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Hansen K, Schwartzman A, Schwarz L, Teyton A, Basu R, Benmarhnia T. The spatial distribution of heat related hospitalizations and classification of the most dangerous heat events in California at a small-scale level. ENVIRONMENTAL RESEARCH 2024; 261:119667. [PMID: 39067799 DOI: 10.1016/j.envres.2024.119667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/29/2024] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
Many studies have explored the impact of extreme heat on health, but few have investigated localized heat-health outcomes across a wide area. We examined fine-scale variability in vulnerable areas, considering population distribution, local weather, and landscape characteristics. Using 36 different heat event definitions, we identified the most dangerous types of heat events based on minimum, maximum, and diurnal temperatures with varying thresholds and durations. Focusing on California's diverse climate, elevation, and population distribution, we analyzed hospital admissions for various causes of admission (2004-2013). Our matching approach identified vulnerable zip codes, even with small populations, on absolute and relative scales. Bayesian Hierarchical models leveraged spatial correlation. We ranked the 36 heat event types by attributable hospital admissions per zip code and provided code, simulated data, and an interactive web app for reproducibility. Our findings showed high variation in heat-related hospitalizations in coastal cities and substantial heat burdens in the Central Valley. Diurnal heat events had the greatest impact in the Central Valley, while nighttime extreme heat events drove burdens in the southeastern desert. This spatially informed approach guides local policies, prioritizing dangerous heat events to reduce the heat-health burden. The methodology is applicable to other regions, informing early warning systems and characterizing extreme heat impacts.
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Affiliation(s)
- Kristen Hansen
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA; Axle Research and Technology, Rockville, MD, USA
| | - Armin Schwartzman
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Lara Schwarz
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Anais Teyton
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA.
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Zeng Y, Chen H, Liu X, Song Z, Yao Y, Lei X, Lv X, Cheng L, Chen Z, Bai C, Yin Z, Lv Y, Lu J, Li J, Land KC, Yashin A, O'Rand AM, Sun L, Yang Z, Tao W, Gu J, Gottschalk W, Tan Q, Christensen K, Hesketh T, Tian XL, Yang H, Egidi V, Caselli G, Robine JM, Wang H, Shi X, Vaupel JW, Lutz MW, Nie C, Min J. Genetic associations with longevity are on average stronger in females than in males. Heliyon 2024; 10:e23691. [PMID: 38192771 PMCID: PMC10772631 DOI: 10.1016/j.heliyon.2023.e23691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/10/2024] Open
Abstract
It is long observed that females tend to live longer than males in nearly every country. However, the underlying mechanism remains elusive. In this study, we discovered that genetic associations with longevity are on average stronger in females than in males through bio-demographic analyses of genome-wide association studies (GWAS) dataset of 2178 centenarians and 2299 middle-age controls of Chinese Longitudinal Healthy Longevity Study (CLHLS). This discovery is replicated across North and South regions of China, and is further confirmed by North-South discovery/replication analyses of different and independent datasets of Chinese healthy aging candidate genes with CLHLS participants who are not in CLHLS GWAS, including 2972 centenarians and 1992 middle-age controls. Our polygenic risk score analyses of eight exclusive groups of sex-specific genes, analyses of sex-specific and not-sex-specific individual genes, and Genome-wide Complex Trait Analysis using all SNPs all reconfirm that genetic associations with longevity are on average stronger in females than in males. Our discovery/replication analyses are based on genetic datasets of in total 5150 centenarians and compatible middle-age controls, which comprises the worldwide largest sample of centenarians. The present study's findings may partially explain the well-known male-female health-survival paradox and suggest that genetic variants may be associated with different reactions between males and females to the same vaccine, drug treatment and/or nutritional intervention. Thus, our findings provide evidence to steer away from traditional view that "one-size-fits-all" for clinical interventions, and to consider sex differences for improving healthcare efficiency. We suggest future investigations focusing on effects of interactions between sex-specific genetic variants and environment on longevity as well as biological function.
