adolescents from Switzerland.

Few large-scale studies have examined the health impacts of overcrowded housing in European countries. The aim of this study was to assess whether household crowding during adolescence increases the risk of all-cause and cause-specific mortality in Switzerland. Study participants were 556,191 adolescents aged 10-19 years at the 1990 census from the Swiss National Cohort. Household crowding at baseline was measured as the ratio between the number of persons living in the household and the number of available rooms, categorized as none (ratio ≤ 1), moderate (1 < ratio ≤ 1.5), and severe (ratio > 1.5). Participants were linked to administrative mortality records through 2018 and followed for premature mortality from all causes, cardiometabolic disease and self-harm or substance use. Cumulative risk differences between ages 10 and 45 were standardized by parental occupation, residential area, permit status and household type. Of the sample, 19% lived in moderately and 5% lived in severely crowded households. During an average follow-up of 23 years, 9766 participants died. Cumulative risk of death from all causes was 2359 (95% compatibility intervals: 2296-2415) per 100,000 persons when living in non-crowded households. Living in moderately crowded households led to 99 additional deaths (-63 to 256) per 100,000 persons and living in severely crowded households 258 additional deaths (-37 to 607) per 100,000 persons. The effect of crowding on mortality from cardiometabolic diseases, self-harm or substance use was negligible. Excess risk of premature mortality in adolescents living in overcrowded households appears to be small or negligible in Switzerland. University of Fribourg Scholarship Programme for foreign post-doctoral researchers.

The impact of COVID-19 pandemic on cardiovascular diseases hospitalization, management and mortality in Switzerland

Abstract Funding Acknowledgements Type of funding sources: None. Background COVID-19 pandemic led to a reduction in hospital admissions and intervention for other diseases in many countries. Purpose We aimed to assess the effect of COVID-19 pandemic on cardiovascular disease (CVD) hospitalizations, management and mortality in Switzerland. Methods Swiss hospital discharge and mortality data for period 2017-2020. CVD hospitalizations, CVD interventions and CVD mortality were assessed before (2017-2019) and during (2020) the pandemic. Results Compared to 2017-2019, 2020 was characterized by a reduction of CVD admissions in age groups 65-84 and ≥85 by approximately 3,700 and 1,700 cases, respectively, and by an increase in the percentage of admissions with a Charlson Index &amp;gt;8. The total number of CVD-related deaths decreased from 21,042 in 2017 to 19,901 in 2019, and increased to 20,511 in 2020, with an estimated excess of 1,181 deaths. This increase was due to out-of-hospital deaths (+1400), while the number of in-hospital deaths decreased from 5030 in 2019 to 4796 in 2020. The total number of cardiovascular interventions increased from 55,181 in 2017 to 57,864 in 2019, and decreased in 2020, with an estimated reduction of 4,472 interventions; PTCA was the exception, as the number and percentage of emergency PTCA increased. The preventive measures applied against COVID-19 inverted the seasonal pattern of CVD admissions, the highest number of admissions being found in summer and the lowest in winter. Preventive measures were also followed by a decrease in CVD admission (figure). Conclusion The COVID-19 pandemic led to a reduction in CVD hospital admissions, planned CVD interventions, an increase in total and out-of-hospital mortality, and a change in seasonal patterns.

Mortality attributable to ambient fine particulate matter and nitrogen dioxide in Switzerland in 2019: Use of two-pollutant effect estimates

