The Association of Psoriatic Arthritis with All-Cause Mortality and Leading Causes of Death in Psoriatic Arthritis

2021 ◽  
pp. jrheum.210159
Author(s):  
Amir Haddad ◽  
Walid Saliba ◽  
Idit Lavi ◽  
Amin Batheesh ◽  
Samir Kasem ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Mortality Rate ◽  
General Population ◽  
Causes Of Death ◽  
Mortality Data ◽  
Control Group ◽  
Lower Socioeconomic ◽  
All Cause Mortality ◽  
Health Database ◽  
Cox Proportional Hazard Regression

Objective To examine the association between PsA and all-cause mortality from a populationbased large database. Methods PsA Patients from the Clalit Health database were identified between 2003-2018 and matched to 4 controls by age, sex, ethnicity and index date. Patient's Demographics, comorbidities and treatments were extracted. Mortality data was obtained from the Notification of Death form. The proportionate mortality rate (PMR) of the leading causes of death was calculated and compared to the general population. Cox-proportional hazard regression models were used to estimate the crude and the multivariate adjusted hazard ratio (HR) for the association between PsA and all-cause mortality and for factors associated with mortality within the PsA group. Results 5275 PsA patients and 21,011 controls were included and followed for 7.2±4.4 years. The mean age was 51.7±15.4 years, and 53% were females. 38.2% of PsA patients were on biologics. 471(8.9%) patients died in the PsA group compared to 1,668(7.9%) in the control group. The crude HR for the association of PsA and allcause mortality was 1.16 (95%CI 1.042-1.29) and 1.02 (95%CI 0.90-1.15) on multivariate analysis. Malignancy was the leading cause of death (26%), followed by ischemic heart disease (15.8%) in keeping with the order in the general population. Older age, male sex, lower socioeconomic status, increased body mass index, Charlson comorbidity index scores and history psoriasis or hospitalization during 1- year prior to entry were positive predictors for mortality. Conclusion No clinically relevant increase in mortality rate was observed in PsA patients, specific PMRs were similar to the general population.

scholarly journals Age-dependency in mortality of Finnish family caregivers: a nationwide register-based study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T M Mikkola ◽  
H Kautiainen ◽  
M Mänty ◽  
M B von Bonsdorff ◽  
T Kröger ◽  
...  
Keyword(s):  
General Population ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Causes Of Death ◽  
Lower Mortality ◽  
All Cause Mortality ◽  
The Difference ◽  
Caregiver Role ◽  
Selection Of

Abstract Purpose Mortality appears to be lower in family caregivers than in the general population. However, there is lack of knowledge whether the difference in mortality between family caregivers and the general population is dependent on age. The purpose of this study was to analyze all-cause mortality in relation to age in family caregivers and to study their cause-specific mortality using data from multiple Finnish national registers. Methods The data included all individuals, who received family caregiver's allowance in Finland in 2012 (n = 42 256, mean age 67 years, 71% women) and a control population matched for age, sex, and municipality of residence (n = 83 618). Information on dates and causes of death between 2012 and 2017 were obtained from the Finnish Causes of Death Register. Flexible parametric survival modeling and competing risk regression adjusted for socioeconomic status were used. Results The total follow-up time was 717 877 person-years. Family caregivers had lower all-cause mortality than the controls over the follow-up (8.1% vs. 11.6%) both among women (hazard ratio [HR]: 0.64, 95% CI: 0.61-0.68) and men (HR: 0.73, 95% CI: 0.70-0.77). Younger adult caregivers had equal or only slightly lower mortality than their controls, but after age 60, the difference increased markedly resulting in over 10% lower mortality in favor of the caregivers in the oldest age groups. Caregivers had lower mortality for all the causes of death studied, namely cardiovascular, cancer, neurological, external, respiratory, gastrointestinal and dementia than the controls. Of these, the lowest was the risk for dementia (subhazard ratio=0.29, 95%CI: 0.25-0.34). Conclusions Older family caregivers have lower mortality than the age-matched controls from the general population while younger caregivers have similar mortality to their peers. This age-dependent advantage in mortality is likely to reflect selection of healthier individuals into the family caregiver role. Key messages The difference in mortality between family caregivers and the age-matched general population varies considerably with age. Advantage in mortality observed in family caregiver studies is likely to reflect the selection of healthier individuals into the caregiver role, which underestimates the adverse effects of caregiving.

