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Cheon S, Li CY, Jeng JS, Wang JD, Ku LJE. Dynamic changes and lifetime effect of functional disability profiles for stroke patients: real-world evidence from South Korea. Qual Life Res 2024; 33:991-1001. [PMID: 38285281 DOI: 10.1007/s11136-023-03579-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE This work aimed to investigate the long-term dynamic changes of functional disabilities and estimate lifetime outcomes of different functional disabilities after a stroke, using real-world data from a nationally representative South Korean cohort. METHODS Patients aged 18 and above with ischemic and hemorrhagic strokes were identified from the Korea Health Panel (KHP) data (2008-2018). Functional disabilities were repeatedly measured for patients aged 55 and over for the prevalence of disabilities associated with activities of daily living (ADL), and kernel smoothing means were estimated for each item. The lifetime survival function of stroke patients in Korea was adopted from another study utilizing the National Health Insurance Service of Korea's national sample cohort. By multiplying the disability-free proportion with the survival function throughout life, disability-free life expectancy (DFLE) for each ADL item was estimated. The loss-of-DFLE was calculated by subtracting the DFLE from age-, sex-, and calendar year-matched referents simulated from Korean life tables. RESULTS The KHP dataset included 466 stroke patients. The overall functional disability needs increased over time after stroke diagnosis. DFLE was lowest for bathing (10.1 years for ischemic stroke and 12.8 years for hemorrhagic stroke), followed by those for dressing and washing. Loss-of-DFLE was highest for bathing for ischemic and hemorrhagic strokes (7.2 and 10.7 years, respectively), indicating that this task required the most assistance for stroke patients compared with the other tasks. DFLEs were slightly lower than the quality-adjusted life expectancy of stroke patients. CONCLUSION Our findings provide valuable insights for resource allocation and policy decisions in long-term stroke care, potentially enhancing the quality of life for stroke survivors and caregivers.
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Affiliation(s)
- Soyeon Cheon
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jiann-Shing Jeng
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan.
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Chang CK, Chesney E, Teng WN, Hollandt S, Pritchard M, Shetty H, Stewart R, McGuire P, Patel R. Life expectancy, mortality risks and cause of death in patients with serious mental illness in South East London: a comparison between 2008-2012 and 2013-2017. Psychol Med 2023; 53:887-896. [PMID: 37132645 PMCID: PMC9975985 DOI: 10.1017/s0033291721002257] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 05/08/2021] [Accepted: 05/20/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND People with serious mental illness (SMI) have a significantly shorter life expectancy than the general population. This study investigates whether the mortality rate in this group has changed over the last decade. METHODS Using Clinical Record Interactive Search software, we extracted data from a large electronic database of patients in South East London. All patients with schizophrenia, schizoaffective disorder or bipolar disorder from 2008 to 2012 and/or 2013 to 2017 were included. Estimates of life expectancy at birth, standardised mortality ratios and causes of death were obtained for each cohort according to diagnosis and gender. Comparisons were made between cohorts and with the general population using data obtained from the UK Office of National Statistics. RESULTS In total, 26 005 patients were included. In men, life expectancy was greater in 2013-2017 (64.9 years; 95% CI 63.6-66.3) than in 2008-2012 (63.2 years; 95% CI 61.5-64.9). Similarly, in women, life expectancy was greater in 2013-2017 (69.1 years; 95% CI 67.5-70.7) than in 2008-2012 (68.1 years; 95% CI 66.2-69.9). The difference with general population life expectancy fell by 0.9 years between cohorts in men, and 0.5 years in women. In the 2013-2017 cohorts, cancer accounted for a similar proportion of deaths as cardiovascular disease. CONCLUSIONS Relative to the general population, life expectancy for people with SMI is still much worse, though it appears to be improving. The increased cancer-related mortality suggests that physical health monitoring should consider including cancer as well.
