Time trends of avoidable deaths in Brazil, 1996 to 2019 / Tendência temporal das mortes evitáveis no Brasil, 1996 a 2019

Introduction: The known achievements of the Brazilian Unified Health System (SUS) stand out in an adverse context. This makes it necessary to examine the effect of the SUS on the population's health, using indicators such as deaths by avoidable causes. Objective: To describe the time trends of mortality from avoidable causes in Brazil and to compare them to those of non-avoidable causes. Methods: Ecological time-series study with official mortality data, during years 1996-2019, in the age group 5-74 years. Time trends in mortality were estimated as the annual percent reduction in mortality rates, and the impact of the SUS was calculated as the difference in trend between avoidable (immunopreventable, infectious and noncommunicable diseases, maternal and external causes) and non-avoidable causes. The analyses consisted of multivariable binomial regression models, by quadrennium. Results: Death rates for each avoidability group remained stable or declined throughout the study period. The probability of a positive impact was greater than 90% for immunopreventable diseases throughout the study period; infectious diseases in 1996-2003 and 2016-2019; noncommunicable diseases in 1996-2003 and 2008-2019; maternal causes in 1996-1999; and external causes in 1996-2007. This probability was less than 10% for maternal deaths in 2016-2019; and external causes in 2008-2015. Conclusion: The SUS has had a positive impact in reducing deaths from immunopreventable, infectious and noncommunicable diseases in Brazil, although not so much for maternal and external causes.

Introdução: As conhecidas conquistas do Sistema Único de Saúde (SUS) se destacam num cenário adverso. Isso torna necessário examinar o efeito do SUS na saúde da população, usando indicadores como as mortes por causas evitáveis. Objetivo: Descrever as tendências temporais de mortalidade por causas evitáveis no Brasil e compará-las às tendências por causas não evitáveis. Métodos: Estudo ecológico de série temporal com dados oficiais de mortalidade, durante os anos 1996-2019, na faixa etária dos 5-74 anos. As tendências temporais de mortalidade foram estimadas como a redução percentual anual nas taxas de mortalidade, e o impacto do SUS foi calculado como a diferença de tendência entre causas evitáveis (doenças imunopreveníveis, infecciosas ou não transmissíveis, mortes maternas, causas externas) e não evitáveis. As análises consistiram em modelos de regressão binomial multivariável, por quadriênio. Resultados: A taxa de mortalidade permaneceu igual ou diminuiu para todos os grupos de causas de morte. A probabilidade de um impacto positivo foi maior do que 90% para as doenças imunopreveníveis ao longo de todo o período de estudo; doenças infecciosas em 1996-2003 e 2016-2019; não transmissíveis em 1996-2003 e 2008-2019; mortes maternas em 1996-1999; e externas em 1996-2007. Essa probabilidade foi menor do que 10% para mortes maternas em 2016-2019; e causas externas em 2008-2015. Conclusão: O SUS tem tido um impacto positivo na redução de mortes por doenças sensíveis à imunização, infecciosas e não transmissíveis no Brasil, embora não tanto para mortes maternas e causas externas.

Liporoteínas de baja densidad y grados de riesgo cardiovascular en adultos mayores de 40 años: estudio de casos y controles

Fundamento: Las enfermedades cardiovasculares constituyen la principal causa de muerte y discapacidad en el mundo. Su incidencia y prevalencia ha aumentado durante la última década y representa un tercio de todas las muertes. Objetivo: Determinar la asociación de LDL-C y grados de riesgo cardiovascular en adultos mayores de 40 años en la Unidad de Medicina Familiar # 43 del Instituto Mexicano del Seguro Social. Método: Se realizó una investigación con un diseño de casos y controles durante el 2023, mediante la fórmula de relación caso-control 1:1, (230 sujetos) que reunieron los criterios de selección. La recolección de la información se realizó por medio de una base de datos en Excel, el contraste de variables se realizó con la fórmula de X2. Mediante el programa de SPSS versión 25 de Windows. Resultados: El género femenino fue el de mayor frecuencia, la media de edad fue de 62 años, el colesterol total elevado presentó 109 (94,8) pacientes con alto riesgo cardiovascular, se calculó una RM: 43.279, IC: 95 %, (17.347-107.980), el colesterol LDL presentó un 68 % (59,1) con riesgo cardiovascular y una RM: 1.28, IC: 95% (0.760-2.158), la evaluación de los triglicéridos con cifras elevadas presentó un 50,4 % (58), RM: 0.037, IC 95 % (0.013-0.106). Conclusiones: La edad media de los sujetos fue, 62 años, predominó el sexo femenino, con mayor proporción de casados, el nivel de escolaridad que prevaleció fue la preparatoria, la religión católica tuvo mayor frecuencia y los sujetos de la zona urbana. Las variables de lípidos como el colesterol total y LDL-C presentaron significancia estadística en relación a riesgo cardiovascular.

Foundation: Cardiovascular diseases are the main cause of death and disability in the world. Its incidence and prevalence has increased over the last decade and accounts for a third of all deaths. Objective: Determine the association of LDL-C and degrees of cardiovascular risk in adults over 40 years of age in the Family Medicine Unit # 43 of the Mexican Social Security Institute. Method: An investigation was carried out with a case-control design during 2023, using the 1:1 case-control ratio formula, (230 subjects) who met the selection criteria. Information collection was carried out through an Excel database, the contrast of variables was carried out with the X2 formula. Using the SPSS version 25 Windows program. Results: The female gender was the most frequent, the average age was 62 years, elevated total cholesterol presented 109 (94.8) patients with high cardiovascular risk, an MRI was calculated: 43,279, CI: 95 %, (17,347-107,980), LDL cholesterol presented 68 % (59.1) with cardiovascular risk and an MRI: 1.28, CI: 95 % (0.760-2.158), the evaluation of triglycerides with high figures presented 50.4 % (58), OR: 0.037, 95 % CI (0.013-0.106). Conclusions: The average age of the subjects was 62 years, the female sex predominated, with a greater proportion of married people, the level of schooling that predominated was high school, the catholic religion was more frequent and the subjects were from the urban area. Lipid variables such as total cholesterol and LDL-C presented statistical significance in relation to cardiovascular risk.

