• Korea journal of population studies
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• v.26 no.2
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• pp.33-62
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• 2003

The purpose of this study is to analyze the relative importance of three factor -socioeconomic development, public health development, egalitarian nature of socioeconomic development- affecting mortality declines. Infant mortality rate and life expectancy at birth are used as the mortality index, that is the dependent variables, while GNP is used as the indicator of socioeconomic development, primary school enrollment ratio of female as the indicator of egalitarian nature of socioeconomic development, population per hospital bed as the indicator of public health. The data of these variables are collected two time-periods -before 1970 and during 1970-1980- over 50 countries. The explanatory data analysis is used as the statistical technique. We can find whether the relationship between dependent variable and independent variables are linear or nonlinear, and which case is the influential case in our model. The main results of this study are followings. First, the association between infant mortality rates and four indices are not linear. The most important factor explaining the variation of infant mortality is GNP, while primary enrollment of female is the second and GINI is the third important factor. However, population per hospital bed does not have a significant effect on the infant mortality rates in this study. Second, life expectancy at birth is log-linearly related to GNP. Unlike infant mortality rates, the most important factor explaining the variation of life expectance at birth is women's education and the next important factor GNP, and then the third one GINI. But, still population per hospital bed is not significantly related to the variation of life expectance in this study.

• Health Policy and Management
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• v.17 no.3
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• pp.87-105
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• 2007

The purpose of this study was to analyze whether nonemergency, isolated coronary artery bypass graft (CABG) surgery for high- or low-risk patients biases the assessment of the risk-adjusted mortality rates of hospitals. This study used 2002 National Health Insurance claims data for tertiary hospitals in Korea. The study sample consisted of 1,959 patients from 23 tertiary hospitals. The risk-adjustment model used the patients' biological, admission, and comorbidity data identified in the claims. The subjects were classified into high- and low-risk groups based on predicted surgical risk. The crude mortality rates and risk-adjusted mortality rates for low-risk, high-risk, and all patients in a hospital were compared based on the rank and the four intervals defined by quartile. Also, the crude mortality rates of the three groups were compared with their 95% confidence intervals of predicted mortality rates. The C-statistic (0.83) and Hosmer-Lemeshow test ($X^2$=11.47, p=0.18) indicated that the risk-adjustment model performed well. Presenting crude mortality rates with their 95% confidence intervals of predicted rates showed higher agreements among the three groups than using the rank or intervals of mortality rates defined by quartile in the hospital performance assessment. The crude mortality rates for the low-risk patients in 21 of the 23 hospitals were located on the same side of their 95% confidence intervals compared to that for all patients. High-risk patients and all patients differed at only one hospital. In conclusion, the impact of risk selection by hospital on the assessment results was the smallest when comparing the crude inpatient mortality rates of CABG patients with the 95% confidence intervals of predicted mortality rates. Given the increasing importance of quality improvements in Korean health policy, it will be necessary to use the appropriate method of releasing the hospital performance data to the public to minimize any unwanted impact such as risk-based hospital selection.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2259-2263
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• 2013

Background: Public use National Health and Nutrition Examination Survey (NHANES III) and NHANES III linked mortality data were here applied to investigate the association between health insurance coverage and all cause and all cancer mortality in adults. Patients and Methods: NHANES III household adult, laboratory and mortality data were merged. Only patients examined in the mobile examination center (MEC) were included in this study. The sampling weight employed was WTPFEX6, SDPPSU6 being used for the probability sampling unit and SDPSTRA6 to designate the strata for the survey analysis. All cause and all cancer mortalities were used as binary outcomes. The effect of health insurance coverage status on all cause and all cancer mortalities were analyzed with potential socioeconomic, behavioral and health status confounders. Results: There were 2398 sample persons included in this study. The mean age was 40 years and the mean (S.E.) follow up was 171.85 (3.12) person months from the MEC examination. For all cause mortality, the odds ratios (significant p-values) of the covariates were: age, 1.0095 (0.000); no health insurance coverage (using subjects with health insurance), 1.71 (0.092); black race (using non-Hispanic white subjects as the reference group) 1.43, (0.083); Mexican-Americans, 0.60 (0.089); DMPPIR, 0.82, (0.000); and drinking hard liquor, 1.014 (0.007). For all cancer mortality, the odds ratio (significant p-values) of the covariates were: age, 1.0072 (0.00); no health insurance coverage, using with health coverage as the reference group, 2.91 (0.002); black race, using non-Hispanic whites as the reference group, 1.64 (0.047); Mexican Americans, 0.33 (0.008) and smoking, 1.017 (0.118). Conclusion: There was a 70% increase in risk of all cause death and almost 300% of all cancer death for people without any health insurance coverage.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5525-5528
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• 2012

Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (${\pm}10.5$) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4723-4727
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• 2016

Background: There are substantial differences in the mortality rates of stomach cancer among the 47 prefectures in Japan, and Aomori prefecture is one of the most severely impacted. The aims of this study were to determine the incidence and mortality rates of stomach cancer in Aomori prefecture in comparison with Japan as a whole and cast light on reasons underlying variation. Methods: Data on stomach cancer cases were extracted from the Aomori Cancer Registry Database. Incidence rates for specific stages at the time of diagnosis were cited from Monitoring of Cancer Incidence in Japan, and mortality rates for stomach cancer in Aomori prefecture and the whole of Japan were obtained from Vital Statistics. Age-standardised incidence and mortality rates were calculated using the direct method. Results: The age-standardised incidence rate of stomach cancer in Aomori prefecture was higher than in the whole of Japan for males but lower for females. However, the age-standardised mortality rates were higher in Aomori prefecture in both sexes. The proportion of localised cancers was lower in Aomori prefecture than in the whole of Japan for most age groups. Conclusions: The lower rate for localised cancer suggests that higher age-standardised mortality rates are due to delays in diagnosis, despite an attendance rate for stomach cancer screening was higher in Aomori prefecture than in the whole of Japan. One plausible explanation for the failure of successful early detection might be poor quality control during screening implementation that impedes early detection.

