• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.201-204
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• 2016

This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

• 한국대기환경학회지
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• 제26권3호
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• pp.253-264
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• 2010

This study investigates the relationship between daily mortality and heat stress in Seoul, using perceived temperatures (PT) derived from a heat budget model. During the summer season, observed PT intensity showed the biggest magnitude of summer heat stress from the middle 10 days of July to the first 10 days of August. The elderly (65 and above) were found to be the most vulnerable to heat stress. The threshold PT, with a significant increase in excess mortality, was $38^{\circ}C$. No time lagged effect was observed with summer heat stress, while a high correlation was observed between anomalies in PT and relative deviation of mortality. A comparison of the heat index and the discomfort index with excess mortality revealed that the discomfort index underestimated excess mortality, whereas the heat index could not appropriately explain the increase in excess mortality correlated with the increase in excess heat. In contrast, PT was found to be the weather element that best represents excess mortality due to heat stress, and is thus expected to serve as a more reliable forecast index of human biometeorology.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.253-256
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• 2016

Geographic disparity for colorectal cancer (CRC) incidence and mortality according to the human development index (HDI) might be expected. This study aimed at quantifying the effect measure of association HDI and its components on the CRC incidence and mortality. In this ecological study, CRC incidence and mortality was obtained from GLOBOCAN, the global cancer project for 172 countries. Data were extracted about HDI 2013 for 169 countries from the World Bank report. Linear regression was constructed to measure effects of HDI and its components on CRC incidence and mortality. A positive trend between increasing HDI of countries and age-standardized rates per 100,000 of CRC incidence and mortality was observed. Among HDI components education was the strongest effect measure of association on CRC incidence and mortality, regression coefficients (95% confidence intervals) being 2.8 (2.4, 3.2) and 0.9 (0.8, 1), respectively. HDI and its components were positively related with CRC incidence and mortality and can be considered as targets for prevention and treatment intervention or tracking geographic disparities.

• 농촌의학ㆍ지역보건
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• 제34권1호
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• pp.1-12
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• 2009

본 연구는 뇌혈관질환 사망에 영향을 미치는 지역의 건강상태 지표를 파악하기 위해 시도되었으며, 연구방법은 2000년 사망 원인 통계를 활용하여 뇌혈관질환으로 인한 사망자 수와 2000년 인구센서스 자료를 이용하여 인구수를 산출하여 뇌혈관질환 표준화 사망률을 산출하였다. 또한 지역사회 건강지표로 지역의 물질적 결핍 지수와 보건의료자원, 도로 포장율, 지방세를 지표로 하였다. 자료는 Excel 2003과 SAS 9.1을 활용하여 분석하였다. GIS 프로그램인 Arcview 9.1을 이용하여 뇌혈관질환 사망률과 지역의 물질적 결핍지수를 시각화하였다. 본 연구의 결과는 다음과 같다. 1. 강원지역에서 뇌혈관질환의 표준화 사망률은 지역, 성별에 따라 차이가 있었다. 남자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 평창군으로 나타났다. 여자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 양양군이었다. 2. 강원도의 지역의 물질적 결핍지수는 태백시가 가장 높게 박탈된 지역으로 나타났고, 가장 적게 박탈된 지역은 평창군이었다. 3. 병 의원의 수, 지역의 물질적 결핍지수, 도로포장율. 지방세와 남녀 표준화 사망률과는 관계가 없었다. 본 연구의 의의는 지역의 여러 건강상태를 나타내는 자원들을 지표로 산출하여 뇌혈관질환 사망과 관련지어 분석하고, 또한 소지역인 시 군별 사망률의 차이와 지역사회 건강 지표인 물질적 결핍지수와의 관계를 시각화하였다는 점이다.

• 대한간호학회지
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• 제35권1호
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.283-290
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• 2005

Objectives : The aim of this paper was to examine the relationship between the summertime (June to August) heat index, which quantifies the bioclimatic apparent temperature in sultry weather, and the daily disease-related mortality in Seoul for the period from 1991 to 2000. Methods : The daily maximum (or minimum) summertime heat indices, which show synergetic apparent temperatures, were calculated from the six hourly temperatures and real time humidity data for Seoul from 1991 to 2000. The disease-related daily mortality was extracted with respect to types of disease, age and sex, etc. and compared with the time series of the daily heat indices. Results : The summertime mortality in 1994 exceeded the normal by 626 persons. Specifically, blood circulation-related and cancer-related mortalities increased in 1994 by 29.7% (224 persons) and 15.4% (107 persons), respectively, compared with those in 1993. Elderly persons, those above 65 years, were shown to be highly susceptible to strong heat waves, whereas the other age and sex-based groups showed no significant difference in mortality. In particular, a heat wave episode on the 22nd of July 2004 ($>45^{\circ}C$ daily heat index) resulted in double the normal number of mortalities after a lag time of 3 days. Specifically, blood circulation-related mortalities, such as cerebral infraction, were predominant causes. Overall, a critical mortality threshold was reached when the heat index exceeded approximately $37^{\circ}C$, which corresponds to human body temperature. A linear regression model based on the heat indices above $37^{\circ}C$, with a 3 day lag time, accounted for 63% of the abnormally increased mortality (${\geq}+2$ standard deviations). Conclusions : This study revealed that elderly persons, those over 65 years old, are more vulnerable to mortality due to abnormal heat waves in Seoul, Korea. When the daily maximum heat index exceeds approximately $37^{\circ}C$, blood circulation-related mortality significantly increases. A linear regression model, with respect to lag-time, showed that the heat index based on a human model is a more dependable indicator for the prediction of hot weather-related mortality than the ambient air temperature.

