Risk Of Mortality In Women Research Articles

The Prognostic Value of Combined Status of Body Mass Index and Psychological Well-Being for the Estimation of All-Cause and CVD Mortality Risk: Results from a Long-Term Cohort Study in Lithuania.

Background and Objectives: It is very important to analyze how body mass index (BMI) and psychological well-being (PWB) combination may be differentially associated with mortality risk. The aim of this study was to evaluate the additional prognostic value of the combined status of BMI and PWB for the estimation of all-cause and cardiovascular disease (CVD) mortality risk in the adult Lithuanian urban population. Materials and Methods: Initial data were collected within the framework of the international cohort HAPIEE study from 2006 to 2008. A random sample of 7115 individuals aged 45-72 years was screened. The response rate was 65%. Deaths were evaluated by the death register of Kaunas city (Lithuania) in a follow-up study until 31 December 2020. The mean (SD) duration of the follow-up for the endpoints period was 12.60 (2.79) years. PWB was evaluated by a CASP-12 questionnaire. Results: The findings from the Cox proportional hazards regression multivariable analysis showed that the combinations of underweight plus lower PWB and severe obesity plus lower PWB increased all-cause mortality risk in men (respectively hazard ratio (HR) = 5.65 and HR = 1.60) and in women (respectively HR = 6.02 and HR = 1.77); and increased the risk of mortality from CVD in men (respectively HR = 6.69 and HR = 2.19) compared with responders with normal weight plus higher PWB. The combination of severe obesity plus higher PWB significantly increased the risk of all-cause and CVD mortality risk in men. The combinations of normal weight plus lower PWB and overweight plus lower PWB significantly increased the risk of all-cause mortality risk in men. Conclusions: The combination of severe obesity independently on lower or higher PWB and the combination of underweight plus lower PWB is a strong predictor for all-cause and CVD mortality risk in men and a strong predictor for all-cause mortality risk in women.

Long-term cardiovascular mortality in women with twin pregnancies by lifetime reproductive history.

Women with one lifetime singleton pregnancy have increased risk of cardiovascular disease (CVD) mortality compared with women who continue reproduction particularly if the pregnancy had complications. Women with twins have higher risk of pregnancy complications, but CVD mortality risk in women with twin pregnancies has not been fully described. We estimated risk of long-term CVD mortality in women with naturally conceived twins compared to women with singleton pregnancies, accounting for lifetime number of pregnancies and pregnancy complications. Using linked data from the Medical Birth Registry of Norway and the Norwegian Cause of Death Registry, we identified 974,892 women with first pregnancy registered between 1967 and 2013, followed to 2020. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for maternal CVD mortality were estimated by Cox regression for various reproductive history (exposure categories): (1) Only one twin pregnancy, (2) Only one singleton pregnancy, (3) Only two singleton pregnancies, (4) A first twin pregnancy and continued reproduction, (5) A first singleton pregnancy and twins in later reproduction and (6) Three singleton pregnancies (the referent group). Exposure categories were also stratified by pregnancy complications (pre-eclampsia, preterm delivery or perinatal loss). Women with one lifetime pregnancy, twin or singleton, had increased risk of CVD mortality (adjusted hazard [HR] 1.72, 95% confidence interval [CI] 1.21, 2.43 and aHR 1.92, 95% CI 1.78, 2.07, respectively), compared with the referent of three singleton pregnancies. The hazard ratios for CVD mortality among women with one lifetime pregnancy with any complication were 2.36 (95% CI 1.49, 3.71) and 3.56 (95% CI 3.12, 4.06) for twins and singletons, respectively. Women with only one pregnancy, twin or singleton, had increased long-term CVD mortality, however highest in women with singletons. In addition, twin mothers who continued reproduction had similar CVD mortality compared to women with three singleton pregnancies.

The Association between Smoking and Mortality in Women with Breast Cancer: A Real-World Database Analysis.

