BACKGROUND: During the German division, two culturally very similar populations were exposed to very disparate socioeconomic conditions, which converged again after 1989. The impact of healthcare and life circumstances on mortality differences can better be estimated when cultural explanations are widely neglectable. OBJECTIVES: For the first time, we analyse harmonised cause-of-death data explicitly by age. Hereby, we can show which ages or birth cohorts were particularly affected by German division and reunification in their mortality and to which causes of death this is attributable. MATERIALS AND METHODS: We harmonised the German cause-of-death statistics by applying an internationally standardised harmonisation process to account for differences and breaks in cause-of-death coding practices. We analysed the data using decomposition methods. RESULTS: During the 1980s, east-west disparities were increasing as progress in the reduction of cardiovascular mortality was much stronger in West Germany, notably at older ages. After 1989, East Germany was able to catch up to the west in many areas. This is especially true for elderly persons and women, while east-west disparities are still visible today, particularly among male adult cohorts (1950-1970) strongly affected by the East German transition crisis. CONCLUSIONS: The lower life expectancy of the East German population in the late 1980s was primarily caused by a slower pace of the cardiovascular revolution. The remaining present-day disparities are rather an aftermath of the East German transition crisis than direct aftereffects of the division.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- naděje dožití * MeSH
- příčina smrti MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Německo východní MeSH
- Německo západní MeSH
- Německo MeSH
INTRODUCTION AND AIMS: Globally, Czechia and Lithuania are among the top-ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol-related mortality and identifies country-specific patterns in educational differences. DESIGN AND METHODS: The study uses harmonised cause-of-death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census-linked mortality data. Directly standardised death rates were used to estimate levels of national and group-specific mortality. Relative and absolute mortality differences by education were assessed by range-type measures (Poisson regression mortality ratios and rate differences) and Gini-type measures. RESULTS: Between 1994-1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol-related age-standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol-related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70-fold difference between low and high educated). The corresponding figures were less than half for Czechia. DISCUSSION AND CONCLUSIONS: Reducing educational disparities in alcohol-related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania.
- MeSH
- lidé MeSH
- pití alkoholu * mortalita MeSH
- příčina smrti MeSH
- stupeň vzdělání * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Litva MeSH
- MeSH
- Betacoronavirus MeSH
- časové faktory MeSH
- koronavirové infekce mortalita MeSH
- lidé MeSH
- mortalita * trendy MeSH
- pandemie MeSH
- počítačové systémy MeSH
- publikování MeSH
- sběr dat MeSH
- šíření informací * MeSH
- surveillance populace * MeSH
- veřejné zdravotnictví * MeSH
- virová pneumonie mortalita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- práce podpořená grantem MeSH
Within the global context, Eastern Europe has been repeatedly identified as the area with the highest levels of alcohol-related health harms. Although the Berlin Wall fell in 1989, and the Soviet Union collapsed soon afterwards, alcohol-related mortality in Eastern Europe remains far higher than in Western Europe. However, despite the high burden of alcohol harm and mortality in Eastern Europe, with the partial exception of Russia, relatively little is known about the country-specific impact of alcohol on health and mortality and the various policy responses to it. In response to this, an international symposium was held in Vilnius, Lithuania in June 2017 entitled Persisting burden of alcohol in Central and Eastern Europe: recent evidence and measurement issues. This special section of Drug and Alcohol Review is based on a selection of the papers presented at this symposium, providing for the first time a broad overview of the problem of alcohol-related mortality in a diverse range of Eastern European countries linked to a description and analysis of alcohol control initiatives that have been developed. While there is strong evidence of the influence of history, culture and education across European countries having a profound and persistent effect on differences in drinking patterns and preferences, there is, nevertheless, evidence that effective policy responses have been mounted in a range of countries.
