Mortality rate

A problem exists in the perception of risk because the experts and lay people s views differ. The experts usually base their assessment on mortality rates, while the lay people s fears are based on "outrage" factors. In order to help solve tliis problem, in tlie future, risk nimuigcrs must work to make truly serious hazards more outrageous. One example is tlie ongoing concern for tlie risk involved in cigarette smoke. Another effort must be made to decrease tlie public s concern with low to modest hazards, i.e., risk managers must diminish "outrage" in these areas. In addition, people must be treated fairly and honestly. 

Adverse consequences of drinking include a variety of social, legal, medical, and psychiatric problems (Babor et al. 1987, 2003). Alcohol is among the top four causes of mortality in 1988, 107,800 deaths, or about 5% of all deaths in the United States, were attributed to alcohol-related causes (Stinson and DeBakey 1992). Approximately 17% of alcohol-related deaths were directly attributable to alcohol, 38% resulted from diseases indirecdy attributable to alcohol, and 45% were attributable to alcohol-related traumatic injury (U.S. Department of Health and Human Services 1994). Alcohol-related mortality declined during the latter part of the twentieth century. For example, the age-adjusted mortality rate from liver cirrhosis in 1993 (7.9 deaths per 100,000 persons) was just over half the rate in 1970 (14.6 deaths per 100,000) (Saadat-mand et al. 1997), and the proportion of automobile fatalities that was related to the use of alcohol fell to a two-decade low of 33.6% in 1993 (Lane et al. 1997). 

Before 1980, the mortality rate among younger addicts was up to 20 times higher than that among control subjects it was 2—3 times higher for older ad-... 

Joe GW, Simpson DO Mortality rates among opioid addicts in a longitudinal study. AmJ Public Health 77 347-348, 1987... 

Mortality—Death mortality rate is a measure of the number of deaths in a population during a specified interval of time. 

Based on prevalence estimates and mortality rates for the French AIDS epidemic, Lambert (1995) calculated indirect cost by using the human capital approach in 1992 as US 3.054 billion. Future indirect costs up to 2020 were simulated under different scenarios of the HIV prevalence. According to a pessimistic scenario, indirect cost would rise until 2010 (US 9.381 billion) and then keep almost stable until 2020 (US 9.069 billion). If the infection rate could be reduced, indirect costs would decrease to US 1.507 billion in 2020. 

Preparations of human albumin have been widely used in the treatment of hemorrhagic shock and of burns. Flowever, this treatment is undet teview because some recent smdies have suggested that administration of albumin in these conditions may increase mortality rates. 

DNA viruses Poxviruses Variola Vaccinia Large particles 200 x 250nm complex symmetry Variola is the smallpox virus. It produces a systemic infection with a characteristic vesicular rash affecting the face, arms and legs, and has a high mortality rate. Vaccinia has been derived from the cowpox virus and is used to immunize against smallpox... 

ECASS-II was designed to test a lower dose of rt-PA (0.9 mg/kg) during the same 0-6-hours time period after stroke onset, using similar inclusion criteria as in ECASS-I. ° The primary endpoint was the proportion with a favorable outcome on the mRS scale (defined as a score of 0 or 1). There was no difference in this outcome between rt-PA-treated and placebo controls (40% vs. 37%, p = 0.28). A separate analysis of the 158 subjects enrolled within 3 hours of stroke onset also showed no difference in the proportion with a favorable outcome (42% vs. 38%, p = 0.63) this result, however, must be treated with caution because in ECASS-II there was a substantially lower number of patients treated within 3 hours of stroke onset, compared to the 1995 NINDS rt-PA study. Parenchymal hematoma on post-treatment CT was seen in 12% of rt-PA-treated and 3% of placebo patients (p < 0.001). The 90-day mortality rate was 11 % for the rt-PA group and 11 % for the placebo group (p = 0.54). Protocol violations were much less frequent in ECASS-II compared to ECASS-I (9% vs. 18%), probably because of standardized training in CT interpretation at the study sites. 

Reed SD, Cramer SC, Blough DK, Meyer K, Jarvik JG. Treatment with tissue plasminogen activator and inpatient mortality rates for patients with ischemic stroke treated in community hospitals. Stroke. 2001 32 1832-1840. 

Lisboa et al. analyzed the safety and efficacy of lAT on the basis of current published data. They found a total of 27 studies (10 patients minimum) with a total of 852 patients who received lAT and 100 control subjects. There were more favorable outcomes in the lAT than in the control group (41.5% vs. 23%), with a lower mortality rate for lAT (27.2% vs. 40%). The lAT group had an OR of 2.4 for favorable outcomes, despite a higher frequency of symptomatic ICH (9.5% vs. 3%). In addition, they found a trend toward better outcomes with combined IV rt-PA and lAT than with lAT alone. They also remarked that lAT-treated supratentorial strokes are more likely to have favorable outcomes than infratentorial ones (42.2% vs. 25.6%). 

The Penumbra stroke system (Penumbra Inc., San Leandro, CA) includes two different revascularization options (1) thrombus debulking and aspiration may be achieved by a reperfusion catheter that aspirates the clot while a separator device fragments it, and (2) direct thrombus extraction may be performed by a ring retriever while a balloon guide catheter is used to temporarily arrest flow. This system has been tested in a pilot trial in Europe. Twenty patients (mean NIHSS 21) with a total of 21 vessel occlusions (7 ICA, 5 MCA, and 9 Basilar) were treated up to 8 hours after symptom onset. Recanalization prior to lA lysis was achieved in all cases (48% TIMI 2 52% TIMI 3). Seven patients were also treated with lA UK or rt-PA. Good outcome at 30 days (defined as mRS < 2 or NIHSS 4-point improvement) was demonstrated in 42%. The mortality rate was 45%, but there were no device-related deaths. There was one asymptomatic SAH and three symptomatic ICHs. A prospective, single-arm, multicenter trial is being conducted in the United States and Europe currently. 

In rodent stroke models, statin pretreatment has been shown to reduce infarct volumes and improve outcomes. Similarly, several clinical studies have shown that prior statin use reduced the severity of acute ischemic stroke and myocardial infarction. Recent studies indicate that beneftt can be achieved even when treatment is initiated after the onset of symptoms. In rodents, atorvastatin and simvastatin have been shown to reduce the growth of ischemic lesions, enhance functional outcome, and induce brain plasticity when administered after stroke onset. A retrospective analysis of the population-based Northern Manhattan Stroke Study (NOMASS) showed that patients using lipid-lowering agents at the time of ischemic stroke have a lower incidence of in-hospital stroke progression and reduced 90-day mortality rates. Retrospective analysis of data of the phase III citicoline trial showed... 

Malignant or life-threatening MCA territory infarction occurs in up to 10% of strokes and is associated with an 80% mortality rate. Stroke progression and... 

Decompressive hemicraniectomy was indirectly compared with moderate hypothermia (33°C) in a series of 36 patients from Georgiadis et al. They found a lower mortality rate for the patients who underwent hemicraniectomy (47% vs. 12%), as well as a lower complication rate. However, this was not a randomized study, and there was no comparison arm of patients who did not undergo either experimental therapy. 

Mortality rates from CVD are generally lower in Asian populations compared to Western populations (Knight and Eden, 1996). Although many dietary factors are known to play a protective role in CVD and it has been suggested that phytoestrogen content of Asian diets may be responsible for the cardioprotective effect. 

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