Trends In Mortality Research Articles

Changes in mortality due to Chronic Liver Diseases (CLD) during the COVID-19 pandemic: Data from the United States' National Vital Statistics System.

We assessed chronic liver disease (CLD)-related mortality in the U.S. using death data (2011-2021) obtained from National Vital Statistics System (NVSS). The average annual percentage change (AAPC) from the models selected by Joinpoint regression analysis over the pre-pandemic (2011-2019) and the 2019-2021 were reported because non-linear trend in death rates were observed over the 2011-2021. Liver-specific death was defined as an underlying cause of death and Chronic liver disease (CLD)-related death was defined as any cause of death. During the pre-pandemic, age-standardized HCC- and cirrhosis-specific death rates were annually increased by AAPC = +1.18% (95% confidence interval, 0.34% to 2.03%) and AAPC = +1.95% (1.56% to 2.35%). In contrast, during the 2019-2021, the AAPC in age-standardized cirrhosis-specific death rate (per 100,000) accelerated by up to AAPC +11.25% (15.23 in 2019 to 18.86 in 2021) whereas that in age-standardized HCC-specific death rate slowed to -0.39 (-1.32% to 0.54%) (3.86 in 2019 to 3.84 in 2021). Compared to HCC-specific deaths, cirrhosis-specific deaths were more likely to be non-Hispanic white (72.4% vs. 62.0%) and non-Hispanic American Indian and Alaska native (AIAN) (2.2% vs. 1.1%) and have NAFLD (45.3% vs. 12.5%) and ALD (27.6% vs. 22.0%). During the 2019-2021, the age-standardized HCV- and HBV-related death rate stabilized, whereas the age-standardized NAFLD- and ALD-related deaths rate increased to 20.16 in 2021 (AAPC = +12.13% [7.76% to 16.68%]) and to 14.95 in 2021 (AAPC = +18.30% [13.76% to 23.03%]), which were in contrast to much smaller incremental increases during the pre-pandemic (AAPC = +1.82% [1.29% to 2.35%] and AAPC = +4.54% [3.97% to 5.11%]), respectively). The most pronounced rise in the age-standardized NAFLD-related death rates during the pandemic was observed among AIAN (AAPC = +25.38%), followed by non-Hispanic White female (AAPC = +14.28%), whereas the age-standardized ALD-related death rates during the pandemic were highest among AIAN (AAPC = +40.65%), followed by non-Hispanic Black female (AAPC = +26.79%). COVID-19 pandemic had a major negative impact on cirrhosis-specific and CLD-related mortality in the U.S. with significant racial and gender disparities.

Trend of gastrointestinal and liver diseases in China: Results of the Global Burden of Disease Study, 2019.

China is one of the countries with the largest burden of gastrointestinal and liver diseases (GILD) in the world. The GILD constitutes various causes of mortality and disability. The study aimed to investigate the trend of GILD in China using the Global Burden of Diseases Study 2019 (GBD 2019) data resources from 1990 to 2019. The data on the age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for GILD in China from 1990 to 2019 were collected from the GBD 2019 data resources. Furthermore, the ranking of the main causes of deaths and DALYs, as well as the trends of ASMR, DALYs, years of life lost (YLLs), and years of life lost due to disability (YLDs) per 1,000,000 in GILD were reported. The ASMR and DALYs for stomach cancer, liver cancer, and esophageal cancer, which ranked top three among the GILDs from 1990 to 2019, were gradually decreasing. Significant decreases in the ASMR and DALYs were found in diarrheal diseases and acute hepatitis (A, E, and C). However, noteworthy increases were found in those of colon and rectum cancer (CRC) and pancreatic cancer. Trend of DALYs, mortality, and YLLs rates for most of GILD were decreasing from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trend. The DALYs, mortality and YLLs of most GILD diseases showed decreasing trends from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trends. The result of the GBD 2019 showed that the rates of most GILDs decreased in China; however, gastrointestinal and liver cancer, such as stomach cancer still held the top ranking. Furthermore, the shift from infectious diseases to non-communicable causes among GILD burden is occurring and is likely to continue with many public health strategies implications.

Trends in adverse effects of medical treatment in Paediatric populations in the United States: A global burden of disease study, 2000-2019.

