Document Detail


Determining stroke's rank as a cause of death using multicause mortality data.
MedLine Citation:
PMID:  22821613     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Stroke has fallen from the second to the fourth leading cause of death in the United States without large declines in stroke incidence or case fatality. We explored whether this decline may be attributable to changes in mortality attribution methodology.
METHODS: Multicause mortality files from 2000 to 2008 were used to compare changes in reporting of stroke as underlying cause of death (UCOD) with changes in death certificates reporting any mention (AMCOD) of stroke. In addition, the UCOD/AMCOD ratio was calculated for the 6 leading organ and disease-specific causes of death. If stroke mortality is underestimated by the system of mortality attribution, we hypothesized that we would find: (1) a greater decline in stroke as UCOD than as AMCOD; and (2) a decline in the UCOD/AMCOD ratio compared with other causes of death.
RESULTS: Age-adjusted death rates for stroke as UCOD (61 per 100,000 in 2000 versus 41 in 2008) and AMCOD (102 per 100,000 versus 68) both declined by 33%. The ratio of UCOD to AMCOD for stroke did not change over time (0.595 in 2000 versus 0.598 in 2008). Changes in UCOD/AMCOD ratio for the diagnoses that surpassed stroke as UCOD were too small (no change for lung cancer and a slight increase from 0.49 to 0.52 for chronic lower respiratory diseases) to explain stroke's decline as UCOD.
CONCLUSION: Changes in mortality attribution methodology are not likely responsible for stroke's decline as a leading cause of death. The discordant trends in incidence, case fatality, and mortality require further study.
Authors:
James F Burke; Lynda D Lisabeth; Devin L Brown; Matthew J Reeves; Lewis B Morgenstern
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.     Date:  2012-07-19
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-10-04     Revised Date:  2013-08-30    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2207-11     Citation Subset:  IM    
Affiliation:
Department of Veterans Affairs, Veterans Affairs Center for Clinical Management and Research, Ann Arbor VA Healthcare System, Ann Arbor, MI, USA. jamesbur@med.umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Algorithms
Cause of Death / trends*
Death Certificates
Diabetes Mellitus / mortality
Female
Humans
Lung Neoplasms / mortality
Male
Middle Aged
Stroke / epidemiology,  mortality*
United States / epidemiology
Vital Statistics
Grant Support
ID/Acronym/Agency:
K23 NS051202/NS/NINDS NIH HHS; R01 HL098065/HL/NHLBI NIH HHS; R01 NS038916/NS/NINDS NIH HHS; R01 NS062675/NS/NINDS NIH HHS; R01 NS070941/NS/NINDS NIH HHS; R01 NS38916/NS/NINDS NIH HHS; R18 HS017690/HS/AHRQ HHS; U01NS052510/NS/NINDS NIH HHS; U01NS056975/NS/NINDS NIH HHS; U01NS062835/NS/NINDS NIH HHS; U54NS057405/NS/NINDS NIH HHS
Comments/Corrections
Comment In:
Stroke. 2012 Aug;43(8):2033-4   [PMID:  22764212 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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