Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyro...Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyroidism.This study aims to attribute the trends in AF/AFL-related mortalities over the past two decades 1999-2020 concerning race and sex and disparity among them.To the best of our knowledge,this is the first study that estimates the trends and mortality due to AF/AFL from 1999-2020 in older adults in the United States.In this 21-year analysis of mortality data,we found a constant increase in mortality rates due to AF/AFL in older adults.From 1999 to 2020,the overall mortality in older adults aged 65 and above,regardless of sex and race,is found to be almost doubled i.e.about a 50.2%increase in the number of deaths due to AF/AFL.Furthermore,other confounding risk factors such has obesity,prior myocardial infarction,inflammation,hypertension,birth weight,diabetes mellitus,hyperthyroidism,hormone replacement therapy in menopausal women increases the risk in the occurrence or recurrent occurrence of AF.展开更多
BACKGROUND Diverticular disease of the intestine is a major gastrointestinal cause of mortality in the United States and the world.It is one of the most common gastrointestinal conditions responsible for hospital admi...BACKGROUND Diverticular disease of the intestine is a major gastrointestinal cause of mortality in the United States and the world.It is one of the most common gastrointestinal conditions responsible for hospital admissions.AIM To identify mortality trends of diverticular disease among adults in the United States,examining regional and demographic variations,as these have not been previously studied.These trends are highly beneficial to studying disease burden and vulnerable populations.METHODS Diverticular disease-related mortality data were extracted as age-adjusted mortality rates(AAMRs)from death certificate data of the CDC WONDER database using International Statistical Classification of Diseases and Related Health Problems-10th Revision codes K57.0 to K57.9 from 1999 to 2020 in adults≥45 years of age per 100000 population.These AAMRs were stratified by gender,ethnicity,and demographics and analyzed using Joinpoint regression to determine annual percent changes(APCs)and assess trend changes.RESULTS Between 1999 and 2020,a total of 114044 diverticular disease-related deaths were reported among adults≥45 years of age.Our analysis reports progressive decline in mortality with AAMR decreasing from 6.7 in 1999 to 6.1 in 2003[APC:-2.60;95%confidence interval(CI):-3.79 to-0.33],after which it further declined to 3.6 in 2013(APC:-5.16;95%CI:-7.26 to-4.74),with a minimal decrease to 3.5 in 2020(APC:-0.65;95%CI:-1.87 to 1.51).Women had a higher AAMR(4.8)than men(3.8)throughout the study period.The racial analysis reported the highest overall AAMR in non-Hispanic(NH)Whites(4.7),followed by NH Black or African American(3.9),Hispanic or Latino(3.1),and Asian or Pacific Islander(1.5),with unreliable data for the American Indian or Alaska Native population.States in the top 90th percentile,such as Wyoming and Vermont,had approximately double the AAMRs compared to states in the bottom 10th percentile.The mortality rate also exhibited regional disparities,with an overall AAMR higher in the Midwest and West regions(4.7)compared to the Northeast and South regions(4.2),and higher in nonmetropolitan areas(5.4)compared to metropolitan areas(4.2).CONCLUSION Although the annual mortality of diverticular disease has decreased since 1999,there are certain demographic and regional disparities,with mortality rates higher in women,NH White and NH Black adults,Western regions,and nonmetropolitan areas.Further research is needed to identify factors responsible for these disparities and plan appropriate interventions.展开更多
BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and...BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and a low pregnancy rate,have been identified as contributors to the increased susceptibility to ovarian cancer.Advancements in cancer therapy over the past century,including the emergence of precision oncology,underscore the importance of early detection and tailored interventions,factors particularly critical in ovarian cancer,where late-stage diagnosis remains a persistent barrier to survival.This challenge is compounded by the lack of a universally endorsed screening program,resulting in late-stage identification and widespread metastasis.AIM To evaluate demographic differences in ovarian cancer-related mortality from 1999 to 2020 among adult females aged≥25 years within the United States.METHODS Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to collect de-identified death certificate data for malignant neoplasm of the ovaries related deaths in female adults aged 25 years and older from the year 1999 to 2020.Crude mortality rates and age-adjusted mortality rates(AAMRs)per 100000 people were calculated.Join point regression program was used to assess annual percent changes in mortality trends,with statistical significance set at P value<0.05.RESULTS Between 1999 and 2020,337619 deaths due to ovarian cancer occurred among United States females aged 25 to>85.The AAMR decreased from 14.62 in 1999 to 10.15 in 2020,with significant declines across various demographics.The AAMRs were highest among non-Hispanic White women,i.e.,13.53.Based on region,they were the highest in the Northeast(13.06)and Midwest(12.94).The steepest decline was observed in metropolitan areas as compared to nonmetropolitan ones.The study highlights significant progress in reducing ovarian cancer mortality across age,race/ethnicity,and geographic regions during this period.CONCLUSION The mortality trends for ovarian carcinoma patients showed an overall decrease,with the highest mortality rates observed among older individuals(65 to>85 years)and non-Hispanic Whites.These disparities underscore the need for equitable healthcare access and targeted policy interventions.展开更多
Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance D...Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance Dataset,which covers 2.37 billion person-years.Age-standardized mortality rates(ASMRs)were calculated using Segi’s world standard population and the trends were evaluated via Joinpoint regression.Bayesian age-period-cohort models were used for mortality projections.Contributions of demographic changes(population size and age structure)and risk factors to the mortality burden were quantified using the decomposition analysis.Results:The combined ASMRs for all cancers decreased annually by 2.3%,driven by significant declines in esophageal(4.8%),stomach(4.5%),and liver cancers(2.7%).In contrast,the pancreatic and prostate cancer ASMRs increased by 2.0% and 3.4% annually,respectively.Urban areas demonstrated a more rapid decline in the combined ASMRs for all cancers[average annual percent change(AAPC)=-3.0% in urban areas vs.-2.0% in rural areas],highlighting persistent disparities.Population aging contributed 20%-50% to death increases between 2013 and 2021.The combined ASMRs for all cancers,like the findings of temporal trend analyses,will continue to decrease and the regional(urban and rural)difference is projected to simulate that of the temporal trend through 2030.In fact,cancer deaths are projected to reach 2.4 million by 2030.Conclusions:The cancer burden in China is facing the dual challenges of population aging and urban-rural disparities.It is necessary to prioritize rural screening,control risk factors,such as smoking and diet,and integrate more efficacious cancer prevention and control programmes into the policy to reduce mortality in the future.展开更多
Objective:Human mortality is affected by a lot of different factors.Geographic and demographic variations are two such criteria that play significant importance in establishing the variation in mortality rate.Methods:...Objective:Human mortality is affected by a lot of different factors.Geographic and demographic variations are two such criteria that play significant importance in establishing the variation in mortality rate.Methods:The current work uses data collected from the Centers for Disease Control and Prevention from 2018 to 2021 to study the dependence of mortality on several parameters such as gender,race,and age group.The analysis looks at all the different causes of death registered in the database and shows how they vary with not only the demographic variables mentioned above but also geographic variables such as states in the USA.The variation in trends pre-,during,and post-pandemic is also investigated.The study undertakes several multi-factorial relations such as location-age group,location-gender,age group-gender,and a blanket study across all the racesfor2018-2021.Results:Texas,California,and Florida were analyzed to be the states with the most number of deaths for the majority of causes.The study shows that before the pandemic two of the most critical causes of death identified were Atherosclerotic heart disease and Alzheimer's disease which was outnumbered by coronavirus disease 2019 in years 2020 and 2021 for the age groups of 35-84 years.Conclusion:The outcome of the study clearly shows the irrational availability of data among different ages,states,and races.In addition,it helps to provide interesting insights into how the mortality trends relate to demographic and geographic factors and point out the discrepancies among them.展开更多
Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in u...Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021.Methods:Age-specific mortality data for cervical and breast cancers among Chinese women aged 20-84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021.Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios,while Joinpoint models with estimated average annual percent changes(AAPC)and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups.Results:From 2009 to 2021,there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas.A rising trend in the screening age of 35-64[AAPC:4.0%,95%confidence interval(CI)0.5-7.6,P=0.026]for cervical cancer was noted in rural areas,while a stable trend(AAPC:-0.7%,95%CI-5.8 to 4.6,P=0.780)was observed in urban areas.As for breast cancer,a stable trend(AAPC:0.3%,95%CI-0.3 to 0.9,P=0.280)was observed in rural areas compared to a decreasing trend(AAPC:-2.7%,95%CI-4.6 to-0.7,P=0.007)in urban areas.Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer.Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments,with the most significant surge in mortality observed among the 35-54 age group across urban and rural areas,periods,and regions in China.Conclusions:Special attention should be given to women aged 35-54 years due to mortality trends and rural-urban disparities.Focusing on vulnerable age groups and addressing rural-urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.展开更多
BACKGROUND Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality.It is well-documented that viral hepatitis is the leading cause of liver canc...BACKGROUND Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality.It is well-documented that viral hepatitis is the leading cause of liver cancer and liver failure,with Hepatitis B and Hepatitis C being the most common viruses associated with these outcomes.AIM To study viral hepatitis-related mortality trends from 1999 to 2022,focusing on gender,race/ethnicity,age,region,and urban/rural classifications.METHODS We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify viral hepatitis-related deaths in the United States from 1999 to 2022.Data on demographic and regional information were analyzed and stratified by gender,race/ethnicity,age,regional,and urban rural classifications.Using the Joinpoint Regression Program(version 4.9.0.0 used,available from the National Cancer Institute,Bethesda,Maryland)the annual percentage change(APC)and average APC(AAPC)were calculated with 95%CI for extracted Age Adjusted Mortality Rates(AAMR).RESULTS From 1999 to 2022,there were 389916 viral hepatitis-related deaths in the United States.The overall AAMR increased from 1999 to 2013(APC:3.20%;95%CI:2.54-3.99;P<0.001),then declined through 2022(APC:-5.54%;95%CI:-6.75 to-4.47;P<0.001).Males accounted for 70.4%of deaths,with steeper declines in females(AAPC:-0.48%;95%CI:-0.87 to-0.12;P<0.05).The American Indian/Alaska Native population had the highest AAMR(AAPC:2.90%;95%CI:2.30 to 3.68;P<0.001).The population of 65-74 years had the largest increase in overall crude mortality rate(AAPC:3.20%;95%CI:2.77 to 3.85;P<0.001).Mortality was highest in the West(AAPC:-0.78%;95%CI-1.28 to-0.29;P<0.05).Rural AAMR exceeded urban rates after 2015.CONCLUSION This study found significant racial,ethnic,and geographical disparities in viral hepatitis AAMR.Key factors for mortality reduction include patient education,screening,and access to hepatitis vaccination and treatment.展开更多