• Hip & pelvis
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• 제36권2호
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• pp.135-143
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• 2024

Purpose: Hip fractures are associated with increased mortality. The identification of risk factors of mortality could improve patient care. The aim of the study was to identify risk factors of mortality after surgery for a hip fracture and construct a mortality model. Materials and Methods: A cohort study was conducted on patients with hip fractures at two institutions. Five hundred and ninety-seven patients with hip fractures that were treated in the tertiary hospital, and another 147 patients that were treated in a secondary hospital. The perioperative data were collected from medical charts and interviews. Functional Assessment Measure score, Short Form-12 and mortality were recorded at 12 months. Patients and surgery variables that were associated with increased mortality were used to develop a mortality model. Results: Mortality for the whole cohort was 19.4% at one year. From the variables tested only age >80 years, American Society of Anesthesiologists category, time to surgery (>48 hours), Charlson comorbidity index, sex, use of anti-coagulants, and body mass index <25 kg/m² were associated with increased mortality and used to construct the mortality model. The area under the curve for the prediction model was 0.814. Functional outcome at one year was similar to preoperative status, even though their level of physical function dropped after the hip surgery and slowly recovered. Conclusion: The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management.

• 응용통계연구
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• 제29권1호
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• pp.41-59
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• 2016

지속적인 사망률 개선으로 인한 평균 수명연장은 인구 고령화의 주요인이며 연금 공급자의 재정건전성에 심각한 영향을 미치는 원인으로 지목되기에 정확한 미래 사망률의 예측은 현 시점에서 선행되어야할 중요한 과제다. 본 연구는 미래 사망률을 예측하는 대표적인 확률적 사망률 모형인 Lee-Carter 모형을 사용하여 과거 생명표로 산출한 왜도를 기반으로 미래 사망률 지수를 간접적으로 예측하는 왜도예측방식을 제시한다. 기존의 Lee-Carter 모형을 이용한 사망률 예측방식은 사망률 지수를 추정하고 미래값을 직접 예측함으로써 미래 사망률이 지나치게 개선되는 현상을 보이며, 이를 바탕으로 산출된 연금액과 지급기간 추정 등 연금 공급자의 리스크 관리에 영향을 미친다. 본 연구는 기존 예측 방식의 사망률 예측 결과와 제시한 왜도 예측 방식의 사망률 예측 결과를 비교함으로써 기존 사망률 예측 방식의 문제점을 지적한다. 분석결과 왜도 예측을 통한 Lee-Carter 모형의 사망률 예측은 기존 방식보다 사망률 개선효과를 더 적게 반영하며 장수리스크를 덜 왜곡한다는 데 의의가 있다고 할 수 있다. 하지만 기존 방식 간 차이를 감안하여 적정한 미래 사망률 수준을 찾기 위해 임의로 부여한 가중치에 대해 향후 검토가 필요할 것으로 보인다.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• Environmental Analysis Health and Toxicology
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• 제26권
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• pp.9.1-9.9
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• 2011

Objectives: In order to evaluate which temperature index is the best predictor for the health impact assessment of heat stress in Korea, several indexes were compared. Methods: We adopted temperature, perceived temperature (PT), and apparent temperature (AT), as a heat stress index, and changes in the risk of death for Seoul and Daegu were estimated with $^1{\circ}C$ increases in those temperature indexes using generalized additive model (GAM) adjusted for the non-temperature related factors: time trends, seasonality, and air pollution. The estimated excess mortality and Akaike's Information Criterion (AIC) due to the increased temperature indexes for the $75^{th}$ percentile in the summers from 2001 to 2008 were compared and analyzed to define the best predictor. Results: For Seoul, all-cause mortality presented the highest percent increase (2.99% [95% CI, 2.43 to 3.54%]) in maximum temperature while AIC showed the lowest value when the all-cause daily death counts were fitted with the maximum PT for the $75^{th}$ percentile of summer. For Daegu, all-cause mortality presented the greatest percent increase (3.52% [95% CI, 2.23 to 4.80%]) in minimum temperature and AIC showed the lowest value in maximum temperature. No lag effect was found in the association between temperature and mortality for Seoul, whereas for Daegu one-day lag effect was noted. Conclusions: There was no one temperature measure that was superior to the others in summer. To adopt an appropriate temperature index, regional meteorological characteristics and the disease status of population should be considered.