Simple SummaryThe association between smoking status and breast cancer mortality in Asian populations has not been extensively studied. In this study, we aimed to investigate the association between smoking status and mortality risk in women diagnosed with breast cancer between 2011 and 2017 using a real-world population database. Women with breast cancer with a history of smoking had a 1.25-fold higher (95% C.I.: 1.08–1.45; p = 0.0022) risk of overall mortality and a 1.22-fold higher (95% C.I.: 1.04–1.44; p = 0.0168) risk of cancer-specific mortality compared with non-smokers. Smokers who did not have comorbidities showed a significantly higher overall nmortality risk (HR: 1.20; 95% CI: 1.01–1.43; p = 0.0408) than non-smokers among women with breast cancer. Additionally, among women with breast cancer who had a history of smoking, current smokers had a 1.57-fold higher risk (95% CI: 1.02–2.42; p = 0.0407) of overall mortality compared with ever smokers. It was shown that a current smoking status is significantly associated with an increase in overall and cancer-specific mortality risk in women with breast cancer. Among women diagnosed with breast cancer, those who quit smoking had a lower mortality risk than current smokers. Our results underscore the importance of smoking cessation for women with BC.Smoking increases the cancer-specific and overall mortality risk in women with breast cancer (BC). However, the effect of smoking cessation remains controversial, and detailed research is lacking in Asia. We aimed to investigate the association between smoking status and mortality in women with BC using the population-based cancer registry. The Taiwan Cancer Registry was used to identify women with BC from 2011 to 2017. A total of 54,614 women with BC were enrolled, including 1687 smokers and 52,927 non-smokers. The outcome, mortality, was identified using Taiwan’s cause-of-death database. The association between smoking status and mortality was estimated using Cox proportional regression. Women with BC who smoked had a 1.25-fold higher (95% C.I.: 1.08–1.45; p = 0.0022) risk of overall mortality and a 1.22-fold higher (95% C.I.: 1.04–1.44; p = 0.0168) risk of cancer-specific mortality compared with non-smokers. The stratified analysis also indicated that women with BC who smoked showed a significantly higher overall mortality risk (HR: 1.20; 95% CI: 1.01–1.43; p = 0.0408) than women with BC who did not smoke among women without comorbidities. Additionally, current smokers had a 1.57-fold higher risk (95% CI: 1.02–2.42; p = 0.0407) of overall mortality compared with ever smokers among women with BC who smoked. It was shown that a current smoking status is significantly associated with an increase in overall and cancer-specific mortality risk in women with BC. Quitting smoking could reduce one’s mortality risk. Our results underscore the importance of smoking cessation for women with BC.

Sex differences in comorbidities and COVID-19 mortality-Report from the real-world data.

BackgroundThe differential effect of comorbidities on COVID-19 severe outcomes by sex has not been fully evaluated.ObjectiveTo examine the association of major comorbidities and COVID-19 mortality in men and women separately.MethodsWe performed a retrospective cohort analysis using a large electronic health record (EHR) database in the U.S. We included adult patients with a clinical diagnosis of COVID-19 who also had necessary information on demographics and comorbidities from January 1, 2016 to October 31, 2021. We defined comorbidities by the Charlson Comorbidity Index (CCI) using ICD-10 codes at or before the COVID-19 diagnosis. We conducted logistic regressions to compare the risk of death associated with comorbidities stratifying by sex.ResultsA total of 121,342 patients were included in the final analysis. We found significant sex differences in the association between comorbidities and COVID-19 death. Specifically, moderate/severe liver disease, dementia, metastatic solid tumor, and heart failure and the increased number of comorbidities appeared to confer a greater magnitude of mortality risk in women compared to men.ConclusionsOur study suggests sex differences in the effect of comorbidities on COVID-19 mortality and highlights the importance of implementing sex-specific preventive or treatment approaches in patients with COVID-19.

Examining the Gradient of All-Cause Mortality Risk in Women across the Cardiorespiratory Fitness Continuum.

Although cardiorespiratory fitness (CRF) is inversely associated with all-cause mortality in women, less is known regarding the gradient of mortality risk in women, particularly at the lower end of the CRF continuum. A total of 17,901 healthy women (mean age, 45.9 yr) completed a baseline clinical examination, including a maximal treadmill exercise test at the Cooper Clinic in Dallas, TX, between 1971 and 2016. Participants were placed into CRF quintiles based on age and treadmill time. After a mean follow-up period of 17.9 yr, 1198 all-cause deaths occurred. More favorable cardiometabolic risk factors, smoking status, and physical activity levels were observed across ordered CRF quintiles ( P < 0.001 for all). Adjusted all-cause mortality hazard ratios with 95% confidence intervals were 1.71 (1.40-2.09), 1.55 (1.29-1.87), 1.25 (1.03-1.51), 1.16 (0.97-1.38), and 1.0 (referent), respectively, across CRF quintiles ( P trend ≤ 0.001). When utilizing CRF as a continuous variable in a spline analysis and using 4.5 METs as the referent, we estimate a 10% reduction in mortality risk per 1-MET increment in CRF ( P < 0.001) until a threshold of approximately 11 METs. Mortality risk was approximately 50% lower at the 11-MET threshold when compared with the referent. No further significant reduction in mortality risk was observed beyond the 11-MET threshold. In addition, age-adjusted hemodynamic variables including resting and maximal double product, heart rate reserve, double-product reserve, and 1-min recovery heart rate were more favorable across CRF quintiles ( P < 0.001 for all). Beginning at a referent value of 4.5 METs, a significant decreasing gradient of all-cause mortality exists across the CRF continuum, until a threshold of approximately 11 METs is reached. Although all women should be encouraged to work toward meeting public health guidelines for physical activity, it is especially important to target those at the low end of the CRF continuum.