• The Korean Journal of Applied Statistics
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• v.31 no.1
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• pp.41-65
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• 2018

In Korea, as the mortality rate improves in a shorter period of time than in developed countries, it is important to consider the selection of the time series as well as the model selection in the mortality projection. Therefore, this study proposed a method using the multiple regression model in respect to the selection of the time series period. In addition, we investigate the problems that arise when various time series are used based on the Lee-Carter (LC) model, the kinds of LC model along with Lee-Miller (LM) and Booth-Maindonald-Smith (BMS), and the non-parametric model such as functional data model (FDM) and Coherent FDM, and examine differences in the age-specific mortality rate and life expectancy projection. Based on the analysis results, the age-specific mortality rate and predicted life expectancy of men and women are calculated for the year 2030 for each model. We also compare the mortality rate and life expectancy of the next generation provided by Korean Statistical Information Service (KOSIS).

• Journal of Chest Surgery
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• v.53 no.6
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• pp.392-399
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• 2020

Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

• Ocean and Polar Research
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• v.28 no.1
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• pp.45-56
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• 2006

This study investigated primarily the toxic effects of bis(tributyltin)oxide (TBT) and DDT (Dichlorodiphenyltrichloroethane) on the mortality of adult Acartia omorii and barnacle nauplii as well as the hatching rate of A. omorii. Subsequently, compound effects of TBT and DDT on the mortality of immature copepods were tested in order to assess whether or not synergistic influence existed in the mixture of sublethal concentration of two pollutants. Mortality of adult A. omorii increased as exposure concentration of DDT increased in the range of from 0.0001 to 1ppm. Egg hatching rate of the copepod showed no distinctive difference in the range between 0.1 and 10ppm, while barnacle nauplii showed abnormal motility of their appendages in the range of 0.0001 to 1 ppm. Mortality of adult A. omorii increased as TBT concentration increased within the range of 1 and 10 ppb, whereas egg hatching rate of the copepod showed no linear response to the same exposure range. Moreover, copepod nauplii were almost motionless even though copepod eggs hatched under the exposure condition of TBT $(0{\sim}10 ppb)$ and DDT $(0{\sim}10 ppm)$, respectively, suggesting that the nauplii are hard to develop into adult stage. On the basis of the sublethal concentration less than the 24-h $LC_{50}$, 0.001 ppm (DDT) and 2 ppb (TBT) were selected to confirm the compound effects of two pollutants on the mortality of immature copepods. Mortality of immature copepods under the condition of mixture of the two pollutants was higher than that in the single exposure condition. This result seems to indicate that synergistic effects of sublethal toxicants can make a more hazardous effect on the survival of immature copepods even though the concentration of single toxicant is not lethal to copepods in the marine environment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2727-2732
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• 2014

Objectives: The aim of this study was to describe and analyze the incidence and mortality of female breast cancer in Jiangsu Province of China. Methods: Incidence and mortality data for female breast cancer and corresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected and analyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated, and annual present changes (APCs) were estimated to describe the time trends. Results: From 2006 to 2010, 11,013 new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu. The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and 17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000. The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. No significant difference was observed in mortality between urban and rural areas. Two peaks were observed when looking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence and mortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu is an area with relatively low risk of female breast cancer. Conclusion: Breast cancer has become a main public health problem among Chinese females. More prevention and control activities should be conducted to reduce the burden of this disease, even in relatively low risk areas like Jiangsu.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.5
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• pp.495-507
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• 2017

The effect of clonidine administered intrathecally (i.t.) on the mortality and the blood glucose level induced by sepsis was examined in mice. To produce sepsis, the mixture of D-galactosamine (GaLN; 0.6 g/10 ml)/lipopolysaccharide (LPS; $27{\mu}g/27{\mu}l$) was treated intraperitoneally (i.p.). The i.t. pretreatment with clonidine ($5{\mu}g/5{\mu}l$) increased the blood glucose level and attenuated mortality induced by sepsis in a dose-dependent manner. The i.t. post-treatment with clonidine up to 3 h caused an elevation of the blood glucose level and protected sepsis-induced mortality, whereas clonidine post-treated at 6, 9, or 12 h did not affect. The pre-treatment with oral D-glucose for 30 min prior to i.t. post-treatment (6 h) with clonidine did not rescue sepsis-induced mortality. In addition, i.t. pretreatment with pertussis toxin (PTX) reduced clonidine-induced protection against mortality and clonidine-induced hyperglycemia, suggesting that protective effect against sepsis-induced mortality seems to be mediated via activating PTX-sensitive G-proteins in the spinal cord. Moreover, pretreatment with clonidine attenuated the plasma tumor necrosis factor ${\alpha}$ ($TNF-{\alpha}$) induced by sepsis. Clonidine administered i.t. or i.p. increased $p-AMPK{\alpha}1$ and $p-AMPK{\alpha}2$, but decreased p-Tyk2 and p-mTOR levels in both control and sepsis groups, suggesting that the up-regulations of $p-AMPK{\alpha}1$ and $p-AMPK{\alpha}2$, or down-regulations of p-mTOR and p-Tyk2 may play critical roles for the protective effect of clonidine against sepsis-induced mortality.