Mortality among patients with idiopathic intracranial hypertension enrolled in the IH Registry

Neurology ◽  
2020 ◽  
Vol 95 (7) ◽  
pp. e921-e929 ◽  
Author(s):  
Sam M. Hermes ◽  
Nick R. Miller ◽  
Carin S. Waslo ◽  
Susan C. Benes ◽  
Emanuel Tanne
Keyword(s):  
General Population ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Causes Of Death ◽  
The United States ◽  
Mortality Data ◽  
Risk Of Death ◽  
Accidental Overdose ◽  
Control And Prevention ◽  
Underlying Causes

ObjectiveTo determine (1) if mortality among patients with idiopathic intracranial hypertension (IIH) enrolled in the Intracranial Hypertension Registry (IHR) is different from that of the general population of the United States and (2) what the leading underlying causes of death are among this cohort.MethodsMortality and underlying causes of death were ascertained from the National Death Index. Indirect standardization using age- and sex-specific nationwide all-cause and cause-specific mortality data extracted from the Centers for Disease Control and Prevention Wonder Online Database allowed for calculation of standardized mortality ratios (SMR).ResultsThere were 47 deaths (96% female) among 1437 IHR participants that met inclusion criteria. The average age at death was 46 years (range, 20–95 years). Participants of the IHR experienced higher all-cause mortality than the general population (SMR, 1.5; 95% confidence interval [CI], 1.2–2.1). Suicide, accidents, and deaths from medical/surgical complications were the most common underlying causes, accounting for 43% of all deaths. When compared to the general population, the risk of suicide was over 6 times greater (SMR, 6.1; 95% CI, 2.9–12.7) and the risk of death from accidental overdose was over 3 times greater (SMR, 3.5; 95% CI, 1.6–7.7). The risk of suicide by overdose was over 15 times greater among the IHR cohort than in the general population (SMR, 15.3; 95% CI, 6.4–36.7).ConclusionsPatients with IIH in the IHR possess significantly increased risks of death from suicide and accidental overdose compared to the general population. Complications of medical/surgical treatments were also major contributors to mortality. Depression and disability were common among decedents. These findings should be interpreted with caution as the IHR database is likely subject to selection bias.

scholarly journals Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu

2006 ◽  
Vol 9 (6) ◽  
pp. 798-807 ◽  
Author(s):  
Andre MN Renzaho
Keyword(s):  
Food Security ◽  
Mortality Rate ◽  
Food Insecurity ◽  
Household Food Security ◽  
External Control ◽  
Mortality Data ◽  
Control Group ◽  
Anthropometric Measures ◽  
Household Food ◽  
Ex Post

AbstractContextThis paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia.ObjectivesTo examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator.SettingTwo-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection.ParticipantsA total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people.Main outcome measuresHousehold food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children.ResultsThe prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR=0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR=0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease.ConclusionsProject initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security.

scholarly journals Total knee arthroplasty reduces the risk of mortality in osteoarthritis patients up to 12 years: A Korean national cohort longitudinal follow-up study

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090258
Author(s):  
Hyo Geun Choi ◽  
Bong Cheol Kwon ◽  
Joong Il Kim ◽  
Joon Kyu Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Mortality Rate ◽  
Knee Arthroplasty ◽  
Causes Of Death ◽  
Age Groups ◽  
Mortality Rates ◽  
Control Group ◽  
Circulatory Disease ◽  
Total Knee