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Affiliation(s)
- Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA, 27710
| | - Huashuai Chen
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China
- Business School of Xiangtan University, Xiangtan, 411105, China
| | | | - Zijun Song
- The First Affiliated Hospital, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yao Yao
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA, 27710
| | - Xiaoyan Lei
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA, 27710
| | - Xiaozhen Lv
- French National Institute of Health and Medical Research (INSERM) and Ecole Pratique des Hautes Etudes (EPHE) FR, Italy
| | - Lingguo Cheng
- School of Business, Nanjing University, Nanjing, 210093, China
| | | | - Chen Bai
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA, 27710
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jiehua Lu
- Department of Sociology, Peking University, Beijing, 100871, China
| | - Jianxin Li
- Department of Sociology, Peking University, Beijing, 100871, China
| | - Kenneth C. Land
- Duke Population Research Institute's Center for Population Health and Aging, Duke University, Durham, NC, USA, 27710
| | - Anatoliy Yashin
- Duke Population Research Institute's Center for Population Health and Aging, Duke University, Durham, NC, USA, 27710
| | - Angela M. O'Rand
- Duke Population Research Institute's Center for Population Health and Aging, Duke University, Durham, NC, USA, 27710
| | - Liang Sun
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, 100730, China
| | - Ze Yang
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, 100730, China
| | - Wei Tao
- School of Life Sciences, Peking University, Beijing, 100871, China
| | - Jun Gu
- School of Life Sciences, Peking University, Beijing, 100871, China
| | - William Gottschalk
- Department of Neurology, Medical Center, Duke University, Durham, NC, USA, 27710
| | - Qihua Tan
- University of Southern Denmark, Odense, DK-5000, Denmark
| | | | - Therese Hesketh
- Institute for Global Health, University College London, London, UK
- Institute for Global Health, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Xiao-Li Tian
- Human Aging Research Institute and School of Life Science, Nanchang University, Jiangxi, 330031, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen, 518083, China
- James D. Watson Institute of Genome Sciences, Hangzhou 310008, China310058
| | - Viviana Egidi
- Department of Statistical Sciences, University of Rome La Sapienza, Roma, 00161, Italy
| | - Graziella Caselli
- Department of Statistical Sciences, University of Rome La Sapienza, Roma, 00161, Italy
| | - Jean-Marie Robine
- French National Institute of Health and Medical Research (INSERM) and Ecole Pratique des Hautes Etudes (EPHE) FR, Italy
| | - Huali Wang
- The Third Affiliated Hospital of Health Science Center, Peking University, Italy
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | | | - Michael W. Lutz
- Department of Neurology, Medical Center, Duke University, Durham, NC, USA, 27710
| | - Chao Nie
- BGI-Shenzhen, Shenzhen, 518083, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, China
| | - Junxia Min
- The First Affiliated Hospital, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
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Lévy L, Robine JM, Rey G, Méndez Turrubiates RF, Quijal-Zamorano M, Achebak H, Ballester J, Rodó X, Herrmann FR. Daylight saving time affects European mortality patterns. Nat Commun 2022; 13:6906. [PMID: 36372798 PMCID: PMC9659560 DOI: 10.1038/s41467-022-34704-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/03/2022] [Indexed: 11/15/2022] Open
Abstract
Daylight saving time (DST) consists in a one-hour advancement of legal time in spring offset by a backward transition of the same magnitude in fall. It creates a minimal circadian misalignment that could disrupt sleep and homoeostasis in susceptible individuals and lead to an increased incidence of pathologies and accidents during the weeks immediately following both transitions. How this shift affects mortality dynamics on a large population scale remains, however, unknown. This study examines the impact of DST on all-cause mortality in 16 European countries for the period 1998-2012. It shows that mortality decreases in spring and increases in fall during the first two weeks following each DST transition. Moreover, the alignment of time data around DST transition dates revealed a septadian mortality pattern (lowest on Sundays, highest on Mondays) that persists all-year round, irrespective of seasonal variations, in men and women aged above 40.
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Affiliation(s)
- Laurent Lévy
- Medical School of the University of Geneva, Geneva, Switzerland
| | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
- École Pratique des Hautes Études, Paris, France
| | | | | | | | | | | | - Xavier Rodó
- ISGlobal, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Catalonia, Spain
| | - François R Herrmann
- Medical School of the University of Geneva, Geneva, Switzerland.
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland.