IntroductionAir pollution health risk assessments have traditionally used single-pollutant effect estimates for one proxy ambient air pollutant such as PM2.5. Two-pollutant effect estimates, i.e. adjusted for another correlated pollutant, theoretically enable the aggregation of pollutant-specific health effects minimizing double-counting. Our study aimed at estimating the adult mortality in Switzerland in 2019 attributable to PM2.5 from a single-pollutant effect estimate and to the sum of PM2.5 and NO2 from two-pollutant estimates; comparing the results with those from alternative global, European and Swiss effect estimates. MethodsFor the single-pollutant approach, we used a PM2.5 summary estimate of European cohorts from the project ELAPSE, recommended by the European Respiratory Society and International Society for Environmental Epidemiology (ERS-ISEE). To derive the two-pollutant effect estimates, we applied ELAPSE-based conversion factors to ERS-ISEE PM2.5 and NO2 single-pollutant effect estimates. Additionally, we used World Health Organization 2021 Air Quality Guidelines as counterfactual scenario, exposure model data from 2019 and Swiss lifetables. ResultsThe single-pollutant effect estimate for PM2.5 (1.118 [1.060; 1.179] per 10 μg/m3) resulted in 2240 deaths (21,593 years of life lost). Using our derived two-pollutant effect estimates (1.023 [1.012; 1.035] per 10 μg/m3 PM2.5 adjusted for NO2 and 1.040 [1.023; 1.058] per 10 μg/m3 NO2 adjusted for PM2.5), we found 1977 deaths (19,071 years of life lost) attributable to PM2.5 and NO2 together (23% from PM2.5). Deaths using alternative effect estimates ranged from 1042 to 5059. DiscussionEstimated premature mortality attributable to PM2.5 alone was higher than to both PM2.5 and NO2 combined. Furthermore, the proportion of deaths from PM2.5 was lower than from NO2 in the two-pollutant approach. These seemingly paradoxical results, also found in some alternative estimates, are due to statistical imprecisions of underlying correction methods. Therefore, using two-pollutant effect estimates can lead to interpretation challenges in terms of causality.

Trends in tropical nights and their effects on mortality in Switzerland across 50 years

Increasing temperatures and more frequent and severe heat waves in Switzerland are leading to a larger heat-related health burden. Additionally, high nighttime temperatures or tropical nights (TNs) also affect the well-being of the population. We aimed to assess the spatiotemporal patterns in the frequency and the exposed population to TNs, and its mortality effect in Switzerland. We identified the TNs (minimum nighttime temperature ≥ 20°C) in each district in Switzerland using population-weighted hourly temperature series (ERA5-Land reanalysis data set) between 1970–2019. We assessed the change in the frequency of TNs and the exposed population per district and decade through a spatiotemporal analysis. We then performed a case time series analysis to estimate the TN-mortality association (controlled for the daily mean temperature) by canton and for the main 8 cities using data on all-cause mortality at the district level between 1980–2018. We found an overall increase in the annual frequency of TN (from 90 to 2113 TNs per decade) and the population exposed (from 3.7 million to over 157 million population-TN per decade) in Switzerland between 1970–2019, mainly in the cities of Lausanne, Geneva, Basel, Lugano, and Zurich, and during the last two decades. The TN-mortality association was highly heterogeneous across cantons and cities. In particular, TNs were associated with an increase of 22–37% in the risk of mortality in the cantons of Vaud (Relative risk: 1.37 (95%CI:1.19–1.59)), Zurich (1.33 (0.99–1.79)), Lucerne (1.33 (0.95–1.87)) and Solothurn (1.22 (0.88–1.69)), while a negative association was observed in Ticino (0.51 (0.37–0.7)), Basel-Land (0.4 (0.24–0.65)) and Thurgau (0.65 (0.5–0.85)), and a null association in the remaining cantons. Our findings indicate that TNs are a relevant health hazard for a large part of the Swiss population leading to potentially larger impacts in the future due to climate change and increasing urbanization.

Explorative Assessment of the Temperature-Mortality Association to Support Health-Based Heat-Warning Thresholds: A National Case-Crossover Study in Switzerland.

Defining health-based thresholds for effective heat warnings is crucial for climate change adaptation strategies. Translating the non-linear function between heat and health effects into an effective threshold for heat warnings to protect the population is a challenge. We present a systematic analysis of heat indicators in relation to mortality. We applied distributed lag non-linear models in an individual-level case-crossover design to assess the effects of heat on mortality in Switzerland during the warm season from 2003 to 2016 for three temperature metrics (daily mean, maximum, and minimum temperature), and various threshold temperatures and heatwave definitions. Individual death records with information on residential address from the Swiss National Cohort were linked to high-resolution temperature estimates from 100 m resolution maps. Moderate (90th percentile) to extreme thresholds (99.5th percentile) of the three temperature metrics implied a significant increase in mortality (5 to 38%) in respect of the median warm-season temperature. Effects of the threshold temperatures on mortality were similar across the seven major regions in Switzerland. Heatwave duration did not modify the effect when considering delayed effects up to 7 days. This nationally representative study, accounting for small-scale exposure variability, suggests that the national heat-warning system should focus on heatwave intensity rather than duration. While a different heat-warning indicator may be appropriate in other countries, our evaluation framework is transferable to any country.

