Male Mortality Research Articles

A comparative study of incidence, mortality and disability adjusted life years (DALYs) for leading cancers in BRICS countries.

While cancer stands as a prominent global contributor to mortality, the BRICS countries, which contribute a considerable proportion of the world's economy, also account for a substantial proportion of global cancer-related deaths. The study aims to compile data on the incidence, mortality and disability-adjusted life years (DALYs) of leading cancers in BRICS countries to assess any variations in these parameters. Indicators such as the age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR) were abstracted from GLOBOCAN 2022. Global Burden of Disease 2019 provided an overview of DALYs. Additionally, 'Cancer Tomorrow' provided projections for future cancer rates up to 2050. The findings revealed that Russia had the highest ASIR for both sexes. Among males, leading cancer sites included prostate, lung and colorectum, while India stood out with lip and oral cavity cancer as the primary site. Breast cancer dominated among females in all BRICS countries, except China, where lung cancer took precedence. South Africa recorded the highest ASMR for both sexes, with Russia leading among males and South Africa among females. Lung cancer has been the leading cause of death in all countries except India, where breast cancer leads. Trachea, bronchus and lung cancers contributed the most to DALYs, except in India, where breast cancer prevailed. South Africa and India are anticipated to have the highest increase in new cancer cases and deaths in future. Breast and lung cancers accounted for the highest incidence, mortality and DALYs in females and males, respectively. Although the BRICS countries anticipate sustained economic growth and have viable cancer control plans, it is essential to investigate cancer risk factors and health systems influencing cancer incidence and outcomes.

Emerging trends and demographic disparities in anal cancer mortality across the United States census regions: An analysis of National Center for Health Statistics mortality data.

Anal cancer, despite its rarity, is a matter of serious concern in the United States, with an uptrend in recent years and marked racial disparities in mortality rates. The aim of this work was to investigate anal cancer mortality trends and sex race disparities in the United States from 1999 to 2020. This is a retrospective study using data from the CDC WONDER database (1999-2020). We investigated deaths attributed to anal cancer, identified by the ICD-10 code C21.1, and excluded individuals aged 14 years and under. The Mann-Kendall trend test was used to investigate temporal trends and a t-test was used to compare continuous variables. Both male and female age-adjusted mortality attributed to anal cancer increased significantly during the study period across all subgroups, including race (Black and White), US Census region (Northeast, Midwest, South and West) and age (15-64 and ≥65 years) (p < 0.001 for all comparisons). For each subgroup, women demonstrated significantly higher rates of mortality than men, except in the Black population, where Black men had higher rates than Black women (0.40 vs. 0.29, p < 0.001). Additionally, Black men had significantly higher mean mortality rates than White men (0.40 vs. 0.27, p < 0.001). The highest rates of anal cancer mortality were among geriatric individuals, especially women aged ≥65 years, at 1.18 per 100 000. The rise in anal cancer mortality and racial and sex disparities present a significant challenge for healthcare providers and policy makers. Further studies are required to devise evidence-based strategies to effectively tackle this challenge.

Dynamic trends of ischemic heart disease mortality attributable to high low-density lipoprotein cholesterol: a joinpoint analysis and age-period-cohort analysis with predictions

AimsThe purpose of this study was to analyze the dynamic trends of ischemic heart disease (IHD) mortality attributable to high low-density lipoprotein cholesterol (LDL-C).MethodsData on IHD mortality attributable to high LDL-C from 1990 to 2021 were extracted from the global disease burden database. Joinpoint software was used to estimate the average annual percentage change (AAPC) in the age-standardized mortality rate (ASMR). An age‒period‒cohort model was used to analyze the impacts of age, period, and cohort on these changes. The Bayesian framework was used to predict IHD mortality attributable to high LDL-C from 2022 to 2040.ResultsThe overall ASMR of IHD attributable to high LDL-C decreased from 50. 479 per 100,000 people in 1990 to 32.286 per 100,000 people in 2021, and ASMR of IHD attributable to high LDL-C was higher in males than in females. The longitudinal age curves of the overall IHD mortality attributable to high LDL-C showed a monotonic upward trend, especially after 65 years of age. The period and cohort effect relative risk (RR) values of overall IHD mortality attributable to high LDL-C showed a downward trend. The overall ASMR of IHD attributable to high LDL-C is predicted to show a downward trend, and male IHD mortality attributable to high LDL-C is expected to be higher than that of females.ConclusionThis study revealed a sustained decrease in IHD mortality attributable to high LDL-C over three decades, with a continued decline expected. Despite this, gender disparities persist, with males experiencing higher mortality rates and elderly individuals remaining a vulnerable group.