Introduction: Mortality rates and causes of death after total knee arthroplasty (TKA) are of great interest to surgeons. However, there is a shortage of studies regarding those of the Asian population. The aim of this study was to compare the mortality rate and causes of death in patients after TKA to the general population. Methods: National sample cohort data from the Korean Health Insurance Review and Assessment Service were used. In this study, 1:4 matched patients after TKA (TKA group: 5072) and general participants (control group: 20,288) were selected as subjects. Their average follow-up duration was 57.2 months ranging from a year up to 12 years. The matches were processed for age, gender, income, region of residence, and past medical history. Mortality rates and causes of death were compared between groups. Regarding the mortality rates, we also performed subgroup analyses according to age. Results: Adjusted hazard ratio (HR) of the TKA group for mortality rate was less than 1 with significance (adjusted HR = 0.61 (95% confidence interval = 0.54–0.70, p < 0.001)). The ratios were less than 1 for both age groups (<70 and ≥70 years), respectively; however, for patients under 70, they were insignificant. Among the 11 major causes of death, the circulatory disease showed the most significantly reduced mortality rate for the TKA group compared to the control group. The neoplasm was the only other cause with a significantly reduced mortality rate for the TKA group. Conclusion: The mortality rate in the TKA group was significantly lower than in the control group up to 12 years after the surgery in Korea. Among the major causes of death, circulatory disease and neoplasm showed a significant reduction in the mortality rate of the TKA group compared with the control group.

scholarly journals SF-36 predicts 13-year CHD incidence in a middle-aged Swedish general population

2019 ◽  
Vol 29 (4) ◽  
pp. 971-975
Author(s):  
Evalill Nilsson ◽  
Karin Festin ◽  
Mats Lowén ◽  
Margareta Kristenson
Keyword(s):  
General Population ◽  
Predictive Ability ◽  
Population Based ◽  
Health Study ◽  
Mortality Data ◽  
Middle Aged ◽  
Sf 36 ◽  
All Cause Mortality ◽  
Related Quality ◽  
Health Related

Abstract Purpose To study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population. Methods The population-based, longitudinal “Life-conditions, Stress and Health” study, in 2003–2004 enrolled 1007 persons aged 45–69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries. Results Seven of the eight SF-36 scales predicted CHD (sex- and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (self-reported) disease did not, in most cases, alter these significant predictions. Conclusion Low SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.

Outcome in biopsy-proven Lupus nephritis: Evaluation of biopsies from the Norwegian Kidney Biopsy Registry

Lupus ◽  
2017 ◽  
Vol 26 (8) ◽  
pp. 881-885 ◽  
Author(s):  
G E Norby ◽  
G Mjøen ◽  
R Bjørneklett ◽  
B E Vikse ◽  
H Holdaas ◽  
...  
Keyword(s):  
General Population ◽  
Lupus Nephritis ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Causes Of Death ◽  
Cox Regression ◽  
Population Sample ◽  
All Cause Mortality ◽  
Class Iv

Objective To evaluate long-term mortality and end-stage renal disease (ESRD) in a cohort of Norwegian patients with biopsy-proven lupus nephritis (LN). Methods Renal biopsies were obtained from 178 patients with LN from 1988 until 2007. Mortality rate and death causes were provided by Statistics Norway and ESRD data were provided by the Norwegian Renal Registry. Risk factors for all-cause mortality were evaluated by Cox regression. Standardized mortality ratio (SMR) was compared to observed deaths in a matched general population sample. Results Mean age was 37.6 (±14.4) years, and median time of follow-up was 8.5 years (0–26.2). Thirty-six patients (20.2%) died during follow-up. The SMR for all-cause mortality was 5.6 (Confidence interval [CI] 3.7–7.5). In an adjusted multivariate analysis proliferative glomerulonephritis (LN class IV) was independently associated with all-cause mortality; hazard ratio (HR) 2.6 (Confidence interval [CI] 1.2–5.7 p = 0.017). Main causes of death were infections (47.2%) and cardiovascular events 8 (22.2%). Thirty-six patients (20.2%) reached ESRD. Conclusions Biopsy-proven LN is associated with increased mortality compared to the general population. LN class IV is associated with all-cause mortality. Infections and cardiovascular events were the most common causes of death. Patients with LN have a high incidence of ESRD.

scholarly journals Mortality and causes of death in a total national sample of patients with affective disorders admitted for the first time between 1973 and 1993

2000 ◽  
Vol 176 (1) ◽  
pp. 76-82 ◽  
Author(s):  
Eyd Hansen Høyer ◽  
Preben Bo Mortensen ◽  
Anne V. Olesen
Keyword(s):  
Mortality Rate ◽  
General Population ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Causes Of Death ◽  
National Sample ◽  
Causes Of Mortality ◽  
One Year ◽  
First Time ◽  
First Admission