Impact of COVID-19 pandemic on cardiovascular diseases hospitalisation, management and mortality in Switzerland

BackgroundCOVID-19 pandemic led to a reduction in hospital admissions and intervention for other diseases in many countries. We aimed to assess the effect of COVID-19 pandemic on cardiovascular disease (CVD)...

Direct and indirect effects of the COVID-19 pandemic on mortality in Switzerland

The direct and indirect impact of the COVID-19 pandemic on population-level mortality is of concern to public health but challenging to quantify. Using data for 2011–2019, we applied Bayesian models to predict the expected number of deaths in Switzerland and compared them with laboratory-confirmed COVID-19 deaths from February 2020 to April 2022 (study period). We estimated that COVID-19-related mortality was underestimated by a factor of 0.72 (95% credible interval [CrI]: 0.46–0.78). After accounting for COVID-19 deaths, the observed mortality was −4% (95% CrI: −8 to 0) lower than expected. The deficit in mortality was concentrated in age groups 40–59 (−12%, 95%CrI: −19 to −5) and 60–69 (−8%, 95%CrI: −15 to −2). Although COVID-19 control measures may have negative effects, after subtracting COVID-19 deaths, there were fewer deaths in Switzerland during the pandemic than expected, suggesting that any negative effects of control measures were offset by the positive effects. These results have important implications for the ongoing debate about the appropriateness of COVID-19 control measures.

Alcohol consumption: context and association with mortality in Switzerland

PurposeNon-communicable diseases generate the largest number of avoidable deaths often caused by risk factors such as alcohol, smoking, and unhealthy diets. Our study investigates the association between amount and context of alcohol consumption and mortality from major non-communicable diseases in Switzerland.MethodsGeneralized linear regression models were fitted on data of the cross-sectional population-based National Nutrition Survey menuCH (2014–2015, n = 2057). Mortality rates based on the Swiss mortality data (2015–2018) were modeled by the alcohol consumption group considering the amount and context (i.e., during or outside mealtime) of alcohol consumption and potential confounders. The models were checked for spatial autocorrelation using Moran’s I statistic. Integrated nested Laplace approximation (INLA) models were fitted when evidence for missing spatial information was found.ResultsHigher mortality rates were detected among drinkers compared to non-drinkers for all-cancer (rate ratio (RR) ranging from 1.01 to 1.07) and upper aero-digestive tract cancer (RR ranging from 1.15 to 1.20) mortality. Global Moran’s I statistic revealed spatial autocorrelation at the Swiss district level for all-cancer mortality. An INLA model led to the identification of three districts with a significant decrease and four districts with a significant increase in all-cancer mortality.ConclusionSignificant associations of alcohol consumption with all-cancer and upper aero-digestive tract cancer mortality were detected. Our study results indicate the need for further studies to improve the next alcohol-prevention scheme and to lower the number of avoidable deaths in Switzerland.

Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics.

Early in the COVID-19 pandemic, it became apparent that members of marginalized populations and immigrants were also at risk of being hospitalized and dying more frequently from COVID-19. To examine how the pandemic affected underserved and marginalized populations, we analyzed data on changes in the number of deaths among people with and without Swiss citizenship during the first and second SARS-CoV-2 waves. We analyzed the annual number of deaths from the Swiss Federal Statistical Office from 2015 to 2020, and weekly data from January 2020 to May 2021 on deaths of permanent residents with and without Swiss citizenship, and we differentiated the data through subdivision into age groups. People without Swiss citizenship show a higher increase in the number of deaths in 2020 than those who were Swiss citizens. The increase in deaths compared to the previous year was almost twice as high for people without Swiss citizenship (21.8%) as for those with it (11.4%). The breakdown by age group indicates that among people between the ages of 64 and 75, those without Swiss citizenship exhibited an increase in mortality (21.6%) that was four times higher than that for people with Swiss citizenship (4.7%). This study confirms that a highly specialized health care system, as is found in Switzerland, does not sufficiently guarantee that all parts of the population will be equally protected in a health crisis such as COVID-19.

A prospective cohort analysis of residential radon and UV exposures and malignant melanoma mortality in the Swiss population.