Adverse effects of medical treatment (AEMT) pose significant risks to paediatric patients. However, the mortality trends associated with AEMT in this population have been unclear. We aimed to clarify the trends in the incidence, disability-adjusted life years (DALYs) and mortality rates of AEMT for children in the US from 2000 to 2019. Data were retrieved from the Global Burden of Disease study 2019. We estimated age-standardized incidence, DALYs and mortality rates of paediatric AEMT per 100,000 children in the US using a Bayesian meta-regression model. We also analysed incidence, DALYs and mortality in different age groups, and employed Joinpoint regression models to assess the age- and sex-specific trends. The number of deaths due to AEMT in children, the number of cases, and DALYs were 105.1, 551,076 and 145,555 in 2019, decreased by 37.5%, 6% and 28% from those in 2000, respectively. Age-standardized mortality rates decreased across all age groups, while the incidence increased across all age groups with an average annual percentage change (AAPC) of 2.2% in those children <1 year and 4.5% in 5-9 years of age. The increases in DALYs over time was higher in children aged 1-4 years (AAPC: 0.51, 95% CI: 0.47, 0.62) and 5-9 years (AAPC: 0.33, 95% CI: 0.15, 0.50), with the 1-4 year age group being the highest. The study reveals declining AEMT mortality but rising incidence and DALYs, emphasizing a disproportionate burden in <1, 1-4 and 5-9 years. To develop effective mitigation strategies, future research is warranted to identify the causes of increased AEMT in children, especially young males.

Survival Outcomes Among Patients With Hepatocellular Carcinoma in a Large Integrated US Health System

Hepatocellular carcinoma (HCC) is the leading oncologic cause of death among patients with cirrhosis, but large studies examining mortality trends are lacking. To evaluate survival among patients with HCC in one of the largest integrated health care systems in the US. This retrospective cohort study included 3441 adult patients who received a diagnosis of HCC between January 1, 2006, and December 31, 2019, with end of follow-up on December 31, 2020. The study period was further categorized as era 1, defined as 2006 to 2012, and era 2, defined as 2013 to 2019. Statistical analysis was conducted from January 2021 to June 2024. Patient demographic characteristics and disease factors. All-cause and HCC-specific mortality were used as primary end points, and survival probabilities were estimated using the Kaplan-Meier method. Cox proportional hazards regression analyses were adjusted for age at diagnosis, sex, race and ethnicity, cause of disease, Barcelona Clinic Liver Cancer (BCLC) stage, alpha-fetoprotein level, and treatment type. Of 3441 patients with HCC, 2581 (75.0%) were men, and the median age was 65 years (IQR, 58-73 years). A total of 1195 patients (34.7%) received curative treatment, 1374 (39.9%) received noncurative treatment, and 872 (25.3%) received no treatment. During the study period, 2500 patients (72.7%) experienced all-cause mortality, and 1809 (52.6%) had HCC-specific mortality. In multivariable analysis, being 70 years of age or older (adjusted hazard ratio [AHR], 1.39; 95% CI, 1.22-1.59), male sex (AHR, 1.20; 95% CI, 1.07-1.35), BCLC stage C or D (AHR, 2.40; 95% CI, 2.15-2.67), increasing alpha-fetoprotein level (vs <20 ng/mL; 20-99 ng/mL: AHR, 1.20; 95% CI, 1.04-1.38; ≥1000 ng/mL: AHR, 2.84; 95% CI, 2.45-3.25), noncurative treatment (AHR, 2.51; 95% CI, 2.16-2.90), and no treatment (AHR, 3.15; 95% CI, 2.64-3.76) were associated with higher all-cause mortality, while Asian or Other Pacific Islander race and ethnicity (vs non-Hispanic White; AHR, 0.76; 95% CI, 0.65-0.88) was associated with lower all-cause mortality. Survival improved in diagnosis era 2 (2013-2019; n = 2007) compared with diagnosis era 1 (2006-2012; n = 1434). This large, racially and ethnically diverse cohort study of patients with HCC found improving survival over time, especially among individuals with early-stage HCC receiving potentially curative treatments. This study highlights the importance of surveillance for detection of HCC at early stages, particularly among groups at risk for poorer outcomes.

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

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

Evaluation of Mortality Rate Disparities for Cardiac Arrest Between Urban and Rural Cohorts in the United States Using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Database.

