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Gustav Wärn¹, Brita Zilg²

¹Karolinska Institute - Stockholm, Sweden Karolinska Institute - Stockholm, Sweden.

Lakartidningen

|September 11, 2019

Summary

Many accidental deaths are misclassified due to incomplete death certificates. This study found elderly fall victims were often misclassified, highlighting a need for better doctor training on accurate death certificate completion.

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Area of Science:

Public Health
Medical Certification
Geriatric Medicine

Background:

Approximately 3200 annual deaths in Sweden are attributed to accidents.
A significant portion, around 900 deaths, are vaguely classified as 'Accidental exposure to other and unspecified factors' due to incomplete death certificates.
This imprecise classification hinders accurate public health data and injury surveillance.

Purpose of the Study:

To investigate the reasons behind the imprecise classification of accidental deaths.
To analyze the specific circumstances and demographics involved in the 'Accidental exposure to other and unspecified factors' category.
To identify potential gaps in medical professionals' understanding of death certificate completion.

Main Methods:

Retrospective analysis of death certificates from 2016 for individuals classified under 'Accidental exposure to other and unspecified factors'.
Comparison of death certificate data with corresponding patient records for a subset of cases.
Qualitative assessment of the reported causes of death and the attending physician's assessment.

Main Results:

The study identified that a majority of these imprecisely classified deaths involved elderly individuals who had experienced a fall.
Complications arising from fall-related injuries were the primary cause of death in these cases.
Attending physicians frequently did not perceive the deaths as accidental, contributing to misclassification.

Conclusions:

There is a notable lack of knowledge among medical practitioners regarding the accurate completion of death certificates, particularly for accidental deaths.
Inaccurate death certification practices, especially concerning falls in the elderly, lead to underestimation of fall-related mortality.
Improved training on death certification is crucial for accurate public health statistics and targeted injury prevention strategies.

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