Radon is a radioactive noble gas naturally found in the earth crust that can accumulate in buildings. In addition to lung cancer, alpha particles emitted by radon may contribute to the risk of skin cancer. We evaluated the association between residential radon exposure and skin cancer mortality, over a fifteen year period, taking residential ultra-violet (UV) exposure into account. We included 4.9 million adults from the Swiss National Cohort. Hazard ratios for melanoma mortality were estimated using Cox proportional hazard models (20+ years old; follow-up 2001-2015). Long-term modelled residential radon and ambient UV exposures were assigned at baseline, and included together in the Cox models. With age as a time scale, models were adjusted for calendar time, sex, marital status, education, mother tongue, socioeconomic position, and occupational environment with potential for UV exposure. Age specific hazard ratios were derived. Effect modification, sensitivity analyses and the shape of the exposure response, as well as secondary analysis using other outcome definitions, were investigated. During follow-up (average of 13.6 years), 3,979 melanoma deaths were observed. Associations declined with age, with an adjusted hazard ratio per 100 Bq/m3 radon at age 60 of 1.10 (95% CI: 0.99, 1.23). The dose-response showed an approximate linear trend between the minimum and mean radon exposure of 75 Bq/m3. Having outdoor occupation significantly increased the risk of melanoma mortality associated with UV exposure compared to indoor jobs. Analysis restricted to the last five years of follow-up showed similar results compared to the main analysis. Similar associations were found for mortality from melanoma and non-melanoma skin cancer combined. With double the follow-up time, this study confirmed the previously observed association between residential radon exposure and melanoma and non-melanoma skin cancer mortality in Switzerland. Accumulation of radon indoors is preventable and of public health importance.

Policy to cover perinatal care costs: a quasi-experimental study on adverse newborn health outcomes

Abstract Background Low birth weight (LBW) and preterm birth are associated with an increased risk of neonatal death and chronic conditions across the life course. Reducing LBW is a global public health priority and requires strategies to improve healthcare during pregnancy. We aimed to assess the effect of a health policy providing full coverage of illness-related costs from 13 weeks of gestation through 8 weeks postpartum on birth outcomes and neonatal mortality in Switzerland. Methods We applied a regression discontinuity design to administrative data gathered as part of a Swiss research program (NCCR on the Move). We included all children (N = 166,709) born between March 1, 2013 and February 28, 2015. The outcomes were birth weight (BW), gestational age (GA), LBW (&amp;lt;2,500 g) and very low birth weight (VLBW; &amp;lt;1,500 g), preterm (&amp;lt;37 weeks of gestation), and extremely preterm (&amp;lt;28 weeks), and neonatal (≤ 28 days) death. Children were exposed to the policy if they were born from March 1, 2014 onwards. We estimated the intention-to-treat effect of the policy using parametric regression models. Results Children had a mean BW of 3,291 g and mean GA of 275 days. The prevalence of LBW was 6.4%, VLBW 1%, preterm 7.2%, and extremely preterm 0.4%, respectively. Some 0.3% newborn died within one month. The policy increased BW (mean difference =13 g [95% confidence interval (CI): 1, 25]) and decreased the risk of LBW (odds ratio [OR]=0.89; 95% CI: 0.82, 0.98) and VLBW (OR = 0.81; 95% CI: 0.64, 1.01). Additionally, the policy slightly decreased the risk of preterm birth (OR = 0.94; 95% CI: 0.87, 1.03), while it did not affect GA. Effect estimates for extremely preterm and neonatal mortality were imprecise and inconclusive. Conclusions This quasi-experimental and population based-study of 166,709 live births between 2013 and 2015 in Switzerland provides evidence of a reduction in the risk of LBW, VLBW and preterm birth thanks to a health policy that fully covered healthcare services during maternity. Key messages • Free access to healthcare during pregnancy may mitigate adverse newborn health outcomes. • A Swiss health policy that fully covered healthcare services during pregnancy reduced the risk of low birth weight and preterm births.