Main causes of death of residents in arsenic poisoning areas in Inner Mongolia Autonomous Region from 2016 to 2021 / 中华地方病学杂志

Objective:To analyze the main causes of death of residents in arsenic poisoning areas of Inner Mongolia Autonomous Region, providing a scientific basis for preventing and controlling the long-term effects of arsenic poisoning and ensuring the health of residents.Methods:The data on the causes of death among residents in arsenic poisoning areas of Inner Mongolia Autonomous Region from 2016 to 2021 were collected from the population death information registration management system and the population information system of various league and city statistical bureaus in Inner Mongolia Autonomous Region. Residents were divided into exposed and non exposed groups based on whether they drank high arsenic water. SPSS 25.0 software was used to statistically analyze the crude mortality rate (CDR), standardized mortality rate (SMR), disease-specific mortality rate, proportion of causes of death, and order of causes of death.Results:Over the past 6 years, there was a total of 9 583 deaths, with an average annual CDR of 633.12/100 000 and an average annual SMR of 446.65/100 000. The CDR of each year showed a decreasing trend over time (χ 2 = 1 058.86, P < 0.001). Male CDR was higher than female CDR (χ 2 = 325.04, P < 0.001). Heart diseases and malignant tumors were the main causes of death for residents in arsenic poisoning areas, with proportions of 25.00% (2 396/9 583) and 18.86% (1 807/9 583), respectively. The top three leading causes of malignant tumor death were lung cancer, liver cancer and gastric cancer. Among residents who died from various diseases and malignant tumors, the SMR of the exposed group was higher than that of the non exposed group (χ 2 = 147.08, 26.26, P < 0.001). Conclusions:The main causes of death of residents in arsenic poisoning areas in Inner Mongolia Autonomous Region are heart diseases and malignant tumors, with lung cancer, liver cancer, and gastric cancer being the top three leading causes of death for malignant tumors. Although the arsenic poisoning areas in the entire region have basically achieved water improvement, the long-term effects of chronic arsenic exposure still exist.

Characteristics and trend analysis of injury causes of death in Qingpu District of Shanghai，2002‒2020 / 上海预防医学

ObjectiveTo analyze the characteristics and changing trend of injury cause of mortality of residents in Qingpu District from 2002 to 2020， and to provide scientific reference for formulating regional prevention and control measures. MethodsThe injury mortality data of the registered residents in Qingpu District from 2002 to 2020 were collected. The indicators such as crude mortality rate， standardized mortality rate， and the ranking of causes of death were calculated. ResultsFrom 2002 to 2020， the average annual crude mortality rate was 50.27/100 000， the age-standardized mortality rate based on the world standard population（ASRW） was 30.08/100 000， and the age-standardized mortality rate based on the 2010 Chinese census（ASMRC） was 35.58/100 000. The average annual crude mortality rate of males was higher than that of females ［Z=54.402， Mantel-Hanszel χ2=1 742.509， P<0.01）. The overall injury mortality rate showed a downward trend with an average annual percent change（AAPC）of -4.07% （95%CI： -5.23%‒-2.90%）， P<0.001］. The top four causes of injury death were transportation accident， indeliberate fall， drowning， and suicide. The leading causes of death in 0‒ years old， 15‒ years old and ≥65 years old were drowning， transportation accident and indeliberate fall， respectively. The ASRW of transportation accident， drowning and suicide all showed a decreasing trend， and the AAPC were -8.22% （95%CI： -10.16%‒-6.24%）， -6.99% （95%CI： -9.68%‒-4.22%） and -6.21% （95%CI： -9.38%‒-2.94%）， respectively. ConclusionThe injury death rate of residents in Qingpu District shows a decreasing trend， and the distribution characteristics of injury death are different among different genders and age groups. Corresponding prevention and control strategies should be adopted for different populations.

A prospective cohort study on the relationship between serum FGF23 and the risk of heart failure and death in end⁃stage renal disease patients / 安徽医科大学学报

Objective @#To explore the correlation between serum fibroblast growth factor⁃23 (FGF23) concentration and heart failure and all⁃cause death in patients with end⁃stage renal disease (ESRD) . @*Methods @#The prospective cohort study design was used in the present study. The ESRD patients who were admitted to the department of nephropathy in the Hospital and without heart failure symptoms were recruited in this study. The data of patients was collected through baseline questionnaires , physical examinations , echocardiography , and laboratory examinations. The serum FGF23 levels were measured by enzyme⁃linked immunosorbent assay (ELISA) . The follow⁃up time was 2 years. The onset of heart failure (ACC/AHA stage C ⁃D) and all⁃cause death were composite endpoint events. The Cox proportional risk model was used to explore the risk factors of outcome events. Through subgroup analyses and interaction analyses , further exploration was conducted to determine whether there was heterogeneity in the association between FGF23 and outcome events in different subgroups.@*Results @#Ultimately , 107 ESRD patients were included in this study , with an average age of (52. 00 ± 12. 51) years. There were 39 males (36. 45% ) , and the median follow⁃up time was 23 months (21 , 25 months) . There were 32 (29. 9% ) outcome events , of which 22 (20. 6% ) onset of heart failure and 10 (9. 3% ) all⁃cause of deaths. The results of this study showed that the concentration of FGF23 in the outcome event group was significantly higher than that in the non⁃event group [(4. 40 ± 1. 16) pmol/ml vs (3. 85 ± 0. 82) pmol/ml ,P < 0. 05] . The Cox proportional risk model showed that the elevated FGF23 was associated with increased risk of the composite endpoint events in ESRD patients (HR = 1. 730 , 95% CI: 1. 164 - 2. 570 , P = 0. 007 ) . Subgroup analyses showed that there was an interactive effect between FGF23 levels and gender on the risk of cardiovascular outcome events. Especially in male ESRD patients , the increased FGF23 level was correlated with a higher risk of cardiovascular events (P⁃interaction < 0. 05) .@*Conclusion @#Elevated serum FGF23 is an independent risk factor for the onset of heart failure and all⁃cause of mortality in ESRD patients , especially in male patients.

Analysis of trends in neonatal mortality and causes of death in NICU,2005-2020: a single-center study / 国际儿科学杂志