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Rodrigues M, Santana P, Rocha A. Modelling of Temperature-Attributable Mortality among the Elderly in Lisbon Metropolitan Area, Portugal: A Contribution to Local Strategy for Effective Prevention Plans. J Urban Health 2021; 98:516-531. [PMID: 33844122 PMCID: PMC8040763 DOI: 10.1007/s11524-021-00536-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/21/2022]
Abstract
Epidemiological studies on the impact of determining environmental factors on human health have proved that temperature extremes and variability constitute mortality risk factors. However, few studies focus specifically on susceptible individuals living in Portuguese urban areas. This study aimed to estimate and assess the health burden of temperature-attributable mortality among age groups (0-64 years; 65-74 years; 75-84 years; and 85+ years) in Lisbon Metropolitan Area, from 1986-2015. Non-linear and delayed exposure-lag-response relationships between temperature and mortality were fitted with a distributed lag non-linear model (DLNM). In general, the adverse effects of cold and hot temperatures on mortality were greater in the older age groups, presenting a higher risk during the winter season. We found that, for all ages, 10.7% (95% CI: 9.3-12.1%) deaths were attributed to cold temperatures in the winter, and mostly due to moderately cold temperatures, 7.0% (95% CI: 6.2-7.8%), against extremely cold temperatures, 1.4% (95% CI: 0.9-1.8%). When stratified by age, people aged 85+ years were more burdened by cold temperatures (13.8%, 95% CI: 11.5-16.0%). However, for all ages, 5.6% of deaths (95% CI: 2.7-8.4%) can be attributed to hot temperatures. It was observed that the proportion of deaths attributed to exposure to extreme heat is higher than moderate heat. As with cold temperatures, people aged 85+ years are the most vulnerable age group to heat, 8.4% (95% CI: 3.9%, 2.7%), and mostly due to extreme heat, 1.3% (95% CI: 0.8-1.8%). These results provide new evidence on the health burdens associated with alert thresholds, and they can be used in early warning systems and adaptation plans.
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Affiliation(s)
- Mónica Rodrigues
- Department of Geography and Tourism, Centre of Studies on Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal.
| | - Paula Santana
- Department of Geography and Tourism, Centre of Studies on Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal
| | - Alfredo Rocha
- Department of Physics, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
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5
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Arifwidodo SD, Chandrasiri O. Urban heat stress and human health in Bangkok, Thailand. ENVIRONMENTAL RESEARCH 2020; 185:109398. [PMID: 32203732 DOI: 10.1016/j.envres.2020.109398] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 06/10/2023]
Abstract
Heat stress has been recognized as one of the consequences of climate change in urban areas. Its adverse effects on the urban population range from economy, social, environment, and human health. With the increasing urbanization and economic development in cities, heat stress is expected to worsen. This particular study aims to achieve two objectives: (1) to understand the determinants of heat stress, especially the roles of the urban environment in exacerbating the heat stress, and (2) to explore the effects of heat stress to human health using self-reported health assessment. We employed a cross-sectional study using a survey questionnaire from 505 respondents living in the urban area of Bangkok, Thailand. We found that socioeconomic conditions of the individual and urban environment were significant determinants of urban heat stress. Low-income urban populations living in high-density areas with less green open space were more likely to experience heat stress. We also found that heat stress significantly affects human health. Those who reported a higher level of heat stress were more likely to have adverse health and well-being outcomes. The findings suggest that the increased risk of heat stress represents a major problem in the Bangkok, Thailand. It is necessary to address heat stress in adaptation policy and measures at the city levels amid the continued increase of global temperature and climate change.
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Affiliation(s)
- Sigit D Arifwidodo
- Department of Landscape Architecture, Faculty of Architecture, Kasetsart University, Thailand.
| | - Orana Chandrasiri
- International Health Policy Program, Ministry of Public Health, Thailand
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6
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Effects of Orientations, Aspect Ratios, Pavement Materials and Vegetation Elements on Thermal Stress inside Typical Urban Canyons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193574. [PMID: 31554334 PMCID: PMC6801860 DOI: 10.3390/ijerph16193574] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/15/2019] [Accepted: 09/17/2019] [Indexed: 01/03/2023]
Abstract
The analysis of local climate conditions to test artificial urban boundaries and related climate hazards through modelling tools should become a common practice to inform public authorities about the benefits of planning alternatives. Different finishing materials and sheltering objects within urban canyons (UCs) can be tested, predicted and compared through quantitative and qualitative understanding of the relationships between the microclimatic environment and subjective thermal assessment. This process can work as support planning instrument in the early design phases as has been done in this study that aims to analyze the thermal stress within typical UCs of Bilbao (Spain) in summertime through the evaluation of Physiologically Equivalent Temperature using ENVI-met. The UCs are characterized by different orientations, height-to-width aspect ratios, pavement materials, trees’ dimensions and planting pattern. Firstly, the current situation was analyzed; secondly, the effects of asphalt and red brick stones as streets’ pavement materials were compared; thirdly, the benefits of vegetation elements were tested. The analysis demonstrated that orientation and aspect ratio strongly affect the magnitude and duration of the thermal peaks at pedestrian level; while the vegetation elements improve the thermal comfort up to two thermophysiological assessment classes. The outcomes of this study, were transferred and visualized into green planning recommendations for new and consolidated urban areas in Bilbao.
