Understanding variations in pneumonia mortality across Michigan, 2011-2015 ... database. (https://wonder.cdc.gov/) for multiple causes of death. (detailed ... In 2011 Saginaw county had the highest crude death rate, but Ottawa county had the ...
Understanding variations in pneumonia mortality across Michigan, 2011-2015 Abdelrahman Awad,
Despite the development of preventative measures, pneumonia remains one of the leading causes of mortality in the United States.
2 MPH ,
Marcus J. Zervos,
2, MD
Paul E. Kilgore,
Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI; 2Henry Ford Health System, Detroit, MI
Pneumonia crude and age adjusted death rates for Genesee, Oakland, Saginaw and Wayne counties from 2011-2015.
Data was extracted with the following UCD (Underlying cause of death) -ICD-10 codes: ➢ J10.0 Influenza with pneumonia, influenza virus identified. ➢ J11.0 Influenza with pneumonia, virus not identified. ➢ J12 Viral pneumonia, not elsewhere classified. ➢ J13 Pneumonia due to Streptococcus pneumoniae. ➢ J14 Pneumonia due to Haemophillus influenzae. ➢ J15 Bacterial pneumonia, not elsewhere classified. ➢ J16 Pneumonia due to other infectious organisms, not elsewhere classified. ➢ J18 Pneumonia, organism unspecified. Age adjusted data was for people 45 years or more at time of death.
35 30 25 20 15 10
Year 2011
Year 2012
Year 2013
Year 2014
100
0 Genesee County
Oakland County
Saginaw County
Wayne County
Figure 3. In 2014 the crude death rate due to pneumonia and influenza in Genesee County increased 64.23% from the previous year, in comparison, surrounding counties like Oakland, Saginaw, and Wayne only increased by 10.39%,28.19%, and 11.36% respectively. Year 2011
Year 2012
Year 2013
Year 2014
Year 2015
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Data was extracted into Microsoft Excel for analysis. In Michigan, the average pneumonia mortality rate for 2011-2015 was 18.08 per 100,000, compared to the national average of 17.7 per 100,000 (NCHS, CDC Wonder).
Etiology of variations in pneumonia mortality at the county-level are unknown as deaths are primarily classified using non-specific codes.
Year 2015
5
70
RESULTS
50
Percentage of total deaths under J18 Code
Pneumonia is an acute infection of the lung that can be caused by bacteria, fungi, or viruses.
Helina M. Misikir, MPH, MD1,2
Crude death rates (per 100,000)
INTRODUCTION
and Katanya Alaga BMSc,
1 MSc ,
Age Adjusted death rates, Per (100,000)
1Eugene
1 MD
90 80 70 60
50 40 30 20 10 0 2011
2012
2013
2014
2015
40
RESULTS
Figure 6. Bars represent percent of total deaths classified under code J18: Pneumonia organism unspecified from 2011-2015 in Michigan counties, the etiology of this increase is difficult to determine as an average of 94.8% of pneumonia deaths were categorized under non-specific codes. Furthermore, crude death rates for pneumonia from northern Michigan are quoted as unreliable, or low through the CDC program.
30 20
Crude and age adjusted Pneumonia and influenza death rates in Michigan had minimum variation over the years (2011–2015).
Average Crude Pneumonia Mortality Rate (per 100,000), United States, 2011- 2015
10 0 Genesee County
Oakland County
Saginaw County
Wayne County
Figure 4. In 2014 the age adjusted death rates due to pneumonia in Genesee County increased 68.21% from the previous year, in comparison, surrounding counties like Oakland, Saginaw, and Wayne only increased by 6.16%, 27.01%, and 10.85% respectively.
Counties with the highest crude and age adjusted death rates variation for 2011-2015 in Michigan.
CONCLUSIONS From 2014 to 2015, pneumonia mortality in Genesee county increased substantially more (64.23%) compared with other counties in mid and Southeast Michigan. To effectively measure trends in pneumonia it is critical that we further evaluate and make improve mortality surveillance at the county level.
OBJECTIVES To quantify the degree of pneumonia disease burden by describing the trends of pneumonia mortality at both the state (MI) and county level that could provide insight into the drivers of pneumonia prevalence and etiology.
METHODS Mortality data and crude death rates were extracted from CDC wonder online database (https://wonder.cdc.gov/) for multiple causes of death (detailed mortality) for 2011-2015 for the state of Michigan and its respective counties.
Moving forward, it is important that we continue to investigate and compare incidence and mortality data from other infectious pneumonia-related conditions, such as Legionnaire’s Disease.
Figure 1. Pneumonia crude (yellow) and age-adjusted (green) death rates for the state of Michigan from 2011-2015.
Pneumonia crude death rates, showing a spike mainly in Genesee county from 2013- 2014. 35
Crude death rates, per (100,000)
To decrease this burden, it is important that we address gaps in knowledge regarding the etiology of pneumonia.
Currently, it remains unknown as to what drives spikes in pneumonia death rates.
30
Genesee County
Oakland County
Saginaw County
Wayne County
REFERENCES
25 20 15 10 5 0 Year 2011
Year 2012
Year 2013
Year 2014
Year 2015
Figure 2. The lines represent crude mortality rates for Genesee, Oakland, Saginaw and Wayne county showing spikes in rates specially for 2013-2014.
Figure 5. In 2011 Saginaw county had the highest crude death rate, but Ottawa county had the highest age adjusted death rate for the same year, in 2013 and 2014 Jackson county and Bay county had the highest crude death rates respectively, but Allegan county and Wayne county had the highest age adjusted death rates respectively, interestingly, in 2012 and 2015 Lapeer county and Calhoun county had both the highest crude and age adjusted death rates respectively.
Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database, released December, 2016. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.