Objective:To investigate the changes of mortality，causes of death，and cause-specific mortality rate（CMR）of hospitalized neonates in NICU of the First Affiliated Hospital of Sun Yat-sen University.Method:A retrospective study was performed to compare the mortality，cause of death，and CMR of hospitalized neonates in period Ⅰ（2005-2009），period Ⅱ（2010-2014）and period Ⅲ（2015-2020）.Result:The overall mortality of hospitalized neonates in NICU of our hospital was 0.51%（104/20 493）through 2005 to 2020. The mortality in period Ⅰ，Ⅱ and Ⅲ were 0.61%（48/7 855），0.43%（27/6 209），and 0.45%（29/6 429），respectively. Compared with period Ⅰ，the mortality of preterm infants decreased significantly in period Ⅱ（3.14% vs 1.24%， χ2=14.076， P<0.01）and in period Ⅲ（3.14% vs 0.90%， χ2=25.157， P<0.01）. Eighty-five（81.7%）neonates were premature，and ninety-one（89.2%）neonates had definite abnormal perinatal factors. The CMR of hospitalized neonates related to pulmonary hemorrhage，congenital anomalies，and NRDS were 1.22‰（25/20 493），0.93‰（19/20 493），and 0.59‰（12/20 493），respectively. The CMR of other causes were sepsis 0.44‰（9/20 493），extremely premature 0.34‰（7/20 493），and perinatal asphyxia 0.24‰（5/20 493），respectively. Compared with period Ⅰ，specific mortality of NRDS in period Ⅱ（1.27‰ vs 0.16‰， χ2=5.487， P=0.016）and period Ⅲ（1.27‰ vs 0.16‰， χ2=5.738， P=0.014）significantly decreased. The leading causes of neonatal death in period Ⅰ，period Ⅱ，and period Ⅲ were NRDS，pulmonary hemorrhage，and congenital anomalies，respectively.And 71.2%（74/104）of neonatal deaths occurred within 7 days after birth. Conclusion:The mortality of preterm infants and specific mortality of NRDS in NICU have significantly decreased over the past 16 years.Congenital anomalies and infections remain important causes of death，and further efforts are needed to improve perinatal care.

Deaths of children under 5 years old in Changsha in 2016 - 2021 / 公共卫生与预防医学

Objective To analyze the death status and main causes of death among children under 5 years old in Changsha from 2016 to 2021, and to provide a scientific basis for formulating preventive measures for children's health care. Methods The data of 1 761 deaths of children under 5 years old in Changsha City from 2016 to 2021 were collected, and the mortality trend, the order of causes of death and the utilization of pre-death medical care services were retrospectively analyzed. Results The 7-day neonatal mortality, 28-day neonatal mortality, 0-1-year-old neonatal mortality, and the mortality rate of children under 5 years old (U5MR) in Changsha City from 2016 to 2021 were 0.76‰, 1.28‰, 2.41‰, and 3.86‰, respectively. All the mortality rates showed a decreasing trend (P<0.05). U5MR in males was significantly higher than that in females (P<0.05), and U5MR in rural areas was significantly higher than that in urban areas (P<0.05). The top five causes of U5MR were drowning, premature delivery or low birth weight, pneumonia, other congenital anomalies, and accidental asphyxia, respectively. The death places of children under 5 years old were mainly medical and health institutions, and 81.72% of them were treated in hospitals before death. Conclusion From 2016 to 2021, the mortality rate of children under the age of 5 in Changsha City has gradually decreased. Preventing congenital malformations, reducing preterm birth or low birth weight, improving the treatment level of pneumonia, and preventing accidents such as drowning and accidental suffocation are the key to reducing the mortality rate of children under 5 years old.

The Progression of Postmortem Biochemistry Analysis in Forensic Discrimination of Cause of Death / 中山大学学报(医学科学版)

The discrimination of the cause of death is an important part in forensic medicine. With the advantages of simple operation， high test efficiency， and easy sensitivity to the death mechanism of the deceased， postmortem biochemistry analysis has become a significant auxiliary analysis method for discrimination of the cause of death. In this paper， we discuss the development status， advantages and current problems of postmortem biochemical analysis， and then describe the application prospect of postmortem biochemistry in the discrimination of the cause of death by posing feasible solutions， so that to provide an idea for this research.

Análise da tendência da mortalidade por causas externas em pessoas idosas no Brasil, 2000 a 2022 / Analysis of the trend of mortality from external causes in older adults in Brazil, 2000 to 2022

Resumo Objetivo analisar a tendência de mortalidade por causas externas em pessoas idosas no Brasil no intervalo temporal entre os anos 2000 e 2022 e identificar o perfil sociodemográfico de mortalidade. Método estudo ecológico de série temporal utilizando dados secundários, envolvendo a mortalidade em pessoas idosas por causas externas no Brasil, no período de 2000 a 2022. Os dados foram coletados a partir das bases de dados do Departamento de Informática do Sistema Único de Saúde, das estimativas da população residente e de dados populacionais censitários disponibilizados pelo Instituto Brasileiro de Geografia e Estatística. A frequência absoluta e relativa dos dados foi analisada a partir do software Excel 2010. As análises das tendências das taxas de mortalidade e regressão linear segmentada foram realizadas por meio do Joinpoint, com significância estatística avaliada por meio do teste de Monte Carl Resultados No período investigado, foram identificados 572.608 óbitos por causas externas em pessoas idosas com 60 anos ou mais. Em relação ao comportamento da mortalidade por causas externas em pessoas idosas, observou-se tendência de aumento nas taxas de mortalidade na maior parte do período estudado (2000 a 2013) com uma variação percentual anual (VPA: 1,86; IC95%: 1,5-2,2). Conclusão os resultados indicam uma tendência de crescimento da mortalidade de pessoas idosas por causas externas, refletindo a necessidade de priorização de políticas públicas que intervenham sobre esse evento.

Abstract Objective To analyze the trend of mortality due to external causes in older adults in Brazil within the temporal interval spanning from 2000 to 2022 and to identify the sociodemographic profile of mortality. Method Ecological time-series study utilizing secondary data, encompassing mortality in older adults due to external causes in Brazil, spanning the period from 2000 to 2022. The data were collected from the databases of the Department of Informatics of the Unified Health System, population estimates, and census population data provided by the Brazilian Institute of Geography and Statistics. The absolute and relative frequency of the data were analyzed using Microsoft Excel 2010 software. The analysis of trends in mortality rates and segmented linear regression was conducted using Joinpoint, with statistical significance assessed through the Monte Carlo test. Results During the investigated period, 572,608 deaths due to external causes were identified in individuals aged 60 years or older. Regarding the mortality pattern due to external causes in older adults, an increasing trend in mortality rates was observed for the majority of the studied period (2000 to 2013) with an annual percent change (APC) of 1.86 (95% CI: 1.5-2.2). Conclusion The results indicate a growing trend in mortality among older individuals due to external causes, highlighting the need for prioritizing public policies that address this issue.