Introduction The United States includes diverse geographic areas with distinct urban and rural settings. Urban areas served with higher health services and the rural regions with restricted facilities. This disparity results in higher rural mortality rates. Thus, the study uses the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to assess the disparities in cardiac arrest mortality rates in urban versus rural areas. Methods This is a retrospective study to assess trends in overall mortality rates for urban versus rural areas in the United States between 1999 and 2020, using the CDC WONDER data for cardiac arrest (ICD-10 CODE I46), extracted on May 25, 2024. Urban/rural classification was based on the Metropolitan 2013 scheme. Statistical analysis was done via RStudio v.4.3.3 and included measures of central tendency, mortality rates per 100,000, and plotting of temporal trends. Results Between 1999 and 2020, the total number of deaths due to cardiac arrest in rural and urban areas was 103,115 and 262,505, respectively. Among the age groups, infants <1 year and elderly >85 years showed a high mortality rate in rural areas compared to urban areas.Gender analysis revealed both males (3.3 per 100,000) and females (3.52 per 100,000) had a high rural mortality rate, compared to urban rates of 1.51 and 1.54 per 100,000, respectively. Racial analysis showed that American Indian or Alaska Native and Asian or Pacific Islander populations had higher mortality in rural areas, with rates of 1.1 and 1.81 per 100,000, respectively, compared to the urban rates of 0.34 and 0.8 per 100,000. Conclusion Trends in mortality rate showed a general decline over time but the gap between urban and rural mortality persists, highlighting the need for continued efforts in rural areas.

Asbestos exposure and asbestosis mortality in Italian cement-asbestos cohorts: Dose-response relationship and the role of competing death causes.

In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks. Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death. The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death. Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis.

What value do teaching hospitals provide commercial beneficiaries when in an ACO?

The number of commercial beneficiaries cared for by accountable care organizations (ACOs) is growing, but the literature examining their trends is nascent. We examined commercial claims data from 2019 to 2021 to compare beneficiaries attributed to participants in Medicare Shared Savings Program ACOs with and without a major teaching hospital. We calculated mortality and spending by setting for each ACO type by year. Compared with per-beneficiary rates at nonteaching ACOs, major teaching ACOs have lower mortality rates by up to 2.2 percentage points depending on the patient age group, $283 lower inpatient spending, and lower emergency department utilization in inpatient (-0.008) and outpatient (-0.013) settings, as well as $146 higher overall outpatient spending. Upward trends in mortality and beneficiary risk scores across both ACO types show disruption to health outcomes during COVID-19. These results provide evidence that ACOs with major teaching hospitals may be more likely to achieve the value-based goals of ACOs. Means to accomplish those goals may include avoiding higher-intensity care and supporting access to lower-cost alternatives where clinically appropriate, such as reducing inpatient and emergency department stays by delivering timely, high-quality outpatient care.

Cardiovascular Disease Mortality Trends, 2010–2022: An Update with Final Data

IntroductionAge-adjusted mortality rates (AAMR) for cardiovascular diseases (CVD) increased in 2020 and 2021, and provisional data indicated an increase in 2022, resulting in substantial excess CVD deaths during the COVID-19 pandemic. Updated estimates using final data for 2022 are needed. MethodsThe National Vital Statistics System's final Multiple Cause of Death files were analyzed in 2024 to calculate AAMR from 2010 to 2022 and excess deaths from 2020 to 2022 for US adults aged ≥35 years, with CVD as the underlying cause of death. ResultsThe CVD AAMR among adults aged ≥35 years in 2022 was 434.6 deaths per 100,000 (95% CI: 433.8, 435.5), which was lower than in 2021 (451.8 deaths per 100,000; 95% CI: 450.9, 452.7). The most recent year with a similarly high CVD AAMR as in 2022 was 2012 (434.7 deaths per 100,000 population, 95% CI: 433.8, 435.7). The CVD AAMR for 2022 calculated using provisional data over-estimated the AAMR calculated using final data by 4.6% (95% CI: 4.3%, 4.9%) or 19.9 (95% CI: 18.6, 21.2) deaths per 100,000 population. From 2020 to 2022, an estimated 190,661 (95% CI: 158,139, 223,325) excess CVD deaths occurred. ConclusionsIn 2022, the CVD AAMR among adults aged ≥35 years did not increase, but rather declined from a peak in 2021, signaling improvements in adverse mortality trends that began in 2020, amid the COVID-19 pandemic. However, the 2022 CVD AAMR remains higher than observed before the COVID-19 pandemic, indicating an ongoing need for cardiovascular disease prevention, detection, and management.

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.