Intergenerational education and premature mortality: a registry population-based study

Abstract Inequalities in premature mortality due to individual's attained education are well documented. Intergenerational educational trajectories, whereby both parental and individual education may affect mortality, have received less attention. Our aim was to assess the effect of intergenerational educational trajectories on sex- and cause-specific risks of chronic disease-related premature mortality in Switzerland. Data were from 695,972 individuals born between 1971 and 1980, who were followed from adolescence (10-19y) to mid-life (38-47y) in the Swiss National Cohort, a registry population-based study. Educational trajectories were categorized into four levels: High-High, High-Low, Low-High, Low-Low, which corresponded to the sequence of parental-individual attained education (exposure). Cause of death categories were cardiovascular disease (CVD), cancer, substance use and all other chronic diseases (outcome). We implemented a counterfactual-based framework to quantify inequalities and ran negative outcome controls to triangulate findings. Overall, inequalities were negligible for women and substantial for men, particularly in CVD and substance use deaths. Specifically, inequalities in CVD were negligible by age 30, while by age 45 inequalities due to a High-Low or Low-Low trajectory corresponded to 229 (95% confidence interval (CI): 99, 381) additional CVD deaths per 100,000 persons compared to a High-High trajectory. Inequalities in substance use deaths due to a High-Low trajectory corresponded to 106 (95% CI: 47, 208) additional deaths per 100,000 persons compared to a High-High trajectory by age 30, and increased afterwards. We identified sex- and cause-specific groups at high-risk of premature mortality, and life periods when inequalities due to both parental and individual education arise. Prioritization of prevention strategies in those life periods and groups may help reduce educational inequalities in chronic disease-related premature mortality.

Trends in Tropical Nights and their Effects on Mortality in Switzerland across 50 years

Despite its temperate climate, increasing temperature and more frequent and severe heat waves in Switzerland are leading to more heat-related health burden. Especially, high nocturnal temperature, usually associated to urban heat island effect, reduces the well-being of the society. We aimed to assess the spatiotemporal patterns in the frequency, the exposed population to Tropical Nights and its effect on daily mortality in Switzerland. We derived the number of TN (night temperature &amp;#x2265;20&amp;#xb0;C) per district using district-specific population-weighted temperature series based on high resolution hourly mean temperature (ERA5-Land reanalysis data set) between 1969-2019. Through a spatiotemporal analysis, we assessed the change of TN frequency as well as the exposed population per district and decade. We then estimated the TN-mortality association by canton using conditional quasi-Poisson regression analysis using data on all-cause mortality at district level from 1980-2019. The model accounted for long-term and seasonal patterns and daily mean temperature. We found an overall increase in the frequency of TN and exposed population in Switzerland between 1969-2019, mainly in the surrounding areas of the main cities of Lausanne, Geneva, Basel, Lugano and region of Zurich, and during the last 2 decades. Across Cantons, no clear spatial patterns were found in the level of vulnerability. In particular, TNs were associated with an increase of 37-22% in the risk of mortality in the cantons of Vaud (RR:1.37 [CI:1.19-1.59]), Zurich (1.33 [0.99-1.79]), Lucerne (1.33 [0.95-1.87]) and Solothurn (1.22 [0.88-1.69]), while a negative association was observed in Ticino (0.51 [0.37-0.7]), Basel-Land (0.4 [0.24-0.65]) and Thurgau (0.65 [0.5-0.85]). A null association was found in the remaining Cantons. Our findings indicate that TN is a relevant health hazard for a large part of the Swiss population with potentially larger impacts in the future due to climate change and increasing urbanization. Climate Change, Tropical Night, Mortality, Human Health, Switzerland

Trends in temperature-mortality projections across urban and rural regions under different climate change scenarios in Switzerland