Mortality related to sickle cell disease and COVID-19 in Brazil, 2020

SUMMARY OBJECTIVE: The ability to cause death is the definitive measure of an infectious disease severity, particularly one caused by a novel pathogen like severe acute respiratory syndrome-CoV-2 (COVID-19). This study describes sickle cell disease-related mortality issues during the COVID-19 pandemic in Brazil. METHODS: The provisional 2020 mortality data originated from the public databases of the Mortality Information System and were investigated using the multiple-cause-of-death methodology. RESULTS: In 2020, 688 sickle cell disease-related deaths occurred, of which 422 (61.3%) had an underlying cause of death and 266 (38.7%) had an associated cause of death. Furthermore, 98 COVID-19-related deaths occurred, of which 78 were underlying cause of death among sickle cell disease associated (non-underlying) cause of death. Sickle cell disease-related deaths occurred mostly among young adults aged 25-49 years. COVID-19 deaths occurred at ages older than among sickle cell disease-related deaths. Majority of deaths happened in the southeast (42.3%) and northeast regions (34.0%), while COVID-19 deaths prevailed in the northeast region (42.9%). Regarding overall deaths, the leading underlying cause of death was sickle cell disease itself, followed by infectious and parasitic diseases (14.8%), owing to COVID-19 deaths, and diseases of the circulatory system (8.9%). Next, in males, diseases of the digestive system (4.8%) occurred, while, in females, maternal deaths succeeded, included in the chapter on pregnancy, childbirth, and the puerperium, accounting for 5.9% of female deaths. The leading overall associated (non-underlying) cause of deaths were septicemias (29.4%), followed by respiratory failure (20.9%), pneumonias (18.3%), and renal failure (14.7%). CONCLUSION: In Brazil, COVID-19 deaths produced trend changes in sickle cell disease-related causes of death, age at death, and regional distribution of deaths in 2020.

Time series analysis: trend in late maternal mortality in Brazil, 2010-2019 / Análisis de serie temporal: tendencia de la mortalidad materna tardía en Brasil, 2010-2019 / Análise de série temporal: tendência da mortalidade materna tardia no Brasil, 2010-2019

Abstract: To analyze the temporal trend of the late maternal mortality ratio (LMMR) in Brazil and its geographic regions in the period from 2010 to 2019, an ecological time series study was conducted. Data related to late maternal mortality from information systems of the Brazilian Ministry of Health were used. Statistical analysis used Prais-Winsten autoregressive models. A total of 1,470 late maternal deaths were reported in Brazil, resulting in an LMMR of 5 deaths per 100,000 live births. The late maternal mortality records revealed regional disparities, with the lowest index in the North (3.5/100,000 live births) and the highest in the South (8.3/100,000 live births). The LMMR showed an increasing trend in the country, with a general increase in the LMMR in the period and a mean annual percentage variation of 9.79% (95%CI: 4.32; 15.54). The Central-West region led this increase, with a mean annual percentage change of 26.06% (95%CI: 16.36; 36.56), followed by the North and Northeast regions, with 23.5% (95%CI: 13.93; 33.88). About 83% of the reported late maternal deaths were investigated, and 65.6% were corrected by the Maternal Mortality Committees. These findings highlight the relevance of late maternal mortality as an important indicator for maternal health, which is often invisible. The increase in the LMMR result from the improvement in the quality of the registration of these deaths in recent years in Brazil, and especially from the work of investigating deaths. The fragility of reporting with regional disparities points to the need for a more comprehensive approach that promotes equity and prevention of avoidable late maternal mortality.

Resumen: Con el objetivo de evaluar la tendencia temporal de la tasa de mortalidad materna tardía (TMMT) en Brasil y sus regiones geográficas para el período de 2010 a 2019, se realizó un estudio de serie temporal ecológica. Se utilizaron datos relacionados con la mortalidad materna tardía de los sistemas de información del Ministerio de la Salud de Brasil. El análisis estadístico empleó modelos de regresión de Prais-Winsten. Hubo 1.470 muertes maternas tardías en Brasil, lo que resultó en una TMMT de 5 muertes por cada 100.000 nacidos vivos. Los registros de mortalidad materna tardía revelaron disparidades regionales con la tasa más baja en la Región Norte (3,5/100.0000 nacidos vivos) y la más alta en la Región Sur (8,3/100.000 nacidos vivos). Hubo una tendencia a aumento de TMMT en el país, con un incremento general de TMMT para el período y una variación media porcentual anual de un 9,79% (IC95%: 4,32; 15,54). La Región Centro-oeste presentó las tasas más elevadas, con una variación media porcentual anual de un 26,06% (IC95%: 16,6; 36,56), seguida de las regiones Norte y Nordeste, con un 23,5% (IC95%: 13,93; 33,88). Aproximadamente el 83% de las muertes materna tardía reportadas fueron investigadas, y el 65,6% fue corregido por los Comités de Mortalidad Materna. Estos hallazgos muestran la relevancia de la mortalidad materna tardía como un indicador de importancia para la salud materna, muchas veces invisibilizada. El incremento en la TMMT encontrada puede deberse a la mejora en la calidad del registro de estas muertes en los últimos años en Brasil, especialmente de la investigación de las muertes. La debilidad de las notificaciones con disparidades regionales apunta a la necesidad de un enfoque más integral que promueva la equidad y la prevención de la mortalidad materna tardía evitable.

Resumo: Com o propósito de analisar a tendência temporal da razão de mortalidade materna tardia (RMMT) no Brasil e suas regiões geográficas no período de 2010 a 2019, conduziu-se um estudo ecológico de série temporal. Foram utilizados dados relacionados à mortalidade materna tardia, provenientes de sistemas de informação do Ministério da Saúde. A análise estatística empregou modelos autorregressivos de Prais-Winsten. Foram notificados 1.470 óbitos maternos tardios no Brasil, resultando em uma RMMT de 5 óbitos a cada 100 mil nascidos vivos. Os registros de mortalidade materna tardia revelaram disparidades regionais com o menor índice na Região Norte (3,5/100 mil nascidos vivos) e o maior na Região Sul (8,3/100 mil nascidos vivos). Houve tendência crescente da RMMT no país, com aumento geral no período e variação percentual média anual de 9,79% (IC95%: 4,32; 15,54). A Região Centro-oeste liderou esse aumento, com variação percentual média anual de 26,06% (IC95%: 16,36; 36,56), seguida pelas regiões Norte e Nordeste, com 23,5% (IC95%: 13,93; 33,88). Cerca de 83% das mortes maternas tardias declaradas foram investigadas, sendo que 65,6% foram corrigidas pelos Comitês de Mortalidade Materna. Esses achados ressaltam a relevância da mortalidade materna tardia como um indicador de importância para a saúde materna muitas vezes invisibilizado. O aumento da RMMT verificado pode ser resultado da melhoria da qualidade do registro desses óbitos nos últimos anos no Brasil, sobretudo do trabalho de investigação dos óbitos. A fragilidade das notificações com as disparidades regionais aponta a necessidade de uma abordagem abrangente que promova equidade e prevenção de mortalidade materna tardia evitáveis.