Sex-based utilization and outcomes of cold-stored whole blood for trauma resuscitation: Analysis of a prospective multicenter study.

Resuscitation with cold-stored whole blood (WB) has outcome benefits, but benefits varied by patient sex is unknown. There are also concerns about alloimmunization risk for premenopausal females given WB, leading to some protocols excluding this cohort. We sought to analyze WB utilization, outcomes, and disparities by patient sex. This is a secondary analysis of a prospective multicenter study of WB resuscitation. Patients were stratified by sex and compared by transfusion strategy of WB or component therapy (CT). Generalized estimated equation models using inverse probability of treatment weighting were utilized. There were 1,617 patients (83% male; 17% female) included. Females were less likely to receive WB versus males (55% vs. 76%; p < 0.001), with wide variability between individual centers (0%-33% female vs. 66%-100% male, p < 0.01). Male WB had more blunt trauma (45% vs. 31%) and higher shock index (1.0 vs. 0.8) compared with the male CT cohort (all p < 0.05) but similar Injury Severity Score. The female WB cohort was older (53 vs. 36) and primarily blunt trauma (77% vs. 62%) compared with the female CT cohort (all p < 0.05) but had similar shock index and Injury Severity Score. Male WB had lower early and overall mortality (27% vs. 42%), but a higher rate of acute kidney injury (16% vs. 6%) vs. the male CT cohort (all p < 0.01). Female cohorts had no difference in mortality, but the WB cohort had higher bleeding complications. Whole blood use was independently associated with decreased mortality (OR, 0.6; p < 0.01) for males but not for females (OR, 0.9; p = 0.78). Whole blood was independently associated with a decreased mortality for males with no difference identified for females. Whole blood was significantly less utilized in females and showed wide variability between centers. Further study of the impact of patient sex on outcomes with WB and WB utilization is needed. Prognostic/Epidemiological; Level IV.

Spatially clustered patterns of suicide mortality rates in South Korea: a geographically weighted regression analysis

BackgroundSuicide mortality remains a global health concern, and community characteristics affect regional variations in suicide. This study investigated spatially clustered patterns of suicide mortality rates in South Korea and evaluated the impact of community factors on suicide.MethodsSuicide mortality rates were estimated by sex, age group, and district, using the 2021 Cause of Death Statistics in South Korea from the MicroData Integrated Service. Community-determinant data for 2021 or the nearest year were collected from the Korean Statistical Information Service. The spatial autocorrelation of suicide by sex and age was examined based on Global Moran’s I index. Geographically weighted regression (GWR) was used to discern the influence of community determinants on suicide.ResultsSuicide mortality rates were significantly higher among men (40.64 per 100,000) and adults over the age of 65 years (43.18 per 100,000). The male suicide mortality rates exhibited strong spatial dependence, as indicated by a high global Moran’s I with p < 0.001, highlighting the importance of conducting spatial analysis. In the GWR model calibration, a subset of the community’s age structure, single-person household composition, access to mental healthcare centers, and unmet medical needs were selected to explain male suicide mortality. These determinants disproportionately increased the risk of male suicide, varying by region. The GWR coefficients of each variable vary widely across 249 districts: aging index (Q1:0.06–Q3:0.46), single-person households (Q1:0.22–Q3:0.35), psychiatric clinics (Q1:-0.20–Q3:-0.01), and unmet medical needs (Q1:0.09–Q3:0.14).ConclusionsCommunity cultural and structural factors exacerbate regional disparities in suicide among men. The influencing factors exhibit differential effects and significance depending on the community, highlighting the need for efficient resource allocation for suicide. A regionally tailored approach is crucial for the effective control of the community’s mental health management system.

