Exploring the determinants associated with adult mortality in Malta: A cohort study between 2014 and 2020

The study set to explore the mortality causes across six years and identify potential mortality determinates at a population level in Malta. A longitudinal follow-up of a Malta based cross-sectional national representative study across 6 years (2014 – 2020) was carried out. The study population was cross-linked to the mortality register and causes of death obtained. Population characteristics gathered during initial examination were analysed through univariant and multivariant logistic regressions. A total of 66 adults, mostly male (65.15% n=43) died, with commonest cause being cancer (42.42% CI95%: 31.24 – 54.45) mostly due to malignant neoplasm of bronchus and lung. This was followed by cardiac pathologies including acute myocardial infarction, ischaemic cardiomyopathy, and cardiomegaly (25.76% CI95%: 16.67 – 37.51). Multivariant logistic regression analyses revealed positive associations between age (OR: 1.99 p=0.02), history of coronary heart disease (OR: 11.78 p=<0.001), smoking for 31 years or more (OR: 8.22 p=<0.001) and presence of multimorbidity (OR: 1.32 p=0.02). It is evident that occurrence of cancers is a concern in Malta, and it requires targeted action including the reduction of smoking habits. Understanding the mortality causes and the associated determining factors at a population level enable the institution of preventive actions while strengthening healthcare services to safeguard the population from premature mortality and co-morbidity.