Análisis temporal de la mortalidad por causas evitables en las primeras 24 horas de vida, 2000-2021 / Temporal analysis of mortality from preventable causes in the first 24 hours of life, 2000-2021 / Análise temporal da mortalidade por causas evitáveis nas primeiras 24 horas de vida, 2000-2021

Objetivo: analizar el patrón temporal y estimar las tasas de mortalidad en las primeras 24 horas de vida y por causas evitables en el estado de Pernambuco en el período de 2000 a 2021. Método: estudio ecológico, teniendo como unidad de análisis el trimestre. La fuente de datos se constituyó por el Sistema de Informaciones sobre Mortalidad y el Sistema de Informaciones sobre Nacidos Vivos. El modelado de series temporales se realizó según el Modelo Autorregresivo Integrado de Promedio Móvil. Resultados: se registraron 14.462 óbitos en las primeras 24 horas de vida, siendo 11.110 (el 76,8%) evitables. Se observa para los pronósticos ( forecasts) que la tasa de mortalidad en las primeras 24 horas de vida registro una variación de 3,3 a 2,4 por 1.000 nacidos vivos, y la tasa de mortalidad por causas evitables de 2,3 a 1,8 por 1.000 nacidos vivos. Conclusión: la predicción sugirió avances en la reducción de la mortalidad en las primeras 24 horas de vida en el estado y por causas evitables. Los modelos ARIMA presentaron estimaciones satisfactorias para las tasas de mortalidad y por causas evitables en las primeras 24 horas de vida.

Objective: to analyze the temporal pattern and estimate mortality rates in the first 24 hours of life and from preventable causes in the state of Pernambuco from 2000 to 2021. Method: an ecological study, using the quarter as the unit of analysis. The data source was made up of the Mortality Information System and the Live Birth Information System. The time series modeling was conducted according to the Autoregressive Integrated Moving Average Model. Results: 14,462 deaths were recorded in the first 24 hours of life, 11,110 (76.8%) of which being preventable. It is observed from the forecasts that the mortality rate in the first 24 hours of life ranged from 3.3 to 2.4 per 1,000 live births, and the mortality rate from preventable causes ranged from 2.3 to 1.8 per 1,000 live births. Conclusion: the prediction suggested progress in reducing mortality in the first 24 hours of life in the state and from preventable causes. The ARIMA models presented satisfactory estimates for mortality rates and preventable causes in the first 24 hours of life.

Objetivo: analisar o padrão temporal e estimar as taxas de mortalidade nas primeiras 24 horas de vida e por causas evitáveis no estado de Pernambuco no período de 2000 a 2021. Método: estudo ecológico, tendo como unidade de análise o trimestre. A fonte de dados foi constituída pelo Sistema de Informações sobre Mortalidade e pelo Sistema de Informações sobre Nascidos Vivos. A modelagem da série temporal foi conduzida segundo o Modelo Autorregressivo Integrado de Médias Móveis. Resultados: foram registrados 14.462 óbitos nas primeiras 24 horas de vida, sendo 11.110 (76,8%) evitáveis. Observa-se para os forecasts que a taxa de mortalidade nas primeiras 24 horas de vida variou de 3,3 a 2,4 por 1.000 nascidos vivos, e a taxa de mortalidade por causas evitáveis variou de 2,3 a 1,8 por 1.000 nascidos vivos. Conclusão: a previsão sugeriu avanços na redução da mortalidade nas primeiras 24 horas de vida no estado e por causas evitáveis. Os modelos ARIMA apresentaram estimativas satisfatórias para as taxas de mortalidade e por causas evitáveis nas primeiras 24 horas de vida.

Continuidad de vínculos en hombres que experiencian duelo por un ser querido / Continuing bonds in men grieving a loved one / Manutenção de vínculos em homens em luto por um ente querido

Objetivo: examinar la continuidad de vínculos interna y externa en hombres que experiencian duelo por un ser querido. Método: estudio correlacional, descriptivo y transversal. Muestra a conveniencia de 170 hombres dolientes. Las variables fueron mediadores del duelo, continuidad de vínculos y datos sociodemográficos. Se utilizó un cuestionario en línea compuesto por mediadores de duelo, escala de continuidad de vínculos y datos sociodemográficos. Se empleó estadística descriptiva, análisis de varianza y coeficiente de Spearman. El nivel de significancia correspondió a p<0,05. Resultados: la media de edad de los participantes fue de 36,61 años (DE=13,40), y el 80,00% tenía educación superior. Los valores medios de continuidad de vínculos interna y externa fueron 24,85 (DE=7,93) y 7,68 (DE=2,33), respectivamente. Se establecieron diferencias significativas referentes a la continuidad de vínculos interna y externa entre parentesco de la persona fallecida (p<0,001), y ninguna con la causa de muerte o con el tiempo transcurrido desde el fallecimiento. No se precisaron correlaciones significativas entre continuidad de vínculos interna/externa y mediadores del duelo. Conclusión: los hombres dolientes expresan la continuidad de vínculos interna de manera frecuente y la externa en ocasiones, con diferencias respecto a quién era la persona fallecida. La Enfermería podría diseñar estrategias específicas que fortalezcan el afrontamiento del duelo en este grupo.

Objective: to examine internalized and externalized continuing bonds in men grieving a loved one. Method: a correlational, descriptive and cross-sectional study. Convenience sample comprised by 170 mourning men. The variables were mediators of mourning, continuing bonds and sociodemographic data. The instrument used was an online questionnaire comprised by mediators of mourning, a continuing bonds scale and sociodemographic data. Descriptive statistics, analysis of variance and Spearman's coefficient were used. The significance level adopted was p<0.05. Results: the participants' mean age was 36.61 years old (SD=13.40), and 80.00% had Higher Education. The mean values corresponding to internalized and externalized continuing bonds were 24.85 (SD=7.93) and 7.68 (SD=2.33), respectively. Significant differences were established referring to internalized and externalized continuing bonds in terms of kinship with the deceased person (p<0.001), and none with the cause of death or with the time elapsed since the event. No significant correlations were defined between internalized/externalized continuing bonds and mediators of mourning. Conclusion: grieving men express internalized and externalized continuing bonds frequently and occasionally, respectively, with differences according to who the deceased person was. The Nursing discipline might devise specific strategies that strengthen coping with grief in this population group.

