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141. Improving the Identification of Out-of-Hospital Sudden Cardiac Deaths in a General Practice Research Database (PubMed)

definition and linking data with Hospital Episode Statistics and death certificates. We developed a separate algorithm to identify end-of-life care in noninstitutionalized patients and excluded associated deaths from the analysis to address their misclassification as SCD.Of the 681,104 patients in the study cohort, 3444 were initially classified as out-of-hospital SCD. Next, 163 deaths were identified as expected deaths by our algorithm for end-of-life home care. After review of patient profiles, 162 (...) Improving the Identification of Out-of-Hospital Sudden Cardiac Deaths in a General Practice Research Database The ascertainment of sudden cardiac death (SCD) in electronic health databases is challenging.Our objective was to evaluate the applicability of the validated computer definition of SCD developed by Chung et al. in a retrospective study of SCD and domperidone exposure in the Clinical Practice Research Datalink (CPRD).We assessed out-of-hospital SCD by applying the validated computer

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2016 Drugs - real world outcomes

142. Primary Care Corner with Geoffrey Modest MD: Increasing Deaths From Opioids

increases in heroin deaths were in Connecticut, Massachusetts, Ohio, and West Virginia, and the largest percentage increases were in South Carolina (57.1%), North Carolina 46.4%, and Tennessee (43.5 percent) Commentary: The above includes 28 states with high quality reporting on death certificates, including specific drugs involved in overdoses. [Seems like all states should be tracking this. And this is why our national statistics and epidemiologic studies pale in comparison to western European (...) Primary Care Corner with Geoffrey Modest MD: Increasing Deaths From Opioids Primary Care Corner with Geoffrey Modest MD: Increasing Deaths From Opioids | BMJ EBM Spotlight by By Dr. Geoffrey Modest The CDC just published their report tracking drug and opioid-involved overdose deaths in the United States from 2010 to 2015 (see ​ ). Details: Background: from 1999 to 2014 there was a tripling of drug overdose deaths , with 47,055 total drug deaths in 2014, and 60.9% involved an opioid. During 2013

2017 Evidence-Based Medicine blog

143. Epidemiologic characteristics of death by burn injury from 2000 to 2009 in Colombia, South America: a population-based study (PubMed)

of burn injuries are unknown. The objectives were establishing the causes, high-risk populations, mortality rate, and tendencies of burn deaths.Observational, analytical, population-based study based on official death certificate occurred between 2000 and 2009. All codes of the International Classification of Diseases-10th Revision (ICD-10) related to burns were included. The mortality rates were standardized using the WHO world average age weights 2000-2025. To determine the tendency, an average (...) Epidemiologic characteristics of death by burn injury from 2000 to 2009 in Colombia, South America: a population-based study Burns are one of the most severe traumas that an individual can suffer. The World Health Organization (WHO) affirms that injuries related to burns are a global public health problem mainly in low- and middle-income countries. The first step towards reducing any preventable injury is based on accurate information. In Colombia, the basic epidemiological characteristics

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2016 Burns & trauma

144. Use of Verbal Autopsy to Determine Underlying Cause of Death during Treatment of Multidrug-Resistant Tuberculosis, India. (PubMed)

treatment in India during January-December 2016. A committee triangulated information from verbal autopsy, death certificate, or other medical records available with the family members to ascertain the underlying cause of death. For 66% of patient deaths (47/71), TB was the underlying cause of death. We assigned TB as the underlying cause of death for an additional 6 patients who died of suicide and 2 of pulmonary embolism. Deaths during TB treatment signify program failure; accurately determining (...) Use of Verbal Autopsy to Determine Underlying Cause of Death during Treatment of Multidrug-Resistant Tuberculosis, India. Of patients with multidrug-resistant tuberculosis (MDR TB), <50% complete treatment. Most treatment failures for patients with MDR TB are due to death during TB treatment. We sought to determine the proportion of deaths during MDR TB treatment attributable to TB itself. We used a structured verbal autopsy tool to interview family members of patients who died during MDR TB

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2018 Emerging Infectious Diseases

145. Behavioral Risk Factors and Regional Variation in Cardiovascular Health Care and Death. (PubMed)

behavioral risks (smoking, poor diet, physical inactivity) were calculated from the Behavioral Risk Factor Surveillance System; HSA-level rates of stress tests, diagnostic cardiac catheterization, and revascularization from a statewide multi-payer claims data set from Maine in 2013 (with 606,260 patients aged ≥35 years), and deaths from state death certificate data. Analyses were done in 2016.There were marked differences across 32 Maine HSAs in behavioral risks: smoking (12.4%-28.6%); poor diet (43.6 (...) Behavioral Risk Factors and Regional Variation in Cardiovascular Health Care and Death. Reducing the burden of death from cardiovascular disease includes risk factor reduction and medical interventions.This was an observational analysis at the hospital service area (HSA) level, to examine regional variation and relationships between behavioral risks, health services utilization, and cardiovascular disease mortality (the outcome of interest). HSA-level prevalence of cardiovascular disease

