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dc.contributor.authorSanchez-Diaz, German 
dc.contributor.authorEscobar, Francisco
dc.contributor.authorVillaverde-Hueso, Ana 
dc.contributor.authorPosada De la Paz, Manuel 
dc.contributor.authorAlonso-Ferreira, Veronica
dc.identifier.citationInt J Environ Res Public Health. 2019 Apr 17;16(8). pii: E1388.es_ES
dc.description.abstractThe aim is to conduct a descriptive, population-based study in order to assess temporal and spatial changes in mortality due to granulomatosis with polyangiitis (GPA) in Spain from 1984 to 2016. Mortality data were obtained from the Spanish Annual Death Registry. Deaths in which GPA was the underlying cause were selected using the 446.4 and M31.3 codes from the International Classification of Diseases, 9th and 10th revision. Annual average age at death and age-adjusted mortality rates were calculated. Geographic analysis was performed at municipality and district level. Variations in mortality according to the type of municipality (urban, agro-urban or rural), district and geographic location (degrees of latitude) were assessed using standardized mortality ratios (SMRs) and smoothed-SMRs. Over the whole period, 620 deaths due to GPA were identified. Age at death increased at an average annual rate of 0.78% over the period 1987-2016 (p < 0.05). Age-adjusted mortality rates increased by an annual average of 20.58% from 1984 to 1992, after which they fell by 1.91% a year (p < 0.05). The agro-urban category had the highest percentage (4.57%) of municipalities with a significantly higher GPA mortality rate than expected. Geographic analysis revealed four districts with a higher risk of death due to GPA, two in the North of Spain and two in the South. This population-based study revealed an increase in the age at death attributed to GPA. Age-adjusted mortality rates went up sharply until 1992, after which they started to decline until the end of the study period. Geographic differences in mortality risk were identified but further studies will be necessary to ascertain the reasons for the distribution of GPA disease.es_ES
dc.description.sponsorshipThis research was supported by the Spanish Stategy Action for Health (AESI), project no. TPY1238/15. GS enjoys a research grant funded by the Spanish Ministry of Education, Culture and Sport (No. FPU14/03914).es_ES
dc.publisherMultidisciplinary Digital Publishing Institute (MDPI) es_ES
dc.subjectGeographic patternses_ES
dc.subjectGranulomatosis with polyangiitises_ES
dc.subjectTemporal trendses_ES
dc.subject.meshFemale es_ES
dc.subject.meshGeography es_ES
dc.subject.meshGranulomatosis with Polyangiitis es_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshRegistries es_ES
dc.subject.meshResearch Design es_ES
dc.subject.meshSpain es_ES
dc.titleTemporal and Cartographic Analyses of the Distribution within Spain of Mortality Due to Granulomatosis with Polyangiitis (1984⁻2016)es_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderMinisterio de Educación, Cultura y Deporte (España) 
dc.identifier.journalInternational journal of environmental research and public healthes_ES
dc.repisalud.centroISCIII::Instituto de Investigación de Enfermedades Rarases_ES
dc.rights.accessRightsopen accesses_ES

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