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7
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Ballester J, Robine JM, Herrmann FR, Rodó X. Effect of the Great Recession on regional mortality trends in Europe. Nat Commun 2019; 10:679. [PMID: 30737401 PMCID: PMC6368579 DOI: 10.1038/s41467-019-08539-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/08/2022] Open
Abstract
Previous studies have consistently shown the recurrent relationship between macroeconomic cycles and changes in mortality trends, so that recessions are generally associated with periods of faster life expectancy rise, and periods of economic growth with slower reductions or even increases in mortality trends. Here we analyze the link between annual per capita estimates of gross domestic product and daily atmospheric temperatures and standardized death rates for a large ensemble of European regions to describe the effect of the Great Recession on annual and seasonal changes in all-cause human mortality trends. Results show that the countries and regions with the largest (smallest) economic slowdown were also those with the largest (smallest) strengthening of the declining mortality trend. This procyclical evolution of mortality rates is found to be stronger during the cold part of the year, showing that it also depends on the seasonal timing of the underlying causes of death.
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Affiliation(s)
- Joan Ballester
- Climate and Health Program, Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain.
| | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
- École Pratique des Hautes Études, Paris, France
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thonex, Switzerland
| | - Xavier Rodó
- Climate and Health Program, Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- ICREA, Barcelona, Catalonia, Spain
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Nuvolone D, Petri D, Voller F. The effects of ozone on human health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:8074-8088. [PMID: 28547375 DOI: 10.1007/s11356-017-9239-3] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/09/2017] [Indexed: 04/16/2023]
Abstract
Ozone is a highly reactive, oxidative gas associated with adverse health outcome, including mortality and morbidity. Data from monitoring sites worldwide show levels of ozone often exceeding EU legislation threshold and the more restrictive WHO guidelines for the protection of human health. Well-established evidence has been produced for short-term effects, especially on respiratory and cardiovascular systems, associated to ozone exposure. Less conclusive is the evidence for long-term effects, reporting suggestive associations with respiratory mortality, new-onset asthma in children and increased respiratory symptom effects in asthmatics. The growing epidemiological evidence and the increasing availability of routinely collected data on air pollutant concentrations and health statistics allow to produce robust estimates in health impact assessment routine. Most recent estimates indicate that in 2013 in EU-28, 16,000 premature deaths, equivalent to 192,000 years of life lost, are attributable to ozone exposure. Italy shows very high health impact estimates among EU countries, reporting 3380 premature deaths and 61 years of life lost (per 100,000 inhabitants) attributable to ozone exposure.
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Affiliation(s)
- Daniela Nuvolone
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy.
| | - Davide Petri
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
| | - Fabio Voller
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
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9
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Mortality during heatwaves 2003–2015 in Frankfurt-Main – the 2003 heatwave and its implications. Int J Hyg Environ Health 2018; 221:81-86. [DOI: 10.1016/j.ijheh.2017.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/12/2017] [Accepted: 10/12/2017] [Indexed: 11/21/2022]
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10
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Summertime, and the livin’ is easy: Winter and summer pseudoseasonal life expectancy in the United States. DEMOGRAPHIC RESEARCH 2017. [DOI: 10.4054/demres.2017.37.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Modeling Human Mortality from All Diseases in the Five Most Populated Countries of the European Union. Bull Math Biol 2017; 79:2558-2598. [PMID: 28887745 DOI: 10.1007/s11538-017-0341-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 08/25/2017] [Indexed: 12/27/2022]
Abstract
Age affects mortality from diseases differently than it affects mortality from external causes, such as accidents. Exclusion of the latter leads to the "all-diseases" category. The age trajectories of mortality from all diseases are studied in the five most populated countries of the EU, and the shape of these 156 age trajectories is investigated in detail. The arithmetic mean of ages where mortality reaches a minimal value is 8.47 years with a 95% confidence interval of [8.08, 8.85] years. Two simple deterministic models fit the age trajectories on the two sides of the mortality minimum. The inverse relationship is valid in all cases prior to this mortality minimum and death rates exactly decreased to three thousandths of its original size during the first 3000 days. After the mortality minimum, the standard Gompertz model fits the data in 63 cases, and the Gompertz model extended by a small quadratic element fits the remaining 93 cases. This analysis indicates that the exponential increase begins before the age of 15 years and that it is overshadowed by non-biological causes. Therefore, the existence of a mechanism switching that would explain the exponential increase in mortality after the age of 35 years is unlikely.
