多种死亡原因的重新分类和权重:美国死亡证明 2003-2023
medRxiv : the preprint server for health sciences
|February 12, 2026
概括
死亡证明的标准化重新分类和考虑多种原因显著改变了疾病负担的估计. 这些变化会影响公共卫生优先事项和资源分配.
科学领域:
- 死亡率统计 死亡率统计
- 公共卫生监督是对公共卫生的监督.
- 流行病学 流行病学
背景情况:
- 传统的死亡率统计通常依赖于单一的潜在死亡原因,可能忽略了有助于死亡的条件.
- 标准化重新分类和权重方案为分析多种死亡原因提供了替代方法.
研究的目的:
- 评估标准化重新分类和各种权重方案对美国死亡证明数据的影响.
- 评估这些方法如何改变疾病负担和死亡率归因的估计.
主要方法:
- 从2003年到2023年,分析了大约5700万份美国死亡证明.
- 将ICD-10代码映射到14个广泛的疾病类别中.
- 将报告的原因 (实体轴) 与重新分类的原因 (记录轴) 进行比较,并将三个权重方案 (W1,W2,W2A) 应用于多个列出的原因.
主要成果:
- 重新分类改变了实体和记录轴之间的潜在原因协议,为类别的84.8%,为特定的ICD-10代码的68.9%.
- 重新分类增加了COVID-19 (+92%) 和运输 (+44%) 的死亡,同时减少了其他外部原因 (-54%).
- 权衡方案大大改变了疾病负担,降低了COVID-19 (-44-63%) 和Falls (-46-66%) 的估计值,W2和W2A显示了更突出的变化.
结论:
- 与传统的单一原因分析相比,标准化的重新分类和权重方案显著改变了疾病负担估计.
- 这些方法对公共卫生政策,资源分配和了解死亡率模式有深远的影响.
- 考虑多种死亡原因,可以更全面地了解死亡率的归因.
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