BACKGROUND Comorbid non-insulin-dependent diabetes mellitus(NIDDM)and stroke sign-ificantly contribute to mortality among older adults.This study examines age-adjusted mortality rates(AAMRs)and disparities by demograp...BACKGROUND Comorbid non-insulin-dependent diabetes mellitus(NIDDM)and stroke sign-ificantly contribute to mortality among older adults.This study examines age-adjusted mortality rates(AAMRs)and disparities by demographics,region,and age groups to identify trends and guide public health efforts.AIM To analyze trends in AAMRs due to comorbid NIDDM and stroke among older adults.The study aims to identify demographic,geographic,and age-related di-sparities to inform targeted public health strategies.METHODS Mortality data from the Centers for Disease Control records were analyzed.AAMRs per 100000 and annual per-centage changes(APCs)with 95%CI were calculated using Joinpoint Regression RESULTS Between 1999 and 2022,209001 deaths among adults aged 55+were attributed to comorbid NIDDM and stroke,with women accounting for 111481 and men 97520 deaths.Urban-rural disparities revealed distinct patterns,with a sharper rise in metropolitan areas post-2014(APC:8.6)as compared to non-metropolitan areas.Racial disparities were pronounced,particularly among the Asian/Pacific Islander population,with a steep increase post-2018(APC:17.6).Age-stratified analysis showed a marked rise in mortality for ages 55-64 and 85+from 2015 onwards(APC:14.3 and 13.5,respectively).Regional trends highlighted the West as having the highest AAMR(14.4),while the Northeast exhibited the lowest(7.0).State-level analysis showed West Virginia with the highest AAMR(18.7)and Nevada the lowest(3.8).CONCLUSION Rising mortality from comorbid NIDDM and stroke underscores increasing disparities across gender,race,age,and regions.Urgent,tailored interventions are required to mitigate these inequities.展开更多
BACKGROUND Chronic kidney disease(CKD)is a major independent stroke risk factor.This study characterizes 22-year national trends and disparities in stroke mortality among United States adults with CKD.AIM To evaluate ...BACKGROUND Chronic kidney disease(CKD)is a major independent stroke risk factor.This study characterizes 22-year national trends and disparities in stroke mortality among United States adults with CKD.AIM To evaluate 22-year national trends and demographic disparities in stroke mortality among United States adults with CKD to inform targeted strategies for reducing cerebrovascular risk in this vulnerable population.METHODS Using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research Multiple Cause-of-Death data(1999-2020),we analyzed stroke deaths(underlying cause)with CKD(contributing cause)among adults≥25 years.Age-adjusted mortality rates per 100000 population were calculated.Joinpoint regression estimated annual percentage changes(APCs)and average APCs with 95%confidence intervals,stratified by sex,race/ethnicity,region,and urbanization.RESULTS Among 37308 stroke deaths with CKD,the overall age-adjusted stroke mortality rates(AAMR)declined from 1.08(95%CI:1.03-1.13)in 1999 to 0.71(95%CI:0.68-0.75)in 2020(average annual percent change:-1.79%).Significant trends included a decline from 1999-2009(APC:-4.25%),followed by an increase from 2009-2012(APC:23.25%),a sharp decline from 2012-2015(APC:-28.10%),and another increase from 2015-2020(APC:8.72%).Males had higher mortality than females(AAMR 0.79 vs 0.71).Non-Hispanic Black individuals had the highest AAMR(1.95),followed by Hispanic(0.87)and Non-Hispanic White individuals(0.63).Regionally,the West had the highest AAMR(0.89).State-level mortality varied more than three-fold(District of Columbia:1.27 vs Arizona:0.38).Small metropolitan areas had the highest urbanization-stratified AAMR.CONCLUSION While stroke mortality among United States adults with CKD significantly declined over two decades,reflecting improvements in prevention and management,substantial disparities persist.The findings underscore the critical need for targeted public health interventions to address underlying biological,structural,and systemic determinants of cerebrovascular risk in this vulnerable population.展开更多
Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth reco...Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.展开更多
BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-r...BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.AIM To investigate AF-CKD comorbidity and mortality on the national level.METHODS Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years.Age-adjusted mortality rates(AAMRs)per 100000 persons and annual percent change(APC)were calculated,stratified by year,sex,race/ethnicity,and geographic region.RESULTS A total of 110733 deaths occurred among adults(aged 35-85 or more years)related to AF associated with CKD in the United States.Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014(APC:-14.89;95%confidence interval(CI):-30.44 to-4.06),followed by an increase to 10.3 in 2020(APC:9.91;95%CI:6.1-19.62).Men had higher AAMRs than women(men:7.6,95%CI:7.6-7.7).Non-Hispanic White adults had the highest AAMR(7.8),followed by non-Hispanic Black(5).States in the top 90th percentile had approximately four times higher AAMRs than those in the lower 10th percentile.AAMR also varied by region(Midwest:7.6,West:6.7,Northeast:6.3,South:5.6),with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.CONCLUSION Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period,with notable disparities across demographic and geographic factors.Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.展开更多
Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated...Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated morbidity and mortality.Recent studies highlight increased mortality related to diabetic kidney disease,with disparities across demographic and geographic groups.Novel pharmacological treatments,including sodium-glucose cotransporter 2 inhibitors,non-steroidal mineralocorticoid receptor antagonists,and glucagon-like peptide-1 agonists,offer promise in slowing disease progression and reducing renal mortality.However,the growing epidemics of obesity and diabetes necessitate prioritizing public health policies focused on primary and secondary prevention,along with comprehensive multidisciplinary care.展开更多
Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proo...Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.展开更多
Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank...Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.展开更多
Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to...Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.展开更多
Background:Although light-intensity physical activity(LPA)has been suggested to be associated with a lower risk of mortality,the minimal and optimal volumes of LPA remain unclear.We aimed to examine the minimal and op...Background:Although light-intensity physical activity(LPA)has been suggested to be associated with a lower risk of mortality,the minimal and optimal volumes of LPA remain unclear.We aimed to examine the minimal and optimal volumes of LPA associated with the risks of mortality and disease incidence(i.e.,cardiovascular diseases and cancer).Methods:Data were derived from the population-based UK Biobank cohort study,including 69,492 adults aged 43-78 years.Accelerometermeasured LPA was defined using a validated,published machine learning-based Random Forest activity method,which was categorized into 4 quartile groups.All-cause and cause-specific mortality(cardiovascular disease-and cancer-specific)were determined according to the International Classification of Diseases,10th version codes.Disease incidence was defined based on primary care,hospitalization,or death records.Results:During a median follow-up period of 8.04 years,2024 adults died from all causes,539 from cardiovascular disease,and 1175 from cancer.For all-cause mortality,compared with participants in the lowest quartile of LPA(<3.9 h/day),the hazard ratios(HRs)and 95%confidence intervals(95%CIs)were 0.82(95%CI:0.73-0.93)for those with 3.9 to<5.0 h/day,0.75(95%CI:0.66-0.85)for those with 5.0 to<6.1 h/day,and 0.77(95%CI:0.68-0.88)for those with≥6.1 h/day,respectively.There was an inverse non-linear dose-response association between LPA and all-cause mortality,with an optimal dose of 5.72 h/day(95%CI:5.45-6.41;HR=0.63,95%CI:0.56-0.71)and a minimal dose of 3.59 h/day(95%CI:3.53-8.56;HR=0.81,95%CI:0.78-0.86),with the 5th percentile as the reference.Similar patterns were observed for cause-specific mortality and disease incidence(cardiovascular disease and cancer).Conclusion:Engaging in LPA for~3.5 h/day was conservatively associated with lower risk of mortality and disease incidence,with further risk reductions observed up to an optimal dose of~6.0 h/day.These findings suggest that sufficient LPA offers important health benefits,which can inform the development of future PA guidelines.展开更多
BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to...BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.展开更多
Objective:Heart failure(HF)is a complex clinical syndrome that affects nearly 64 million individuals globally.Frequent hospital readmissions lead to poor health outcomes,impact quality of life(QoL),and are associated ...Objective:Heart failure(HF)is a complex clinical syndrome that affects nearly 64 million individuals globally.Frequent hospital readmissions lead to poor health outcomes,impact quality of life(QoL),and are associated with high mortality rates.This study assessed readmissions,mortality,and QoL outcomes in patients with HF in a tertiary care hospital setting.Methods:Patients aged≥18 years with HF,who visited the tertiary care hospital in Karad,India were included in the study(November2019 to October 2021).Demographics,disease characteristics,and condition at discharge were recorded using the medical records of patients.The quantitative data included readmission rates and mortality rates.The qualitative aspects describing patients'QoL were assessed using a patient-reported 21-question QoL questionnaire.Results:A total of 98 patients,predominantly male(63.3%),with a mean age of 62.9 years were included.The majority of the patients(80.6%)required<15 days of hospitalization.The 2-year readmission rate was 24.4%,while the mortality rate was 43.9%.Self-care pattern showed that patients seemed to be taking mild to average care while taking good care was rare.The QoL data showed that 22.4% were living a good quality life,44.9% average,while 32.7% were living a low-quality life.Better education and better self-care were associated with a low rate of readmission.Conclusions:We were able to assess the incidence of readmission,mortality,and QoL in patients with HF in a tertiary care hospital setting.The study showed that HF impacts patients'physical,emotional,and psychological wellbeing.展开更多
Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Fa...Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
文摘Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyroidism.This study aims to attribute the trends in AF/AFL-related mortalities over the past two decades 1999-2020 concerning race and sex and disparity among them.To the best of our knowledge,this is the first study that estimates the trends and mortality due to AF/AFL from 1999-2020 in older adults in the United States.In this 21-year analysis of mortality data,we found a constant increase in mortality rates due to AF/AFL in older adults.From 1999 to 2020,the overall mortality in older adults aged 65 and above,regardless of sex and race,is found to be almost doubled i.e.about a 50.2%increase in the number of deaths due to AF/AFL.Furthermore,other confounding risk factors such has obesity,prior myocardial infarction,inflammation,hypertension,birth weight,diabetes mellitus,hyperthyroidism,hormone replacement therapy in menopausal women increases the risk in the occurrence or recurrent occurrence of AF.