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Benmarhnia T, Kihal-Talantikite W, Ragettli MS, Deguen S. Small-area spatiotemporal analysis of heatwave impacts on elderly mortality in Paris: A cluster analysis approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 592:288-294. [PMID: 28319715 DOI: 10.1016/j.scitotenv.2017.03.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/21/2017] [Accepted: 03/10/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Heat-waves have a substantial public health burden. Understanding spatial heterogeneity at a fine spatial scale in relation to heat and related mortality is central to target interventions towards vulnerable communities. OBJECTIVES To determine the spatial variability of heat-wave-related mortality risk among elderly in Paris, France at the census block level. We also aimed to assess area-level social and environmental determinants of high mortality risk within Paris. METHODS We used daily mortality data from 2004 to 2009 among people aged >65 at the French census block level within Paris. We used two heat wave days' definitions that were compared to non-heat wave days. A Bernoulli cluster analysis method was applied to identify high risk clusters of mortality during heat waves. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the mortality risk. RESULTS The spatial approach revealed a spatial aggregation of death cases during heat wave days. We found that small scale chronic PM10 exposure was associated with a 0.02 (95% CI: 0.001; 0.045) increase of the risk of dying during a heat wave episode. We also found a positive association with the percentage of foreigners and the percentage of labor force, while the proportion of elderly people living in the neighborhood was negatively associated. We also found that green space density had a protective effect and inversely that the density of constructed feature increased the risk of dying during a heat wave episode. CONCLUSION We showed that a spatial variation in terms of heat-related vulnerability exists within Paris and that it can be explained by some contextual factors. This study can be useful for designing interventions targeting more vulnerable areas and reduce the burden of heat waves.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health, Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Séverine Deguen
- EHESP School of Public Health-Rennes, Sorbonne-Paris Cité, France
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13
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Dolejs J, Marešová P. Onset of mortality increase with age and age trajectories of mortality from all diseases in the four Nordic countries. Clin Interv Aging 2017; 12:161-173. [PMID: 28176929 PMCID: PMC5268335 DOI: 10.2147/cia.s119327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The answer to the question "At what age does aging begin?" is tightly related to the question "Where is the onset of mortality increase with age?" Age affects mortality rates from all diseases differently than it affects mortality rates from nonbiological causes. Mortality increase with age in adult populations has been modeled by many authors, and little attention has been given to mortality decrease with age after birth. MATERIALS AND METHODS Nonbiological causes are excluded, and the category "all diseases" is studied. It is analyzed in Denmark, Finland, Norway, and Sweden during the period 1994-2011, and all possible models are screened. Age trajectories of mortality are analyzed separately: before the age category where mortality reaches its minimal value and after the age category. RESULTS Resulting age trajectories from all diseases showed a strong minimum, which was hidden in total mortality. The inverse proportion between mortality and age fitted in 54 of 58 cases before mortality minimum. The Gompertz model with two parameters fitted as mortality increased with age in 17 of 58 cases after mortality minimum, and the Gompertz model with a small positive quadratic term fitted data in the remaining 41 cases. The mean age where mortality reached minimal value was 8 (95% confidence interval 7.05-8.95) years. The figures depict an age where the human population has a minimal risk of death from biological causes. CONCLUSION Inverse proportion and the Gompertz model fitted data on both sides of the mortality minimum, and three parameters determined the shape of the age-mortality trajectory. Life expectancy should be determined by the two standard Gompertz parameters and also by the single parameter in the model c/x. All-disease mortality represents an alternative tool to study the impact of age. All results are based on published data.
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Affiliation(s)
- Josef Dolejs
- Department of Informatics and Quantitative Methods
| | - Petra Marešová
- Department of Economics, Faculty of Informatics and Management, University of Hradec Králové, Hradec Králové, Czech Republic
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Review Article: Vulnerability to Heat-related Mortality: A Systematic Review, Meta-analysis, and Meta-regression Analysis. Epidemiology 2016; 26:781-93. [PMID: 26332052 DOI: 10.1097/ede.0000000000000375] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Addressing vulnerability to heat-related mortality is a necessary step in the development of policies dictated by heat action plans. We aimed to provide a systematic assessment of the epidemiologic evidence regarding vulnerability to heat-related mortality. METHODS Studies assessing the association between high ambient temperature or heat waves and mortality among different subgroups and published between January 1980 and August 2014 were selected. Estimates of association for all the included subgroups were extracted. We assessed the presence of heterogeneous effects between subgroups conducting Cochran Q tests. We conducted random effect meta-analyses of ratios of relative risks (RRR) for high ambient temperature studies. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the RRR. RESULTS Sixty-one studies were included. Using the Cochran Q test, we consistently found evidence of vulnerability for the elderly ages >85 years. We found a pooled RRR of 0.99 (95% confidence interval [CI] = 0.97, 1.01) for male sex, 1.02 (95% CI = 1.01, 1.03) for age >65 years, 1.04 (95% CI = 1.02, 1.07) for ages >75 years, 1.03 (95% CI = 1.01, 1.05) for low individual socioeconomic status (SES), and 1.01 (95% CI = 0.99, 1.02) for low ecologic SES. CONCLUSIONS We found strongest evidence of heat-related vulnerability for the elderly ages >65 and >75 years and low SES groups (at the individual level). Studies are needed to clarify if other subgroups (e.g., children, people living alone) are also vulnerable to heat to inform public health programs.