Sex Disparities in Ischemic Heart Disease Mortality in Europe

BackgroundIschemic heart disease (IHD) is the leading cause of death in the European Union (EU). Understanding variations by sex, income, and countries can help in tailoring effective public health policies. ObjectivesThe purpose of the study was to examine trends in sex differences in IHD prevalence and prognosis within the EU. MethodsWe conducted a cross-sectional analysis of IHD using the Global Burden of Disease Study Database to examine trends in sex-specific age-standardized mortality rate (ASMR)-to-age-standardized prevalence rate (ASPR) ratio (ASMR-to-ASPR index) per 100,000 inhabitants/year across the EU from 2005 to 2019. ResultsMen showed higher ASMR than women. However, the ASMR-to-ASPR index was notably higher in women than in men indicating that women who develop IHD have a higher risk of dying from the disease compared with their male counterparts. Despite a significant decline in ASMR across EU from 2005 to 2019 both among women (from 1.752 to 1.662) and men (from 3.372 to 3.135), sex disparities in ASMR-to-ASPR index (EU average: 4.96% vs 4.34%) persisted (with a women-to-men ratio ranging from 1.05 to 1.44). No significant relationship was found between country-specific ASMR or country income status and ASMR-to-ASPR index. Examples include Romania, which displayed higher ASMR (men: 219.87, women: 143.54) compared with Germany (men: 107.22, women: 60.76), yet with smaller differences in ASMR-to-ASPR index between women and men (Romania: 6.54% vs 5.85%; ratio: 1.12, and Germany: 4.79% vs 3.80%; ratio: 1.26). ConclusionsMortality from IHD has decreased substantially among EU countries. However, the declines were accompanied by a persistently higher ASMR-to-ASPR index in women, indicating significant potential for further gains in closing the gender gap in IHD mortality.

Trends in Hospitalization and Mortality Rates Associated with Subarachnoid Hemorrhage and Unruptured Cerebral Aneurysms in Brazil

PurposeSpontaneous subarachnoid haemorrhage (SAH) and unruptured intracranial aneurysm (UIA) epidemiology is valuable for determining neurosurgical and general healthcare effectiveness· There is an information gap regarding these conditions in middle- and low-income countries· Therefore, we aimed to investigate their hospitalisation and mortality rates in Brazil from 2011-2019· MethodsThis observational, population-based study used hospital admission and mortality data and included all SAH- and UIA-related public hospitalisations and deaths occurring from 2011-2019· Data were obtained from the Ministry of Health’s National Hospitalisation and Mortality Information Systems· Population data were obtained from the Brazilian Institute of Geography and Statistics· Simple linear regression models with normal responses were adjusted to explain the temporal evolution of variables· Joinpoint regression models were adjusted to detect moments of significant change in variable behaviour· Graduated choropleth maps were generated using georeferencing and geospatial analyses· ResultsThe annual SAH hospitalisation and mortality coefficients were 4·81 and 2·49/100,000 persons, respectively· The unruptured intracranial aneurysm hospitalisation and mortality coefficients were 1·21 and 0·24/100,000 persons, respectively· In addition to regional differences, we found a stable SAH hospitalisation trend and an increasing mortality rate of 0·062 cases/100,000 inhabitants annually· The UIA hospitalisation rate increased by 0·074 cases/100,000 inhabitants annually and mortality decreased by 0·07 deaths/100,000 inhabitants annually· ConclusionIn Brazil, the SAH hospitalisation trend is stable, while there is a worrisome increasing SAH-related mortality trend· A better scenario was observed for an UIA, with an increase in hospitalisations and decrease in mortality·

Mortality Rate and Years of Life Lost Due to Ischemic Heart Disease in Southern Iran between 2004 and 2019: A Population-Based Study.

Cardiovascular diseases (CVDs) account for one-third of all deaths worldwide. In this cross-sectional study, we extracted all death records from the Electronic Death Registration System categorized as ischemic heart disease (IHD) based on age, gender, and the year of death according to ICD-10 for this cross-sectional analysis. The Fars province is situated in southern Iran with a population of about 4 million. An analysis of years of life lost (YLL) resulting from premature death from IHD was conducted using the World Health Organization's 2015 YLL framework. The trend of the YLL rates was investigated using joinpoint regression. In the Fars province, IHD was the cause of 46969 deaths throughout a 16-year study period, (2004 to 2019). Among these, 26,503 (56.4%) were men. The crude death rates per 100000 population for men and women were 84.2 and 66.5, respectively. The total YLL due to premature death due to IHD, during the 16-year study period, was 287625 in male, 209665 in female. The joinpoint regression showed a declining trend in the YLL rate associated with premature death. Annual Percent Change (APC) was -0.6% (95% CI -6.9 to 6.1, P=0.851) for males and -1.5% (95% CI -5.2 to 2.2, P=0.418) for females. The trends of the standardized mortality rate, YLL, and crude mortality rate held steady throughout a 16-year period. Planning for comprehensive primary and secondary prevention and increasing public knowledge of IHD are necessary.