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Affiliation(s)
- Chi-Kang Chang
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan
| | - Edward Chesney
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Wei-Nung Teng
- Department of Anaesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei City, Taiwan
| | - Sam Hollandt
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - Hitesh Shetty
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Philip McGuire
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Rashmi Patel
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Zheng Y, Ye Y, Chen L, Ma Z, Liu L, Cheng G, Xiao W, Liu Y, Liu J, Miao Q, Wei Z, Ruan H, Zhang X. Prevalence and outcomes of focal ablation versus prostatectomy for elderly patients with prostate cancer: a population-based study. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:25-32. [PMID: 39035213 PMCID: PMC11256698 DOI: 10.1016/j.jncc.2021.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 12/20/2022] Open
Abstract
Background Despite rapid advances in the treatment of prostate cancer (PCa), the optimal treatment for elderly patients with PCa remains unclear due to a lack of high-quality evidence. This study aimed to evaluate whether surgical procedures are beneficial for PCa patients aged 75 years and older and compare the effects of focal ablation and prostatectomy. Methods Male patients aged 75 years and older who were diagnosed with Tis-T2/N0/M0 PCa between 2000 and 2017 were retrospectively identified from the Surveillance, Epidemiology, and End Results program database. Cox regression models were used to test for statistical differences between the overall survival (OS) and disease-specific survival (DSS). Results A total of 114,506 patients aged 75 years and older with PCa were included in this study, among which 60,131 died during the study period. The most prevalent surgical procedure for these patients was focal ablation. The local excision rate increased with advancing age, while the prostatectomy rate decreased sharply with age. The proportion of the elderly patients who underwent a focal ablation also increased with the age at diagnosis. The survival rate of patients aged 75 years and older who underwent a focal ablation was significantly worse than that for those who did not undergo any surgical procedures (OS: HR, 1.32, P<0.001; DSS: HR, 1.58, P<0.001). Although only a few of the patients underwent prostatectomy, the procedure was still related to improved OS and DSS (OS: HR, 0.60, P< 0.001; DSS: HR, 0.37, P<0.001) rates. Conclusions Focal ablation has gradually replaced prostatectomy as the most common surgical procedure for elderly patients with PCa in the United States. However, our results revealed that the procedure might not provide benefits for elderly patients with PCa; instead, we found that focal ablation resulted in increased negative effects on patient prognoses. Elderly patients should have the same opportunity to be treated with standard surgical interventions as younger patients.
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Affiliation(s)
- Yongqiang Zheng
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yuzhong Ye
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lezong Chen
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Zikun Ma
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Lei Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gong Cheng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wen Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yuenan Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jingchong Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qi Miao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhihao Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Hailong Ruan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiaoping Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Salehi M, Aziz-Mohammdlooha M, Masaebi F, Zayeri F. Six-Decade Trend Analysis of Life Expectancy at Birth in Asia, Regions of Asia and Iran: A Joinpoint Analysis. Med J Islam Repub Iran 2022; 36:166. [PMID: 37159757 PMCID: PMC10163212 DOI: 10.47176/mjiri.36.166] [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: 05/22/2022] [Indexed: 05/11/2023] Open
Abstract
Background Life expectancy is one of the key indicators for investigating the overall health status of a population. Thus, analyzing the trend of this demographic measure is of great importance for planning health and social services in different societies. In this study, we aimed to model the trends of life expectancy in Asia, regions of Asia, and Iran over the past six decades. Methods The annual life expectancy at birth data sets were extracted for Iran and the total Asia population between 1960 and 2020 from the database provided by the Our World in Data website. The trend analysis was performed using the joinpoint regression model. Results During the study period, Iranians and Asians have, respectively, experienced about 32 and 28.6 years increase in life expectancy. The results from joinpoint regression showed that the average annual percent change (AAPC) of life expectancy was positive for all regions of Asia, and ranged from 0.4% for Central Asia to 0.9% for Southern Asia. In addition, the estimated AAPC in Iranian people was about 0.1 higher than the total Asian population (0.9% vs. 0.8%). Conclusion Despite protracted wars, poverty, and social inequality in some parts of Asia, life expectancy has drastically increased in this continent over the last decades. However, life expectancy in Asia (and Iran) is still remarkably lower than in more developed parts of the world. To elevate life expectancy to a higher level, the policymakers in Asian countries should put more effort into improving the standards of living and access to health facilities in their societies.
