title: [On the increase in mortality in Italy in 2015: analysis of seasonal mortality in the 32 municipalities included in the Surveillance system of daily mortality].
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  to estimate the excess mortality in 2015 using data from the rapid mortality surveillance system (SiSMG) operational in 32 Italian cities.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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).
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Paola
authors.initials: P
authors.lastname: Michelozzi
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Francesca
authors.initials: F
authors.lastname: De' Donato
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Matteo
authors.initials: M
authors.lastname: Scortichini
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Manuela
authors.initials: M
authors.lastname: De Sario
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Federica
authors.initials: F
authors.lastname: Asta
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma. n.agabiti@deplazio.it.
authors.forename: Nera
authors.initials: N
authors.lastname: Agabiti
authors.affiliation: Direzione generale della prevenzione sanitaria, Ministero della salute, Roma.
authors.forename: Ranieri
authors.initials: R
authors.lastname: Guerra
authors.affiliation: Direzione generale della prevenzione sanitaria, Ministero della salute, Roma.
authors.forename: Annamaria
authors.initials: A
authors.lastname: de Martino
authors.affiliation: Dipartimento di epidemiologia, Servizio sanitario regionale del Lazio, Roma.
authors.forename: Marina
authors.initials: M
authors.lastname: Davoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002947:Cities / Q000706:statistics & numerical data*; D006801:Humans; D007251:Influenza, Human / Q000401:mortality*; D007259:Infrared Rays / Q000009:adverse effects*; D007558:Italy / Q000453:epidemiology; D009026:Mortality / Q000639:trends; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D012621:Seasons