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1.
Epidemiol Prev ; 34(3): 109-19, 2010.
Article in Italian | MEDLINE | ID: mdl-20852348

ABSTRACT

OBJECTIVE: This study evaluates the impact of the introduction of ICD-10 on mortality statistics in Italy. DESIGN: «Bridge-Coding¼ analysis carried out by a working group that has coded a number of death certificates using both ICD-9 and ICD-10 versions. In 2006, a training project was launched in order to allow the group to standardize the coding procedures. SETTING: The study was carried out by professionals from the following regions: Emilia-Romagna, Veneto, Tuscany, Liguria; and from the towns of Biella and Milan. The analysis included 74,525 Death Certificates produced in the aforementioned areas. RESULTS: A limited variability was observed for the most important groups of diseases (diseases of the circulatory system and neoplasms), with low impact on mortality statistics. The variability was higher for "minor" diseases like infectious and respiratory diseases, and dementia. The variability was similar but not identical to that observed in other national and international studies. The «Bridge-Coding¼ analysis has a local impact. Furthermore, changes depending on the variation in the selection rules are impossible to predict or to correct with the trans-coding procedure. CONCLUSIONS: In some cases, the changes determined by the implementation of ICD-10 are not completely corrected by the transcoding procedure, even applying appropriate Comparability Ratios (CR) from «Bridge Coding¼ analysis like this. Studies on respiratory diseases, or dementia and some neoplasms require new coding procedures in only one ICD version. Quality and accuracy of the compilation of death certificates have more effect than a correct coding, though more casual and less evaluable by means of comparability studies like this one.


Subject(s)
Cause of Death , Death Certificates , International Classification of Diseases/statistics & numerical data , Mortality , Humans , Italy
2.
Coll Antropol ; 30(3): 479-88, 2006 Sep.
Article in English | MEDLINE | ID: mdl-17058511

ABSTRACT

The aim of our study is to evaluate the temporal trend of deaths in a cohort of i.v. drug users (IVDU) followed in a city of Northen Italy (Bologna), and to assess its relationship with HIV infection and AIDS, and availability of potent anti-retroviral therapy. One thousand and 214 IVDUs (mainly heroin addicts), 916 males and 298 females, attending an out-patient service for treatment and prevention of substance abuse between 1977 and November 1996, were enrolled into our observational cohort, and their vital status was ascertained up to December 31, 2002. The large majority of enrolled subjects were born in the Bologna metropolitan area and surroundings; no extra-European immigrants were present. During the observation period, 271 IVDUs (22.3%) died, 211 males (23.0%), and 60 females (20.1%). No death was recorded before 1984. Main death causes result as follows: AIDS (52.8% of episodes), heroin overdose (22.1%), street accidents (7.4%), decompensated liver cirrhosis (6.3%), and suicide (2.9%). The highest absolute number of deaths was observed between years 1991 and 1996. Crude mortality rate caused by AIDS was 10.0 per 1000 for males and 13.2/1000 for females; the rate of death due to other causes proved 11.1/1000 among males and 5.2/1000 among females. In most recent years, a sharp decrease in the number of AIDS-related deaths, attributable to the increased use of potent antiretroviral regimens, was recorded among IVDUs, although overall mortality rate remained appreciable.


Subject(s)
Acquired Immunodeficiency Syndrome/mortality , Drug Overdose/mortality , Substance Abuse, Intravenous/mortality , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/epidemiology , Adolescent , Adult , Age Distribution , Antiretroviral Therapy, Highly Active , Child , Cohort Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Sex Distribution , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/epidemiology , Urban Population
3.
Epidemiology ; 17(3): 315-23, 2006 May.
Article in English | MEDLINE | ID: mdl-16570026

ABSTRACT

BACKGROUND: Although studies have documented increased mortality during heat waves, little information is available on the subgroups most susceptible to these effects. We evaluated the effects of summertime high temperature on daily mortality among population subgroups defined by demographic characteristics, socioeconomic status, and episodes of hospitalization for various conditions during the preceding 2 years. METHODS: We studied a total of 205,019 residents of 4 Italian cities (Bologna, Milan, Rome, and Turin) age 35 or older who died during 1997-2003. The case-crossover design was applied to evaluate the association between mean apparent temperature (same and previous day) and all-cause mortality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) of dying at 30 degrees C (apparent temperature) relative to 20 degrees C were estimated accounting for time, population changes, and air pollution. RESULTS: We found an overall OR of 1.34 (CI = 1.27-1.42) at 30 degrees C relative to 20 degrees C. The odds ratio increased with age and was higher among women (OR = 1.45; 1.37-1.52) and among widows and widowers (1.50; 1.33-1.69). Low area-based income modestly increased the effect. Among the preexisting medical conditions investigated, effect modification was detected for previous psychiatric disorders (1.69; 1.39-2.07), depression (1.72; 1.24-2.39), heart conduction disorders (1.77; 1.38-2.27), and circulatory disorders of the brain (1.47; 1.34-1.62). Temperature-related mortality was higher among people residing in nursing homes, and a large effect was also detected for hospitalized subjects. CONCLUSIONS: Subsets of the population that are particularly vulnerable to high summer temperatures include the elderly, women, widows and widowers, those with selected medical conditions, and those staying in nursing homes and healthcare facilities.


Subject(s)
Heat Stroke/mortality , Urban Population , Adult , Aged , Aged, 80 and over , Cross-Over Studies , Demography , Female , Humans , Italy/epidemiology , Male , Middle Aged , Population Surveillance , Social Class
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