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Affiliation(s)
- Masoud Salehi
- Health Management and Economics Research Center, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Aziz-Mohammdlooha
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Masaebi
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author:Farid Zayeri,
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Mortality in Inflammatory Rheumatic Diseases: Lithuanian National Registry Data and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312338. [PMID: 34886062 PMCID: PMC8656671 DOI: 10.3390/ijerph182312338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 02/03/2023]
Abstract
Despite significant improvement in survival, rheumatic diseases (RD) are associated with premature mortality rates comparable to cardiovascular and neoplastic disorders. The aim of our study was to assess mortality, causes of death, and life expectancy in an inflammatory RD retrospective cohort and compare those with the general population as well as with the results of previously published studies in a systematic literature review. Patients with the first-time diagnosis of inflammatory RD during 2012-2019 were identified and cross-checked for their vital status and the date of death. Sex- and age-standardized mortality ratios (SMR) as well as life expectancy for patients with inflammatory RDs were calculated. The results of a systematic literature review were included in meta-standardized mortality ratio calculations. 11,636 patients with newly diagnosed RD were identified. During a total of 43,064.34 person-years of follow-up, 950 death cases occurred. The prevailing causes of death for the total cohort were cardiovascular diseases and neoplasms. The age- and sex-adjusted SMR for the total cohort was calculated to be 1.32 (1.23; 1.40). Patients with rheumatoid arthritis if diagnosed at age 18-19 tend to live for 1.63 years less than the general population, patients with spondyloarthritis-for 2.7 years less, patients with connective tissue diseases-for almost nine years less than the general population. The findings of our study support the hypothesis that patients with RD have a higher risk of mortality and lower life expectancy than the general population.
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Kuenzig ME, Manuel DG, Donelle J, Benchimol EI. Life expectancy and health-adjusted life expectancy in people with inflammatory bowel disease. CMAJ 2021; 192:E1394-E1402. [PMID: 33168761 DOI: 10.1503/cmaj.190976] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) may be life-threatening and often reduces quality of life. We determined trends in life expectancy and health-adjusted life expectancy in people with and without IBD. METHODS We conducted a retrospective cohort study of population-level health administrative, demographic and health survey data available from databases in Ontario. We matched people with a diagnosis of IBD to those without a diagnosis of IBD. We used period life tables that were generated using age- and sex-specific 5-year mortality rates to calculate life expectancy (for 1996, 2000, 2008 and 2011). We incorporated the Health Utility Index (National Population Health Study; Canadian Community Health Survey) to estimate health-adjusted life expectancy (for 1996, 2000 and 2008). RESULTS Life expectancy in patients with IBD increased between 1996 and 2011 (females: from 75.5 to 78.4 yr, difference: 2.9 yr [95% confidence interval (CI) 1.3 to 4.5]; males: from 72.2 to 75.5 yr, difference: 3.2 yr [95% CI 2.1 to 4.4]). Between 1996 and 2008, health-adjusted life expectancy decreased among males by 3.9 years (95% CI 1.2 to 6.6). There was no statistically significant change in health-adjusted life expectancy among females with IBD (difference: 2.0 yr, 95% CI -1.6 to 5.7). Life expectancy and health-adjusted life expectancy were lower in people with IBD compared with those without IBD. Differences in life expectancy in people with and without IBD ranged from 6.6 to 8.1 years in females and 5.0 to 6.1 years in males, depending on the year. Differences in health-adjusted life expectancy for people with and without IBD ranged from 9.5 to 13.5 years in females and 2.6 to 6.7 years in males. INTERPRETATION Whilst life expectancy has increased among people with IBD, a gap in life expectancy between those with and without IBD remains, and the effect of pain on daily functioning contributes substantially to reduced health-adjusted life expectancy, suggesting that improved pain mitigation strategies should be implemented.