Sex differences in mortality after first time, isolated coronary artery bypass graft surgery: a systematic review and meta-analysis of randomized controlled trials.

Reports of sex-specific differences in mortality after coronary artery bypass graft surgery (CABGS) are contradictory. The review aim was to determine whether CABGS is differentially efficacious than alternative procedures by sex, on short- and longer-term mortality. EMBASE, CINAHL, Medline, and the Cochrane Library were searched. Inclusion criteria: English language, randomized controlled trials from 2010, comparing isolated CABGS to alternative revascularization. Analyses were included Mantel-Haenszel fixed-effects modelling, risk of bias (Cochrane RoB2), and quality assessment (CONSORT). PROSPERO Registration ID: CRD42020181673. The search yielded 4459 citations, and full-text review of 29 articles revealed nine studies for inclusion with variable time to follow-up. Risk of mortality for women was similar in pooled analyses [risk ratio (RR) 0.94, 95% confidence interval (CI) 0.84-1.05, P = 0.26] but higher in sensitivity analyses excluding 'high risk' patients (RR 1.22, 95% CI 1.01-1.48, P = 0.04). At 30 days and 10 years, in contrast to men, women had an 18% (RR 0.82, 95% CI 0.66-1.02, P = 0.08) and 19% (RR 0.81, 95% CI 0.69-0.95, P = 0.01) mortality risk reduction. At 1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, P = 0.77), and at 2-5 years a 25% increase in risk of mortality compared with men (RR 1.25, 95% CI 1.03-1.53, P = 0.03). Women were increasingly under-represented over time comprising 41% (30 days) to 16.7% (10 years) of the pooled population. Meta-analysis revealed inconsistent sex-specific differences in mortality after CABGS. Trials with sex-specific stratification are required to ensure appropriate sex-differentiated treatments for revascularization.

MO515: Mortality Differences Between Men and Women With Chronic Kidney Disease in the Irish Health System: The National Kidney Disease Surveillance Programme

Abstract BACKGROUND AND AIMS Chronic kidney disease is associated with higher mortality compared with the general population, but mortality differences between men and women with CKD are poorly understood. Although the prevalence of CKD is consistently higher in women than in men, emerging studies suggest that men experience poorer survival. The primary goal of this study was to compare mortality rates between men and women in the Irish health system and determine whether kidney function influenced these sex-specific risks. METHOD We created a cohort of 125 890 patients from the National Kidney Disease Surveillance System (NKDSS) to compare mortality rates between men and women. Patients were recruited from 1 January 2005 to 31 December 2010 and followed until 31 December 2013. Kidney function was determined using the CKD-EPI equation, generating estimated glomerular filtration rate (mL/min/1.73 m2) (eGFR). The primary outcome was all-cause mortality from national records provided by the Central Statistics Office (CSO). The principal exposure was participant sex, classified as men or women. Patients were censored at the date of initiation of dialysis or kidney transplantation, death, loss to follow-up or end of follow-up 31 December 2013. Mortality risks were compared using the Fine-Gray approach, which accounted for the competing risks of renal replacement therapy. Adjustments were made for baseline age, kidney function and blood biomarkers, which indicated the presence and severity of clinical disease. RESULTS Of the 125 890 participants, 55.1% were women, with a mean age of 54.1 (SD: 17.7) years. The median follow-up was 7.75 years (IQR: 6.33–8.55), 243 patients (0.19%) patients progressed to RRT and 14 179 patients (11.26%) died. Overall, mortality rates were significantly higher in men than in women (18.4 versus 16.6 deaths/1000 pyrs, respectively). Compared with women, men with CKD experienced significantly higher rates of death and RRT, P &amp;lt; .001 (Figure 1a). With each worsening GFR category, crude mortality rates increased by 18-fold in women compared with 9-fold in men. The P-value for the interaction of sex and GFR with mortality was &amp;lt;0.001. In stratified analyses, the magnitude of the sHR for men versus women decreased with each descending eGFR category from a peak of 2.17 (1.88–2.49) for eGFR &amp;gt;90 mL/min down to 1.21 (0.98–1.49) for eGFR &amp;lt;29 mL/min/1.72 m2 (Table 1) and was no longer significant in the eGFR &amp;lt;29 mL/min/1.72 m² category. CONCLUSION Although women have a higher burden of CKD than men in the Irish health system, the overall risks of death and RRT were far greater in men than in women. However, the excess risk in men diminished with increasing severity of kidney disease such that mortality risks for women approached those of men with advanced kidney disease. While these findings may have a biologic basis, fundamental disparities in care delivery, quality or accessibility between men and women is a far more likely explanation.

