Cause of death

From the New England Research Institutes, Watertown, Massachusetts (VK, GRC, RCR), Loyola University Medical Center, Maywood, Illinois (MPF), Cornell University, Weill Medical College, New York, New York (SAK), and Ferring International Pharmascience Center, ...

Stroke is defined as an abnormality in brain function resulting from disruption of cerebral circulation. It is the third leading cause of death in the United States and the primary cause of long-term disability. The economic burden of stroke will only increase as the population ages, making prevention and treatment of stroke one of the most important public health issues

This study presents the case of the post-mortem pink teeth phenomenon observed during an autopsy procedure performed on the body of a man who was kidnapped and murdered approximately 30 days before the examination. The corpse was in an advanced stage of decomposition and putrefaction. Both maxillary and jaw bones were intact, as well as the permanent teeth which presented the "pink teeth phenomenon", probably due to a haemorrhage in the pulp chambers. The pink discolouration was most pronounced at the neck of the teeth. The cause of death was asphyxia. Although the examiners stressed that post-mortem pink teeth must not be considered as a reliable odontological parameter for determining the cause of death, the results of other studies have shown that the pink teeth phenomenon is a common finding related to cases of asphyxia such as strangulation, drowning or suffocation. Thus, the pink teeth phenomenon must be studied in order to determine its role as a post-mortem finding...

Keywords: Mortality/statistics; Cause of death; Statistics; Africa South of the Sahara; Bangladesh (source: MeSH, NLM). ... OBJECTIF: Fournir des données comparables au niveau international sur la fréquence des différentes causes de décès. MÉTHODES: Il s'agissait d'analyser les ...

Silent coeliac disease is reported in 1% of Caucasian populations, but there is a lack of knowledge of its natural course and the risk of complications. The need for population screening is debated. We sought for complications of untreated coeliac disease in a well-defined cohort of Finnish adults. Subjects (n=2427, ages 24-39 years) attending the 21-year follow-up visit of the study "Cardiovascular Risk in Young Finns" completed an extensive questionnaire on their health, diet, social situation and family life, and were given a medical examination. Measurement of serum IgA-transglutaminase and IgA-endomysium antibodies identified 21 subjects with silent coeliac disease. The subjects with silent coeliac disease did not differ from the rest of the cohort in age, gender, stature, weight, medical diagnoses (autoimmune, malignant), health concerns, use of alternative medications, physical activity, or in the cause of death their parents. They had lower serum HDL-cholesterol (1...

In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths. We designed and piloted a community-linked maternal death review (CLMDR) process in Mchinji District, Malawi, which partnered community and health facility stakeholders to identify and review maternal deaths and generate actions to prevent future deaths. The CLMDR process involved five stages: community verbal autopsy, community and facility review meetings, a public meeting and bimonthly reviews involving both community and facility representatives. The CLMDR process was found to be comparable to a previous research-driven surveillance system at identifying deaths in Mchinji District (population 456 500 in 2008). 52 maternal deaths were identified between July 2011 and June 2012, 27 (52%) of which would not ...

The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT). Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015. Participants were randomized to an SBP target of less than 120 mm Hg (intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard treatment group, n = 1319). The primary cardiovascular disease outcome was a composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes. All-cause mortality w...

The objective was to assess the magnitude causes and substandard care factors responsible for the third delay of maternal mortality seen in our unit III Department of Obstetrics and Gynecology Civil Hospital Karachi. This Cross-sectional retrospective study was carried out on 152 mothers who died over a period of eight years from 1997 to 2004 at Civil Hospital Karachi. Death summaries of all maternal deaths were reviewed from death registers and were studied for substandard care factors which could have been responsible for the third delay of maternal mortality. The frequency of maternal mortality was 1.3 per 100 deliveries. The mean age was 29+or-6.49 years and mean parity was 3.24+or-3.25. The main causes of death were hypertensive disorders in 52/152 (34.21%) hemorrhage in 40/152 (26.31%) unsafe abortion in 16/152 (10.52%) puerperal sepsis in 14/152 (9.21%) and obstructed labor in 11/152 (7.2%) cases. Substandard care factors were present in 76.7% of patients which included inapp...

The purpose of this study was to collect descriptive information on a large number of children, adolescents and young adults who had committed suicide. The medical examiner's records for deaths of persons 25 and under from non-natural causes were reviewed; 656 youth suicides were identified. Children, adolescents and young adults who committed suicide were most likely to be older males with a current psychiatric disorder, usually an affective disorder or alcohol or drug abuse. Suicides appeared to be impulsive and triggered by age-normative precipitants. Sex, age and cohort differences are presented. Results are evaluated in light of previous research.

Different modes of death are described in selected populations, but few data report the characteristics of death in a general intensive care unit population. This study analyzed the causes and characteristics of death of critically ill patients and compared anticipated death patients to unexpected death counterparts. An observational multicenter cohort study was performed in 96 intensive care units. During 1 yr, each intensive care unit was randomized to participate during a 1-month period. Demographic data, characteristics of organ failures (Sequential Organ Failure Assessment subscore greater than or equal to 3), and organ supports were collected on all patients who died in the intensive care unit. Modes of death were defined as anticipated (after withdrawal or withholding of treatment or brain death) or unexpected (despite engagement of full-level care or sudden refractory cardiac arrest). A total of 698 patients were included during the study period. At the time of death, 84% ha...