Objetivo: examinar a manutenção de vínculos interna e externa em homens vivenciando o luto por um ser querido. Método: estudo correlacional, descritivo e de corte transversal. Amostra de conveniência de 170 homens em luto. As variáveis foram: mediadores do luto, manutenção de vínculos e dados sociodemográficos. Utilizou-se um questionário online composto por mediadores de luto, escala de manutenção de vínculos e dados sociodemográficos. Empregou-se estatística descritiva, análise de variância e coeficiente de Spearman. Nível de significância p<0,05. Resultados: os participantes tinham uma média de idade de 36,61 anos (DP=13,40) e 80,00% tinham ensino superior. A média de manutenção interna dos vínculos foi de 24,85 (DP=7,93) e a de manutenção externa foi de 7,68 (DP=2,33). Foram estabelecidas diferenças significativas para a manutenção dos vínculos internos e externos entre os parentes do falecido (p<0,001), nenhuma com a causa da morte ou o tempo decorrido desde a morte. Não foram encontradas correlações significativas entre a manutenção dos vínculos internos e externos e os mediadores do luto. Conclusão: os homens em luto expressaram a manutenção interna dos vínculos com frequência e a manutenção externa dos vínculos ocasionalmente, com diferenças a respeito de quem era a pessoa falecida. A enfermagem poderia criar estratégias específicas para fortalecer o enfrentamento do luto nesse grupo.

Riesgo de muerte por insuficiencia cardiaca congestiva en pacientes anémicos de la población peruana / Risk of death due to congestive heart failure in anemic patients in the Peruvian population

Objetivo: Determinar el riesgo de muerte por insuficiencia cardiaca congestiva subyacente en pacientes anémicos de la población peruana. Materiales y métodos: Estudio observacional, descriptivo, de casos y controles y retrospectivo basado en datos del Sistema Informático Nacional de Defunciones (Sinadef) del Ministerio de Salud (Minsa) peruano entre enero de 2021 y agosto de 2022. El muestreo fue no probabilístico, intencional por conveniencia según los criterios de inclusión y exclusión. Se incluyó a todos los pacientes con y sin anemia que fallecieron por insuficiencia cardiaca congestiva u otras comorbilidades, que sumaron un total de 35 724 personas. Las variables fueron anemia, definida como un trastorno del tamaño o número de hematíes, de la hemoglobina, así como de la absorción y disponibilidad del hierro, e insuficiencia cardiaca congestiva, definida como la incapacidad del miocardio para bombear sangre de forma competente. Se realizó la prueba de chi al cuadrado y de los coeficientes Phi y V de Cramer para determinar la existencia y grado de asociación de las variables y la razón de probabilidades para la estimación del riesgo. Se consideró un valor de p significativo menor del 0,05, con un intervalo de confianza al 95 %. Resultados: La anemia estuvo moderadamente asociada a la insuficiencia cardiaca congestiva: fallecieron 62,80 % de personas con anemia. Las variables están estadísticamente relacionadas y, según los coeficientes Phi y V de Cramer, se trata de una relación moderada. Se halló que los anémicos tuvieron 11,14 veces mayor riesgo de morir por insuficiencia cardiaca congestiva que las personas con otras comorbilidades. Conclusiones: La anemia se asocia a un alto riesgo de muerte por insuficiencia cardiaca subyacente en la población peruana. Es necesario el seguimiento de los niveles de hierro, hemoglobina y hematíes en pacientes con insuficiencia cardiaca, así como tratar las causas de estas deficiencias, con el objetivo de reducir la morbimortalidad en este grupo de pacientes.

Objective: To determine the risk of death from underlying congestive heart failure among Peruvian patients with anemia. Materials and methods: An observational, descriptive, case-control and retrospective study based on data from the Sistema Informático Nacional de Defunciones (SINADEF National Death Computer System) of the Ministry of Health of Peru (MINSA) and conducted between January 2021 and August 2022. A non-probability purposive convenience sampling was used considering the inclusion and exclusion criteria. All patients with and without anemia who died from congestive heart failure or other comorbidities were included in the research, totaling 35,724 people. The variables were anemia, defined as a condition related to the amount or number of red blood cells and hemoglobin, as well as to iron absorption and availability, and congestive heart failure, defined as the inability of the myocardium to pump blood efficiently. Chi-square test and phi and Cramer's V coefficients were used to determine the presence and degree of association of the variables and the odds ratio for risk estimation. A significant p value less than 0.05 with a 95 % confidence interval was considered. Results: Anemia was moderately associated with congestive heart failure: 62.80 % of people with anemia died from this disease. The variables were statistically related and, according to phi and Cramer's V coefficients, there was a moderate relationship. People with anemia had 11.14 times higher risk of dying from congestive heart failure than people with other comorbidities. Conclusions: Anemia is associated with high risk of death from underlying heart failure in the Peruvian population. It is necessary to monitor iron, hemoglobin and red blood cell levels among patients with heart failure, as well as to identify the causes of these deficiencies in order to reduce morbidity and mortality in this group of patients.

Caracterización de la mortalidad por accidentes en Cuba en el decenio 2010-2019

Fundamento: los accidentes constituyen cadenas de eventos y circunstancias que llevan a la ocurrencia de lesiones no intencionales. Son responsables de numerosas muertes cada año en el mundo. En el año 2019, los accidentes del tránsito y las caídas estuvieron entre las primeras 20 causas de muerte. En Cuba se erigieron como la quinta causa de mortalidad por todas las causas y edades en el decenio 2010-2019. Objetivo: caracterizar la mortalidad por accidentes en Cuba en el decenio 2010- 2019. Métodos: se realizó un estudio ecológico, longitudinal, descriptivo, de la mortalidad anual por accidentes en Cuba, a lo largo del decenio que comprende los años 2010 al 2019. Los anuarios estadísticos, publicados desde el año 2012 al 2022, por la Dirección de Registros Médicos y Estadísticas de Salud, del Ministerio de Salud Pública de Cuba, constituyeron la principal fuente de información. Para su procesamiento estadístico, los datos obtenidos fueron incluidos en una hoja de cálculo en Microsoft Excel y los resultados se expresaron en figuras y tablas. Resultados: las tasas brutas de mortalidad por accidentes en Cuba en el decenio 2010- 2019 se incrementaron de 43 a 49,9 por 100 000 habitantes, las más elevadas fueron por caídas: 23,7 en el año 2018 y 23,4 por 100 000 habitantes en el 2019. Los años de vida potencialmente perdidos por accidentes disminuyeron de 5,4 a 4,7 por 1 000 habitantes de 1 a 74 años. Conclusiones: en Cuba, en el decenio 2010- 2019, se observó un aumento en la mortalidad por accidentes a expensas de las caídas accidentales, estas con mayor frecuencia en el sexo femenino.

