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Incomplete and inaccurate death certification--the impact on research
1Imperial College School of Medicine, National Heart and Lung Institute at Hammersmith Hospital Campus, London.
Journal of Public Health Medicine
|July 27, 2000
Summary
Many death certificates inaccurately report Bjork-Shiley Convexo-Concave (BSCC) heart valve information, potentially under-reporting valve failures. Improved death certification for cardiac devices is recommended.
Area of Science:
- Cardiovascular Surgery
- Medical Device Safety
- Public Health Surveillance
Background:
- Investigating inaccuracies in death certificates for patients with Bjork-Shiley Convexo-Concave (BSCC) heart valves.
- Assessing potential under-reporting of acute mechanical failure of BSCC valves due to data errors.
Purpose of the Study:
- To quantify erroneous and omitted information on death certificates for BSCC valve recipients.
- To determine if these inaccuracies correlate with under-reported valve failures.
Main Methods:
- Multicenter review of death certificates and clinical notes for 478 BSCC valve patients in the UK (1979-1996).
- Analysis of death certificates for recorded presence of prosthesis, accuracy of surgical information, and post-mortem details.
Main Results:
- Only 21% of death certificates noted the BSCC valve prosthesis.
- Inaccurate surgical information was reported on 6% of certificates.
- 8% of death certificates for patients with post-mortems failed to record the post-mortem.
Conclusions:
- High rates of unrecorded valve prostheses and under-reported post-mortems skew BSCC valve failure data.
- Previous recommendations for accurate death certification have been ignored.
- Consideration of changes in death certificate completion for cardiac device patients is necessary.