文摘BACKGROUND Diverticular disease of the intestine is a major gastrointestinal cause of mortality in the United States and the world.It is one of the most common gastrointestinal conditions responsible for hospital admissions.AIM To identify mortality trends of diverticular disease among adults in the United States,examining regional and demographic variations,as these have not been previously studied.These trends are highly beneficial to studying disease burden and vulnerable populations.METHODS Diverticular disease-related mortality data were extracted as age-adjusted mortality rates(AAMRs)from death certificate data of the CDC WONDER database using International Statistical Classification of Diseases and Related Health Problems-10th Revision codes K57.0 to K57.9 from 1999 to 2020 in adults≥45 years of age per 100000 population.These AAMRs were stratified by gender,ethnicity,and demographics and analyzed using Joinpoint regression to determine annual percent changes(APCs)and assess trend changes.RESULTS Between 1999 and 2020,a total of 114044 diverticular disease-related deaths were reported among adults≥45 years of age.Our analysis reports progressive decline in mortality with AAMR decreasing from 6.7 in 1999 to 6.1 in 2003[APC:-2.60;95%confidence interval(CI):-3.79 to-0.33],after which it further declined to 3.6 in 2013(APC:-5.16;95%CI:-7.26 to-4.74),with a minimal decrease to 3.5 in 2020(APC:-0.65;95%CI:-1.87 to 1.51).Women had a higher AAMR(4.8)than men(3.8)throughout the study period.The racial analysis reported the highest overall AAMR in non-Hispanic(NH)Whites(4.7),followed by NH Black or African American(3.9),Hispanic or Latino(3.1),and Asian or Pacific Islander(1.5),with unreliable data for the American Indian or Alaska Native population.States in the top 90th percentile,such as Wyoming and Vermont,had approximately double the AAMRs compared to states in the bottom 10th percentile.The mortality rate also exhibited regional disparities,with an overall AAMR higher in the Midwest and West regions(4.7)compared to the Northeast and South regions(4.2),and higher in nonmetropolitan areas(5.4)compared to metropolitan areas(4.2).CONCLUSION Although the annual mortality of diverticular disease has decreased since 1999,there are certain demographic and regional disparities,with mortality rates higher in women,NH White and NH Black adults,Western regions,and nonmetropolitan areas.Further research is needed to identify factors responsible for these disparities and plan appropriate interventions.
文摘BACKGROUND Ovarian carcinoma has the highest mortality rate among all gynecological cancers.Several reproductive and hormonal risk factors,including early menarche,late menopause,limited use of oral contraceptives,and a low pregnancy rate,have been identified as contributors to the increased susceptibility to ovarian cancer.Advancements in cancer therapy over the past century,including the emergence of precision oncology,underscore the importance of early detection and tailored interventions,factors particularly critical in ovarian cancer,where late-stage diagnosis remains a persistent barrier to survival.This challenge is compounded by the lack of a universally endorsed screening program,resulting in late-stage identification and widespread metastasis.AIM To evaluate demographic differences in ovarian cancer-related mortality from 1999 to 2020 among adult females aged≥25 years within the United States.METHODS Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to collect de-identified death certificate data for malignant neoplasm of the ovaries related deaths in female adults aged 25 years and older from the year 1999 to 2020.Crude mortality rates and age-adjusted mortality rates(AAMRs)per 100000 people were calculated.Join point regression program was used to assess annual percent changes in mortality trends,with statistical significance set at P value<0.05.RESULTS Between 1999 and 2020,337619 deaths due to ovarian cancer occurred among United States females aged 25 to>85.The AAMR decreased from 14.62 in 1999 to 10.15 in 2020,with significant declines across various demographics.The AAMRs were highest among non-Hispanic White women,i.e.,13.53.Based on region,they were the highest in the Northeast(13.06)and Midwest(12.94).The steepest decline was observed in metropolitan areas as compared to nonmetropolitan ones.The study highlights significant progress in reducing ovarian cancer mortality across age,race/ethnicity,and geographic regions during this period.CONCLUSION The mortality trends for ovarian carcinoma patients showed an overall decrease,with the highest mortality rates observed among older individuals(65 to>85 years)and non-Hispanic Whites.These disparities underscore the need for equitable healthcare access and targeted policy interventions.
基金supported by the CAMS Innovation Fund for Medical Sciences(Grant No.2021-I2M-1-011)the Capital’s Funds for Health Improvement and Research(Grant No.CFH2024-2G-40214).