Temperature vulnerability tends to be heterogenous between urban and rural regions, with usually larger risks in the former. However, it is unclear whether this pattern will persist under different climate change scenarios. Climate change combined with population growth, ageing and urbanization is expected to amplify the current temperature-related mortality burden, particularly since these drivers will follow diverse trajectories across urban and rural areas in the future. This study aimed to compare the impact of climate change regarding changes in heat- and cold-related mortality under various warming scenarios across urban/rural districts in Switzerland, while also accounting for changes in population demographics. We first estimated the district-age-specific (&amp;#x3c;75/&amp;#x3e;=75years) temperature-mortality association between 1990-2010 in Switzerland using a two-stage time series design with distributed-lag nonlinear models. We then projected heat- and cold-related mortality under 1.5C, 2.0C, 3.0C and 4.0C warming scenarios using downscaled temperature projections under RCP8.5 while accounting for the Shared Socio-economic pathway (SSP5) population development storyline. In Switzerland, heat- and cold-related mortality will increase by 2,420(95%CI:1654;3,884) and 993(82;1883) deaths /year, respectively, under 4.0C warming (vs. 1990-2010). Urban areas are more affected by both heat and cold and this pattern appears to be amplified under warmer scenarios. In particular, per 100 heat-related deaths in rural areas, there will be an increase from 362 to 391 deaths in urban areas, with similar results for cold (from 262 to 286 per 100 deaths in rural areas), indicating a slight increase in vulnerability to climate change in urban regions in the near future. Our preliminary findings suggest that climate change will increase current heat and cold-related mortality in Switzerland, and moreover, urban areas will continuously more be disproportionately affected. Further analyses will aim to account for urbanization projections and disentangle the contribution of the different drivers across urban and rural regions.

The impact of face-mask mandates on all-cause mortality in Switzerland: a quasi-experimental study

BackgroundWhereas there is strong evidence that wearing a face mask is effective in reducing the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evidence on the impact of mandating the wearing of face masks on deaths from coronavirus disease 2019 (COVID-19) and all-cause mortality is more sparse and likely to vary by context. Focusing on a quasi-experimental setting in Switzerland, we aimed to determine (i) the effect of face-mask mandates for indoor public spaces on all-cause mortality; and (ii) how the effect has varied over time, and by age and sex.MethodsOur analysis exploited the fact that between July and October 2020, nine cantons in Switzerland extended a face-mask mandate at different time points from being restricted to public transportation only to applying to all public indoor places. We used both a Difference-in-Differences approach with fixed-effects for canton and week and an event-study approach.ResultsIn our main Difference-in-Differences model, the face-mask mandate was associated with a 0.3% reduction in all-cause mortality [95% confidence interval (CI): −3.4% to 2.7%; P = 0.818]. This null effect was confirmed in the event-study approach and a variety of robustness checks. Combining the face-mask mandate with social distancing rules led to an estimated 5.1% (95% CI: −7.9% to −2.4%; P = 0.001) reduction in all-cause mortality.ConclusionsMandating face-mask use in public indoor spaces in Switzerland in mid-to-late 2020 does not appear to have resulted in large reductions in all-cause mortality in the short term. There is some suggestion that combining face-mask mandates with social distancing rules reduced all-cause mortality.

Mortality in Switzerland in 2021.

ObjectiveTo analyze mortality trends in Switzerland in 2021, the second year of the COVID-19 pandemic.MethodsUsing data from the Swiss Federal Statistical Office, we compared mortality in Switzerland in 2021 with that of previous years in terms of standardized weekly deaths, standardized (annual) mortality rates (overall and stratified by age and sex) and life expectancy. The latter is a well-known demographic concept defining the average lifespan of a hypothetical cohort living and dying according to the mortality rates of a given year.ResultsAfter a favorable first half of the year and a fairly standard second half in terms of mortality in Switzerland, the year 2021 ended with a wave of deaths of moderate intensity related to the 5th wave of COVID-19. Overall, and after a notable increase in mortality in 2020 (+9.2%, 95%CI: +8.0%; +10.3%, compared to 2019, and +5.1%, 95%CI: +4.3%; +6.0%, compared to 2015–19), the pre-pandemic mortality level was approximately recovered in 2021 (+0.8%, 95%CI: -0.3%; +0.8%, compared to 2019, and -2.9%, 95%CI: -3.7%; -2.2%, compared to 2015–19). Life expectancy, after declining by 10 months for men and 6 months for women in 2020 (i.e. men would have lost 10 months and women 6 months had they lived their entire lives with COVID-19 as it was in 2020), returned in 2021 to 2019 levels for women (85.6 years) and regained 2018 levels for men (81.6 years, still -0.3 years from 2019). The age group responsible for the small remaining loss for men was the 50–70 age group, which had similar mortality in 2020 and 2021.ConclusionsThe second year of the COVID-19 pandemic in Switzerland was characterized by an approximate return to pre-pandemic mortality levels, with a faster recovery for women than for men with respect to 2020.

Hospital incidence and mortality of patients treated for abdominal aortic aneurysms in Switzerland - a secondary analysis of Swiss DRG statistics data.