Trends and Patterns in Obesity-Related Deaths in the US (2010-2020): A Comprehensive Analysis Using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Data.

Obesity is a significant public health issue in the United States, contributing to a range of chronic conditions and premature mortality. This study analyzes patterns in obesity-related deaths from 2010 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) databaseto identify trends and demographic disparities. A retrospective analysis was conducted using the CDC WONDER Database, focusing on mortality data associated with specific International Classification of Diseases, Tenth Revision (ICD-10) codes for obesity (E66.0, E66.1, E66.2, E66.8, and E66.9). Data were extracted for the period from January 1, 2010, to December 31, 2020. Mortality rates per 100,000 population were calculated and analyzed across different demographic groups, including age, gender, and race/ethnicity. The analysis revealed an overall increase in obesity-related mortality rates, rising from 1.8 per 100,000 in 2010 to 3.1 per 100,000 in 2020. Age-specific mortality rates showed a significant increase in older age groups, with the highest rates observed in individuals aged 55-64 years (6.4 per 100,000) and 65-74 years (7.2 per 100,000). Gender disparities were evident, with higher mortality rates in males (3.4 per 100,000) compared to females (2.8 per 100,000) by the end of the study period. Racial disparities were also noted, with Black or African American individuals experiencing the highest mortality rates (4.3 per 100,000). The study highlights a concerning upward trend in obesity-related mortality in the United States over the past decade, with notable disparities based on age, gender, and race. These findings underscore the need for targeted public health interventions and policies aimed at reducing obesity prevalence and its associated mortality. Further research should explore the underlying causes and contributing factors to these trends to develop effective strategies for obesity management and prevention. Among the notable strengths of this study include the observation that it leveraged a comprehensive and decade-long countrywide database with detailed and up-to-date ICD-10 codes and demographic data to offer in-depth insights into obesity-related disparities and mortality trends in the United States. Nevertheless, the findings of this study have been limited by its increased focus on the United States' data, depending only on mortality records devoid of consideration of morbidity, alongside the lack of detailed data on lifestyle factors and comorbid conditions.

Abstract P123: Gender Difference in the In-hospital Mortality for Hypertensive Heart Disease – United States Population-Based Survey Analysis

Background: Females have steeper increases in blood pressure than males throughout life, thus setting the stage for gender based phenotypic and clinical differences in hypertension related pathologies. We set out to determine the in-hospital mortality for the patients primarily admitted for Hypertensive Heart Disease (HHD) in the United States. Methods: Data was extracted from the National Inpatient Sample (NIS) 2016 - 2020 Database. We used ICD-10 code I11.9 to identify the patients primarily admitted for HHD. Multivariable Logistic regression was used to estimate Odds Ratio (OR) for in-hospital mortality between the two genders. Multivariable Poisson regression model was performed for yearly trends with year as the independent variable and in-hospital mortality as the dependent variable. In-hospital mortality rate trends between the two genders were compared using a group-year interaction term in a multivariable regression analysis with in-hospital mortality event as the dependent variable. All the outcomes were adjusted for age, insurance status, race, Charlson comorbidity index (CCI) and the hospital characteristics (location, bed-size). The analysis was performed on STATA 16 software. Results: We identified 1,877,150 patients with HHD. Mean age of the patient cohort was 70 years, mean CCI was 2.7 and 51% were females. Unadjusted in-hospital mortality rate for males was 1.6% compared to 1.8% for females. When adjusted for cofounders, females had lower risk of in-hospital mortality compared to males (OR: 0.95, 95% CI 0.90 – 0.99). In-hospital mortality rate for either gender did not appreciably change from 2016 – 2020, however, when compared to males the mortality rate for females rose more sharply (Interaction p = 0.038) as shown in Figure 1. Conclusion: In our adjusted population-based survey analysis, short term mortality risk for HHD was lower for females than males, however, during the study period 2016 – 2020 mortality rate for females rose more sharply than for male subjects.