文摘Objective:This study aimed to analyze the temporal trends in cancer mortality in China from 2013-2021 and project the future trends through 2030.Methods:This study was based on the China Causes of Death Surveillance Dataset,which covers 2.37 billion person-years.Age-standardized mortality rates(ASMRs)were calculated using Segi’s world standard population and the trends were evaluated via Joinpoint regression.Bayesian age-period-cohort models were used for mortality projections.Contributions of demographic changes(population size and age structure)and risk factors to the mortality burden were quantified using the decomposition analysis.Results:The combined ASMRs for all cancers decreased annually by 2.3%,driven by significant declines in esophageal(4.8%),stomach(4.5%),and liver cancers(2.7%).In contrast,the pancreatic and prostate cancer ASMRs increased by 2.0% and 3.4% annually,respectively.Urban areas demonstrated a more rapid decline in the combined ASMRs for all cancers[average annual percent change(AAPC)=-3.0% in urban areas vs.-2.0% in rural areas],highlighting persistent disparities.Population aging contributed 20%-50% to death increases between 2013 and 2021.The combined ASMRs for all cancers,like the findings of temporal trend analyses,will continue to decrease and the regional(urban and rural)difference is projected to simulate that of the temporal trend through 2030.In fact,cancer deaths are projected to reach 2.4 million by 2030.Conclusions:The cancer burden in China is facing the dual challenges of population aging and urban-rural disparities.It is necessary to prioritize rural screening,control risk factors,such as smoking and diet,and integrate more efficacious cancer prevention and control programmes into the policy to reduce mortality in the future.
文摘Objective:Human mortality is affected by a lot of different factors.Geographic and demographic variations are two such criteria that play significant importance in establishing the variation in mortality rate.Methods:The current work uses data collected from the Centers for Disease Control and Prevention from 2018 to 2021 to study the dependence of mortality on several parameters such as gender,race,and age group.The analysis looks at all the different causes of death registered in the database and shows how they vary with not only the demographic variables mentioned above but also geographic variables such as states in the USA.The variation in trends pre-,during,and post-pandemic is also investigated.The study undertakes several multi-factorial relations such as location-age group,location-gender,age group-gender,and a blanket study across all the racesfor2018-2021.Results:Texas,California,and Florida were analyzed to be the states with the most number of deaths for the majority of causes.The study shows that before the pandemic two of the most critical causes of death identified were Atherosclerotic heart disease and Alzheimer's disease which was outnumbered by coronavirus disease 2019 in years 2020 and 2021 for the age groups of 35-84 years.Conclusion:The outcome of the study clearly shows the irrational availability of data among different ages,states,and races.In addition,it helps to provide interesting insights into how the mortality trends relate to demographic and geographic factors and point out the discrepancies among them.
基金supported by the High-Level Public Health Specialized Talents Project of Beijing Municipal Health Commission(YFH,2024-3-028)the National Natural Science Foundation of China(YFH,72061137007)SHV is supported,in part,by U.S.National Institutes of Health(P30CA016359).
文摘Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021.Methods:Age-specific mortality data for cervical and breast cancers among Chinese women aged 20-84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021.Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios,while Joinpoint models with estimated average annual percent changes(AAPC)and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups.Results:From 2009 to 2021,there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas.A rising trend in the screening age of 35-64[AAPC:4.0%,95%confidence interval(CI)0.5-7.6,P=0.026]for cervical cancer was noted in rural areas,while a stable trend(AAPC:-0.7%,95%CI-5.8 to 4.6,P=0.780)was observed in urban areas.As for breast cancer,a stable trend(AAPC:0.3%,95%CI-0.3 to 0.9,P=0.280)was observed in rural areas compared to a decreasing trend(AAPC:-2.7%,95%CI-4.6 to-0.7,P=0.007)in urban areas.Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer.Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments,with the most significant surge in mortality observed among the 35-54 age group across urban and rural areas,periods,and regions in China.Conclusions:Special attention should be given to women aged 35-54 years due to mortality trends and rural-urban disparities.Focusing on vulnerable age groups and addressing rural-urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.
文摘BACKGROUND Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality.It is well-documented that viral hepatitis is the leading cause of liver cancer and liver failure,with Hepatitis B and Hepatitis C being the most common viruses associated with these outcomes.AIM To study viral hepatitis-related mortality trends from 1999 to 2022,focusing on gender,race/ethnicity,age,region,and urban/rural classifications.METHODS We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify viral hepatitis-related deaths in the United States from 1999 to 2022.Data on demographic and regional information were analyzed and stratified by gender,race/ethnicity,age,regional,and urban rural classifications.Using the Joinpoint Regression Program(version 4.9.0.0 used,available from the National Cancer Institute,Bethesda,Maryland)the annual percentage change(APC)and average APC(AAPC)were calculated with 95%CI for extracted Age Adjusted Mortality Rates(AAMR).RESULTS From 1999 to 2022,there were 389916 viral hepatitis-related deaths in the United States.The overall AAMR increased from 1999 to 2013(APC:3.20%;95%CI:2.54-3.99;P<0.001),then declined through 2022(APC:-5.54%;95%CI:-6.75 to-4.47;P<0.001).Males accounted for 70.4%of deaths,with steeper declines in females(AAPC:-0.48%;95%CI:-0.87 to-0.12;P<0.05).The American Indian/Alaska Native population had the highest AAMR(AAPC:2.90%;95%CI:2.30 to 3.68;P<0.001).The population of 65-74 years had the largest increase in overall crude mortality rate(AAPC:3.20%;95%CI:2.77 to 3.85;P<0.001).Mortality was highest in the West(AAPC:-0.78%;95%CI-1.28 to-0.29;P<0.05).Rural AAMR exceeded urban rates after 2015.CONCLUSION This study found significant racial,ethnic,and geographical disparities in viral hepatitis AAMR.Key factors for mortality reduction include patient education,screening,and access to hepatitis vaccination and treatment.
