概括
根据编码方法,COVID-19死亡人数的估计有很大差异. 世卫组织的指令确定了比ICD-10规则更多的COVID-19死亡人数进行监视,这些规则专注于COVID-19作为直接原因.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医学编码 医学编码
背景情况:
- 准确的COVID-19死亡人数对于了解大流行影响至关重要.
- 死亡估计的差异引发了关于COVID-19作为死亡原因的作用的辩论.
研究的目的:
- 调查和比较不同的方法来确定COVID-19作为死亡原因.
- 分析编码实践对COVID-19死亡统计数据的影响.
主要方法:
- 从荷兰死亡原因登记 (2020-2022) 中使用了51,288份死亡证明的双重 (桥梁) 编码.
- 使用世卫组织特别指令 (2020年4月) 与现行国际疾病分类第10版 (ICD-10) 规则进行编码结果比较.
主要成果:
- 世卫组织特别指令确定COVID-19是94%病例的潜在死亡原因.
- 根据现行ICD-10规则,COVID-19是76% (一般原则) 和49% (直接后续,包括并发症) 的潜在原因.
- 差异来自不同的观点:WHO的流行病监测,ICD-10的病理生理因果关系.
结论:
- 不同的COVID-19死亡估计反映了对其作为死亡原因的作用的不同观点.
- 解释死亡原因统计需要承认这些方法和观点差异.
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