BackgroundThe high mortality from suicide in patients admitted to hospital with an affective disorder is well documented, although specific causes of mortality and changes in mortality are less well studied.AimsTo describe the pattern of mortality in patients with affective disorder and to study changes in suicide riskduring the study period.MethodAll patients (n=54 103) admitted for the first time to a psychiatric hospital in Denmarkduring the period 1973–1993 because of affective disorder were included in this study. The mortality rate was compared with that of the general population.ResultsMortality from natural and unnatural causes was elevated in all subgroups of affective disorder. The risk of suicide among patients ill for one year or less after first admission increased during the period 1973–1993.ConclusionsMore attention should be paid to the risk of suicide and to physical illness in patients with affective disorders.

scholarly journals Why do young children die in the UK? A comparison with Sweden

2015 ◽  
Vol 100 (10) ◽  
pp. 928-931 ◽  
Author(s):  
Parag Tambe ◽  
Helen M Sammons ◽  
Imti Choonara
Keyword(s):  
Mortality Rate ◽  
Young Children ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Mortality Data ◽  
National Board ◽  
Under Five ◽  
Child Mortality Rate ◽  
The Individual ◽  
The Uk

BackgroundThe UK has a high child mortality rate, whereas Sweden's is lower (under-five mortality rates of five and three, respectively, in 2011).We therefore wished to compare causes of death in young children aged <5 years in the two countries.MethodsUnder-five mortality data were obtained from the Office of National Statistics for each of the individual countries within the UK for 3 years (2006–2008). Data for Sweden for the same period were obtained from the National Board of Health and Welfare. Causes of death were compared statistically using χ2 test.ResultsThere were a total of 14 104 and 1036 deaths aged <5 years in the UK and Sweden, respectively, between 2006 and 2008. The total numbers of live births during the same period were 2 295 964 and 315 884, respectively. The overall mortality rate in the UK was 614 per 100 000 children which was significantly higher than that in Sweden (328; p<0.001). The mortality rates for the three main causes of death in the UK (prematurity, congenital malformations and infections) were 138.5, 112.1 and 63.9, respectively, per 100 000 children. The mortality rates for the same three conditions in Sweden were 10.1, 88.6 and 34.8, respectively. They were all significantly more frequent in the UK than in Sweden (p<0.001), as were the majority of the disorders. Treatable infections, such as pneumonia, meningitis and septicaemia, in both neonates and young children had significantly higher mortality rates in the UK than in Sweden (p<0.001).ConclusionsIn order to reduce the mortality rate in the UK, we need to try and reduce the causes of prematurity. Additionally, the care of children with treatable infections should be reviewed to understand ways in which to reduce the differences in mortality seen.

Quantifying the indirect effects of key child survival interventions for pneumonia, diarrhoea, and measles

2012 ◽  
Vol 141 (1) ◽  
pp. 115-131 ◽  
Author(s):  
C. L. FISCHER WALKER ◽  
M. K. MUNOS ◽  
R. E. BLACK
Keyword(s):  
Indirect Effects ◽  
Causes Of Death ◽  
Child Survival ◽  
Additional Benefit ◽  
Mortality Data ◽  
Measles Vaccine ◽  
Insecticide Treated Nets ◽  
Primary Interest ◽  
Pneumonia Case ◽  
All Cause Mortality

SUMMARYTo date many studies have measured the effect of key child survival interventions on the main cause of mortality while anecdotally reporting effects on all-cause mortality. We conducted a systematic literature review and abstracted cause-specific and all-cause mortality data from included studies. We then estimated the effect of the intervention on the disease of primary interest and calculated the additional deaths prevented (i.e. the indirect effect). We calculated that insecticide-treated nets have been shown to result in a 12% reduction [95% confidence interval (CI) 0·0–23] among non-malaria deaths. We found pneumonia case management to reduce non-pneumonia mortality by 20% (95% CI 8–22). For measles vaccine, seven of the 10 studies reporting an effect on all-cause mortality demonstrated an additional benefit of vaccine on all-cause mortality. These interventions may have benefits on causes of death beyond the specific cause of death they are targeted to prevent and this should be considered when evaluating the effects of implementation of interventions.