文摘BACKGROUND Comorbid non-insulin-dependent diabetes mellitus(NIDDM)and stroke sign-ificantly contribute to mortality among older adults.This study examines age-adjusted mortality rates(AAMRs)and disparities by demographics,region,and age groups to identify trends and guide public health efforts.AIM To analyze trends in AAMRs due to comorbid NIDDM and stroke among older adults.The study aims to identify demographic,geographic,and age-related di-sparities to inform targeted public health strategies.METHODS Mortality data from the Centers for Disease Control records were analyzed.AAMRs per 100000 and annual per-centage changes(APCs)with 95%CI were calculated using Joinpoint Regression RESULTS Between 1999 and 2022,209001 deaths among adults aged 55+were attributed to comorbid NIDDM and stroke,with women accounting for 111481 and men 97520 deaths.Urban-rural disparities revealed distinct patterns,with a sharper rise in metropolitan areas post-2014(APC:8.6)as compared to non-metropolitan areas.Racial disparities were pronounced,particularly among the Asian/Pacific Islander population,with a steep increase post-2018(APC:17.6).Age-stratified analysis showed a marked rise in mortality for ages 55-64 and 85+from 2015 onwards(APC:14.3 and 13.5,respectively).Regional trends highlighted the West as having the highest AAMR(14.4),while the Northeast exhibited the lowest(7.0).State-level analysis showed West Virginia with the highest AAMR(18.7)and Nevada the lowest(3.8).CONCLUSION Rising mortality from comorbid NIDDM and stroke underscores increasing disparities across gender,race,age,and regions.Urgent,tailored interventions are required to mitigate these inequities.
文摘BACKGROUND Chronic kidney disease(CKD)is a major independent stroke risk factor.This study characterizes 22-year national trends and disparities in stroke mortality among United States adults with CKD.AIM To evaluate 22-year national trends and demographic disparities in stroke mortality among United States adults with CKD to inform targeted strategies for reducing cerebrovascular risk in this vulnerable population.METHODS Using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research Multiple Cause-of-Death data(1999-2020),we analyzed stroke deaths(underlying cause)with CKD(contributing cause)among adults≥25 years.Age-adjusted mortality rates per 100000 population were calculated.Joinpoint regression estimated annual percentage changes(APCs)and average APCs with 95%confidence intervals,stratified by sex,race/ethnicity,region,and urbanization.RESULTS Among 37308 stroke deaths with CKD,the overall age-adjusted stroke mortality rates(AAMR)declined from 1.08(95%CI:1.03-1.13)in 1999 to 0.71(95%CI:0.68-0.75)in 2020(average annual percent change:-1.79%).Significant trends included a decline from 1999-2009(APC:-4.25%),followed by an increase from 2009-2012(APC:23.25%),a sharp decline from 2012-2015(APC:-28.10%),and another increase from 2015-2020(APC:8.72%).Males had higher mortality than females(AAMR 0.79 vs 0.71).Non-Hispanic Black individuals had the highest AAMR(1.95),followed by Hispanic(0.87)and Non-Hispanic White individuals(0.63).Regionally,the West had the highest AAMR(0.89).State-level mortality varied more than three-fold(District of Columbia:1.27 vs Arizona:0.38).Small metropolitan areas had the highest urbanization-stratified AAMR.CONCLUSION While stroke mortality among United States adults with CKD significantly declined over two decades,reflecting improvements in prevention and management,substantial disparities persist.The findings underscore the critical need for targeted public health interventions to address underlying biological,structural,and systemic determinants of cerebrovascular risk in this vulnerable population.
文摘Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.
文摘BACKGROUND Atrial fibrillation(AF)associated with chronic kidney disease(CKD)is a prevalent condition in the United States,significantly impacting global morbidity and mortality.Understanding temporal patterns in AF-related mortality among CKD patients is crucial for effective clinical and public health strategies.AIM To investigate AF-CKD comorbidity and mortality on the national level.METHODS Death certificates from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database spanning 2011-2020 were analyzed to investigate AF-related CKD mortality in adults aged 35 to 85 or more years.Age-adjusted mortality rates(AAMRs)per 100000 persons and annual percent change(APC)were calculated,stratified by year,sex,race/ethnicity,and geographic region.RESULTS A total of 110733 deaths occurred among adults(aged 35-85 or more years)related to AF associated with CKD in the United States.Overall AAMR declined from 8.1 in 2011 to 5.5 in 2014(APC:-14.89;95%confidence interval(CI):-30.44 to-4.06),followed by an increase to 10.3 in 2020(APC:9.91;95%CI:6.1-19.62).Men had higher AAMRs than women(men:7.6,95%CI:7.6-7.7).Non-Hispanic White adults had the highest AAMR(7.8),followed by non-Hispanic Black(5).States in the top 90th percentile had approximately four times higher AAMRs than those in the lower 10th percentile.AAMR also varied by region(Midwest:7.6,West:6.7,Northeast:6.3,South:5.6),with nonmetropolitan areas exhibiting higher AF-associated CKD mortality.CONCLUSION Temporal trends in AF-related mortality among CKD patients showed fluctuations over the study period,with notable disparities across demographic and geographic factors.Targeted interventions are warranted to mitigate the burden of AF associated with CKD and reduce mortality rates in the United States.
