[The main principles underlying the pathologo-anatomical diagnostics and coding of the causes of death from...

The objective of the present study was to universalize the approaches to pathologoanatomical diagnostics and coding of the causes of death from tuberculosis and other diseases. We undertook the analysis of 409 medical death certificates of the subjects who died from tuberculosis in Moscow during 2013. It revealed the main errors of pathologoanatomical diagnostics and formulation of the respective medical documentation. The recommendations are proposed for pathologoanatomical diagnostics of tuberculosis, completion of medical death certificates, and formulation of the conclusions of the causes of death. It was shown that tuberculosis should be regarded either as the main independent disease or one of the components of the combined pathology in the structure of pathologoanatomical diagnosis. The diagnosis must reflect the form of the disease, its localization, the extension of the pathological process, phases of the clinical course, and the results of bacteriological studies. Only one form of tuberculosis should be indicated with the emphasis on its chronic or destructive character. The fatal complications of a single form of tuberculosis may differ. The categorization of a "minor" form as the "major" disease is the serious error even if it is confirmed by the results of the bacteriological study. Such nosological forms as acute coronary heart disease, urgent surgical pathology, etc. in the combined "major" disease must be indicated in the first place, even in the presence of progressive tuberculosis. It is concluded that the pathologoanatomical diagnosis structure must include the comparison of the clinical and morphological data, correct assessment of the activity and the extension of the tuberculosis process, its role in tanatogenesis, and the significance of tuberculosis compared with the concomitant diseases.