Association of digoxin with mortality and rehospitalization in heart failure patients treated with beta-blockers: Results from the Persian Heart Failure Patient Registry.

Numerous clinical trials have reported conflicting results regarding the benefit of digoxin in treating heart failure (HF) patients. This study was conducted with the aim to demonstrate the impact of added digoxin to beta-blocker and beta-blocker alone on all-cause mortality and rehospitalization among these patients. We investigated the data of 1998 patients admitted with a primary diagnosis of decompensated HF in the prospective Persian Heart Failure Patients Registry in Iran. The outcomes of interest were time until death and time until first rehospitalization. Multivariate cox regression was used to compare the impact of beta-blocker plus digoxin and beta-blocker alone on 2.5-year survival and 90-day rehospitalization. The mean age of the participants was 69.18 ± 13.26 years, and 38.1% of patients were women. The incidence rate of all-cause mortality in the total sample was 0.18 and 0.22 in patients on beta-blocker plus digoxin and beta-blocker alone, respectively [incidence rate ratio (IRR) = 1.25; 95% CI: 0.92-1.7]. The adjusted risk of all-cause mortality was significantly higher in women discharged with beta-blocker plus digoxin than beta-blocker groups [hazard ratio (HR) = 2.31; 95% CI: 1.27-4.19]. Rates of 90-day first rehospitalization were 0.10 and 0.12 in the beta-blocker plus digoxin and beta-blocker alone groups, respectively (IRR = 0.85; 95% CI: 0.53-1.35). After adjustment for covariates, beta-blocker plus digoxin therapy had no significant effect on increasing the risk of 90-day first rehospitalization in the total cohort (HR = 0.77; 95% CI: 0.48-1.23), in men (HR = 0.73; 95% CI: 0.40-1.35), and women (HR = 0.76; 95% CI: 0.36-1.65). In patients hospitalized with decompensated HF, digoxin administration at discharge was associated with increased 30-month mortality risk in women.

Thoracic Aortic Diameter and Cardiovascular Events and Mortality among Women and Men.

Background Thoracic aortic diameter may have a role as a biomarker for major adverse cardiovascular events. Purpose To evaluate the sex-specific association of the diameters of the ascending (AA) and descending (DA) thoracic aorta with risk of stroke, coronary heart disease, heart failure, cardiovascular mortality, and all-cause mortality. Materials and Methods Study participants from the population-based Rotterdam Study who underwent multidetector-row CT between 2003 and 2006 were evaluated. Cox proportional hazard models were conducted to evaluate the associations of AA and DA diameters indexed and not indexed for body mass index (BMI) with cardiovascular events and mortality for men and women. Hazard ratios (HRs) were calculated per 1-unit greater SD of aortic diameters. Results A total of 2178 participants (mean age, 69 years; 55% women) were included. Mean follow-up was 9 years. Each 0.23-mm/(kg/m2) larger BMI-indexed AA diameter was associated with a 33% higher cardiovascular mortality risk in women (HR, 1.33; 95% CI: 1.03, 1.73). Each 0.16-mm/(kg/m2) larger BMI-indexed DA diameter was associated with a 38% higher risk of stroke (HR, 1.38; 95% CI: 1.07, 1.78) and with a 46% greater risk of cardiovascular mortality (HR, 1.46; 95% CI: 1.10, 1.94) in women. Larger BMI-indexed AA and DA diameters were associated with greater risk of all-cause mortality in both sexes. Conclusion Larger ascending and descending thoracic aortic diameters indexed by body mass index were associated with greater risk of adverse cardiovascular outcomes and mortality in women and men. Clinical trial registration no. NTR6831 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Williams in this issue.