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown. Participants included postmenopausal women in the Women's Health Initiative-Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self-reported at baseline, year 3, and year 6. Self-reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as the difference between the cumulative average immediately following MI and the cumulative average immediately preceding MI. The 4 categories of change were: maintained low, decreased, increased, and maintained high. The cut points were ≥7.5 metabolic equivalent of task hours/week versus <7.5 metabolic equivalent of task hours/week for PA and ≥8 h/day versus <8 h/day for s...

Background: Perinatal (stillbirths and first week neonatal deaths) and neonatal (deaths in the first 4 weeks) mortality rates remain high in developing countries like Nepal. As most births and deaths occur in the community, an option to ascertain causes of death is to conduct verbal autopsy. Objective: The objective of this study was to classify and review the causes of stillbirths and neonatal deaths in Dhanusha district, Nepal. Materials and Methods: Births and neonatal deaths were identified prospectively in 60 village development committees of Dhanusha district. Families were interviewed at six weeks after delivery, using a structured questionnaire. Cause of death was assigned independently by two pediatricians according to a predefined algorithm; disagreement was resolved in discussion with a consultant neonatologist. Results: There were 25,982 deliveries in the 2 years from September 2006 to August 2008. Verbal autopsies were available for 601/813 stillbirths and 671/954 neona...

Attention deficit hyperactivity disorder (ADHD) is a common mental disorder associated with factors that are likely to increase mortality, such as oppositional defiant disorder or conduct disorder, criminality, accidents, and substance misuse. However, whether ADHD itself is associated with increased mortality remains unknown. We aimed to assess ADHD-related mortality in a large cohort of Danish individuals. By use of the Danish national registers, we followed up 1·92 million individuals, including 32 061 with ADHD, from their first birthday through to 2013. We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, family history of psychiatric disorders, maternal and paternal age, and parental educational and employment status, by Poisson regression, to compare individuals with and without ADHD. During follow-up (24·9 million person-years), 5580 cohort members died. The mortality rate per 10 000 person-years was 5·85 among individuals with ADHD compared with ...

Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies according to the personnel involved in certification, the diagnostic capacity of the hospital, and the category of hospitals. There are no published studies that have analysed how certifying doctors in Bangladesh adhere to international rules when completing the MCCD or have assessed the quality of clinical record keeping. The study took place between January 2011 and April 2014 in the Chandpur and Comilla districts of Bangladesh. We introduced the international MCCD to all study hospitals. Trained project physicians assigned an underlying cause of death, assessed the quality of the death certificate, and reported the degree of certainty of the medical records provided for a...

Sweden has a long tradition of recording cause of death data. The Swedish cause of death register is a high quality virtually complete register of all deaths in Sweden since 1952. Although originally created for official statistics, it is a highly important data source for medical research since it can be linked to many other national registers, which contain data on social and health factors in the Swedish population. For the appropriate use of this register, it is fundamental to understand its origins and composition. In this paper we describe the origins and composition of the Swedish cause of death register, set out the key strengths and weaknesses of the register, and present the main causes of death across age groups and over time in Sweden. This paper provides a guide and reference to individuals and organisations interested in data from the Swedish cause of death register.

Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide. This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System. Epidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for...

The main objective of this study was to identify the clinical-pathological discrepancies in autopsies performed in the institution. We reviewed autopsies of clinical cases in 53 adults in the period between January 2005 and June 2009, carried out in the Pathology Service at the Hospital Privado de Córdoba, Argentina. Six autopsies were excluded due to insufficient information. The Goldman et al. classification was applied to establish clinico-pathologic discrepancies between clinical diagnoses and autopsy findings. Frequently clinical diagnoses were respiratory infections and acute pulmonary embolism. The most frequently reported postmortem diagnoses were respiratory infections and acute myocardial infarction. There were 17 major discrepancies and 30 coincidences. No any minor discrepancy was detected. Respiratory infections were the main cause of error, followed by myocardial infarction. We conclude that in 17/47 (37%) of cases the pre-mortem and postmortem diagnoses were different...

Despite the introduction of road safety measures and media campaigns, crashes are a leading cause of death in Western Australia. While economic costs of crashes are relatively easy to determine, their psychosocial burden remains appreciably understudied, as are the social, cultural, historical, temporal, and political contexts within which grief experiences are housed. As such, I explored the experience of grief resulting from losing a loved one in a crash in Western Australia and described the influence of contextual factors on those grief experiences. Constructionist grounded theory methodology was utilised. Data were collected from two informant groups – 10 were employed in road safety and post-crash services in Western Australia and 21 were Western Australians bereaved through the loss of a family member in crashes. Data were collected via in-depth recursive interviews, a ‘scoping and profiling’ process, and public documents. The data indicate that the bereaved informants were s...

Since the introduction of recreational closed-circuit rebreathers (CCRs) in 1998, there have been many recorded deaths. Rebreather deaths have been quoted to be as high as 1 in 100 users. Rebreather fatalities between 1998 and 2010 were extracted from the Deeplife rebreather mortality database, and inaccuracies were corrected where known. Rebreather absolute numbers were derived from industry discussions and training agency statistics. Relative numbers and brands were extracted from the Rebreather World website database and a Dutch rebreather survey. Mortality was compared with data from other databases. A fault-tree analysis of rebreathers was compared to that of open-circuit scuba of various configurations. Finally, a risk analysis was applied to the mortality database. The 181 recorded recreational rebreather deaths occurred at about 10 times the rate of deaths amongst open-circuit recreational scuba divers. No particular brand or type of rebreather was over-represented. Closed-c...