2018 American journal of preventive medicine

146. Early deaths from ischaemic heart disease in childhood-onset type 1 diabetes. (PubMed)

Early deaths from ischaemic heart disease in childhood-onset type 1 diabetes. The risk of ischaemic heart disease (IHD) death in early type 1 diabetes onset was assessed using death certification data.The Yorkshire Register of type 1 Diabetes in Children and Young People was linked to clinically validated death certification data for those diagnosed under 15 years. Standardised mortality ratios (SMRs) were calculated using the England and Wales population and IHD death rates between 1978 (...) and 2014 by 5-year age group and sex.The cohort included 4382 individuals (83 097 person years). Of 156 deaths, nine were classed as IHD deaths before clinical validation. After clinical validation, 14 IHD deaths were classified, with an SMR of 13.8 (95% CI 8.2 to 23.3) and median age at death of 35.1 years (range 21.9â€"47.9 years).There is an early emergence of death from IHD in early onset type 1 diabetes. Underascertainment of IHD deaths was present without clinical validation of death

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2018 Archives of Disease in Childhood

147. Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study. (PubMed)

. Cause of death was classified as cardiovascular or noncardiovascular according to death certificates. Landmark analyses of the cumulative incidences of cardiovascular and noncardiovascular mortality after 1, 3, and 5 years after coronary artery bypass grafting were performed. Multivariable cause-specific Cox regression models were used to evaluate changes over time in the risk of all-cause, cardiovascular, and noncardiovascular mortality after 1 and 7 years after coronary artery bypass grafting (...) Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study. Knowledge of the association between time and causes of death after coronary artery bypass grafting is sparse. We examined short- and long-term mortality and cause of death in patients undergoing coronary artery bypass grafting.With the use of Danish nationwide registries, we identified all patients undergoing isolated coronary artery bypass grafting from 1998 to 2014

2018 Journal of Thoracic and Cardiovascular Surgery

148. Performance of InSilicoVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards. (PubMed)

Performance of InSilicoVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards. Recently, a new algorithm for automatic computer certification of verbal autopsy data named InSilicoVA was published. The authors presented their algorithm as a statistical method and assessed its performance using a single set of model predictors and one age group.We perform a standard procedure for analyzing the predictive accuracy of verbal autopsy (...) was comparable.The default format and training data provided by the software lead to results that are at best suboptimal, with poor cause-of-death predictive performance. This method is likely to generate erroneous cause of death predictions and, even if properly configured, is not as accurate as alternative automated diagnostic methods.

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2018 BMC Medicine

149. Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST SCD Study. (PubMed)

Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST SCD Study. Studies of out-of-hospital cardiac arrest and sudden cardiac death (SCD) use emergency medical services records, death certificates, or definitions that infer cause of death; thus, the true incidence of SCD is unknown. Over 90% of SCDs occur out-of-hospital; nonforensic autopsies are rarely performed, and therefore causes of death are presumed. We conducted a medical examiner-based (...) , and histology via medical examiner surveillance of consecutive out-of-hospital deaths, all reported by law. We obtained comprehensive records to determine whether out-of-hospital cardiac arrest deaths met World Health Organization (WHO) criteria for SCD. We reviewed death certificates filed quarterly for missed SCDs. Autopsy-defined sudden arrhythmic deaths had no extracardiac cause of death or acute heart failure. A multidisciplinary committee adjudicated final cause.All 20 440 deaths were reviewed; 12 671

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2018 Circulation

150. Nationwide Study of Sudden Cardiac Death in People With Congenital Heart Defects Aged 0 to 35 Years. (PubMed)

in Denmark.All deaths (n=11 451) among people aged 0 to 35 years in Denmark in 2000 to 2009 (24.4 million person-years) were included. Danish death certificates, autopsy reports, records from hospitals and general practitioners, and data from nationwide Danish registries were used to identify SCD-CHD cases.We identified 90 (11%) cases of SCD-CHD from 809 SCD. The incidence rate of SCD-CHD was 0.4 per 100 000 person-years among people aged 0 to 35 years. In total, 53 (59%) were diagnosed with CHD before death (...) Nationwide Study of Sudden Cardiac Death in People With Congenital Heart Defects Aged 0 to 35 Years. Congenital heart defects (CHD) are among the leading causes of sudden cardiac death (SCD) in the young. Nationwide incidence of SCD in people with CHD (SCD-CHD) has not been established in the young general population. The aims of this study were to investigate incidence of SCD-CHD and whether incidence of SCD-CHD in infants declined after implementation of nationwide fetal ultrasound screening

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2018 Circulation. Arrhythmia and electrophysiology

151. Place of death in patients with dementia and the association with comorbidities: a retrospective population-based observational study in Germany. (PubMed)

(Germany), based on the analysis of death certificates from 2011. Individuals with dementia ≥ 65 years were identified using the documented cause of death. In this context, all mentioned causes of death were included. In addition, ten selected comorbidities were also analyzed. The results were presented descriptively. Using multivariate logistic regression, place of death was analyzed for any association with comorbidities.A total of 10,364 death certificates were analyzed. Dementia was recorded (...) in 1646 cases (15.9%; mean age 86.3 ± 6.9 years; 67.3% women). On average, 1.5 ± 1.0 selected comorbidities were present. Places of death were distributed as follows: home (19.9%), hospital (28.7%), palliative care unit (0.4%), nursing home (49.5%), hospice (0.9%), no details (0.7%). The death certificates documented cardiac failure in 43.6% of cases, pneumonia in 25.2%, and malignant tumour in 13.4%. An increased likelihood of dying in hospital compared to home or nursing home, respectively

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2018 BMC Palliative Care

152. Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland. (PubMed)

six providers of mandatory Swiss health insurance. We probabilistically linked these persons to death certificates to get cause of death information and analysed data using sex-stratified, multivariable logistic regression. Supplementary analyses looked at selected subgroups of persons according to the primary cause of death.The study population included 113,277 persons (46% males). Among these persons, 1199 (proportion 0.022, 95% CI: 0.021-0.024) males and 803 (0.013, 95% CI: 0.012-0.014) females (...) Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland. Lack of health insurance claims (HIC) in the last year of life might indicate suboptimal end-of-life care, but reasons for no HIC are not fully understood because information on causes of death is often missing. We investigated association of no HIC with characteristics of individuals and their place of residence.We analysed HIC of persons who died between 2008 and 2010, which were obtained from

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2018 BMC health services research

153. Asthma-Related Mortality in the United States of America, 1999-2015: A Multiple Causes of Death Analysis. (PubMed)

Asthma-Related Mortality in the United States of America, 1999-2015: A Multiple Causes of Death Analysis. Asthma mortality based on the underlying cause of death (UCOD) underestimates disease burden.To analyze asthma mortality in the United States from 1999 to 2015 and the pattern of reporting of asthma and its comorbidities in death certificates, using multiple cause of death (MCOD) records.All 156,517 death certificates with any mention of asthma were analyzed for 1999 to 2015. Asthma (...) was defined by International Classification of Diseases, 10th Revision code J45 based on the UCOD or MCOD. Annual age-adjusted asthma death rates were computed according to age, sex, and race/ethnicity. The 6,304 MCOD coded status asthmaticus cases (J46) were also examined.From 1999 to 2015 a total of 59,067 deaths with a UCOD of asthma occurred; 37,832 deaths occurred in females and 21,235 in males (female-male ratio = 1.78). A total of 156,517 deaths with MCOD of asthma occurred; 101,371 deaths occurred

2018 Asthma & Immunology

154. Trends in Texas maternal mortality by maternal age, race/ethnicity, and cause of death, 2006-2015. (PubMed)

causes of death. Efforts are needed to strengthen reporting of death certificate data, and to improve access to quality maternal health care services.© 2018 Wiley Periodicals, Inc. (...) Trends in Texas maternal mortality by maternal age, race/ethnicity, and cause of death, 2006-2015. Maternal mortality is a sentinel indicator of health care quality. Our purpose was to analyze trends in Texas maternal mortality by demographic characteristics and cause of death, and to evaluate data quality.Maternal mortality data were initially analyzed by single years, but then were grouped into 5-year averages (2006-2010 and 2011-2015) for more detailed analyses. Rates were computed per 100

2018 Birth

155. Do The Zen Diaries of Garry Shandling Yield Insight Into The Cause of His Death?

, which can break loose and embolize into the pulmonary arteries. Such a pulmonary embolism, if massive, can result in swift and sudden death. I wrote another on this after his autopsy was released. His autopsy revealed that he died from a pulmonary embolism, the disease I had raised as a likely alternative cause of his sudden death in my post in April, 2016. The actual death certificate can be viewed . The medical report on his death reveals that Shandling had a prior history of clots in the leg (s (...) Do The Zen Diaries of Garry Shandling Yield Insight Into The Cause of His Death? Do The Zen Diaries of Garry Shandling Yield Insight Into The Cause of His Death? | The Skeptical Cardiologist Primary Menu Search for: , Do The Zen Diaries of Garry Shandling Yield Insight Into The Cause of His Death? The skeptical cardiologist watched a little bit of the Judd Apatow HBO Documentary on Garry Shandling last night. For fans of the comedian like me, it is fascinating. As I watched I was reminded