Within-hospital Temporal Clustering of Postoperative Complications and Implications for Safety Monitoring and Benchmarking Using ACS-NSQIP Data.

To determine the extent to which within-hospital temporal clustering of postoperative complications is observed in the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP). ACS-NSQIP relies on periodic and on-demand reports for quality benchmarking. However, if rapid increases in postoperative complication rates (clusters) are common, other reporting methods might be valuable additions to the program. This article focuses on estimating the incidence of within-hospital temporal clusters. ACS-NSQIP data from 1,547,440 patients, in 425 hospitals, over a 2-year period was examined. Hospital-specific Cox proportional hazards regression was used to estimate the incidence of mortality, morbidity, and surgical site infection (SSI) over a 30-day postoperative period, with risk adjustment for patient and procedure and with additional adjustments for linear trend, day-of-week, and season. Clusters were identified using scan statistics, and cluster counts were compared, using unpaired and paired t tests, for different levels of adjustment and when randomization of cases across time eliminated all temporal influences. Temporal clusters were rarely observed. When clustering was adjusted only for patient and procedure risk, an annual average of 0.31, 0.85, and 0.51 clusters were observed per hospital for mortality, morbidity, and SSI, respectively. The number of clusters dropped after adjustment for linear trend, day-of-week, and season (0.31-0.24; P = 0.012; 0.85-0.80; P = 0.034; and 0.51-0.36; P < 0.001; using paired t tests) for mortality, morbidity, and SSI, respectively. There was 1 significant difference in the number of clusters when comparing data with all adjustments and after data were randomized (0.24 and 0.25 for mortality; P = 0.853; 0.80 and 0.82 for morbidity; P = 0.529; and 0.36 and 0.46 [randomized data had more clusters] for SSI; P = 0.001; using paired t tests) for mortality, morbidity, and SSI, respectively. Temporal clusters of postoperative complications were rarely observed in ACS-NSQIP data. The described methodology may be useful in assessing clustering in other surgical arenas.

Demographical and Regional Trends of HIV-Related Mortality Among Young Adults in the United States From 1999-2020.

BackgroundHIV remains a leading cause of death in the U.S. Previous research has examined mortality patterns among older adults with HIV, revealing regional and demographic disparities. This study aims to assess demographic and regional trends in HIV-related mortality among young adults from 1999 to 2020. MethodologyCDC WONDER database was used to identify young adults aged 15-44 where HIV was mentioned as either underlying or contributory cause of mortality between 1999 and 2020, using the B20-B24 codes from the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Age adjusted mortality rates (AAMRs) per 100,000 population and Annual percentage change (APC) were determined. ResultsThe AAMRs for HIV in young adults consistently declined from 1999-2018, followed by a period of stability from 2018-2020 (APC: 0.5%; 95% CI, -7.4 to 9.0), with 64% deaths occurred in medical facilities. Overall, males had a twice AAMR than females (Female: 2.22, 95% CI 2.19-2.24; Male: 5.19, 95% CI 5.15-5.23). Non-Hispanic (NH) Blacks had seven-fold higher mortality rates than Whites (AAMR 14.88 vs. 2.036). The Southern region experienced three-fold higher mortality compared to the Midwest. Metropolitan adults had a two-fold higher AAMR than non-metropolitan adults. States in the top 90th percentile for HIV-related mortality, including Mississippi, Maryland, Florida, Louisiana, and the District of Columbia, exhibited six times higher mortality compared to states in the bottom 10th percentile, such as North Dakota, Idaho, Wyoming, Montana, and Utah. ConclusionTo address these disparities and ensure continued progress, urgent measures are required.

Interstitial Lung Disease as an Emerging Contributor to Mortality in Patients With Inflammatory Bowel Disease: A Population-Based Epidemiological Study.

