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Дни рождения как источник избыточной смертности: диагностический состав причин смерти
Problem statement. Earlier it was shown that in Russia and in the world, holidays are accompanied by an increase in mortality, mainly at Christmas and New Years. And what about diagnoses of the excess mortality due to birthday celebration? Material and methods. For this purpose, the data of 16.77 million deaths from 01/01/2011 to 12/31/2019 were examined for the relationship between birth and death dates. In all cases, the dates of birth and death were given the number of the day of the year. If these numbers coincided, the death case was assigned a value of 0, if they did not match - the number of days of the difference with the birthday before or after this day, from ± 1 to ± 182. This procedure was performed both for mortality in general and for 6 large classes of deaths and 8 types of external causes. Excess deaths on birthday were estimated using the LOWESS moving average (locally weighted polynomial regression), which described non-holiday mortality, and on holidays its breaks were filled with linear regression, which served as an indicator of “natural” non-holiday mortality on holidays. Results. A significant increase in birthday mortality was revealed (4.0 thousand per day for 9 years), and the total excess death rate associated with birthday was 19.7 thousand, or 3.5% of the "natural" mortality. The main contribution to excess mortality was made by diseases of the circulatory system (9.1 thousand) and external causes (5.2 thousand), and among the external causes of suicide (1.3 thousand), alcohol poisoning (1.0 thousand) and injuries with undetermined intentions (0.8 thousand). Excess deaths on birthday were proportional to non-holiday deaths, with the exception of alcohol poisoning, which was twice the expected number of deaths. The peculiarity of suicides is that the increase in their number begins two months before the birthday with a maximum at 35 days, followed by a decrease and a sharp increase on the birthday. Further suicide mortality is cyclical with peaks at 7 and 15 days after the birthday. Comparison with other holidays showed that birthdays, in terms of excess mortality, occupy an intermediate position between the New Year and other public holidays. The main factor in excess mortality on holidays is the abuse of strong alcoholic beverages. Conclusion. Birthday celebration, like public holidays, is accompanied by an increase in mortality. It is known that morbidity is wider than mortality on holidays. This requires informing the public about the possible negative consequences of celebrating a birthday.