2018 The Skeptical Cardiologist

156. Burden and Risk Factors for Cold-Related Illness and Death in New York City (PubMed)

Burden and Risk Factors for Cold-Related Illness and Death in New York City Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during the cold season from 2005 to 2014 in New York City (NYC), the largest city in the United States. On average each year (...) , there were 180 treat-and-release emergency department visits (average annual rate of 21.6 per million) and 240 hospital admissions (29.6 per million) for cold-related illness, and 15 cold-related deaths (1.8 per million). Seventy-five percent of decedents were exposed outdoors. About half of those exposed outdoors were homeless or suspected to be homeless. Of the 25% of decedents exposed indoors, none had home heat and nearly all were living in single-family or row homes. The majority of deaths

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2018 International journal of environmental research and public health

157. Deaths From Pneumonia—New York City, 1999–2015 (PubMed)

Deaths From Pneumonia—New York City, 1999–2015 "Pneumonia and influenza" are the third leading cause of death in New York City. Since 2012, pneumonia and influenza have been the only infectious diseases listed among the 10 leading causes of death in NYC. Most pneumonia and influenza deaths in NYC list pneumonia as the underlying cause of death, not influenza. We therefore analyzed death certificate data for pneumonia in NYC during 1999-2015.We calculated annualized pneumonia death rates (...) of neighborhoods with higher poverty levels, and in Staten Island.While the accuracy of death certificates is unknown, investigation is needed to understand why certain populations are disproportionately recorded as dying from pneumonia in NYC.

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2018 Open forum infectious diseases

158. Disease characteristics and causes of early and late death in a group of Croatian patients with systemic lupus erythematosus deceased over a 10-year period (PubMed)

frequent COD category was cardiovascular diseases (40%), followed by infections (33%), active SLE (29%), and malignancies (17%). No significant difference was found between the frequencies of causes of ED and LD, except for stroke, which caused only LD≥10 years after the diagnosis. SLE was reported in death certificates of only 41 of 90 patients.Although stroke occurred both in the early and late disease course, it was primarily associated with LD. Given the low proportion of SLE recorded in death (...) Disease characteristics and causes of early and late death in a group of Croatian patients with systemic lupus erythematosus deceased over a 10-year period To assess the causes of early death (ED) and late death (LD) in patients with systemic lupus erythematosus (SLE) and determine the features of deceased SLE patients followed-up in a single Croatian tertiary hospital center, because little if any data on causes of death (CODs) in SLE patients are available for Croatia.We identified SLE

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2018 Croatian medical journal

159. Validation of the verbal autopsy questionnaire for adult deaths in Iran (PubMed)

families of deceased persons accepted an invitation to complete the questionnaire. A physician determined the cause of death. These causes were compared with the registered cause of death on the death certificate. Sensitivity, specificity, positive predictive value (PPV), as well as the kappa statistic (between the first verbal autopsy questioning and death registry) were calculated to determine the validity of the questionnaire. Kappa statistic was also used to determine the reliability between (...) the first and second questioning. Results: The sensitivity of the questionnaire varied from 75% among deaths due to diabetes to 100% Due to breast cancer. The specificity of the questionnaire for all causes of death was higher than 97%. PPV varied from 62.5% to 100% for all causes of death. The kappa statistic between causes of death derived from death certificate, and the first VA questioning for all causes of death was above 0.7 (p<0.001), and it was above 0.78 for the first and second verbal autopsy

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2018 Medical journal of the Islamic Republic of Iran

160. Smoking and Mortality in Tianjin, China: A Death Registry–Based Case-Control Study, 2010–2014 (PubMed)

Smoking and Mortality in Tianjin, China: A Death Registry–Based Case-Control Study, 2010–2014 We conducted a mortality case-control study to assess the risks of all-cause and major causes of death attributable to smoking in Tianjin from 2010 through 2014. The death registry-based study used data from The Tianjin All Causes of Death Surveillance System, which collects information routinely on smoking of the deceased in the death certificate of Tianjin Centers for Disease Control (...) and Prevention.Cases (n = 154,086) and controls (n = 25,476) were deaths at 35 to 79 years from smoking-related and nonsmoking-related causes, respectively. Mortality rate ratios (RRs) for ever smokers versus never smokers, with adjustment for sex, 5-year age group, education, marital status, and year of death, and smoking-attributed fractions were calculated.The RRs in men were 1.38 (95% confidence interval [CI], 1.33-1.43) for all causes and 3.07 (95% CI, 2.91-3.24) for lung cancer, and in women were 1.46 (95

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2018 Preventing chronic disease

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