Sex differences in association of healthy eating pattern with all-cause mortality and cardiovascular mortality

BackgroundAlthough the Healthy Eating Index (HEI) is widely recommended to reduce the risk of cardiovascular disease and all-cause death, there are significant differences in physiological and nutritional factors between the sexes. The potential impact of sex on adult dietary health is still poorly understood. The study was designed to assess whether the health benefits of diet differed by sex.MethodsIn a prospective study of 39,567 U.S. adults (51.2% female, age 46.8 ± 17.6 years), we examined sex-specific, multivariable-adjusted associations of HEI with all-cause mortality and cardiovascular disease mortality. Restricted cubic splines (RCS), subgroup analysis, propensity score matching (PSM), random forest feature importance, and sensitivity analysis were also used.ResultsDuring 328,403 person-years of follow-up, a total of 4754 all-cause deaths were recorded, including 1481 cardiovascular deaths. Compared to the lowest quartile of HEI, the all-cause mortality rate of females and males in the highest quartile array decreased by 34% (HR 0.66 [95% CI 0.55–0.8]) and 15% (HR 0.85 [95% CI 0.73–0.99]), respectively. The restricted cubic spline showed a linear inverse association between baseline HEI and all-cause mortality and CVD mortality, with similar sex-specific results. Similarly, component scores were sex-specific for mortality risk, with females benefiting more from diet. The benefits of dairy products, vegetables, and sodium scores on the risk of all-cause death were higher in males and females. However, the benefits of vegetable, sodium, and fatty acid scores on the risk of cardiovascular death were different.ConclusionsIn the adult population of the U.S., there are more opportunities for females to reduce the risk of all-cause mortality and cardiovascular mortality from the same dose of healthy dietary intake than males. These findings could reduce the risk of death by motivating the population, especially females, to consume healthy dietary components, especially vegetables and dairy products.

Trends in alcohol-attributable morbidity and mortality in Germany from 2000 to 2021: A modelling study.

We aimed to assess: (i) trends in alcohol-specific - that is, fully attributable - morbidity and mortality in the German adult population aged 15-69 between 2000 and 2021; and (ii) changes in alcohol-attributable disease burden - that is, fully and partially alcohol-attributable categories - for 2006, 2012, 2018 and 2021. Morbidity data was pulled from hospitalisation and rehabilitation statistics and mortality data was pulled from the causes of death registry. Alcohol use, adjusted for unrecorded consumption, was estimated using the Epidemiological Survey of Substance Abuse and triangulated with per capita consumption from annual sales data. For major disease categories, alcohol-attributable fractions were estimated for males and females by age groups (15-29, 30-49, 50-69 years) using the comparative risk assessment methodology. For males and females, the age-standardised rate of alcohol-specific morbidity peaked in 2012 and decreased thereafter showing a steep decline from 2019 to 2021. The rates of alcohol-specific mortality decreased constantly from 2000 to 2019 but increased from 2019 to 2021. Compared to 2006 the age-standardised alcohol-attributable morbidity and mortality rates in males and females were lower in 2021. For both sexes, the age-standardised alcohol-attributable morbidity and mortality rates and the proportions of morbidity/mortality rates relative to all-cause morbidity/mortality decreased between 2006 and 2021. The declines in alcohol-attributable morbidity and mortality are in line with decreases in consumption and signal that the importance of alcohol in health service utilisation and mortality has weakened. Sex ratios in morbidity and mortality do not indicate a strong converging trend.