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Verdier JM, Acquatella I, Lautier C, Devau G, Trouche S, Lasbleiz C, Mestre-Francés N. Lessons from the analysis of nonhuman primates for understanding human aging and neurodegenerative diseases. Front Neurosci 2015; 9:64. [PMID: 25788873 PMCID: PMC4349082 DOI: 10.3389/fnins.2015.00064] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/13/2015] [Indexed: 12/13/2022] Open
Abstract
Animal models are necessary tools for solving the most serious challenges facing medical research. In aging and neurodegenerative disease studies, rodents occupy a place of choice. However, the most challenging questions about longevity, the complexity and functioning of brain networks or social intelligence can almost only be investigated in nonhuman primates. Beside the fact that their brain structure is much closer to that of humans, they develop highly complex cognitive strategies and they are visually-oriented like humans. For these reasons, they deserve consideration, although their management and care are more complicated and the related costs much higher. Despite these caveats, considerable scientific advances have been possible using nonhuman primates. This review concisely summarizes their role in the study of aging and of the mechanisms involved in neurodegenerative disorders associated mainly with cognitive dysfunctions (Alzheimer's and prion diseases) or motor deficits (Parkinson's and related diseases).
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Affiliation(s)
- Jean-Michel Verdier
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Isabelle Acquatella
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Corinne Lautier
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Gina Devau
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Stéphanie Trouche
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Christelle Lasbleiz
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
| | - Nadine Mestre-Francés
- Université de Montpellier Montpellier, France ; Institut National de la Santé et de la Recherche Médicale, U1198 Montpellier, France ; Ecole Pratique des Hautes Etudes Paris, France
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Lowe R, Ballester J, Creswick J, Robine JM, Herrmann FR, Rodó X. Evaluating the performance of a climate-driven mortality model during heat waves and cold spells in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1279-94. [PMID: 25625407 PMCID: PMC4344666 DOI: 10.3390/ijerph120201279] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/19/2015] [Indexed: 11/16/2022]
Abstract
The impact of climate change on human health is a serious concern. In particular, changes in the frequency and intensity of heat waves and cold spells are of high relevance in terms of mortality and morbidity. This demonstrates the urgent need for reliable early-warning systems to help authorities prepare and respond to emergency situations. In this study, we evaluate the performance of a climate-driven mortality model to provide probabilistic predictions of exceeding emergency mortality thresholds for heat wave and cold spell scenarios. Daily mortality data corresponding to 187 NUTS2 regions across 16 countries in Europe were obtained from 1998–2003. Data were aggregated to 54 larger regions in Europe, defined according to similarities in population structure and climate. Location-specific average mortality rates, at given temperature intervals over the time period, were modelled to account for the increased mortality observed during both high and low temperature extremes and differing comfort temperatures between regions. Model parameters were estimated in a Bayesian framework, in order to generate probabilistic simulations of mortality across Europe for time periods of interest. For the heat wave scenario (1–15 August 2003), the model was successfully able to anticipate the occurrence or non-occurrence of mortality rates exceeding the emergency threshold (75th percentile of the mortality distribution) for 89% of the 54 regions, given a probability decision threshold of 70%. For the cold spell scenario (1–15 January 2003), mortality events in 69% of the regions were correctly anticipated with a probability decision threshold of 70%. By using a more conservative decision threshold of 30%, this proportion increased to 87%. Overall, the model performed better for the heat wave scenario. By replacing observed temperature data in the model with forecast temperature, from state-of-the-art European forecasting systems, probabilistic mortality predictions could potentially be made several months ahead of imminent heat waves and cold spells.
