Articles: mortality.
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A retrospective study of the pattern of paediatric deaths at the children's emergency room (CHER) of the University College Hospital, Ibadan revealed a steady decline from 208 per 1000 admissions in 1978 to 179 per 1000 admissions in 1986. The study, however, showed that one in every five children admitted to the CHER died over the study period 1978, and 1981-1986. Measles has the highest proportionate death rate of 13.1% and it shares the highest fatality rate of 32.6% with tetanus. ⋯ The age distribution of the children who died shows that the highest proportion was in the age group 1-2 yr. The use of the proportion of deaths of children in the 1-2 yr age group as a more reliable index for assessing the health status of a community is discussed. Also discussed is the preponderance of males over females in emergency admissions.
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Comparative Study
The effect of known risk factors on the excess mortality of black adults in the United States.
We compared the mortality rate ratios, before and after adjustment for different risk factors, of black vs white adults in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. For persons 35 to 54 years old, the rate ratio of mortality for blacks vs whites decreased from 2.3 (unadjusted) to 1.9 when adjusted simultaneously for six well-established risk factors (smoking, systolic blood pressure, cholesterol level, body-mass index, alcohol intake, and diabetes) and decreased from 1.9 to 1.4 when adjusted for the six risk factors plus family income. ⋯ This leaves 31% unexplained. Broader social and health system changes and research targeted at the causes of the mortality gap, coupled with increased efforts aimed at modifiable risk factors, may all be needed for egalitarian goals in health to be realized.
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J Public Health Med · Feb 1990
Frequency of emergency department attendances as a predictor of mortality: nine-year follow-up of a population-based cohort.
Heavy users of the services of emergency departments (EDs) have in previous studies been found to have psychological, social, economic and other difficulties besides their more or less acute medical problems. In order to establish whether mortality is associated with high ED use, a nine-year follow-up study was conducted of a 10 per cent population sample (n = 17,000), selected from the catchment area of Huddinge Hospital, Sweden. ED visits were found to predict nine-year mortality in the cohort. ⋯ The three predominant causes of death in the cohort were diseases in the circulatory system, tumours and violent death. Heavy ED users had elevated mortality in all diagnoses, the most important excess mortality being from violent death, comprising suicide, probable suicide and alcohol/drug abuse, with an SMR of 6.3 (95 per cent CI = 6.0-6.7). The excess mortality from these causes of the heavy ED users accounted for more than one-third of their total excess mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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The World Health Organization estimates that almost half a million women in developing countries die in pregnancy and childbirth every year. Unsafe induced abortion is responsible for perhaps one-quarter of these deaths. ⋯ United States international policy on funding abortion-related activities in maternal health and family planning programs is especially restrictive. A new policy approach is clearly needed if unacceptably high rates of maternal morbidity and mortality in many countries are to be reduced.
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A maternal mortality audit was introduced in the Midlands Province (Zimbabwe) in order to identify which avoidable factors were involved most frequently. During the two-year study period, the maternal mortality rate was 137 per 100,000 total births. ⋯ An avoidable factor was identified among 87% of these deaths involving the health system in 57% of the cases and the patient in 33%. Access to the health facilities and transport problems only played a minor role.