| Abstract [eng] |
SUMMARY The aim of study was to determine the trends of mortality from external causes and suicides in Lithuania and other EU (European Union) countries in 1996-2006, using advanced trend analysis methods. Methods. Study design – descriptive epidemiology. Mortality from all external causes (by ICD-10 coding V01-Y98) and from suicides (by ICD-10 coding X60-X84) was analyzed in eighteen EU countries. It was used midyear of every countries population, numbers of deaths from external causes and from suicides based on five-year age groups, which totaled to 324 groups. Age-standardized (European standard population) mortality rates (per 100 000 persons) from causes mentioned above was calculated calculated using direct method. These standardized values were used to determine the trends, comparisons with other countries was made. MICROSOFT EXCEL 2003, WINPEPI module Describe (v. 1.78), JOINPOINT (v. 3.2.0), Harward Graphics 98 (v. 6.50), MAP WIEVER (v. 5.00) statistical packages and programmes were used for data processing and analysis. The following indices was calculated: standardized mortality rates, weighted standard error (SE), annual absolute change (AAC), annual percentage change (APC), 95% confidence intervals, data considered significant, when p<0,05. Results. In most of the EU countries it was observed decreasing mortalityrates from external causes over the period 1996-2006, but at the earlier phase of this period in some countries mortality rates increased. At the latest phase mortality rates decreased in all countries, except Lithuania, Finland and Sweden. Suicide mortality trends in 1996–2006 were decreasing in most of the EU countries, including Lithuania. Through the whole time of research, the rates of suicide deaths were decreasing in Austria, Bulgaria, Estonia, Latvia, Lithuania, Slovenia, Netherlands, Hungary, and Germany. In comparison with other countries, in 1996–2004 mortality from all external causes in Lithuania declined, while at the same time many countries showed increasing rates. Situation changed in 2004–2006 – in many countries rates begin to decrease, but in Lithuania determined increasing rates. Overall numbers of suicidal deaths in Lithuania were declining in the 1996-2006. Despite this, mortality from external causes and suicides remains a huge problem in Lithunia – mortality rates are highest, moreover mortality from external causes shows increasing levels in 2004–2006. When comparing with other Baltic states, mortality rates from external causes remained highest in Lithuania. It is because of slowest decrease of rates and because of increasing trends in 2004-2006. All periods of Joinpoint analysis showed decreasing trends of suicidal deaths in Lithuania, Latvia an Estonia. However, Lithuanian rates in absolute values remained highest. Most intensive declining trend in Lithuania and Estonia found at the last period of Joinpoint analysis (2004–2006 m.), but in Latvia declining suicide rates determined a few years earlier (2001–2004 m.). Conclusion. To analyse the trends of mortality rates we recommend to use Joinpoint analysis more widely. It is necessary to continue the research, analyze possible risk factors, and find more significant information about possible causes of high mortality in Lithuania compared to other EU countries. |