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Affiliation(s)
- Rachel Lowe
- Institut Català de Ciències del Clima (IC3), Carrer Doctor Trueta, 203, 3a, 08005 Barcelona, Spain.
| | - Joan Ballester
- Institut Català de Ciències del Clima (IC3), Carrer Doctor Trueta, 203, 3a, 08005 Barcelona, Spain.
| | - James Creswick
- World Health Organization (WHO) Regional Office for Europe, European Centre for Environment and Health, Platz der Vereinten Nationen 1, 53113 Bonn, Germany.
| | - Jean-Marie Robine
- National Institute of Health and Medical Research, INSERM U988 and U1198, Université Montpellier II, U1198 MMDN-Bâtiment 24, Place Eugène Bataillon-CC105, 34095 Montpellier Cedex 05, France.
| | - François R Herrmann
- Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Ch. Pont-Bochet, 1226 Thônex, Switzerland.
| | - Xavier Rodó
- Institut Català de Ciències del Clima (IC3), Carrer Doctor Trueta, 203, 3a, 08005 Barcelona, Spain.
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Dolejs J. Age trajectories of mortality from all diseases in the six most populated countries of the South America during the last decades. Bull Math Biol 2014; 76:2144-74. [PMID: 25124764 DOI: 10.1007/s11538-014-0005-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 07/25/2014] [Indexed: 01/19/2023]
Abstract
Age trajectories of total mortality represent an irreplaceable source of information about aging. In principle, age affects mortality from all diseases differently than it affects mortality from external causes. External causes (accidents) are excluded here from all causes, and the resultant category "all-diseases" is tested as a helpful tool to better understand the relationship between mortality and age. Age trajectories of all-diseases mortality are studied in the six most populated countries of the South America during 1996-2010. The numbers of deaths for specific causes of death are extracted from the database of WHO, where the ICD-10 revision is used. The all-diseases mortality shows a strong minimum, which is hidden in total mortality. Two simple deterministic models fit the age trajectories of all-diseases mortality. The inverse proportion between mortality and age fits the mortality decreases up to minimum value in all six countries. All previous models describing mortality decline after birth are discussed. Theoretical relationships are derived between the parameter in the first model and standard mortality indicators: Infant mortality, Neonatal mortality, and Postneonatal mortality. The Gompertz model extended with a small positive quadratic element fit the age trajectories of all-diseases mortality after the age of 10 years.
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Affiliation(s)
- Josef Dolejs
- Department of Informatics and Quantitative Methods, University of Hradec Králové, Rokitanského 62, 500 03, Hradec Králové, Czech Republic,
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Benmarhnia T, Oulhote Y, Petit C, Lapostolle A, Chauvin P, Zmirou-Navier D, Deguen S. Chronic air pollution and social deprivation as modifiers of the association between high temperature and daily mortality. Environ Health 2014; 13:53. [PMID: 24941876 PMCID: PMC4073194 DOI: 10.1186/1476-069x-13-53] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 06/05/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND Heat and air pollution are both associated with increases in mortality. However, the interactive effect of temperature and air pollution on mortality remains unsettled. Similarly, the relationship between air pollution, air temperature, and social deprivation has never been explored. METHODS We used daily mortality data from 2004 to 2009, daily mean temperature variables and relative humidity, for Paris, France. Estimates of chronic exposure to air pollution and social deprivation at a small spatial scale were calculated and split into three strata. We developed a stratified Poisson regression models to assess daily temperature and mortality associations, and tested the heterogeneity of the regression coefficients of the different strata. Deaths due to ambient temperature were calculated from attributable fractions and mortality rates were estimated. RESULTS We found that chronic air pollution exposure and social deprivation are effect modifiers of the association between daily temperature and mortality. We found a potential interactive effect between social deprivation and chronic exposure with regards to air pollution in the mortality-temperature relationship. CONCLUSION Our results may have implications in considering chronically polluted areas as vulnerable in heat action plans and in the long-term measures to reduce the burden of heat stress especially in the context of climate change.
