• Title/Summary/Keyword: All-cause mortality

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Between-Hospital Variation in All-Cause Mortality for Potentially Avoidable Hospitalizations in Older People

  • Kim, Jae-Hyun;Lee, Yunhwan
    • Health Policy and Management
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    • v.29 no.2
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    • pp.220-227
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    • 2019
  • Background: Potentially avoidable hospitalizations (PAH) contribute to an increased post-discharge mortality. Methods: To investigate the between-hospital variation and the relationship between all predictors and mortality after discharge among older adults with PAH, we studied 15,186 older patients with PAH in 2,200 hospitals included in the National Health Insurance Service-Senior claims database from 2002 to 2013. Multivariable multilevel logistic regression analyses were performed to analyze the variance at between-hospital for mortality after accounting for differences in patient characteristics. Results: The between-hospital variation in mortality that could be attributed to hospital practice variations were 37.6% at 1-week to 13.9% at 12-month post-discharge, after adjustment for individual patient characteristics and hospital-level factors. Hospital-level factors significantly explained mortality at 3 weeks after discharge. Clinics, compared with general hospitals, demonstrated a 2.75 times higher likelihood of deaths at 3-week post-discharge (p<0.001). Compared with private hospitals, public hospitals exhibited 1.61 times higher odds of 3-week mortality (p=0.01). Conclusion: This study demonstrates considerable between-hospital variations in PAH-related mortality that could be attributed to hospital practices. Monitoring of hospitals to identify practice variations would be warranted to improve the survival of older patients with PAH.

Association Between Liver Enzyme and Risk of All-Cause Mortality: Use of Korean Genome and Epidemiology Study (KoGES) Data (간 효소(AST, ALT)와 전체원인사망 위험의 관련성: 한국인유전체역학조사 자료 활용)

  • Lee, Tae-Yong;Ryu, Hyo-Sun;Park, Chang-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.94-103
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    • 2016
  • This study was conducted to investigate the association of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with all-cause mortality among populations. The data used were from a Korean Genome and Epidemiology Study (KoGES) based on health examinations and questionnaires. The subjects consisted of 10,110 persons aged 40 and over. Hazard ratio was analyzed using Cox's proportional hazard model. The hazard ratio of AST (${\geq}50.0\;IU/L$) was 2.198 (95% CI: 1.217-3.971) after being adjusted for age, sex, education, regular exercise, smoking, drinking, WHR, and TG. In conclusion, AST was an independent significant risk factor of all-cause mortality, and ALT showed a tendency to increase. Overall, these findings indicate that AST and ALT may be useful tools for predicting mortality.

Cancer incidence and mortality estimations in Busan by using spatial multi-level model (공간 다수준 분석을 이용한 부산지역 암발생 및 암사망 추정)

  • Ko, Younggyu;Han, Junhee;Yoon, Taeho;Kim, Changhoon;Noh, Maengseok
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1169-1182
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    • 2016
  • Cancer is a typical cause of death in Korea that becomes a major issue in health care. According to Cause of Death Statistics (2014) by National Statistical Office, SMRs (standardized mortality rates) in Busan were counted as the highest among all cities. In this paper, we used data of Busan Regional Cancer Center to estimate the extent of the cancer incidence rate and cancer mortality rate. The data are considered in small areas of administrative units such as Gu/Dong from years 2003 to 2009. All cancer including four major cancers (stomach cancer, colorectal cancer, lung cancer, liver cancer) have been analyzed. We carried out model selection and parameter estimation using spatial multi-level model incorporating a spatial correlation. For the spatial effects, CAR (conditional autoregressive model) has been assumed.