- MeSH
- lidé MeSH
- mortalita MeSH
- pití alkoholu mortalita MeSH
- postup * MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- úvodníky MeSH
- Geografické názvy
- východní Evropa MeSH
Cíle: Sepse je stále častější komplikací u hospitalizovaných pacientů. Tato problematika však v rámci České republiky zatím nebyla podrobně analyzována. Předložená studie podchycuje trendy a specifika úmrtnosti související se sepsí v České republice v období 1998–2011 na základě individuálních dat z úmrtních listů včetně tzv. vícečetných příčin úmrtí. Materiál a metody: Pro identifikaci úmrtí souvisejících se sepsí byla využita data z úmrtních listů obsahujících některý z kódů sepse podle 10. revize Mezinárodní klasifikace nemocí (MKN). Data byla poskytnuta Ústavem zdravotnických informací a statistiky (ÚZIS). Byla provedena analýza frekvencí, standardizovaných měr úmrtnosti a komorbidity. Výsledky: Sepse byla identifikována u 41 425 případů úmrtí (3 %) z celkových 1 456 539 v období 1998–2011. V rámci úmrtí hospitalizovaných pacientů byla v roce 2011 sepse přítomna u 8 % případů. Sepse je nejčastěji (z 66 %) certifikována jako bezprostřední příčina úmrtí, což vede k jejímu významnému podhodnocení při zahrnutí pouze tzv. základní příčiny úmrtí, která je běžně publikována ve statistikách zemřelých. Úmrtnost související se sepsí se mezi roky 1998–2011 ztrojnásobila, především důsledkem nárůstu výskytu u starších osob (65 let a více). Ve 44 % případů bylo základní příčinou úmrtí některé z kardiovaskulárních onemocnění. Analýza relativní komorbidity však prokázala, že nejvyšší riziko rozvoje fatální sepse mají pacienti s infekčním, kožním, metabolickým nebo muskuloskeletálním onemocněním. Závěr: Analýza vícečetných příčin úmrtí poukázala na rostoucí riziko rozvoje sepse jakožto fatální komplikace základního onemocnění. Příčiny je možné spatřovat v demografickém stárnutí populace a s ním související epidemiologickou zátěží: chronickými nemocemi. Pozorovaný dosavadní nárůst a očekávané pokračování populačního stárnutí tak může vést k dalšímu zvyšování míry ohrožení pacientů sepsí. V souladu s mezinárodními studiemi proto doporučujeme zvážit přijetí klinických doporučení pro prevenci a léčbu sepse.
Aim: Sepsis represents an increasingly frequent complication in the survival of the hospitalized persons. The nation-wide burden of the sepsis-related mortality in the Czech Republic has not yet been analysed. The present study aims to assess the trends and the disparities in the sepsis-related mortality in the Czech Republic for the period 1998–2011 using multiple causes of death reported on the death certificates. Materials and methods: Individual death records provided by the Institute for Health Information and Statistics were used to identify sepsis-related deaths based on the codes of the 10th revision of the International classification of the diseases (ICD-10). Frequencies, age-standardized rates and comorbidity patterns were studied. Results: A total of 41,425 cases (3%) out of 1,456,539 deaths within the period 1998–2011 were associated with sepsis. In 2011, sepsis was reported in 8% of all in-hospital deaths. Sepsis is the most likely to be reported as immediate cause of death (66%), which results in its considerable underestimation in the underlying cause of death statistics. The sepsis-related mortality almost tripled between 1998 and 2011, and the most of the increase is attributable to persons aged 65 and over. In 44% of cases, circulatory disease or cancer was reported as the underlying cause of death. Significant associations with sepsis were however found for infectious diseases, diseases of skin, and metabolic or musculoskeletal disorders. Conclusion: Multiple cause of death analysis of sepsis-related mortality revealed that sepsis represents a growing burden related to the population ageing and increased prevalence of complications of chronic diseases. The observed upward trends, as well as the expected continuation of the ageing process, may result in further increase of sepsis-related mortality. Preventive measures in the clinical management of sepsis are recommended.
- MeSH
- incidence MeSH
- interpretace statistických dat MeSH
- komorbidita MeSH
- lidé MeSH
- příčina smrti MeSH
- sepse * epidemiologie komplikace mortalita MeSH
- stárnutí MeSH
- věkové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH