Michelozzi Paola, De' Donato Francesca, Scortichini Matteo, De Sario Manuela, Asta Federica, Agabiti Nera, Guerra Ranieri, de Martino Annamaria, Davoli Marina
Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
Direzione generale della prevenzione sanitaria, Ministero della salute, Roma.
Epidemiol Prev. 2016 Jan-Feb;40(1):22-8. doi: 10.19191/EP16.1.P022.010.
the Italian National Institute of Statistics (Istat) estimated an increase in mortality in Italy of 11.3% between January and August 2015 compared to the previous year. During summer 2015, an excess in mortality, attributed to heat waves, was observed.
to estimate the excess mortality in 2015 using data from the rapid mortality surveillance system (SiSMG) operational in 32 Italian cities.
time series models were used to estimate the excess in mortality among the elderly (65+ years) in 2015 by season (winter and summer). Excess mortality was defined as the difference between observed daily and expected (baseline) mortality for the five previous years (2009- 2013); seasonal mortality in 2015 was compared with mortality observed in 2012, 2013, and 2014. An analysis by cause of death (cardiovascular and respiratory), gender, and age group was carried out in Rome.
data confirm an overall estimated excess in mortality of +11% in 2015. Seasonal analysis shows a greater excess in winter (+13%) compared to the summer period (+10%). The excess in winter deaths seems to be attributable to the peak in influenza rather than to low temperatures. Summer excess mortality was attributed to the heat waves of July and August 2015. The lower mortality registered in Italy during summer 2014 (-5.9%) may have contributed to the greater excess registered in 2015. In Rome, cause-specific analysis showed a higher excess among the very old (85+ years) mainly for cardiovascular and respiratory causes in winter. In summer, the excess was observed among both the elderly and in the adult population (35-64 years).
results suggest the need for a more timely use of mortality data to evaluate the impact of different risk factors. Public health measures targeted to susceptible subgroups should be enhanced (e.g., Heat Prevention Plans, flu vaccination campaigns).
意大利国家统计局（Istat）估计，与上一年相比，2015年1月至8月期间意大利的死亡率上升了11.3%。在2015年夏季，观察到因热浪导致的死亡率过高。
利用意大利32个城市运行的快速死亡率监测系统（SiSMG）的数据，估计2015年的超额死亡率。
采用时间序列模型，按季节（冬季和夏季）估计2015年老年人（65岁及以上）的超额死亡率。超额死亡率定义为观察到的每日死亡率与前五年（2009 - 2013年）预期（基线）死亡率之间的差异；将2015年的季节性死亡率与2012年、2013年和2014年观察到的死亡率进行比较。在罗马，按死因（心血管和呼吸系统）、性别和年龄组进行了分析。
数据证实2015年总体估计超额死亡率为+11%。季节性分析显示，与夏季（+10%）相比，冬季超额死亡率更高（+13%）。冬季死亡人数过多似乎归因于流感高峰，而非低温。夏季超额死亡率归因于2015年7月和8月的热浪。2014年夏季意大利记录的较低死亡率（-5.9%）可能导致了2015年记录的更高超额死亡率。在罗马，特定病因分析显示，在冬季，85岁及以上的高龄人群中，主要因心血管和呼吸系统病因导致的超额死亡率更高。在夏季，老年人和成年人群体（35 - 64岁）中均观察到超额死亡率。
结果表明需要更及时地利用死亡率数据来评估不同风险因素的影响。应加强针对易感亚组的公共卫生措施（例如，防暑计划、流感疫苗接种活动）。
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