Analysis of mortality metrics associated with a comprehensive range of disorders in Denmark, 2000 to 2018: A population-based cohort study

Background: The provision of different types of mortality metrics (e.g., mortality rate ratios [MRRs] and life expectancy) allows the research community to access a more informative set of health metrics. The aim of this study was to provide a panel of mortality metrics associated with a comprehensive range of disorders and to design a web page to visualize all results. Methods and findings: In a population-based cohort of all 7,378,598 persons living in Denmark at some point between 2000 and 2018, we identified individuals diagnosed at hospitals with 1,803 specific categories of disorders through the International Classification of Diseases-10th Revision (ICD-10) in the National Patient Register. Information on date and cause of death was obtained from the Registry of Causes of Death. For each of the disorders, a panel of epidemiological and mortality metrics was estimated, including incidence rates, age-of-onset distributions, MRRs, and differences in life expectancy (estimated as life years lost [LYLs]). Additionally, we examined models that adjusted for measures of air pollution to explore potential associations with MRRs. We focus on 39 general medical conditions to simplify the presentation of results, which cover 10 broad categories: circulatory, endocrine, pulmonary, gastrointestinal, urogenital, musculoskeletal, hematologic, mental, and neurologic conditions and cancer. A total of 3,676,694 males and 3,701,904 females were followed up for 101.7 million person-years. During the 19-year follow-up period, 1,034,273 persons (14.0%) died. For 37 of the 39 selected medical conditions, mortality rates were larger and life expectancy shorter compared to the Danish general population. For these 37 disorders, MRRs ranged from 1.09 (95% confidence interval [CI]: 1.09 to 1.10) for vision problems to 7.85 (7.77 to 7.93) for chronic liver disease, while LYLs ranged from 0.31 (0.14 to 0.47) years (approximately 16 weeks) for allergy to 17.05 (16.95 to 17.15) years for chronic liver disease. Adjustment for air pollution had very little impact on the estimates; however, a limitation of the study is the possibility that the association between the different disorders and mortality could be explained by other underlying factors associated with both the disorder and mortality. Conclusions: In this study, we show estimates of incidence, age of onset, age of death, and mortality metrics (both MRRs and LYLs) for a comprehensive range of disorders. The interactive data visualization site (https://nbepi.com/atlas) allows more fine-grained analysis of the link between a range of disorders and key mortality estimates.publishedVersio

Epidemiologic Assessment of Mortality among Inpatients in a Psychiatric Hospital

Individuals with psychiatric disorders have higher early mortality rates than the general population, and all types of mental disorders are associated with a short life expectancy. In this context, assessment of the mortali-ties of both natural and unnatural causes in psychiatric inpatients is of critical importance in terms of mortality epidemiology, which provides data that can help improve the quality and planning of psychiatric care. The popu-lation of this study retrospective, cross-sectional study consisted of inpatients that died in Manisa Mental Health and Diseases Hospital between May 2002 and December 2022. Of the 120 inpatients that died, 119 patients, 63.9% male, and 36.1% female, were included in the study sample. The mortality rate decreased from 3.2% to 0.22% during the period covered by the study. The difference between mortality rates before 2013, when qua-lity and accreditation processes started, and after 2013 has decreased from 74.8% to 25.2%. Of the natural deaths, 45.4% were caused by cardiac arrest, whereas 100% of the unnatural deaths occurred due to suicides. Short hospital stays and close follow-up in the first week of hospitalization are essential in reducing mortality rates in psychiatric inpatients. In addition, increasing the quality of health care in accordance with the national and international quality and accreditation criteria will further reduce the mortality rates in psychiatric inpati-ents