Mortality from cerebrovascular diseases in Ukraine
Keywords:cerebrovascular disease, mortality, dynamics, estimation
Objective. To analyse the dynamics, gender, age, and geographical peculiarities of cerebrovascular disease (CVD) mortality in Ukraine, to estimate the indicator for the coming years.
Materials and methods. A retrospective CVD mortality study was conducted in Ukraine. Mortality database (MDB) of the World Health Organization (WHO) and the data of the Ministry of Health of Ukraine (MoH) were used as the starting material.
Time series analysis and regression analysis, hazard ratio (HR) were used.
Results. From 1991 to 2012, CVD mortality decreased by 7.2% (from 220.4 to 204.6 per 100,000 population).
CVD mortality rate is close to 0 at the age of 0 to 29 years, it exponentially increases with growing-up and aging of the population, and reaches its maximum at the age of 75 to 90 years (181 deaths per 10,000 men and 178 – in women). It was found that 99% of CVD deaths were at the age of over 45 years, 90% – over 60 years, 59% – over 75 years.
Based on the mortality rates in 2012, at the time of the birth, CVD death risk in men is 0.18% (of 10,000 boys born, 18 will die of CVD at some point of life), in women – 0.23% (of 10,000 girls born, 23 will die of CVD at some point of life).
The population of men aged 15 to 74 years, CVD death risk is 1.7-2.6 times higher than in women of the same age. At the age of 0 to 14 and from 75 to 90 years, parity is observed. At the age of 45 to 90 years, men and women have an equal CVD death risk.
The essential heterogeneity of CVD mortality was revealed in different regions of Ukraine – the difference between the highest (472.1) and the lowest (64.6) value is 407.5 (630%).
A strong highly significant inverse correlation was established between the value of health care (HC) costs and CVD mortality in Ukraine (r = -0.72, p = 0.00). In turn, the value of HC costs depends on GDP (r = 0.99, p = 0.00). By 2020, the estimated CVD mortality in Ukraine is 217-225 per 100,000 population.
Conclusions. Over the period studied, Ukraine has a consistently high CVD mortality rate with low decline. In women, CVD mortality is higher than in men, but in some age periods, the situation is reversed. In different regions of Ukraine, mortality varies considerably, in the south-eastern regions, the value is extremely high. A strong highly significant inverse correlation between the value of HC costs and CVD mortality in Ukraine indicates that in the next 5 years a significant reduction in CVD mortality rate is not expected.
1. World Health Statistics 2014: Large gains in life expectancy [Internet]. Geneva: WHO; 2016 [updated 2014 May 15; cited 2016 May 14]. Available at: http://www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/en/
2. WHO Mortality Database [Internet]. World Health Organization. 2016 [updated 25 November 2015; cited 29 April 2016]. Available at: http://www.who.int/healthinfo/statistics/mortality_rawdata/en/
3. [Health indicators and use of health care resources in Ukraine for 2012-2013]. Kyiv: Ministry of Health of Ukraine, 2014. 327 p. Ukrainian.
4. [Order of Ministry of Health of Ukraine date 30 July 2002 Number 297 “On improvement of medical care to patients with cerebrovascular pathology”] [Internet]. Ministry of Health of Ukraine. Kyiv. 2016 [cited 07 May 2016]. Ukrainian. Available at: http://mozdocs.kiev.ua/view.php?id=1438
5. [The state program “Prevention and treatment of cardiovascular and cerebrovascular diseases, 2006-2010] [Internet]. Government portal: The official portal of the executive power of Ukraine. Kyiv. 2016 [cited 07 May 2016]. Ukrainian. Available at: http://www.kmu.gov.ua/control/uk/cardnpd?docid=38710845
6. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry ishemichnomu insulti [On approval and introduction of medical and technological documents for standardization of care in ischemic stroke] [Internet]. Kyiv (Ukraine): Ministry of Health of Ukraine. 2012 [cited 29 March 2016]. Ukrainian. Available at: http://www.moz.gov.ua/ua/portal/dn_20120803_602.html
7. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry hemorahichnomu insulti [On approval and introduction of medical and technological documents for standardization of medical care in hemorrhagic stroke] [Internet]. Kyiv (Ukraine): Ministry of Health of Ukraine. 2012 [cited 29 March 2016]. Ukrainian. Available at: http://www.moz.gov.ua/ua/portal/dn_20140417_0275.html
8. Sapon NA, Huk AP, Kirichenko VV, Chitaeva GE, Nikiforova AN, Yovenko TA. [Assessment of quality of neurosurgical care rendering in secondary prevention of cerebrovascular diseases in Ukraine]. Ukrainian Neurosurgical Journal. 2012(3):57-63. Russian. [Abstract/Full Text]
9. Sapon NA, Nikiforova AN. [Correlation between access to health care and stroke mortality]. Ukrainian Neurosurgical Journal. 2016(2):54-62. Russian. [Abstract/Full Text]
10. Health expenditure, total (% of GDP) [Internet]. Washington (U.S.): World Bank. 2016 [cited 17 May 2016]. Available at: http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS/countries
11. Download entire World Economic Outlook database, October 2015 [Internet]. Washington (U.S.): The International Monetary Fund (IMF). 2016 [cited 03 April 2016]. Available at: http://www.imf.org/external/pubs/ft/weo/2015/02/weodata/download.aspx
12. Health expenditure per capita (current US$) [Internet]. Washington (U.S.): World Bank. 2016 [cited 17 May 2016]. Available at: http://data.worldbank.org/indicator/NY.GDP.PCAP.CD
How to Cite
Copyright (c) 2016 Eugene Pedachenko, Anna Nikiforova, Nikolay Sapon, Andriy Huk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.