文摘Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated morbidity and mortality.Recent studies highlight increased mortality related to diabetic kidney disease,with disparities across demographic and geographic groups.Novel pharmacological treatments,including sodium-glucose cotransporter 2 inhibitors,non-steroidal mineralocorticoid receptor antagonists,and glucagon-like peptide-1 agonists,offer promise in slowing disease progression and reducing renal mortality.However,the growing epidemics of obesity and diabetes necessitate prioritizing public health policies focused on primary and secondary prevention,along with comprehensive multidisciplinary care.
文摘Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.
基金supported by grants from the National Key Research and Development Program of China(No.2023YFC3606300,No.2022YFC3600300)the National Natural Science Foundation of China(No.82325043)the National Key Research and Development Program of Hubei Province(2022BCA036)。
文摘Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.
文摘Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.
基金supported by the National Key Research and Development Plan:Real-Time Intelligent Active Intervention on Integration of Ten Important Chronic Diseases(2020YFC2003504-2,to BX)。
文摘Background:Although light-intensity physical activity(LPA)has been suggested to be associated with a lower risk of mortality,the minimal and optimal volumes of LPA remain unclear.We aimed to examine the minimal and optimal volumes of LPA associated with the risks of mortality and disease incidence(i.e.,cardiovascular diseases and cancer).Methods:Data were derived from the population-based UK Biobank cohort study,including 69,492 adults aged 43-78 years.Accelerometermeasured LPA was defined using a validated,published machine learning-based Random Forest activity method,which was categorized into 4 quartile groups.All-cause and cause-specific mortality(cardiovascular disease-and cancer-specific)were determined according to the International Classification of Diseases,10th version codes.Disease incidence was defined based on primary care,hospitalization,or death records.Results:During a median follow-up period of 8.04 years,2024 adults died from all causes,539 from cardiovascular disease,and 1175 from cancer.For all-cause mortality,compared with participants in the lowest quartile of LPA(<3.9 h/day),the hazard ratios(HRs)and 95%confidence intervals(95%CIs)were 0.82(95%CI:0.73-0.93)for those with 3.9 to<5.0 h/day,0.75(95%CI:0.66-0.85)for those with 5.0 to<6.1 h/day,and 0.77(95%CI:0.68-0.88)for those with≥6.1 h/day,respectively.There was an inverse non-linear dose-response association between LPA and all-cause mortality,with an optimal dose of 5.72 h/day(95%CI:5.45-6.41;HR=0.63,95%CI:0.56-0.71)and a minimal dose of 3.59 h/day(95%CI:3.53-8.56;HR=0.81,95%CI:0.78-0.86),with the 5th percentile as the reference.Similar patterns were observed for cause-specific mortality and disease incidence(cardiovascular disease and cancer).Conclusion:Engaging in LPA for~3.5 h/day was conservatively associated with lower risk of mortality and disease incidence,with further risk reductions observed up to an optimal dose of~6.0 h/day.These findings suggest that sufficient LPA offers important health benefits,which can inform the development of future PA guidelines.
基金funded by the Shenzhen Science and Technology Program(JCYJ20230807112007014 to PG)the Shenzhen Key Medical Discipline Construction Fund(SZXK046 to PG).
文摘BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.
文摘Objective:Heart failure(HF)is a complex clinical syndrome that affects nearly 64 million individuals globally.Frequent hospital readmissions lead to poor health outcomes,impact quality of life(QoL),and are associated with high mortality rates.This study assessed readmissions,mortality,and QoL outcomes in patients with HF in a tertiary care hospital setting.Methods:Patients aged≥18 years with HF,who visited the tertiary care hospital in Karad,India were included in the study(November2019 to October 2021).Demographics,disease characteristics,and condition at discharge were recorded using the medical records of patients.The quantitative data included readmission rates and mortality rates.The qualitative aspects describing patients'QoL were assessed using a patient-reported 21-question QoL questionnaire.Results:A total of 98 patients,predominantly male(63.3%),with a mean age of 62.9 years were included.The majority of the patients(80.6%)required<15 days of hospitalization.The 2-year readmission rate was 24.4%,while the mortality rate was 43.9%.Self-care pattern showed that patients seemed to be taking mild to average care while taking good care was rare.The QoL data showed that 22.4% were living a good quality life,44.9% average,while 32.7% were living a low-quality life.Better education and better self-care were associated with a low rate of readmission.Conclusions:We were able to assess the incidence of readmission,mortality,and QoL in patients with HF in a tertiary care hospital setting.The study showed that HF impacts patients'physical,emotional,and psychological wellbeing.
基金supported by the National Natural Science Foundation of China(82341245,82371491)the Chinese Central Government(Key Project of Public Health Program)the National Key Research and Development Program of China(2018YFC1311706,2018YFC1311702)。
文摘Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