Risk of Cardiovascular Disease in Women With and Without Breast Cancer: The Pathways Heart Study.

To examine cardiovascular disease (CVD) and mortality risk in women with breast cancer (BC) by cancer therapy received relative to women without BC. The study population comprised Kaiser Permanente Northern California members. Cases with invasive BC diagnosed from 2005 to 2013 were matched 1:5 to controls without BC on birth year and race/ethnicity. Cancer treatment, CVD outcomes, and covariate data were from electronic health records. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% CIs of CVD incidence and mortality by receipt of chemotherapy treatment combinations, radiation therapy, and endocrine therapy. A total of 13,642 women with BC were matched to 68,202 controls without BC. Over a 7-year average follow-up (range < 1-14 years), women who received anthracyclines and/or trastuzumab had high risk of heart failure/cardiomyopathy relative to controls, with the highest risk seen in women who received both anthracyclines and trastuzumab (HR, 3.68; 95% CI, 1.79 to 7.59). High risk of heart failure and/or cardiomyopathy was also observed in women with BC with a history of radiation therapy (HR, 1.38; 95% CI, 1.13 to 1.69) and aromatase inhibitor use (HR, 1.31; 95% CI, 1.07 to 1.60), relative to their controls. Elevated risks for stroke, arrhythmia, cardiac arrest, venous thromboembolic disease, CVD-related death, and death from any cause were also observed in women with BC on the basis of cancer treatment received. Women with BC had increased incidence of CVD events, CVD-related mortality, and all-cause mortality compared with women without BC, and risks varied according to the history of cancer treatment received. Studies are needed to determine how women who received BC treatment should be cared for to improve cardiovascular outcomes.

Parental Grief, Wrongful Incarceration, and the Continued Effects after Exoneration

ABSTRACT The current article was motivated by a case study to diversify present literature on parental grief and wrongful conviction. The authors sought to accomplish this by reviewing available literature on parental grief through the lens of mothers who are forced to grieve both the loss of their child as well as the loss of their personal freedom as a result of being wrongfully incarcerated for the death of said child. The integration of these two topics revealed significant emotional, physical, and adaptive effects of being a female exoneree compounded with the effect of being convicted of physically harming or killing her own child. A review of this information revealed several risk factors contributing to the development of both psychiatric and medical conditions, as well as increasing the risk of mortality in women, and allowed the current authors to propose future directions for practice and research.

Mortality following elective abdominal aortic aneurysm repair in women.

Previous studies have focused on patient-related risk factors to explain the higher mortality risk in women undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to evaluate whether hospital-related factors influence outcomes following AAA repair in women. Patients undergoing elective AAA repair in 61 hospitals in the Netherlands were identified from the Dutch Surgical Aneurysm Audit registry (2013-2018). A mixed-effects logistic regression analysis was conducted to assess the effect of sex on in-hospital and/or 30-day mortality. This analysis accounted for possible correlation of outcomes among patients who were treated in the same hospital, by adding a hospital-specific random effect to the statistical model. The analysis adjusted for patient-related risk factors and hospital volume of open surgical repair (OSR) and endovascular aneurysm repair (EVAR). Some 12 034 patients were included in the analysis. The mortality rate was higher in women than among men: 53 of 1780 (3.0 per cent) versus 152 of 10 254 (1.5 per cent) respectively. Female sex was significantly associated with mortality after correction for patient- and hospital-related factors (odds ratio 1.68, 95 per cent c.i. 1.20 to 2.37). OSR volume was associated with lower mortality (OR 0.91 (0.85 to 0.95) per 10-procedure increase) whereas no such relationship was identified with EVAR volume (OR 1.03 (1.01 to 1.05) per 10-procedure increase). Women are at higher risk of death after abdominal aortic aneurysm repair irrespective of patient- and hospital-related factors.

Dose-response relationships of sarcopenia parameters with incident disability and mortality in older Japanese adults.