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Affiliation(s)
- M Ellen Kuenzig
- Division of Gastroenterology, Hepatology and Nutrition (Benchimol), The Hospital for Sick Children, Toronto, Ont.; Children's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition (Kuenzig, Benchimol: during the conduct of the study), CHEO and CHEO Research Institute; ICES uOttawa (Kuenzig, Manuel, Donelle, Benchimol); Ottawa Hospital Research Institute (Manuel, Donelle); School of Epidemiology and Public Health (Manuel, Benchimol), University of Ottawa; Department of Pediatrics (Benchimol), University of Ottawa, Ottawa, Ont
| | - Douglas G Manuel
- Division of Gastroenterology, Hepatology and Nutrition (Benchimol), The Hospital for Sick Children, Toronto, Ont.; Children's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition (Kuenzig, Benchimol: during the conduct of the study), CHEO and CHEO Research Institute; ICES uOttawa (Kuenzig, Manuel, Donelle, Benchimol); Ottawa Hospital Research Institute (Manuel, Donelle); School of Epidemiology and Public Health (Manuel, Benchimol), University of Ottawa; Department of Pediatrics (Benchimol), University of Ottawa, Ottawa, Ont
| | - Jessy Donelle
- Division of Gastroenterology, Hepatology and Nutrition (Benchimol), The Hospital for Sick Children, Toronto, Ont.; Children's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition (Kuenzig, Benchimol: during the conduct of the study), CHEO and CHEO Research Institute; ICES uOttawa (Kuenzig, Manuel, Donelle, Benchimol); Ottawa Hospital Research Institute (Manuel, Donelle); School of Epidemiology and Public Health (Manuel, Benchimol), University of Ottawa; Department of Pediatrics (Benchimol), University of Ottawa, Ottawa, Ont
| | - Eric I Benchimol
- Division of Gastroenterology, Hepatology and Nutrition (Benchimol), The Hospital for Sick Children, Toronto, Ont.; Children's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition (Kuenzig, Benchimol: during the conduct of the study), CHEO and CHEO Research Institute; ICES uOttawa (Kuenzig, Manuel, Donelle, Benchimol); Ottawa Hospital Research Institute (Manuel, Donelle); School of Epidemiology and Public Health (Manuel, Benchimol), University of Ottawa; Department of Pediatrics (Benchimol), University of Ottawa, Ottawa, Ont.
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Perron L, Simard M, Brisson J, Hamel D, Lo E. Perron et al. Respond. Am J Public Health 2018; 108:e15. [DOI: 10.2105/ajph.2017.304269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | | | - Ernest Lo
- Linda Perron, Marc Simard, Denis Hamel, and Ernest Lo are with the Institut national de santé publique du Québec, Quebec City, Canada. Linda Perron and Jacques Brisson are with the Département de médecine sociale et préventive, Québec-Université Laval, Quebec City. Jacques Brisson is also with the Centre de recherche du CHU de Québec-Université Laval, Centre hospitalier universitaire de Québec, Quebec City. Ernest Lo is also with the Department of Epidemiology, Biostatistics, and Occupational Health,
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Steensma C, Choi BC, Loukine L, Schanzer D. Period Life Tables for Calculating Life Expectancy: Options to Assess and Minimize the Potential for Bias. Am J Public Health 2018; 108:e14. [DOI: 10.2105/ajph.2017.304268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Colin Steensma
- Colin Steensma and Lidia Loukine are with Health Canada, Ottawa, Ontario. Bernard C. K. Choi and Dena Schanzer are with the Public Health Agency of Canada, Ottawa
| | - Bernard C. K. Choi
- Colin Steensma and Lidia Loukine are with Health Canada, Ottawa, Ontario. Bernard C. K. Choi and Dena Schanzer are with the Public Health Agency of Canada, Ottawa
| | - Lidia Loukine
- Colin Steensma and Lidia Loukine are with Health Canada, Ottawa, Ontario. Bernard C. K. Choi and Dena Schanzer are with the Public Health Agency of Canada, Ottawa
| | - Dena Schanzer
- Colin Steensma and Lidia Loukine are with Health Canada, Ottawa, Ontario. Bernard C. K. Choi and Dena Schanzer are with the Public Health Agency of Canada, Ottawa
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