We aim to investigate the contribution of interstitial lung disease (ILD) to mortality in patients with inflammatory bowel disease (IBD). We performed a comprehensive retrospective, population-based epidemiological study across the United States from 2001 to 2020, using the Wide-ranging Online Data for Epidemiologic Research database. Mortality data were classified according to the International Classification of Diseases, Tenth Revision , with the codes J84 for ILD, K50 for Crohn's disease, and K51 for ulcerative colitis. To discern patterns, age-adjusted mortality rates (AMR) were computed, stratified by sex, geographic census region, and racial/ethnic demographics. From 2001 to 2020, there were 57,967 reported deaths among patients with IBD with an AMR per million significantly rising from 10.989 in 2001-2005 to 11.443 in 2016-2020 ( P < 0.0001). ILD was a contributor to death in 1.19% (692/57,967) of these cases, with AMR rising from 0.092 to 0.143 per million ( P = 0.010). The percentage of ILD-related deaths in the IBD population increased from 1.02% to 1.30% over 2 decades. ILD was a more common cause of death in patients with Crohn's disease than with ulcerative colitis (54.6% vs 45.4%), with a significant increase for both conditions from 2001 to 2020 ( P < 0.05). An upward trend in ILD-related mortality was observed in both sexes ( P < 0.05) and within the White population ( P = 0.010). The observed increase in mortality rates due to ILD among patients with IBD is concerning and highlights a critical need for systematic ILD screening protocols within the IBD patient population to facilitate early detection and management.

Trends in cancer and heart failure related mortality in adult US population: A CDC WONDER database analysis from 1999 to 2020

BackgroundWith the advent of novel chemotherapy, survival of patients with cancer has improved. However, people with cancer have an increased risk of heart failure (HF). Conversely, HF-related mortality may undermine survival among people with cancer. We aim to analyze the trends of mortality in people with HF and cancer in the adult US population. MethodsWe conducted an examination of death certificates sourced from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database, from the years 1999 to 2020. Mortality in adults with HF and cancer was assessed. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change were reported. ResultsBetween 1999 and 2020, 621,783 deaths occurred from HF in people with cancer. The AAMR declined from 16.4 in 1999 to 11.9 in 2017, after which an increase to 14.5 was observed in 2020. Men had consistently higher overall AAMR as compared to women (men = 18.1 vs women = 9.9). Similar AAMR was observed between non-Hispanic (NH) Blacks/African Americans (13.9) and NH Whites (13.3), with lower in American Indian/Alaska Native (9.6) and Hispanics (7.4). Asian/Pacific Islanders reported the lowest AAMR (5.7). The Midwestern region reported the highest AAMR (14.8). We observed the highest AAMR amongst the older population (61.4). ConclusionThe mortality rates of people with HF and cancer are increasing in the adult U.S. population. This underscores the need for increased screening, aggressive management, and subsequent surveillance of people at risk or with manifested HF in people with cancer.

Trends in incidence and mortality for gynaecological cancers in Southeastern China during 2011–2020: a retrospective analysis of registry data

ObjectivesThis study aimed to investigate the changes in the incidence and mortality trends of ovarian cancer (OC), cervical cancer (CC) and uterine cancer (UC) in the Fujian Province, southeastern China.DesignProvincial,...

54853 Trends in Incidence and Mortality of Pleomorphic Dermal Sarcoma: A Retrospective Cohort Study Using SEER Data

54853 Trends in Incidence and Mortality of Pleomorphic Dermal Sarcoma: A Retrospective Cohort Study Using SEER Data

Health-related quality of life of cancer patients: Findings from Western Rajasthan.

Cancer is one of the major public health concerns leading to high trends of mortality and morbidity in India. Health-related quality of life (HRQoL) is an indicator of the sense of well-being applicable, which includes all the domains of physical, social, emotional, and functional well-being. The inferences can strengthen the palliative care needs of patients. This study was conducted to assess the HRQoL of patients on anticancer therapy and to measure the perceived palliative care needs amongst diagnosed patients on cancer therapy. Mixed method approach was used to assess the objectives of the study. FACT-G questionnaire was used to assess the HRQoL of patients among a sample size of 290 participants for quantitative analysis and 9 for in-depth interviews. Data were generated and analyzed in SPSS version 23. Spearman correlation coefficient was used to test the association between the well-being score and demographic factors. The mean age of the study population was 52.46 ± 13.83 years with 65% females. The mean FACT-G score was 61.1 ± 17.1 with mean domain values of 14.97 (physical well-being), 16.55 (social well-being), 16.21 (emotional well-being) and 13.35 (functional well-being). FACT-G score was significantly associated with education level, type of cancer and type of anticancer therapy. Qualitative themes described pertaining to delayed diagnosis, financial distress, side effects, social isolation (factors worsening QoL) and support, and attitude (factors improving QoL). HRQOL scores were found low in all types of cancer and early referral for palliative care might have a positive effect on the quality of life of cancer patients. Cancer is the leading cause of morbidity and mortality with its profound social and economic consequences leading to impoverishment and societal inequity.