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Affiliation(s)
- Tarik Benmarhnia
- EHESP School of Public Health, Sorbonne-Paris Cité, Rennes, France
- Université de Montréal, DSEST, Montréal, QC, Canada
| | | | - Claire Petit
- EHESP School of Public Health, Sorbonne-Paris Cité, Rennes, France
- INSERM U1085 (IRSET), Rennes, France
| | | | - Pierre Chauvin
- INSERM UMRS707, DS3, Paris, France
- UPMC Univ Paris 06, UMRS 707, Paris, France
| | - Denis Zmirou-Navier
- EHESP School of Public Health, Sorbonne-Paris Cité, Rennes, France
- INSERM U1085 (IRSET), Rennes, France
- Lorraine University Medical School, Vandœuvre-les, Nancy, France
| | - Séverine Deguen
- EHESP School of Public Health, Sorbonne-Paris Cité, Rennes, France
- INSERM U1085 (IRSET), Rennes, France
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Brunetti ND, Amoruso D, De Gennaro L, Dellegrottaglie G, Di Giuseppe G, Antonelli G, Di Biase M. Hot Spot: Impact of July 2011 Heat Wave in Southern Italy (Apulia) on Cardiovascular Disease Assessed by Emergency Medical Service and Telemedicine Support. Telemed J E Health 2014; 20:272-81. [DOI: 10.1089/tmj.2013.0086] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
| | - Daniele Amoruso
- Unità Operativa Cardiologia, Azienda Ospedaliera Policlinico, Bari, Italy
| | | | | | | | | | - Matteo Di Biase
- Department of Cardiology, University of Foggia, Foggia, Italy
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Finch CE, Beltrán-Sánchez H, Crimmins EM. Uneven futures of human lifespans: reckonings from Gompertz mortality rates, climate change, and air pollution. Gerontology 2013; 60:183-8. [PMID: 24401556 PMCID: PMC4023560 DOI: 10.1159/000357672] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 12/02/2013] [Indexed: 01/13/2023] Open
Abstract
The past 200 years have enabled remarkable increases in human lifespans through improvements in the living environment that have nearly eliminated infections as a cause of death through improved hygiene, public health, medicine, and nutrition. We argue that the limit to lifespan may be approaching. Since 1997, no one has exceeded Jeanne Calment's record of 122.5 years, despite an exponential increase of centenarians. Moreover, the background mortality may be approaching a lower limit. We calculate from Gompertz coefficients that further increases in longevity to approach a life expectancy of 100 years in 21st century cohorts would require 50% slower mortality rate accelerations, which would be a fundamental change in the rate of human aging. Looking into the 21st century, we see further challenges to health and longevity from the continued burning of fossil fuels that contribute to air pollution as well as global warming. Besides increased heat waves to which elderly are vulnerable, global warming is anticipated to increase ozone levels and facilitate the spread of pathogens. We anticipate continuing socioeconomic disparities in life expectancy.
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Affiliation(s)
- Caleb E Finch
- Davis School of Gerontology and Dornsife College, University of Southern California, Los Angeles, Calif., USA
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Kim SH, Lee SE, Hong SK, Jeong CW, Park YH, Kim YJ, Kang SH, Hong SH, Choi WS, Byun SS. Incidence and risk factors of chronic kidney disease in korean patients with t1a renal cell carcinoma before and after radical or partial nephrectomy. Jpn J Clin Oncol 2013; 43:1243-8. [PMID: 24198287 DOI: 10.1093/jjco/hyt149] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate the incidence of chronic kidney disease in patients with T1a renal cell carcinoma both before and after partial or radical nephrectomy, and to assess risk factors for chronic kidney disease. METHODS From January 2001 to December 2011, 1928 patients with a single renal mass ≤4 cm undergoing partial nephrectomy or radical nephrectomy with the existence of a normal contralateral kidney were retrospectively reviewed for the evaluation of preoperative chronic kidney disease, and reviewed only 1676 patients for the postoperative chronic kidney disease. The estimated glomerular filtration rates were used to define chronic kidney disease <60 ml/min/1.73 m(2) by the Modification of Diet in Renal Disease equation. Demographics and clinicopathological parameters were evaluated to determine the risk factors with the development of chronic kidney disease both before and after surgery. RESULTS Chronic kidney disease was found preoperatively in 10.0% (n = 192) of patients; 16.1% (n = 269) of patients developed chronic kidney disease postoperatively, including 102 (6.1%) chronic kidney disease patients >65 years of age. Between the non-chronic kidney disease and chronic kidney disease patients, male gender (odds ratio 3.55 vs. 3.78, respectively) and diagnostic age (odds ratio 1.04 vs. 1.05) were significantly distinctive common risk factors for chronic kidney disease both before and after surgery (P < 0.002). In addition, hypertension (odds ratio 0.46), serum albumin (odds ratio 0.23) and calcium (odds ratio 2.06) were significant as preoperative risk factors (P < 0.015), and preoperative serum creatinine (odds ratio 1.90) and surgical type (partial nephrectomy or radical nephrectomy; odds ratio 11.89) were significant as postoperative risk factors (P < 0.030). CONCLUSIONS Old, male hypertensive patients with a small renal mass would be better candidates for partial nephrectomy to prevent postoperative chronic kidney disease.
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Affiliation(s)
- Sung Han Kim
- *Department of Urology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 463-707, Korea.
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