BackgroundSarcopenia‐related parameters may have differential impacts on health‐related outcomes in older adults. We examined dose–response relationships of body composition, muscle strength, and physical performance with incident disability and mortality.MethodsThis prospective study included 1765 Japanese residents (862 men; 903 women) aged ≥65 years who participated in health check‐ups. Outcomes were incident disability and all‐cause mortality. Fat mass index (FMI) and skeletal muscle mass index (SMI), determined using segmental multi‐frequency bioelectrical impedance analysis, handgrip strength (HGS), and usual gait speed (UGS) were measured. We determined multivariate‐adjusted hazard ratios (HRs) for disability and mortality relative to sex‐specific reference values (FMI: medians; SMI: 7.0 kg/m2 for men and 5.7 kg/m2 for women; HGS: 28 kg for men and 18 kg for women; or UGS: 1.0 m/s for both sexes). Association shapes were examined using restricted cubic splines or fractional polynomial functions.ResultsThe median follow‐up was 5.3 years; 107 (12.7%) men and 123 (14.2%) women developed disability, and 101 (11.7%) men and 56 (6.2%) women died. FMI did not impact any outcome in men and disability in women, while an FMI ≤ 7.3 kg/m2 (median) was significantly associated with higher mortality risk in women, compared with median FMI. SMI did not impact disability in either sex and mortality in women, but showed a significant inverse dose–response relationship with mortality risk in men [HRs (95% confidence intervals) of minimum and maximum values compared with the reference value: 2.18 (1.07–4.46) and 0.43 (0.20–0.93), respectively], independent of HGS and UGS. HGS and UGS showed a significant inverse dose–response relationship with disability in both sexes [HGS: 1.71 (1.00–2.91) and 0.31 (0.09–0.99), respectively, in men, 2.42 (1.18–4.96) and 0.41 (0.20–0.85), respectively, in women; UGS: 2.14 (1.23–3.74) and 0.23 (0.08–0.67), respectively, in men, 3.26 (2.07–5.14) and 0.11 (0.05–0.26), respectively, in women] and mortality in women [HGS: 6.84 (2.84–16.47) and 0.06 (0.02–0.21), respectively; UGS: 2.67 (1.14–6.27) and 0.30 (0.11–0.85), respectively], independent of body composition, but did not impact mortality in men.ConclusionsDisability risk was more dependent on muscle strength and physical performance in both sexes. Mortality risk in men was more dependent on muscle mass, and mortality risk in women was influenced by lower fat mass along with muscle strength and physical performance. Although improving muscle strength and physical performance should be the first target for health promotion, it is also necessary to pay attention to body composition to extend life expectancy in older adults.

Sex-specific differences in mortality after first time, isolated coronary artery bypass graft surgery: a systematic review and meta-analysis of randomized controlled trials

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND Evidence quantifying sex-specific differences in cardiac surgical outcomes is scant. PURPOSE The purpose of this review was to determine whether contemporary evidence indicates Coronary Artery Bypass Graft Surgery (CABGS) is differentially efficacious than alternative procedures by sex on mortality outcomes. METHODS EMBASE, CINAHL, Medline and Cochrane Library databases were searched (January 2010-April 2020). English language, randomized controlled trials, comparing isolated CABGS to an alternative revascularization strategy in adults, with analyses comparing sex-specific differences in mortality were included. Analyses of incidence data was performed using Mantel-Haenszel fixed-effects modelling, Cochrane RoB2 tool and CONSORT checklist. PROSPERO Registration ID: CRD42020181673. RESULTS The search yielded 4459 citations, with 29 articles for full-text review revealing 9 eligible studies with variability in time to follow-up. In contrast to men, mortality risk for women was lower in pooled analyses (RR 0.95, 95% CI 0.85-1.05, p = 0.33) but higher in sensitivity analyses excluding ‘high-risk’ patients (RR 1.18, 95% CI 0.99-1.40, p = 0.07). At 30-days and 10 years, women had an 18% (RR 0.82, 95% CI 0.66-1.02, p = 0.08) and 19% (RR 0.81, 95% CI 0.69-0.95, p = 0.01) mortality risk reduction. At 1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, p = 0.77), and at 2-5 years a 25% increase in risk of mortality compared to men (RR 1.25, 95% CI 1.03-1.53, p = 0.03). Women were increasingly under represented (23.2%) over time, comprising 29% (30-days) to 16% (10 years) of the pooled population. CONCLUSION Trials with sex-specific stratification are required to ensure appropriate treatment options for coronary revascularization.

