Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study

Anuradhani Kasturiratne; Dileepa Senajith Ediriweera; Shamila Thivanshi De Silva; Madunil Anuk Niriella; Uthuru Beddage Thulani; Arunasalam Pathmeswaran; Anuradha Supun Dassanayake; Arjuna Priyadarsin De Silva; Sureka Chackrewarthy; Udaya Ranawaka; Norihiro Kato; Ananda Rajitha Wickremasinghe; Hithanadura Janaka De Silva

doi:10.1136/bmjopen-2020-038772

Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study

Anuradhani Kasturiratne
, Dileepa Senajith Ediriweera
, Shamila Thivanshi De Silva
, Madunil Anuk Niriella
, Uthuru Beddage Thulani
, Arunasalam Pathmeswaran
, Anuradha Supun Dassanayake
, Arjuna Priyadarsin De Silva
, Sureka Chackrewarthy
, Udaya Ranawaka
, Norihiro Kato
, Ananda Rajitha Wickremasinghe
, Hithanadura Janaka De Silva

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Objective To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. Design A prospective population-based cohort study. Setting Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. Participants Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007.

Measures At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population.

Results There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations.

Conclusions Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.

Original language	English
Article number	e038772
Journal	BMJ Open
Volume	10
Issue number	9
DOIs	https://doi.org/10.1136/bmjopen-2020-038772
Publication status	Published - 29 Sept 2020
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

coronary heart disease
epidemiology
public health

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10.1136/bmjopen-2020-038772

Cite this

Kasturiratne, A., Ediriweera, D. S., De Silva, S. T., Niriella, M. A., Thulani, U. B., Pathmeswaran, A., Dassanayake, A. S., De Silva, A. P., Chackrewarthy, S., Ranawaka, U., Kato, N., Wickremasinghe, A. R., & De Silva, H. J. (2020). Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study. BMJ Open, 10(9), Article e038772. https://doi.org/10.1136/bmjopen-2020-038772

@article{ed612db8943f4b01aa68f93ffba7b1db,

title = "Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study",

abstract = "Objective To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. Design A prospective population-based cohort study. Setting Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. Participants Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. Measures At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. Results There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. Conclusions Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.",

keywords = "coronary heart disease, epidemiology, public health",

author = "Anuradhani Kasturiratne and Ediriweera, \{Dileepa Senajith\} and \{De Silva\}, \{Shamila Thivanshi\} and Niriella, \{Madunil Anuk\} and Thulani, \{Uthuru Beddage\} and Arunasalam Pathmeswaran and Dassanayake, \{Anuradha Supun\} and \{De Silva\}, \{Arjuna Priyadarsin\} and Sureka Chackrewarthy and Udaya Ranawaka and Norihiro Kato and Wickremasinghe, \{Ananda Rajitha\} and \{De Silva\}, \{Hithanadura Janaka\}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2020. ",

year = "2020",

month = sep,

day = "29",

doi = "10.1136/bmjopen-2020-038772",

language = "English",

volume = "10",

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Kasturiratne, A, Ediriweera, DS, De Silva, ST, Niriella, MA, Thulani, UB, Pathmeswaran, A, Dassanayake, AS, De Silva, AP, Chackrewarthy, S, Ranawaka, U, Kato, N, Wickremasinghe, AR & De Silva, HJ 2020, 'Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study', BMJ Open, vol. 10, no. 9, e038772. https://doi.org/10.1136/bmjopen-2020-038772

TY - JOUR

T1 - Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka

T2 - findings from the Ragama Health Study

AU - Kasturiratne, Anuradhani

AU - Ediriweera, Dileepa Senajith

AU - De Silva, Shamila Thivanshi

AU - Niriella, Madunil Anuk

AU - Thulani, Uthuru Beddage

AU - Pathmeswaran, Arunasalam

AU - Dassanayake, Anuradha Supun

AU - De Silva, Arjuna Priyadarsin

AU - Chackrewarthy, Sureka

AU - Ranawaka, Udaya

AU - Kato, Norihiro

AU - Wickremasinghe, Ananda Rajitha

AU - De Silva, Hithanadura Janaka

PY - 2020/9/29

Y1 - 2020/9/29

N2 - Objective To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. Design A prospective population-based cohort study. Setting Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. Participants Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. Measures At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. Results There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. Conclusions Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.

AB - Objective To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. Design A prospective population-based cohort study. Setting Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. Participants Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. Measures At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. Results There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. Conclusions Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.

KW - coronary heart disease

KW - epidemiology

KW - public health

U2 - 10.1136/bmjopen-2020-038772

DO - 10.1136/bmjopen-2020-038772

M3 - Article

C2 - 32994253

AN - SCOPUS:85092455300

SN - 2044-6055

VL - 10

JO - BMJ Open

JF - BMJ Open

IS - 9

M1 - e038772

ER -

Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study

Abstract

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Keywords

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