https://digital.library.adelaide.edu.au/dspace/bitstream/2440/104804/2/hdl_104804.pdf

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

/pdf/cdc-guideline-for-prescribing-opioids-for-chronic-pain-48d7kdjqlr.pdf

CDC guideline for prescribing opioids for chronic pain

https://biblio.ugent.be/publication/8617256/file/8617262.pdf

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause. More often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest. Asphyxia begins with a variable period of systemic hypoxemia, hypercapnea, and acidosis, progresses to bradycardia and hypotension, and culminates with cardiac arrest.1

Another mechanism of cardiac arrest, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), is the initial cardiac rhythm in approximately 5% to 15% of pediatric in-hospital and out-of-hospital cardiac arrests;2,–,9 it is reported in up to 27% of pediatric in-hospital arrests at some point during the resuscitation.6 The incidence of VF/pulseless VT cardiac arrest rises with age.2,4 Increasing evidence suggests that sudden unexpected death in young people can be associated with genetic abnormalities in myocyte ion channels resulting in abnormalities in ion flow (see “Sudden Unexplained Deaths,” below).

Since 2010 marks the 50th anniversary of the introduction of cardiopulmonary resuscitation (CPR),10 it seems appropriate to review the progressive improvement in outcome of pediatric resuscitation from cardiac arrest. Survival from in-hospital cardiac arrest in infants and children in the 1980s was around 9%.11,12 Approximately 20 years later, that figure had increased to 17%,13,14 and by 2006, to 27%.15,–,17 In contrast to those favorable results from in-hospital cardiac arrest, overall survival to discharge from out-of-hospital cardiac arrest in infants and children has not changed substantially in 20 years and remains at about 6% (3% for infants and 9% for children and adolescents).7,9

It is unclear why the improvement in outcome from in-hospital cardiac arrest has occurred, although earlier recognition and management of at-risk patients on general inpatient units …

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.110.971101

Part 14: Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Results. Of 184 reports meeting inclusion criteria, 133 related to general anaesthesia: 46 events per million general anaesthetics [95% confidence interval (CI) 38 ‐54] or one per 22 000 (95% CI 1 per 26‐ 18 000). Anaesthesia events led to 16 deaths and three episodes of persistent brain damage: a mortality rate of 5.6 per million general anaesthetics (95% CI 2.8‐ 8.3): one per 180 000 (95% CI 1 per 352‐120 000). These estimates assume that all such cases were captured. Rates of death and brain damage for different airway devices (facemask, supraglottic airway, tracheal tube) varied little. Airway management was considered good in 19% of assessable anaesthesia cases. Elements of care were judged poor in three-quarters: in only three deaths was airway management considered exclusively good. Conclusions. Although these data suggest the incidence of death and brain damage from airway management during general anaesthesia is low, statistical analysis of the distribution of reports suggests as few as 25% of relevant incidents may have been reported. It therefore provides an indication of the lower limit for incidence of such complications. The review of airway management indicates that in a majority of cases, there is ‘room for improvement’.

/pdf/major-complications-of-airway-management-in-the-uk-results-2yb6kvg3x1.pdf

Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia

Suicide is increasing against the backdrop of generally declining mortality, and is currently one of the 10 leading causes of death overall and within each age group 10-64 (4). This report highlights increases in suicide mortality from 1999 through 2014 and shows that while the rate increased almost steadily over the period, the average annual percent increase was greater for the second half of this period (2006-2014) than for the first half (1999-2006). Increases in suicide rates occurred for both males and females in all but the oldest age group (75 and over). Percent increases in rates were greatest for females aged 10-14 and for males, those aged 45-64. The male-female disparity in suicide rates (as measured by rate ratios) narrowed slightly over the period. Poisoning was the most common suicide method for females in 2014, and firearms were the most frequent for males, but both sexes showed increases since 1999 in the percentage of suicides attributable to suffocation. Suicide numbers and rates for females and males by Hispanic origin and race for 1999 and 2014 are also available. Data sources and methods Mortality and population data are from the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics 1999-2014 multiple cause-of-death mortality files (6). Suicide deaths are those classified with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) underlying cause-of-death codes U03, X60-X84, and Y87.0 (7). Suicide deaths are categorized by method of injury using the following ICD-10 codes: firearm (X72-X74), suffocation (X70), poisoning (X60-X69), and other methods (U03, X71, X75-X84, and Y87.0). Age-adjusted death rates were calculated using the direct method and the 2000 standard population (8). Demographic information comes from death certificates. Population data for 2000 and 2010 are April 1 bridged-race census counts, and for 1999, 2001-2009, and 2011-2014 are July 1 bridged-race estimates from the vintage 2014 postcensal series. Trends in age-adjusted death rates were evaluated using the Joinpoint Regression Program (9). Suicide rates by age group were analyzed by comparing 1999 and 2014 only; trends during this time period were not analyzed and may have varied by subgroup. The small number of suicides during 1999-2014 for persons aged 5-9 years (79) were included in the total age-adjusted rates and in the percentages by method. Male-female differences in suicide rates were based on rate ratios calculated as male age-adjusted rate divided by female age-adjusted rate. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. Language: en

https://www.cdc.gov/nchs/data/databriefs/db241.pdf

Increase in suicide in the United States, 1999-2014

Deaths from drug overdose continue to contribute to mortality in the United States (1-5). This report uses the most recent data from the National Vital Statistics System (NVSS) to update trends in drug overdose deaths for all drugs and for specific drugs and drug types, and to identify changes in rates by state from 2017 to 2018.