Accounting for Hospital Related Factors in the High Mortality in Women Following Elective Abdominal Aortic Aneurysm Repair: Application of a Mixed Effects Logistic Regression Analysis in a Nationwide Cohort Study (2013–2018)

Introduction: Prior studies have focused on patient related risk factors in an effort to explain the higher mortality risk in women versus men following elective open surgical repair (OSR) and endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs). However, there may also be hospital related factors that contribute to this disparity in mortality. A nationwide retrospective study that accounted for both types of factors was undertaken.

An Investigation Using Specific Absorption Rate Analysis to Diagnose Early- stage Breast Tumor using UWB Antenna.

This work was focused on the detection of early-stage breast tumors and their location. The most frequently seen disease progression and mortality in women's lives is Breast Cancer. Because of breast cancer/tumors, the risk of mortality for women has risen exponentially. From the 2020 deadline for breast cancer, women who died from carcinoma were 123.8 cases per lac women between 2006-2010. This problem is also overcome by the early identification of the tumor using different detection procedures like X-ray mammography, computerized tomography, ultrasound imaging technique, Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI), microwave imaging. Researchers carried out multiple studies in these areas. To detect early-stage breast tumors and their location using SAR analysis. The major dielectrical difference between cancerous breast tissues and normal tissues in this technique is the microwave frequency range. The term Specific Absorption Rate (SAR) describes the amount of energy which is absorbed (W/kg) in the breast tissue. This segment illustrates the usefulness to diagnose the tumor position in the breast by means of maximum SAR value coordinates. Changes in breast and tumor size are important for the risk of diagnosis. The power absorbed in connecting with a normal breast and a tumor breast is measured and equivalent for different breast masses. The maximum SAR is also analyzed at distinct tumor locations at various frequency ranges. It is observed that max SAR coordinates are very close to the actual tumor location. So, the maximal value of SAR coordinates indicates the existence of a tumor in the breast phantom. The simulated data above strongly suggests that the Max SAR values were higher in the breast phantom with tumor as compared to the breast without tumor. With different tumor radius (3 mm and 5 mm) analyzed with different resonant frequencies like 3GHz, 4GHz and 5GHz at the actual tumor location of (0, 0, 35). Even though a model representing the real properties of breast tissue is required to assess the validation of any imaging process, so the real-time development of an equivalent breast phantom and its execution is needed.

Can Comorbidity Burden Explain Women’s Higher Mortality Risk After Elective Aortic Aneurysm Repair?: Abdominal Aortic Aneurysms

Introduction: To explore whether the higher 30 day mortality risk in women versus men after elective surgical repair for abdominal aortic aneurysms (AAAs) can be explained by differences in comorbidity at baseline.

Association between exposure to parabens and total mortality in US adults

BackgroundParabens are a group of endocrine disruptors that have been associated with health effects such as hypertension, diabetes, oxidative stress and obesity, which are associated with increased mortality risk over time. Women are exposed to higher paraben levels than men through use of consumer products. The current prospective study examines paraben exposure in association with mortality risk for women and men. MethodsWe analyzed 2005–2008 National Health and Nutrition Examination Survey (NHANES) data on urinary paraben analyte concentrations and covariates in adults aged 20 years and over, prospectively linked to National Center for Health Statistics (NCHS) mortality through 2015 (N = 2939). Proportional hazard regression models examined mortality risk in association with exposures, controlling for covariates for women and men. Covariates included age, race/ethnicity, smoking, education, income, body mass index, physical activity, self-reported health status and baseline health conditions. ResultsWomen were exposed to significantly higher concentrations of all studied parabens than men. Exposures were highest for methyl paraben. Women had significantly higher mortality risk in association with higher natural log exposure to ethyl (HR = 2.048, 95% CI 1.164–3.601), methyl (HR = 1.312, 95% CI 1.013–1.700), butyl (HR = 2.719, 95% CI 1.591–4.647) and total parabens (HR = 1.292, 95% CI 1.006–1.659). Exposure concentrations were associated with higher mortality risk for men only for ethyl paraben (HR = 2.532, 95% CI 1.217–5.268). DiscussionWomen were found to be at greater mortality risk in association with exposure to ethyl, methyl, butyl and total parabens. These findings require confirmatory research but add to the evidence base that exposure to parabens, probably through consumer products, may have adverse effects on human health, especially for women.

