Gianfranco Alicandro1, Carlo LA Vecchia2, Giuseppe Remuzzi3, Alberto Gerli4, Stefano Centanni5. 1. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy - gianfranco.alicandro@unimi.it. 2. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 3. Istituto di Ricerche Farmacologiche, Centro Anna Maria Astori, Science and Technology Park Kilometro Rosso, Bergamo, Italy. 4. Management Engineering Tourbillon Tech srl, Padova, Italy. 5. Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy.
Abstract
BACKGROUND: Differences between total deaths registered during the Covid-19 pandemic and those registered in a previous reference period is a valid measure of the pandemic effect. However, this does not consider demographic changes and temporal trends in mortality. OBJECTIVE: To estimate the excess mortality in 2020 in Italy considering demographic changes and temporal trends in mortality. METHODS: We used daily mortality and population data for the 2011-2019 period to estimate the expected deaths in 2020. Expected deaths were estimated, separately by sex, through an over-dispersed Poisson regression model including calendar year and age group as covariates, a smooth function of the year's week, and the logarithm of the population as offset. The difference between observed and expected deaths was considered a measure of excess mortality. RESULTS: In 2020, 746,146 deaths occurred in Italy. We estimated an excess mortality of 90,725 deaths (95% CI: 86,503-94,914), which became 99,289 deaths after excluding January and February, when mortality was lower than expected. The excess was higher among men (49,422 deaths) than women (41,303 deaths) and it was mostly detected at ages ≥80 (60,224 deaths) and ages 65-79 (25,791 deaths), while among the population aged 25-49 and 50-64 we estimated an excess of 281 and 4764 deaths, respectively. CONCLUSIONS: After considering demographic changes and temporal improvement in mortality the excess deaths in 2020 still remains above 90,000 deaths. More important, considering these factors, the excess at ages <80 years is revised upwards, while the excess at older ages is revised downwards.
BACKGROUND: Differences between total deaths registered during the Covid-19 pandemic and those registered in a previous reference period is a valid measure of the pandemic effect. However, this does not consider demographic changes and temporal trends in mortality. OBJECTIVE: To estimate the excess mortality in 2020 in Italy considering demographic changes and temporal trends in mortality. METHODS: We used daily mortality and population data for the 2011-2019 period to estimate the expected deaths in 2020. Expected deaths were estimated, separately by sex, through an over-dispersed Poisson regression model including calendar year and age group as covariates, a smooth function of the year's week, and the logarithm of the population as offset. The difference between observed and expected deaths was considered a measure of excess mortality. RESULTS: In 2020, 746,146 deaths occurred in Italy. We estimated an excess mortality of 90,725 deaths (95% CI: 86,503-94,914), which became 99,289 deaths after excluding January and February, when mortality was lower than expected. The excess was higher among men (49,422 deaths) than women (41,303 deaths) and it was mostly detected at ages ≥80 (60,224 deaths) and ages 65-79 (25,791 deaths), while among the population aged 25-49 and 50-64 we estimated an excess of 281 and 4764 deaths, respectively. CONCLUSIONS: After considering demographic changes and temporal improvement in mortality the excess deaths in 2020 still remains above 90,000 deaths. More important, considering these factors, the excess at ages <80 years is revised upwards, while the excess at older ages is revised downwards.
Authors: Pietro Perotti; Paola Bertuccio; Stefano Cacitti; Silvia Deandrea; Lorenza Boschetti; Simona Dalle Carbonare; Stefano Marguati; Simona Migliazza; Eleonora Porzio; Simona Riboli; Ennio Cadum; Lorella Cecconami; Anna Odone Journal: Int J Environ Res Public Health Date: 2022-05-26 Impact factor: 4.614
Authors: Gianfranco Alicandro; Giuseppe Remuzzi; Stefano Centanni; Alberto Gerli; Carlo La Vecchia Journal: Med Lav Date: 2021-12-23 Impact factor: 1.275
Authors: Gianfranco Alicandro; Giuseppe Remuzzi; Stefano Centanni; Alberto Gerli; Carlo La Vecchia Journal: Med Lav Date: 2022-04-26 Impact factor: 2.244