Optimizing Prostate Imaging Practices in Saudi Arabian Hospitals: A Comprehensive Analysis of PI-RADS Compliance in Multiparametric MRI.

Prostate cancer, a significant contributor to male cancer mortality globally, demands improved diagnostic strategies. In Saudi Arabia, where the incidence is expected to double, this study assessed the compliance of multiparametric MRI (mpMRI) practices with Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) guidelines across diverse healthcare institutions. A survey was distributed to the radiology departments of all tertiary referral hospitals in Saudi Arabia (n=60) to assess their compliance with the technical specifications outlined in PI-RADS v2. Statistical analysis included chi-square, Fisher exact, ANOVA, and Student t-tests to examine the collected data. The study revealed an overall commendable compliance rate of 95.23%. However, significant variations were observed in technical parameters, particularly between 1.5 Tesla and 3 Tesla scanners and tertiary versus non-tertiary hospitals. Notable adherence in certain sequences contrasted with discrepancies in T2-weighted and diffusion-weighted imaging parameters. These findings underscore the need for nuanced approaches to optimize prostate imaging protocols, considering field strength and institutional differences. The study contributes to the ongoing refinement of standardized mpMRI practices, aiming to enhance diagnostic accuracy and improve clinical outcomes in prostate cancer.

Serum Transaminases and Older Adults: Distribution and Associations With All-Cause Mortality.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are commonly ordered tests in general medical practice. However, their distribution and significance in older adults are understudied. As such, we aimed to evaluate sex-stratified distribution of both ALT and AST in older adults (≥70 years) and assess for associations with mortality. Post-hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) randomized, placebo-controlled trial of daily low-dose aspirin for initially relatively healthy older persons. Univariate analysis and multiple logistic regression were used to explore baseline characteristics. Cox regression and restricted cubic splines were used to examine links between transaminase levels and mortality. Of the 11 853 participants with ALT and AST levels, 1 054 (8.9%) deaths were recorded over a median of 6.4 (interquartile range [IQR] 5.4-7.6) years. For ALT, the lowest quintiles for males and females were 6-15 and 5-13 U/L, respectively; for AST, the lowest quintiles were 8-18 and 7-17 U/L, respectively. On both univariate and models adjusted for covariates including age, body mass index, frailty, diabetes, and kidney disease, males and females in the lowest quintile of ALT had an increased hazard of mortality (aHR 1.51 [95% confidence interval {CI} 1.14-1.99] and aHR 1.39 [95% CI 1.03-1.88], respectively). For the lowest quintile of AST, only males were at increased risk (aHR 1.33 [95% CI 1.04-1.70]). Associations remained significant when removing outliers. Low ALT levels independently confer an increased hazard of mortality for older males and females; low AST only affected older male survival. Further evaluation of mechanisms would be worthwhile, and re-evaluating the lower limit of normal for ALT in older adults should be considered.

Healthy worker hire and survivor effects in a cohort of medical radiation workers.

The healthy worker effect may distort the association between exposure and health effects in workers. However, few studies have investigated both the healthy worker hire and survival effects simultaneously, and they are limited to mortality studies in male workers. We utilized a data set comprising South Korean diagnostic medical radiation workers registered in the National Dose Registry between 1996 and 2011, and merged it with mortality and cancer incidence data. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were computed for comparison with the general population. To account for time-varying confounders influenced by prior occupational radiation exposure, we applied g-estimation using structural nested accelerated failure time models and compared the outcomes with those from Weibull regression. A total of 1831 deaths and 3759 first primary cancer cases were identified among 93 918 workers. Both male (SMR = 0.44; 95% CI: 0.42, 0.46) and female workers (SMR = 0.53; 95% CI: 0.46, 0.60) showed lower mortality rates compared with national rates. In the SIR analysis, male workers exhibited reduced risks of solid cancer whereas female workers had increased risks. The g-estimation-derived hazard ratios (HRs) from radiation exposure exceeded those from Weibull regression estimates for all-cause death (HR = 2.55; 95% CI: 1.97, 3.23) and all-cancer incidence (HR = 1.96; 95% CI: 1.52, 2.55) in male workers whereas female workers showed the opposite results. Comprehensive consideration of the healthy worker effect by sex is essential for estimating the unbiased impact of occupational exposure on health outcomes, notably in studies focusing on male mortality.