Association of dairy intake with all-cause, cancer, and cardiovascular disease mortality in Japanese adults: a 25-year population-based cohort

PurposeThe association between dairy intake and mortality remains uncertain, and evidence for the Japanese population is scarce. We aimed to investigate the association between dairy intake and all-cause, cancer, and cardiovascular disease (CVD) mortality in Japanese adults.MethodsA total of 34,161 participants (16,565 men and 17,596 women) aged 40–64 years without a history of cancer, myocardial infarction, or stroke at baseline were included in the analysis, using data from the Miyagi Cohort Study initiated in 1990. Milk, yogurt, and cheese intake were obtained using a validated food frequency questionnaire. Total dairy intake was calculated as the sum of milk, yogurt, and cheese intake and then categorized by quartile. The outcomes were all-cause, cancer, and CVD mortality. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality risks.ResultsDuring 750,016 person-years of follow-up, the total number of deaths was 6498, including 2552 deaths due to cancer and 1693 deaths due to CVD. There was no association between total dairy intake and all-cause, cancer, and CVD mortality for both men and women. We also examined the associations between subgroup dairy products and mortality. For milk and yogurt intake, our results suggest null associations. However, cheese intake was modestly associated with lower all-cause mortality in women; compared with non-consumers, the multivariable HRs (95%CIs) were 0.89 (0.81–0.98) for 1–2 times/month, 0.88 (0.78–1.00) for 1–2 times/week, and 0.89 (0.74–1.07) for 3 times/week or almost daily (p trend = 0.016).ConclusionDairy intake was not associated with mortality in Japanese adults, except for limited evidence showing a modest association between cheese intake and a lower all-cause mortality risk in women.

Increased Perceived Age as a Risk Factor for All-cause Mortality and Comorbidities: A Systematic Review

INTRODUCTION: Chronological age has been identified as a major risk factor for a wide variety of pathologies, also serving as a mortality predictor. However, same-aged patients’ diverse health outcomes put its predictor role for reconsideration. Biological age is a measure based on physical, physiological, cellular, and biochemical parameters and might reflect a person’s aging process more accurately. A higher biological age or its isolated components have been associated with a higher risk of developing several chronic diseases and increased mortality risk. Perceived age, defined as how old a person looks to external evaluators, reflects the underlying biological age. Therefore, this review aimed to find whether perceived age is associated with mortality risk or comorbidity outcomes. METHODS: PubMed, EMBASE, and CINAHL were inquired on July 27, 2020. Mesh terms related to perceived age, mortality, and the most prevalent chronic diseases in the United States (including heart disease, cancer, and diabetes) were used. Studies were included if they (1) measured perceived age or isolated facial characteristics of old age, (2) measured mortality risk, mortality rate, or comorbidity outcomes, and (3) were in English. RESULTS: Of the 977 studies, 15 fulfilled the inclusion criteria. Follow-up periods ranged from 2 to 15 years. Same age younger-looking people were used as control groups in all studies. Four studies correlated perceived age with all-cause mortality risk. These studies found that mortality risk increased by 6%–51% in older-looking people (HR 1.06–1.51, P < 0.05) compared with controls. This association was found in women in only one study (HR 1.51, P < 0.05). One study correlated isolated facial characteristics with mortality risk, finding a decreased mortality risk in men with no gray hair (RR 0.81, P < 0.05) and increased mortality risk in women with arcus senilis (RR 1.13, P < 0.05 for half arcus; RR 1.25, P < 0.05 for complete arcus). Two studies measuring mortality rate found deceased patients to look between 1.04 and 1.15 years older than same-aged survivors (P < 0.05). Nine studies correlated perceived age or isolated facial characteristics with different comorbidity parameters. Older-looking people were found to have a higher carotid intima-media thickness (P < 0.01). Breaking down perceived age by facial characteristics, pigmentation showed a significant positive correlation with carotid intima-media thickness (P < 0.05). Younger-looking patients were found to have lower cardiovascular risk (P < 0.01). Additionally, gray hair increased the risk of myocardial infarction in men (RR 1.91, P < 0.01). Older-looking people were also found to have decreased cognitive function and lower bone mineral density (P < 0.01). Lastly, high wrinkle scores were associated with low forced expiratory volume in one second (P < 0.05), the extent of emphysema on computed tomography (P < 0.05), and increased the risk of chronic obstructive pulmonary disease (P < 0.05). CONCLUSIONS: Measurement outcomes differed among included studies and, although perceived age promises to be a useful predictor of mortality and comorbidities, further characterization of its role as a risk factor and its application in general practice is warranted.