Background: accidents constitute chains of events and circumstances that lead to the occurrence of unintentional injuries. They are responsible for numerous deaths every year in the world. In 2019, traffic accidents and falls were among the top 20 causes of death. In Cuba, they stood as the fifth cause of mortality from all causes and ages in the decade 2010-2019. Objective: to characterize mortality from accidents in Cuba in the 2010-2019 decade. Methods: an ecological, longitudinal, descriptive study of annual mortality due to accidents in Cuba was carried out, throughout the decade from 2010 to 2019. The statistical yearbooks, published from 2012 to 2022, by the Directorate of Medical Records and Health Statistics, from the Ministry of Public Health of Cuba, constituted the main source of information. For its statistical processing, the data obtained were included in a spreadsheet in Microsoft Excel and the results were expressed in figures and tables. Results: the gross mortality rates due to accidents in Cuba in the 2010-2019 decade increased from 43 to 49.9 per 100,000 inhabitants, the highest being due to falls: 23.7 in 2018 and 23.4 per 100 000 inhabitants in 2019. The years of potential life lost due to accidents decreased from 5.4 to 4.7 per 1,000 inhabitants between 1 and 74 years of age. Conclusions: in Cuba, in the 2010-2019 decade, an increase in mortality from accidents was observed at the expense of accidental falls, these more frequently in the female sex.

Common Causes of Neonatal Death in Calabar, South-South Nigeria: An Autopsy Study

Background: Neonatal deaths are deaths of live born babies occurring before 28 completed days. The vast majority occur in low-income countries like Nigeria with a high neonatal mortality rate. There is paucity of autopsy studies due to refusal of family to give consent for such procedures. Aim: To identify the commonest causes of neonatal death in 53 neonatal autopsies in Calabar, Nigeria. Materials and Methods: Detailed postmortem was carried out using lettules techniques and bits taken for histological analysis to ascertain the cause of death. Other relevant contributory factors such as the gestational age, mode of delivery, place of birth, antemortem cause of deaths and maternal obstetric history were obtained from the medical records and autopsy request forms. Results: In the one-year retrospective study of 53 neonatal autopsies, male: female ratio was 1: 0.83 and mean age at death was 6.5 + 7.3 days, ranging from 1 to 28 days. The commonest cause of neonatal death was severe birth asphyxia seen in 10 cases (18.9%), followed by kernicterus in 6 cases (11.3%), birth trauma seen in 6 cases (11.3%), congenital heart disease seen in 5 cases (9.4%), and prematurity seen in 5 cases (9.4%). Conclusion: The study confirms the usefulness of neonatal autopsy in ascertaining the definitive cause of death. Severe birth Asphyxia was identified as the commonest cause of death in the neonatal period followed by birth trauma, kernicterus and congenital heart diseases.

Accuracy of mortality indicators due sepsis-associated deaths in the Federal District / Acurácia dos indicadores de mortalidade devido a sepse dos óbitos ocorridos no Distrito Federal / Precisión de los indicadores de mortalidad por sepsis de las defunciones ocurridas en el Distrito Federal

Background: Sepsis currently represents a challenge for health systems, this fact may be related to the spread of bacterial resistance, the increase in the population of elderly, immunosuppressed individuals, and the improvement of emergency care, favoring the survival of critically ill patients. This article aimed to evaluate the accuracy of mortality indicators due to sepsis in 2018. Method: Validation study of death certificates that occurred in the Federal District in 2018. Declarations whose basic causes of death identified were classified as garbage codes were identified, which were investigated by a multidisciplinary team, capable of reclassifying them with codes that allow for the improvement of health data. In order to assess accuracy, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of death certificates from sepsis were calculated, with 95% confidence intervals. Results: A total of 6.244 statements were evaluated, of which 233 (3.74%) presented sepsis as the underlying cause before being investigated and only 35 (0.56%) maintained it after the investigation. The filling of statements with sepsis as the underlying cause by physicians showed a sensitivity of 0.9% (95%CI: 0.6 to 1.3) and a specificity of 92.0% (95%CI: 90.9 to 93.1). Conclusion: The low accuracy of the declarations demonstrates the non-reliability of the underlying cause of death from sepsis, especially the completion of death certificates that occurred in the Federal District in 2018.(AU)

Justificativa: A sepse, atualmente, representa um desafio para os sistemas de saúde, tal fato pode estar relacionado com a disseminação da resistência bacteriana, o aumento da população de idosos, os indivíduos imunossuprimidos, e a melhoria do atendimento de emergência, favorecendo a sobrevivência de pacientes críticos. Este artigo teve por objetivo avaliar a acurácia dos indicadores de mortalidade devido à sepse em 2018. Método: Estudo de validação da causa básica dos óbitos ocorridos no Distrito Federal em 2018. Foram identificadas as declarações de óbito cujas causas básicas de morte apontadas foram classificadas como garbage code sepse, as quais foram investigadas por uma equipe multidisciplinar, capacitada para reclassificá-las com códigos que permitem o aprimoramento dos dados em saúde. A fim de avaliar a acurácia, foram calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo, razões de verossimilhança positiva e negativa das declarações dos óbitos por sepse, com intervalos de confiança de 95%. Resultados: Um total de 6.244 declarações foram avaliadas, das quais 233 (3,74%) apresentavam a sepse como causa básica antes de serem investigadas e apenas 35 (0,56%) mantiveram-na após a investigação. O preenchimento das declarações com a sepse enquanto causa básica pelos médicos apresentou sensibilidade de 0,9% (IC95%: 0,6 a 1,3) e especificidade de 92,0% (IC95%: 90,9 a 93,1). Conclusão: A baixa acurácia das declarações demonstra a não fidedignidade da causa básica de óbito por sepse, sobretudo, do preenchimento das declarações dos óbitos ocorridos no Distrito Federal em 2018.(AU)

Justificación: Sepsis representa en la actualidad un desafío para los sistemas de salud, este hecho puede estar relacionado con propagación de resistencias bacterianas, aumento de la población de ancianos, inmunodeprimidos, y mejora de la atención de urgencias, favoreciendo la supervivencia de los pacientes críticos. Este artículo tuvo como objetivo evaluar la precisión de los indicadores de mortalidad por sepsis en 2018. Método: Estudio de validación de causa básica de muertes ocurridas en Distrito Federal en 2018. Se identificaron actas de defunción cuyas causas básicas de muerte fueron clasificadas como sepsis código basura y fueron investigadas por un equipo multidisciplinario capacitado para reclasificarlas con códigos que permitan la mejora de datos de salud. Para evaluar la precisión, se calcularon sensibilidad, especificidad, valores predictivos positivo y negativo y razones de verosimilitud positiva y negativa de certificados de defunción por sepsis, con intervalos de confianza del 95%. Resultados: se evaluaron 6.244 declaraciones, de las cuales 233 (3,74%) tenían como causa básica la sepsis antes de ser investigadas y solo 35 (0,56%) mantuvieron después de investigación. Realización de declaraciones con sepsis como causa subyacente por parte de los médicos mostró sensibilidad del 0,9% (95%IC: 0,6 a 1,3) y especificidad del 92,0% (95%IC: 90,9 a 93,1). Conclusión: Baja precisión de las declaraciones demuestra la poca confiabilidad de la causa subyacente de muerte por sepsis, especialmente la finalización de los certificados de defunción ocurridos en Distrito Federal en 2018.(AU)