/pdf/drug-overdose-deaths-in-the-united-states-1999-2018-3uvettbsyw.pdf

Drug overdose deaths in the United States, 1999-2018

Deaths from drug overdose are an increasing public health burden in the United States (1–4). This report uses the most recent data from the National Vital Statistics System (NVSS) to update trends in drug overdose deaths, describe demographic and geographic patterns, and identify shifts in the types of drugs involved.

/pdf/drug-overdose-deaths-in-the-united-states-1999-2016-3tuukyxxny.pdf

Drug Overdose Deaths in the United States, 1999-2016.

In 2008, the number of poisoning deaths exceeded the number of motor vehicle traffic deaths and was the leading cause of injury death for the fi rst time since at least 1980. During the past three decades, the poisoning death rate nearly tripled, while the motor vehicle traffic death rate decreased by one-half. During this period, the percentage of poisoning deaths that were caused by drugs increased from about 60% to about 90%. The population groups with the highest drug poisoning death rates in 2008 were males, people aged 45–54 years, and non-Hispanic white and American Indian or Alaska Native persons. The vast majority of drug poisoning deaths are unintentional (see Appendix table). Opioid analgesics were involved in more drug poisoning deaths than other specified drugs, including heroin and cocaine. Opioid analgesics were involved in nearly 15,000 deaths in 2008, while cocaine was involved in about 5,100 deaths and heroin was involved in about 3,000 deaths (data not shown). Deaths involving opioid analgesics may involve other drugs as well, including benzodiazepines (2). In addition to an increase in the number of deaths caused by drug poisoning, increases in drug use, abuse, misuse, and nonfatal health outcomes have been observed. In the past two decades, there has been an increase in the distribution and medical use of prescription drugs, including opioid analgesics (3). From 1999 to 2008, the use of prescription medications increased (4). In 2007–2008, 48% of Americans used at least one prescription drug in the past month and 11% of Americans used five or more prescriptions in the past month. Analgesics for pain relief were among the common drugs taken by adults aged 20–59 years (4). In 2009–2010, over 5 million Americans reported using prescription pain relievers nonmedically in the past month (that is, without a doctor’s prescription or only for the experience or feeling they caused), and the majority of people using prescription pain relievers nonmedically reported getting the drugs from friends or family (5,6). From 2004 to 2008, the estimated rate of emergency department visits involving nonmedical use of opioid analgesics doubled from 49 per 100,000 to 101 per 100,000 (7). Government agencies and other organizations joined together to achieve great reductions in the number of deaths from motor vehicle crashes in the past three decades (8,9). A comprehensive approach, including improvements in the safety of vehicles; improvements in roadways; increased use of restraint systems, such as seat belts and child safety seats; reductions in speed; and also efforts to reduce driving under the influence of alcohol and drugs, contributed to the decline in motor vehicle related deaths (8,9). Using a comprehensive, multifaceted approach, it may be possible to reverse the trend in drug poisoning mortality.

/pdf/drug-poisoning-deaths-in-the-united-states-1980-2008-3cmhgonv91.pdf

Drug poisoning deaths in the United States, 1980-2008

KEY FINDINGS: Data from the National Vital Statistics System Mortality File From 1999 through 2006, the number of fatal poisonings involving opioid analgesics more than tripled from 4,000 to 13,800 deaths Opioid analgesics were involved in almost 40% of all poisoning deaths in 2006 In 2006, the rate of poisoning deaths involving opioid analgesics was higher for males, persons aged 35-54 years, and non-Hispanic white persons than for females and those in other age and racial/ethnic groups In about one-half of the deaths involving opioid analgesics, more than one type of drug was specified as contributing to the death, with benzodiazepines specified with opioid analgesics most frequently The age-adjusted death rate for poisoning involving opioid analgesics varied more than eightfold among the states in 2006 Language: en

/pdf/increase-in-fatal-poisonings-involving-opioid-analgesics-in-4wbjvr2vgp.pdf

Margaret Warner

Papers

Increase in suicide in the United States, 1999-2014

Drug overdose deaths in the United States, 1999-2018

Drug Overdose Deaths in the United States, 1999-2016.

Drug poisoning deaths in the United States, 1980-2008

Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006.