揭露错误编码和错误分类在中风死亡率中的负担:分析墨西哥多种死亡原因数据
Lucero Cahuana-Hurtado1, Héctor Gómez-Dantés2, Vanessa De la Cruz-Góngora3
1School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
Neuroepidemiology
|July 3, 2023
概括
墨西哥中风死亡人数报告不足,原因是死亡证明中的编码和分类错误. 改进死亡编码对于准确反映脑血管疾病的真实负担至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医学统计 医学统计
背景情况:
- 在墨西哥,脑血管疾病的危险因素正在上升.
- 自2010年以来,中风死亡率停滞不前,尽管之前的死亡率有所下降.
- 不准确的死亡证明实践可能会掩盖真正的中风负担.
研究的目的:
- 评估墨西哥中风死亡的错误编码和错误分类的程度.
- 确定这些错误对报告中风死亡率的影响.
- 突出需要改进死亡认证和死亡原因分类的需要.
主要方法:
- 在墨西哥 (2009-2015) 分析了4,262,666份死亡证明.
- 作为潜在和多种原因的中风年龄标准化死亡率 (ASMR) 的计算.
- 根据三个错误分类场景 (当前,中等,高) 的ASMR比较.
主要成果:
- 由于错误编码和错误分类,严重低于报告中风负担.
- 近60%的中风死亡被编码为未指定的.
- 在中等到高错误分类场景下,中风ASMR可能增加39.9%-52.9%.
结论:
- 错误的编码和错误的分类导致墨西哥大大低估了中风负担.
- 当糖尿病等并发症存在时,中风死亡人数经常被低估.
- 加强死亡编码程序对于准确的公共卫生监测至关重要.
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