The health legacy of coal mining: Analysis of mortality rates over time in England and Wales (1981–2019)

Background– Coal mining areas in the UK continue to suffer worse health outcomes despite the industry disappearing by the early 1990s. Unemployment and deprivation are cited as key explanations. However, as the health effects of hazardous working environments continue after the industry's closure, it is unclear to what extent this ongoing health deficit is due to the legacy health effect of coal mining versus socioeconomic factors, including unemployment and deprivation. Methods– I isolate the legacy health effect of coal mining using a matching research design. Coal mining areas are paired with non-mining areas using propensity score matching. This creates a sample of socioeconomically similar local authority districts in England and Wales. I estimate the effect of coal mining on male and female age-standardised period mortality rates for 1981–2019, analysing temporal dynamics and testing for convergence. Results– I find an initial coal mining effect in 1981 on male (female) mortality rates of 122.6 (66.5) deaths per 100,000. This effect decreases by 91% (70%) during this period, indicating convergence in mortality rates. The timing of this convergence is consistent with that of the industry's closure, with higher convergence rates observed during the 1990s. Conclusions– These results provide evidence for a legacy health effect on mortality from coal mining and convergence in mortality rates between 1981 and 2019. This effect is important when explaining the health deficit experienced by coal mining areas. Furthermore, as coal mining areas tend to be more deprived, these results also shed light on relevant mechanisms driving recent health inequality in the UK.

Birth outcomes and survival by sex among newborns and children under 2 in the Birhan Cohort: a prospective cohort study in the Amhara Region of Ethiopia

IntroductionDespite the progress in reducing child mortality, the rate remains high, particularly in sub-Saharan African countries. Limited data exist on child survival and other birth outcomes by sex. This study...

National Estimates for the Percentage of All Readmissions With Demographic Features, Morbidity, Overall and Gender-Specific Mortality of Transcutaneous Versus Open Surgical Tricuspid Valve Replacement/Repair.

The aim of the study was to determine national estimates for the percentage of all readmissions with demographic features, length of stay (LOS), cost analysis, comorbidities, complications, overall and gender-specific mortality and complications of transcutaneous tricuspid valve replacement/repair (TTVR) vs. open surgical tricuspid valve replacement/repair (open TVR). Data were extrapolated from the Nationwide Readmissions Database (NRD) 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 - 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 dataset, and 10,077 had one or more of the open approach codes. Overall, the number of cases performed each year through open TVR was higher than TTVR, but there was an increased trend towards the TTVR every passing year. TTVR was performed more in females and advanced age groups than open TVR. The LOS and cost were lower in the TTVR group than in open TVR. Patients undergoing TTVR had more underlying comorbidities like congestive heart failure, hypertension, and uncomplicated diabetes mellitus. Overall mortality was 3.49% in TTVR vs. 6.09% in open TVR. The gender-specific analysis demonstrated higher female mortality in the open TVR compared to TTVR (5.45% vs. 3.03%). Male mortality was statistically insignificant between the two groups (6.8% vs. 4.3%, P-value = 0.15). Patients with TTVR had lower rates of complications than open TVR, except for arrhythmias, which were higher in TTVR. Patients undergoing open TVR required more intracardiac support, such as intra-aortic balloon pump (IABP) and Impella, than TTVR. TTVR is an emerging alternative to open TVR in patients with tricuspid valve diseases, especially tricuspid regurgitation. Despite having more underlying comorbidities, the TTVR group had lower in-hospital mortality, hospital cost, LOS, and fewer complications than open TVR.

Trends analysis of cancer incidence, mortality, and survival for the elderly in the United States, 1975-2020.

