Maternal ; morbidity aspects ; Aspects of mortality statistics ; Hospitals, General

Monthly demographic surveillance by local reporters was continuous in the Tari Basin from 1971 until 1995 and cause of death was determined primarily by verbal autopsy. In 1982 the de jure population was 26,500, 15% aged less than 5 years. Crude birth rate was 34/1000/annum in 1980-1984; from 1977 to 1983 crude mortality rate was 15/1000/annum and life expectancy at birth 50 years. Infant mortality fell from 160 in the 1920s to 72/1000 livebirths in the 1970s, the greatest decline occurring between 1952 and 1971 when antibiotics became widely available. Respiratory disease (particularly chronic lung disease in adults) accounted for 39% of all deaths, and pneumonia for 50% and 33% of infant and toddler deaths respectively. Very few deaths from pigbel have occurred since the introduction of pigbel vaccine. Initially childhood mortality from diarrhoea declined following introduction of an oral rehydration program but subsequently rose when medical attention was no longer sought and children were inadequately treated at home. The higher mortality in the lower-lying Iumu area was attributed to malaria. Since the opening of the Highlands Highway in 1981, there has been a dramatic increase in short-term movement of both men and women in and out of Tari resulting in increased incidence of sexually transmitted diseases and viral infections such as measles. If restored, the Tari Research Unit could continue to play a key role in assisting the Department of Health in making decisions on appropriate interventions to improve the quality of life of Papua New Guineans.
Basin ; Aspects of mortality statistics ; seconds ; Infant ; etiology

The purpose of this study was to clarify the survival rates and prognostic factors in elderly Japanese patients with hip fractures. This study investigated the outcome of 256 patients aged 60 years and older with surgically treated hip fractures. Information including age, gender, duration of hospitalization, place of residence before fracture and at discharge, and level of mobility before fracture and at discharge was obtained from patient records. The survival of the patients after discharge was determined by mail surveys supplemented with telephone inquiries.The observed survival rates were significantly lower than the expected survival rates (p<0.001, by Mantel Haenszel test). The short-term mortality rates were 6% for six months and 12.7% for one year, which were lower than previously reported rates in Western countries. Significantly higher hazard ratios (HR) for mortality adjusted for age and gender were observed in patients who had lived in places other than their own home before fracture (HR=2.67(1.63-4.3)), were discharged to places other than their own home (Nursing home HR=2.25 (1.24-4.1) or to a non-orthopedic unit (HR=5.95 (3.12-11.34)), those requiring full-time assistance for mobility at discharge (HR=5.71 (3.59-9.01)), and those who had stayed in a hospital for fewer than 40 days (HR=2.20 (1.38-3.51)). After adjusting for the effects of all the potential prognostic factors, discharge to places other than their own home and the lowest level of mobility at discharge remained significant factors causing adverse effects on survival.Therefore, to improve the prognosis, patients should be allowed to recover to a level at which they can ambulate with some assistance, enabling them return to their own homes.
survival aspects ; seconds ; Japanese language ; prognostic ; Mortality Vital Statistics

Pregnancy-related deaths in four published perioperative mortality review reports were analysed. The aim is to look at the quality of surgical and anaesthetic services along with the perioperative care provided. The audit identified shortfalls in the logistic and support services and recommended remedial strategies. The review was conducted by a committee consisting of practising anaesthetists, surgeons and obstetricians who analysed the questionnaires collectively. A consensus was reached to categorise the death. There were 280 pregnancy-related deaths. Post-partum haemorrhage accounted for 31.8%, followed by hypertensive disorders of pregnancy (20.0% obstetric embolism (16.1%), sepsis (10.7%) and associated medical conditions (21.4%). In brief, there were comings in preoperative, intra-operative and post-operative care in some of the cases. Increased consultant input, clinical audit, improvements in monitoring and expansion of critical care facilities were the integral issues recommended.
Pregnancy ; Review [Publication Type] ; Aspects of mortality statistics ; seconds ; Sepsis