To analyse hospital incidence and in-hospital mortality of patients treated for abdominal aortic aneurysms in Switzerland. Secondary data analysis of case-related hospital discharge data of the Swiss Federal Statistical Office for the years 2009-2018. Patients who were hospitalised and surgically treated for nonruptured abdominal aortic aneurysms or hospitalised and treated for ruptured abdominal aortic aneurysms were included in the analysis. Standardised annual incidences rates were calculated using the European standard population 2013. In-hospital all-cause mortality rates were calculated as raw values and standardised for age, sex, and the van Walraven comorbidity score. A total of 10,728 cases were included in this study, of which 87.1% were male. Overall, 22.7% of the patients presented with a ruptured abdominal aortic aneurysm; 46% of these cases were surgically treated whereas 54% received conservative therapy. The age-standardised cumulative hospital incidences for treatment of nonruptured abdominal aortic aneurysms were 2.6 (95% confidence interval 2.5-2.8) and 19.7 (19.2-20.1) per 100,000 for women and men, respectively; for ruptured aneurysms it was 0.4 (0.3-2.4) per 100,000 in women, and 2.7 (2.6-2.9) in men. The annual incidence rates were stable in the decade observed. The adjusted mortality rates for treatment of nonruptured aneurysms decreased from 5.5% (2.6-11.2%) in 2009 to 1.4% (0.5-3.6%) in 2018 in women, and from 2.4% (1.3-4.5%) in 2009 to 0.6% (0.2-1.5%) in 2018 in men. The adjusted mortality rates for treatment of ruptured abdominal aortic aneurysms remained high without relevant improvements for either sex over time: for women 32.4% (24.1-42.1%), for men 19.7% (16.8-22.8%). The hospital incidence rates for nonruptured and ruptured abdominal aortic aneurysms remained unchanged in the decade observed. Compared with Germany, there was no evidence for a decrease in the annual incidence rates for ruptured abdominal aortic aneurysms in Switzerland. Mortality rates in the elective setting were low and decreased in the last decade but remained high in patients treated for ruptured aneurysms. Efforts to reduce the incidence of ruptured abdominal aortic aneurysms are needed to reduce aneurysm-related mortality in Switzerland.

Hospital incidence and mortality of patients treated for AAA in Switzerland

Abstract Objective To analyse hospital incidence and in hospital mortality of patients treated for abdominal aortic aneurysms (AAA) in Switzerland. Methods Secondary data analysis of case-related hospital discharge data of the Swiss Federal Statistical Office for the years 2009–2018. Patients who were hospitalized and surgically treated for non-ruptured AAA (nrAAA) or hospitalized and treated for ruptured AAA (rAAA) were included in the analysis. Standardised incidences rates were calculated using the European standard population 2013. In-hospital mortality rates were calculated as raw values and standardized for age, sex, and the Elixhauser comorbidity score. Results A total of 10,728 patients were included in this study, of which 87.1% were male. 22.7% of the patients presented with rAAA, 46% of these patients were surgically treated whereas 54% patients received conservative therapy. The age standardized cumulative hospital incidence for treatment of nrAAA was 2.6 (95%-confidence interval: 2.5–2.8) and 19.7 (19.2–20.1) per 100,000 for women and men, respectively; for rAAA 0.4 (0.3–2.4) per 100,000 in women, and 2.7 (2.6–2.9) in men. The incidence rates were stable in the observed decade. The adjusted mortality rates for treatment of nrAAA decreased from 5.5% (2.6–11.2%) in 2009 to 1.4% (0.5–3.6%) in 2018 in women, and from 2.4% (1.3–4.5%) in 2009 to 0.6% (0.2–1.5%) in 2018 in men. The adjusted mortality rates for treatment of rAAA remained high without relevant improvements for both sexes over time; for women 32.4% (24.1–42.1%), for men 19.7% (16.8–22.8%). Conclusion The hospital incidence rates for nrAAA and rAAA remained unchanged in the observed decade. The incidence of rAAA is substantially higher than in comparable populations like Germany. Mortality rates in the elective setting are low and decreased in the last decade but remained high in patients treated for rAAA. Efforts to reduce the incidence of rAAA are needed to reduce aneurysm-related mortality in Switzerland.