Cancer burden from the elderly has been rising largely due to the aging population. However, research on the long-term epidemiological trends in cancer of the elderly is lacking. Registry data of this population-based cross-sectional study were from the Surveillance, Epidemiology, and End Results (SEER) database. The study population aged 65 years or more, from geographically distinct regions. Joinpoint regression and JP Surv method were used to analyze cancer trends and survival. Mortality rate during 1975-2020 decreased from 995.20 to 824.99 per 100,000 elderly persons, with an average annual decrease of 0.421% (95% CI, 0.378-0.464). While overall incidence increased with no significance. Prostate (29%) and breast (26%) cancer were the most common malignancies, respectively, in elderly males and females, and the mortality for both of the two (prostate 15%, breast 14%) ranked just behind lung and bronchus cancer, which had the highest mortality rates in males (29%) and females (23%). Many cancers showed adverse trends in the latest follow-up periods (the last period calculated by the Joinpoint method). For intrahepatic cholangiocarcinoma, incidence (male Annual Percentage Change [APC] = 7.4*; female APC = 6.7*) and mortality (male APC = 3.0*; female APC = 3.3*) increased relatively fast, and its survival was also terrible (3-year survival only 10%). Other cancers with recent increasing mortality included cancer of anus, anal canal and anorectum, retroperitoneum, pleura, peritoneum, etc. Most cancers had favorable trends of survival during the nearest follow-up period. Against the background of overall improvement, many cancers showed adverse trends. Further research for the underlying mechanisms and targeted implements towards adverse trends is also urgent.

Association of Body Mass Index with Outcomes in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF).

Heart failure (HF) is a major health issue, affecting up to 2% of the adult population worldwide. Given the increasing prevalence of obesity and its association with various cardiovascular diseases, understanding its role in HFrEF outcomes is crucial. This study aimed to investigate the impact of obesity on in-hospital mortality and prolonged hospital stay in patients with heart failure with reduced ejection fraction (HFrEF). We conducted a retrospective analysis of 425 patients admitted to the cardiology unit at the University Clinical Hospital in Wroclaw, Poland, between August 2018 and August 2020. Statistical analyses were performed to evaluate the interactions between BMI, sex, and comorbidities on in-hospital mortality. Significant interactions were found between sex and BMI as well as between BMI and post-stroke status, affecting in-hospital mortality. Specifically, increased BMI was associated with decreased odds of in-hospital mortality in males (OR = 0.72, 95% CI: 0.55-0.94, p < 0.05) but higher odds in females (OR = 1.18, 95% CI: 0.98-1.42, p = 0.08). For patients without a history of stroke, increased BMI reduced mortality odds (HR = 0.78, 95% CI: 0.64-0.95, p < 0.01), whereas the effect was less pronounced in those with a history of stroke (HR = 0.89, 95% CI: 0.76-1.04, p = 0.12). In conclusion, the odds of in-hospital mortality decreased significantly with each 10% increase in BMI for males, whereas for females, a higher BMI was associated with increased odds of death. Additionally, BMI reduced in-hospital mortality odds more in patients without a history of cerebral stroke (CS) compared to those with a history of CS. These findings should be interpreted with caution due to the low number of observed outcomes and potential interactions with BMI and sex.

Sex Differences in Cardiovascular Disease-Related Hospitalization and Mortality in Japan - Analysis of Health Records From a Nationwide Claim-Based Database, the Japanese Registry of All Cardiac and Vascular Disease (JROAD).