De que morrem as crianças de 5 a 14 anos no estado do Rio de Janeiro? Análise do período 2000-2019 / What do children aged 5 to 14 years die from in the state of Rio de Janeiro, Brazil? Trend analysis of the period 2000-2019

Resumo Objetivou-se investigar a magnitude e a tendência da mortalidade de crianças de 5 a 14 anos por causas, no estado do Rio de Janeiro, de 2000 a 2019. Estudo ecológico de tendência temporal utilizando dados do Sistema de Informações sobre Mortalidade (SIM). Calcularam-se taxas de mortalidade por 100 mil crianças, por capítulos, grupos e categorias (CID-10). Estimou-se a série temporal por regressão joinpoint. As taxas de mortalidade de 10 a 14 anos foram superiores às da faixa de 5 a 9 anos. As cinco principais causas foram as mesmas de 5 a 14 anos, com diferente ordem de importância. As duas principais foram causas externas e neoplasias (31% e 15% para 5 a 9 anos; 45% e 11% para 10 a 14 anos). De 5 a 9 anos, a tendência da mortalidade teve declínio anual (8%) entre 2011 e 2015. De 10 a 14 anos, o declínio anual foi 1,3%, de 2000 a 2019. A mortalidade por causas externas decresceu em ambas as faixas, menos para a categoria "Agressão por arma de fogo" (meninos,10-14 anos) e "Afogamento" (meninos, 5-9 anos). A mortalidade por neoplasias ficou estável para todos. Doenças infecciosas e respiratórias decresceram de forma diferenciada entre os grupos. A maioria das causas de morte é evitável ou tratável, apontando necessidade de investimentos em saúde e intersetoriais.

Abstract This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category "Assault by unspecified firearm" (boys, 10 to 14 years) and "Unspecified drowning and submersion" (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.

Óbitos por condições de saúde posteriores à COVID-19 no Brasil / Deaths from post-COVID conditions in Brazil

Resumo O objetivo deste artigo é avaliar a magnitude e o perfil dos óbitos por condições posteriores à COVID-19 no Brasil. Estudo descritivo com base nos dados preliminares de registro de óbitos do Sistema de Informação sobre Mortalidade ocorridos em 2021. Foram considerados os registros com código CID B94.8 como causa básica e com código U09 em alguma linha da parte I ou II da declaração de óbito. Foi avaliada a distribuição dos óbitos por região geográfica, semestre de ocorrência, sexo, faixa etária, raça/cor, escolaridade e local de ocorrência. Foram registrados 2.948 óbitos por condições posteriores à COVID-19, variando de 0,5 óbito por 1.000 registros na região Nordeste a 3,6/1.000 na região Centro-Oeste. Mais da metade ocorreu entre o sexo masculino (58,0%), aqueles com 60 anos ou mais de idade (66,9%) e de cor da pele branca (51,8%). Os óbitos por condições posteriores à COVID-19 apresentaram características sociodemográficas distintas entre as regiões.

Abstract This paper aims to assess the magnitude and profile of deaths from post-COVID conditions in Brazil. Descriptive study based on preliminary data from the 2021 Mortality Information System. Records with ICD code B94.8 as the Basic Cause and with code U09 in some lines of part I or II of the declaration were considered for analysis. The distribution of deaths by geographic region, semester of occurrence, sex, age group, ethnicity/skin color, schooling, and place of occurrence was evaluated. We identified 2,948 deaths from conditions subsequent to COVID-19 were recorded, ranging from 0.5 deaths per 1,000 records in the Northeast Region to 3.6/1,000 in the Midwest Region. More than half occurred among males (58.0%), those aged 60 years or older (66.9%), and whites (51.8%). Conclusion: Deaths from post-COVID conditions had distinct sociodemographic characteristics between regions.

Mortalidade de imigrantes bolivianos em São Paulo, Brasil: análise de causas evitáveis / Mortality of Bolivian immigrants in São Paulo, Brazil: analysis of avoidable causes

Resumo Objetivou-se analisar a mortalidade dos imigrantes bolivianos residentes no município de São Paulo comparada à dos brasileiros, com ênfase na análise das mortes evitáveis. Estudo descritivo dos óbitos do município de São Paulo entre 2007 e 2018 registrados no Sistema de Informações sobre Mortalidade. Foram analisados os óbitos de pessoas de 5 a 74 anos, conforme a lista de causas de mortes evitáveis por intervenções do Sistema Único de Saúde, segundo grupos e sexo; o teste de qui-quadrado foi utilizado na comparação das nacionalidades. A tendência temporal foi avaliada pela regressão de Prais-Winsten. Houve 1.123 óbitos de bolivianos e 883.116 de brasileiros, com predomínio de óbitos masculinos, com idade média ao morrer menor (-13,6 anos) para bolivianos. A proporção de óbitos por causas evitáveis foi semelhante entre bolivianos (71,0%) e brasileiros (72,8%) e a tendência não apresentou variação anual proporcional significante para ambas as nacionalidades. Para bolivianos, houve maior frequência de causas externas (27,6%) e de causas reduzíveis por ações de promoção, prevenção, controle e atenção às doenças infecciosas (20,8%). Os bolivianos exibiram mortalidade mais jovem, sem redução na proporção de causas evitáveis, o que pode indicar acesso desigual aos serviços de saúde.

Abstract The objective was to analyze the mortality of Bolivian immigrants compared to the Brazilian population, living in the city of São Paulo, with an emphasis on the analysis of avoidable deaths. Descriptive study of deaths in the city of São Paulo, between 2007 and 2018, registered in the Mortality Information System. Deaths of people aged 5 to 74 years were analyzed, according to "Brazilian List of Causes of Preventable Deaths", according to groups and sex; Pearson's chi-square test was used to compare nationalities. The temporal trend of avoidable deaths was evaluated by Prais-Winsten regression. There were 1.123 Bolivians deaths and 883.116 among Brazilians, with a predominance of male deaths and the Bolivians died on average 13.6 years younger. The proportion of deaths from preventable causes was similar between Bolivians (71.0%) and Brazilians (72.8%) and the trend did not show significant proportional annual variation for both nationalities. There is a higher frequency, among Bolivians, of external causes (27.6%) and of causes reducible by actions to health promotion, prevention, control, and care for infectious diseases (20.8%) than to Brazilians. Conclusion: Bolivians died younger and showed no reduction in the proportion of potentially avoidable causes, which may indicate unequal access to health services.