使用CODAC分类系统了解巴西死产的原因
Sherly Metelus1, Matias C Vieira1,2, Mariana Brasileiro1
1Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), School of Medical Sciences, Cidade Universitaria, Campinas, Brazil.
概括
与ICD-10相比,死亡原因和相关疾病 (CODAC) 系统在巴西显著减少了未指定的死胎. 这种分类系统有助于了解死产的原因,并为卫生政策提供信息.
科学领域:
- 围产儿医学 围产儿医学
- 公共卫生 公共卫生
- 医学分类系统 医学分类系统
背景情况:
- 死亡出生仍然是一个重大的全球健康挑战,其中很大一部分病例被归类为非特定或未指定的原因.
- 准确的死产分类对于识别潜在原因和实施有效的预防策略至关重要.
- 巴西目前的ICD-10系统在指定死胎病因方面存在局限性.
研究的目的:
- 为了比较死亡原因和相关疾病 (CODAC) 分类系统与ICD-10系统在减少巴西未指定的死胎的有效性.
- 确定与巴西人口中死产相关的孕产妇和妊娠相关因素.
主要方法:
- 一项回顾性横截面研究分析了来自巴西十个高等产科机构的2545例死产病例 (2009-2018).
- 数据来源于医疗记录,死亡证明和死后调查.
- 应用了CODAC系统,并将其性能与ICD-10进行了比较,使用kappa系数和McNemar的测试.
主要成果:
- 在CODAC系统下,未确定的死产比例从40.79% (ICD-10) 降至22.00%.
- 观察到显著的区域差异,东北地区的不明原因率较高,东南地区的特定原因率较高.
- 孕产前和胎盘断裂等母亲的疾病与CODAC确定的死产的特定原因有显著的关联.
结论:
- 与ICD-10系统相比,CODAC分类系统可以更好地了解死产的原因.
- 实施CODAC可以减少无法解释的死产病例的数量,从而有可能加强巴西的孕产妇和产周健康政策.
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