A Study on Infant Mortality in Korea : 1981-86 (최근의 영아사망율 수준의 추정)

  • 김일현;최봉호
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.76-86
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    • 1988
  • The primary objective of this study was to estimate the level of infant mortality rate and to find the cause of infant deaths prevailed in 1981~86 from vital registration data. In the course of that undertaking we have considered the non-registered portion of infant deaths especially for the non-registered portion of neonatal deaths. The main reason is that deaths occurring in the neonatal period and prior to the registration of the birth leave little incentive for the registration of either the birth or the death. From several ad-hoc survey's results and other countries' experiences it was, however, found that the proportion of neonatal deaths was 69.3%, the proportion of deaths in the period of first month in infanty was 7%, and the proportion of deaths in the period of 2 months and over in infancy was 23.7% respectivily. Thus, adoption the hypothesis that post-neonatal mortality is completly registered, we obtained the extimated number of infant deaths. Attempt to test the hypothesis was also made using the Brougeois- Pichats's function. The result was that the registered number of deaths in the post-neonatal period is almost compatible with the expected number. The major finding in this study was that the level of infant mortality rate in Korea was 19 per thousand live births in 1981 and 13 in 1986. This level of 1986 was almost identical with the level of Japan in 1970. It was also found that there was a difference in the level of infant mortality rate between sexes during 1981-83 but the difference was disappeared in 1985-86. Looking into the cause of infant deaths, it was found from registration that 21.2% of all infant deaths was due to congenital snomalies, 11.5% was due to pneumonia and 5.1% was due to the conditions originating in the perinatal period in that order. This pattern seems to be different with that of U.S.A., Japan and France. However, if we consider the non-registered neo-natal deaths, the order of the cause of infant deaths in Korea will be the same as compared countries. Finally, every efforts should should be made to obtain a good quality of data on infant mortality, making the non-registered events reported completely through hospitals.

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Effect of Low-fat Diet on Breast Cancer Survival: a Meta-analysis

  • Xing, Mei-Yuan;Xu, Su-Zhen;Shen, Peng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1141-1144
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    • 2014
  • Background: Even though many studies have examined the possible effect of low-fat diet on breast cancer survival, the relationship remains unclear. Objectives: To summarize the current evidence about the effect of post-diagnostic low-fat diet on recurrence and all-cause mortality of breast cancer. Methods: We conducted a search of Pubmed, Embase, Web of Science, and Cochrane Library and as a result two randomized controlled trials (RCT) and one large multi-center prospective cohort study with 9,966 breast cancer patients were included in this report. Results: Post-diagnostic low-fat diet reduced risk of recurrence of breast cancer by 23% (HR=0.77, 95%CI 0.63 to 0.94, P=0.009) and all cause mortality of breast cancer by 17% (HR=0.83, 95%CI 0.69 to 1.00, P=0.05). Conclusions: This meta-analysis suggested the post-diagnostic low-fat diet can improve breast cancer survival by reducing risk of recurrence. However, more trials of the relationship between low-fat diet and allcause mortality of breast cancer are still needed.

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data

  • Choe, Seung Ah;Cho, Sung-Il
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.336-342
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    • 2014
  • Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Risk Factors for Lung Cancer Mortality in a Referral Center

  • Jamaati, H;Baghaei, P;Sharifianfard, M;Emami, H;Najmi, K;Seifi, S;Salimi, B;Pourabdollah, M;Kiani, A;Hashemian, M;Khosravi, A
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2877-2881
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    • 2016
  • Background: Lung cancer is one of the most common causes of death that is rising in many countries including Iran. This study aimed to determine the impact of factors on survival of lung cancer patients at a referral center of lung diseases in Tehran, Iran. Materials and Methods: A retrospective study was conducted on adult lung cancer cases admitted to a referral center for lung diseases from 2011 to 2015. Multivariate analysis was performed to determine the risk factors for all-cause mortality. Results: Of a total 933 patients with lung cancer, 53.4% died, 49.3% of them at the hospital. Overall median follow-up time was 7 months. The most common histological type of cancer was adenocarcinoma with a 13 month median survival time. Age ${\geq}55$ and smoking remained significant for all-cause mortality on Cox analysis, whereas gender was not. Conclusions: The survival of lung cancer patients is poor and the patients with history of smoking and age${\geq}55$ are at increased risk of death. Having a large hospital-based registry provides a good measurement of prognostic statistics for lung cancer. Further investigations are necessary to establish reasons for mortality.