scholarly journals OP0219 THE ASSOCIATION OF PSORIATIC ARTHRITIS WITH ALL-CAUSE MORTALITY AND LEADING CAUSES OF DEATH IN PSORIATIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 131.1-131
Author(s):  
A. Haddad ◽  
W. Saliba ◽  
I. Lavi ◽  
A. Batheesh ◽  
S. Kasem ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Causes Of Death ◽  
Ischemic Heart ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
All Cause Mortality ◽  
History Of

Background:Data on the association between PsA and mortality remains conflicting as it has been hampered by small sample size with few events and the potential for confounders of selection and severity biases from clinic-based studies.Objectives:To examine the association between PsA and all-cause mortality in a cohort of PsA patients and matched controls, using data from a population-based large medical record database.Methods:Patients with newly diagnosis of PsA between January 1st, 2003 and December 31st, 2018 from the Clalit Health database were identified. 4 controls without PsA were selected and matched to cases of PsA by age (within 1 year), sex, ethnicity (Jewish vs. non-Jewish), and index date. The two groups were followed from the index date until the first occurrence of death from any cause or end of follow-up (June 30, 2019). Data on mortality and on the immediate cause of death was based on the Notification of Death form legally required by the Israeli Ministry of the Interior for every deceased person in the country. Demographic data including age, sex, ethnicity (Jewish or Arab), and socioeconomic status (SES) at inception were retrieved from the CHS database. Data regarding tobacco use (ever), obesity, body mass index, diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, prior cerebrovascular accident, congestive heart failure, chronic renal failure, chronic obstructive pulmonary disease, cirrhosis, prior malignancy, psoriasis, and the concomitant use of glucocorticosteroids, conventional and biologic disease-modifying anti-rheumatic drugs (cDMARDs and bDMARDs, respectively) were extracted from the database.We estimated the attributable fraction of the various causes of death in PsA patients and compared it to the proportionate mortality rate (PMR) of the leading causes of death in Israel during 2014-2016 based on a recently published report by the Central Bureau of Statistics. Cox proportional hazard regression models were used to estimate the crude and the multivariate adjusted hazard ratio (HR) for the association between PsA and all-cause mortality, as well as for factors associated with mortality within the PsA group.Results:A total of 5275 PsA patients were identified between 2003 and 2018 and where matched to 21,011 controls based on age, sex, and ethnicity. The mean age was 51.7 ± 15.4 years of whom 53% were females. More individuals in the PsA group were smokers, obese, with diabetes, hypertension, and dyslipidemia, as well as with a history of ischemic heart disease, cerebrovascular disease, congestive heart failure, chronic obstructive pulmonary disease, chronic renal failure and cirrhosis than patients in the control group, and 38.2% of PsA patients were on b-DMARDS. Overall 471 (8.9%) patients died in the PsA group compared to 1,668 (7.9%) in the control group during a mean follow-up of 7.2 ± 4.4 years. The crude HR for the association of PsA and all-cause mortality was 1.16 (95% CI, 1.042-1.29). However, the association was not significant on multivariate analysis with HR of 1.096 (95% CI, 0.977-1.229).In PsA patients, malignancy was the leading cause of death, constituting 26% of all deaths, followed by ischemic heart disease 15.8%, diabetes 6.2%, cerebrovascular diseases 5.5% and septicemia 5.5%, in keeping with the order of the leading causes of death in the general population of Israel during 2014-2016 as recently reported by the Central Bureau of Statistics.On multivariate model Cox regression analysis, male sex, increased body mass index, increased Charlson comorbidity index scores and history of hospitalization in a year prior to death were associated with higher mortality, whereas treatment bDMARDs and cDMARDs were associated with a lower relative risk of death.Conclusion:No clinically relevant increase in mortality rate was observed in PsA patients from the period 2003-2018. The most common causes of specific proportionate mortality rates in our cohort were similar to those in the general population.Disclosure of Interests:None declared

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