The prevalence of cardiovascular disease (CVD) is rising in Japan with its aging population, but there is a lack of epidemiological data on sex differences in CVD, including acute coronary syndrome (ACS), acute heart failure (AHF), and acute aortic disease. This retrospective study analyzed data from 1,349,017 patients (January 2012-December 2020) using the Japanese Registry Of All Cardiac and Vascular Diseases database. ACS patients were youngest on average (70.5±12.9 years) and had the lowest female proportion (28.9%). AHF patients had the oldest mean age (79.7±12.0 years) and the highest proportion of females (48.0%). Acute aortic disease had the highest in-hospital mortality (26.1%), followed by AHF (11.5%) and ACS (8.9%). Sex-based mortality differences were notable in acute aortic disease, with higher male mortality in Stanford Type A acute aortic dissection (AAD) with surgery (males: 14.2% vs. females: 10.4%, P<0.001) and similar rates in Type B AAD (males: 6.2% vs. females: 7.9%, P=0.52). Aging was a universal risk factor for in-hospital mortality. Female sex was a risk factor for ACS and acute aortic disease but not for AHF or Types A and B AAD. Sex-based disparities in the CVD-related hospitalization and mortality within the Japanese national population have been highlighted for the first time, indicating the importance of sex-specific strategies in the management and understanding of these conditions.

Trend in the age mortality structure during the COVID-19 pandemic

Introduction. The COVID-19 pandemic, caused by a novel SARS-CoV-2 coronavirus infection, lasted just over three years. Its end was announced in early May 2023. According to official data, the pandemic claimed 6.9 million lives worldwide, but it is believed that at least 20 million people were victims. The first wave of the pandemic was caused by a virus that spread from China. The virus mainly kills representatives of older age groups of the population and is characterized by a high degree of mutagenicity, which contributes to the emergence of new strains of the virus. The most aggressive and established in the population new strains of the virus spread and gave rise to the second wave of the pandemic, which turned out to be the longest. The third wave was caused by the most aggressive strain, spreading from India, and caused the greatest number of deaths. Aim of the study was to identify the extent to which changes in the virus itself affected the gender and age mortality structure during the three waves of the COVID-19 pandemic observed between 2020 and 2021. Materials and methods. The method of single factor analysis of variance was applied. The study was based on the data of the Operational Headquarters under the Government of Samara region, which were published daily with the indication of gender, age, and cause of each death. Results. The analysis confirmed the influence of the virus variability factor on the age mortality structure at the significance level of p&lt;0.05. Comparison of the diagrams of the shares of the selected age segments in the mortality of men and women in each of the pandemic waves clearly showed how the gender and age mortality structure changed. The result of the analysis of variance showed that the changes occurring in the virus itself, although not as significant, affected the mortality pattern, with male mortality being more affected than female mortality. Conclusion. The result of the analysis of variance showed changes occurring in the virus itself to have an impact on the mortality structure, and on male mortality to a greater extent than on female mortality.

Gender Disparity in Hemodialysis Practices and Mortality: A Nationwide Cross-Sectional Observational Study

Background Disparities between genders are well documented in incidence, progression, and outcomes of chronic kidney disease (CKD). This study aimed to describe demographic characteristics, clinical and socio-economic factors among males and females on maintenance hemodialysis and to determine any association with mortality among males and females. Materials and Methods A nationwide cross-sectional study was conducted in a hemodialysis network in India. All adult (&gt;18 years) patients who died while receiving maintenance hemodialysis and an equal number of surviving control patients on maintenance hemodialysis (MHD) between January 1, 2021 to March 31, 2021 were included in the study. The demographic, socioeconomic, and hemodialysis factors were compared between both the genders. Results A total of 1177 patients who died during the study period were included. The majority were males (824, 70.01%). Males were more educated than females (P &lt; 0.001). The proportion of female patients dialysed with temporary catheters where more than males, who had definite vascular access such as AV fistula or AV graft (P &lt; 0.001). More female patients required out-of-pocket expenditure (P = 0.005). Multivariate logistic regression demonstrated that lower educational status, hypoalbuminemia, previous history of hospitalization, and dialysis in centres run by Public Private Partnership (PPP) were associated with mortality in males. Lower educational status, heart failure and previous history of hospitalization were the factors associated with mortality in females. Conclusion Males predominated on hemodialysis. Females were less educated and were less likely to be covered under public or private health insurance compared to males.