Articles: mortality.
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Arch Gerontol Geriatr · May 2010
Comparative StudyDeveloping a self-reported comorbidity index to predict mortality of community-dwelling older adults.
Current common comorbidity measures have poor to moderate predictive validity of mortality of community-dwelling older adults. Hence, our aim is to develop a simpler resource-efficient self-reported comorbidity index in the prediction of survival. 113 older adults in Greater Manchester, United Kingdom attended a routine medical examination whereby information gathered was used to construct Charlson Comorbidity Index (CCI). They completed the Cornell Medical Index (CMI) questionnaire and reported the number of medication prescribed to them. ⋯ Remarkably, by means of forward step-wise Cox-regression, two variables emerged significant: (i) number of medicine (beta coefficient=0.229, SE=0.090 and p=0.011) and (ii) age (beta coefficient=0.106, SE=0.051 and p=0.037). We demonstrated that simple count of medication predicted mortality of community-dwelling older adults over the next 7 years more accurately than CMI or CCI. Further works involving a larger scale of subjects is needed for use in epidemiological study of survival where cost and resources are concerned.
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J. Korean Med. Sci. · May 2010
Clinical characteristics and risk factors for nosocomial candidemia in medical intensive care units: experience in a single hospital in Korea for 6.6 years.
The aim of this study was to determine candidemia incidence among patients in a medical intensive-care unit (MICU) and the associated mortality rate and to identify risk factors associated with candidemia. We retrospectively performed a 1:3 matched case-control study of MICU patients with candidemia. Controls were matched for sex, age, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. ⋯ Multivariate analysis identified the following independent risk factors for candidemia: central venous catheterization (odds ratio [OR] = 3.2, 95% confidence interval [CI]=1.2-9.0), previous steroid therapy (OR=4.7, 95% CI=1.8-12.1), blood transfusion during the same admission period (OR=6.3, 95% CI=2.4-16.7), and hepatic failure upon MICU admission (OR=6.9, 95% CI=1.7-28.4). In conclusion, we identify an additional independent risk factor for candidemia, the presence of hepatic failure on MICU admission. Therefore, increased awareness of risk factors, including hepatic failure, is necessary for the management of candidemia.
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Gigiena i sanitariia · May 2010
Comparative Study Historical Article[Consideration of a potential death risk in the methodology of assessing the population's health].
It has been shown that when calculating the summarized population's health index and the significance (weight) of partial signs, it is expedient to use the calculation from the potential death risk index rather than an expert judgment. The results of calculation examples using morbidity and mortality rates suggest that public health can be assessed on this methodic ground. It is advisable to apply the proposed method for assessing the population's health during sanitary-and-epidemiological surveillance (sociohygienic monitoring) when decisions are taken on the lines of health-promotion measures to reduce morbidity and mortality mainly by circulatory diseases, neoplasms, injuries, and intoxications.
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We investigated whether mortality in intensive care unit (ICU) patients without cerebral damage is associated with fever manifestation and characteristics. ⋯ These findings imply that, although fever is not generally associated with mortality in patients without cerebral damage, it can be harmful and should be suppressed when it becomes very high. Rigorous clinical trials are needed to help establish antipyretic therapy guidelines.
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Objectives-This report presents final 2007 data on U. S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, state of residence, and cause of death. Methods-Information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners, is presented in descriptive tabulations. ⋯ The infant mortality rate in 2007 was 6.75 deaths per 1,000 live births. Conclusions-Mortality patterns in 2007, such as the decline in the age-adjusted death rate to a record historical low, were generally consistent with long-term trends. Life expectancy reached a record high in 2007, increasing 0.2 year from 2006.